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Maternal mental health and reproductive outcomes: a scoping review of the current literature

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Abstract

Purpose

Current data show that maternal mental conditions affect about 10% of pregnant women worldwide. Assessing timing and patterns of mental health illness, therefore, is critical to ensure the wellbeing of the mother, the new-born and the whole family. The aim of this review is to summarize the latest evidence linking maternal mental disorders and adverse reproductive outcomes.

Methods

Following the PRISMA guidelines for systematic reviews, a literature search was conducted to ascertain the possible impact of mental health conditions on reproductive outcomes before and during pregnancy. The comprehensive strategy included cohort studies, randomised controlled trials and literature reviews on women with Primary Maternal Mental Illness (PMMI) and Secondary Maternal Mental Illness (SMMI) considering periconceptional, obstetric and foetal-neonatal outcomes. PubMed, WoS, CINAHL and Google scholar were used for the search. Cross-referencing in bibliographies of the selected papers ensured wider study capture.

Results

Evidence linking depressive disorders and infertility among PMMI is weak. Given this, women with prior mental conditions experience additional distress when undergoing fertility treatments. Primary mental disorders may also increase the risk of miscarriage and other pregnancy complications (e.g., gestational diabetes). For SMMI, there is more robust evidence correlating Preterm Birth (PTB) and Low Birth Weight (LBW) with common mental disorders which develop during pregnancy.

Conclusion

Prevention and management of maternal mental health diseases and minor mental conditions within the first 1000 days’ timeframe, should have a place in the holistic approach to women going through reproductive decisions, infertility treatment and pregnancy.

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Funding

The current literature review was developed in the frame of the project “Implementazione di un percorso formativo e informativo finalizzato ad un approccio integrato epigenetico per la prevenzione nei primi 1000 giorni di vita” funded by the Italian Ministry of Health—CCM aimed to update the current guidelines on parental preventive lifestyles before and during the first 1000 days of life. This funding was supported by the Italian Ministry of Health—CCM, CUP J59I17000320001.

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Authors and Affiliations

  1. Department of the Hospital Management, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

    Caterina Montagnoli & Chiara Bovo

  2. Department of Surgery, Odonto-Stomatology and Maternal and Child Health, University of Verona, Verona, Italy

    Giovanni Zanconato

  3. Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

    Giulia Cinelli & Alberto Eugenio Tozzi

  4. School of Specialization in Food Science, University of Rome Tor Vergata, Rome, Italy

    Giulia Cinelli

  5. Directorate General for Preventive Health - Office 9, Ministry of Health, Rome, Italy

    Renata Bortolus

  6. Research Centre for Food and Nutrition-CREA, Roma, Italy

    Stefania Ruggeri

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  1. Caterina Montagnoli
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  2. Giovanni Zanconato
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  3. Giulia Cinelli
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  4. Alberto Eugenio Tozzi
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  5. Chiara Bovo
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  6. Renata Bortolus
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  7. Stefania Ruggeri
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Contributions

CM data collection, data management, data analysis and manuscript writing, GZ conceptualization, methodology, supervision, manuscript writing, manuscript editing, GC supervision, manuscript editing, AET supervision, manuscript editing, CB supervision, RB: supervision, SR project administration, supervision, manuscript editing.

Corresponding author

Correspondence to Alberto Eugenio Tozzi.

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The author declares that they have no conflicts of interest. Renata Bortolus is part of the Funding Board and has a role of supervision.

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Table 7 Risk of bias assessment
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Montagnoli, C., Zanconato, G., Cinelli, G. et al. Maternal mental health and reproductive outcomes: a scoping review of the current literature. Arch Gynecol Obstet 302, 801–819 (2020). https://doi.org/10.1007/s00404-020-05685-1

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