Depression in pregnancy increases the risk of behavioral and emotional problems in children, according to a new study published in The Lancet Psychiatry .
The authors of the review, which focused mainly on low and MICs call for urgent interventions for mothers and children.
Depression in pregnancy is thought to affect one in five women in the world in the last stages of pregnancy and shortly after birth. It is characterized by low mood and feelings of hopelessness, and is caused by a number of factors that may include life events such as bereavement, and changes in brain chemistry.
Previous work by a team at Imperial College London suggests depression during pregnancy can affect the baby’s development in the womb, besides affecting the bond between mother and child after birth.
Now the same team has shown that depression or anxiety can reduce placental enzyme that breaks down cortisol “stress hormone”, which can cause increased fetal exposure to the hormone. The fetus may also suffer epigenetic changes under stress, where the underlying DNA remains the same, but the expression of that DNA is altered, perhaps affects mental health in childhood.
So far, much of the research on depression during pregnancy has focused on high-income countries. The team argue that the problem is more common in low- and middle-income, and therefore more resources than are now needed in these areas to help pregnant women and new. is not only necessary investment in research but also the development of appropriate low-cost interventions that are specific to these areas.
Professor Vivette Glover, co-author of the research in the Department of Surgery and Cancer at Imperial, said: “Our review of the available literature suggests that treatment of depression itself is crucial in reducing the risk to the child as well as to help the mother. the specific symptoms orientation of depression cognitive behavioral therapy is displayed using for example, can be useful in reducing depression and therefore their effect on the child.
“However, there is substantial poorest lack of specific research of women in countries where interventions such as CBT may not be available.”
Glover added that in very poor areas, where wars, political violence, food insecurity, and little help after natural disasters, health workers have little time or resources are to meet basic physical needs , and fewer mental health on their own, such as maternal depression.
The new review examined studies of mental health in children under five years in low- and middle-income as Bangladesh and Brazil. The report highlights the specific mental health needs of mothers and children in the poorest countries that are not necessarily relevant to high-income countries .
Depression in mothers in low- and middle-income countries is common during and after pregnancy. Women are more likely than richer countries to experience intimate partner violence and have little social support. Moreover, unwanted pregnancies are more common, such as malnutrition, infections and overcrowded conditions.
Risk factors are often more intense and more common than in high-income countries. These factors also intensify each other -. For example, a malnourished mother or a child may have a very weak immune system to fight an infection, exacerbating the stress of the mother which in turn contributes to depression
Maternal depression in these countries is also more likely to result in poor nutrition, increased substance abuse, inadequate prenatal care, preeclampsia, low birth weight, premature birth, and suicide.
The authors argue that due to the risk factors vary among different income countries, interventions for the poorest countries should focus on issues affecting these countries in particular.
They add that mitigation of the global burden of maternal depression require a multi-faceted approach that child development is addressed, poverty, education, health and violence prevention in countries low and middle income.
Last in Melbourne, Glover and his colleagues week launched a new organization, “The Global Alliance for Maternal Mental Health”, which aims to promote a better understanding of these issues and to generate more resources to in front of them, worldwide.
“mother depression and mental health in early childhood: a review of the underlying mechanisms in low- and middle-income” by Prof. Vivette Glover et al is published in The Lancet Psychiatry September 17, 2016.
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