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. 2025 Aug;28(4):903-910.
doi: 10.1007/s00737-024-01541-2. Epub 2024 Dec 4.

A new perspective on the causal pathway between maternal mental health and neonatal adversity

Emma Lin  1 , Elah Wilson  2 , Arad Kodesh  3   4 , Stephen Z Levine  5 , Abraham Reichenberg  6   7 , Nathan Fox  8 , Nina Zaks  9 , Magdalena Janecka  10   11
Affiliations

A new perspective on the causal pathway between maternal mental health and neonatal adversity

Emma Lin et al. Arch Womens Ment Health. 2025 Aug.

Abstract

Purpose: Substantial evidence suggests a downstream impact of maternal mental health on birth outcomes. The roles of comorbid maternal physical health and familial confounding underlying this association remain unclear.

Methods: This cohort study included a random sample of children born 1997-2008 within a health maintenance organization (HMO) in Israel, their parents, and siblings. Outcomes were ICD-9 diagnoses of neonatal adversities (birth complications and congenital anomalies) and exposures were maternal diagnoses of mental health disorders. Odds ratios (ORs) and their 95% confidence intervals for the associations between maternal mental health diagnoses and measures of neonatal adversity were calculated using logistic regression, adjusting for maternal age, child's year of birth, socioeconomic status, and maternal physical morbidity burden. We examined potential familial confounding using a negative control approach based on paternal exposure.

Results: In our sample of 74,533 children, 6,674 (9.1%) were born after birth complications and 14,569 (19.9%) with a congenital anomaly. Maternal mental health diagnosis around pregnancy was significantly associated with these measures of neonatal adversity after adjustment for potential confounders (birth complications: OR = 1.3 (1.2-1.4), p < 0.001; congenital anomalies: OR = 1.2 (1.1-1.3), p < 0.001). These associations became attenuated and non-significant after further adjustment for maternal physical morbidity burden. In a joint model, maternal and paternal diagnosis of a mental health disorder were independently associated with neonatal adversity (birth complications: ORmat=1.3 (1.1-1.4), p < 0.001; ORpat=1.2 (1.1-1.3), p = 0.004; congenital anomalies: ORmat=1.2 (1.1-1.3), p < 0.001; ORpat=1.1 (1.0-1.2), p = 0.01).

Conclusion: Physical health and familial factors play a role in the associations between maternal mental health and neonatal adversity.

Keywords: Comorbidity; Familial effects; Maternal mental health; Neonatal complications; Pregnancy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the institutional review board of the University of Haifa and the Helsinki Ethics Committee. Those bodies waived the need for informed consent because the study data were fully deidentified. Consent for publication: Not applicable. Competing interests: The authors did not declare any competing interests.

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References

    1. Adane AA, Bailey HD, Morgan VA et al (2021) The impact of maternal prenatal mental health disorders on stillbirth and infant mortality: a systematic review and meta-analysis. Arch Womens Ment Health 24:543–555. https://doi.org/10.1007/s00737-020-01099-9/Published - DOI - PubMed
    1. Aliaga A, Cunillera O, del Amador M C, et al (2019) Association between affective disorders presenting before and during pregnancy and pre-term birth, considering socio-demographic factors, obstetric factors, health conditions, and use of medication. Aten Primaria 51:626–636. https://doi.org/10.1016/j.aprim.2018.06.009 - DOI - PubMed
    1. Cavazos-Rehg P, Krauss M, Spitznagel E et al (2015) Maternal age and risk of Labor and Delivery complications. Matern Child Health J 19:1202–1211. https://doi.org/10.1007/s10995-014-1624-7 - DOI - PubMed
    1. Cripe SM, Frederick IO, Qiu C, Williams MA (2011) Risk of preterm delivery and hypertensive disorders of pregnancy in relation to maternal co-morbid mood and migraine disorders during pregnancy. Paediatr Perinat Epidemiol 25:116–123. https://doi.org/10.1111/j.1365-3016.2010.01182.x - DOI - PubMed
    1. De Paz NC, Sanchez SE, Huaman LE et al (2011) Risk of placental abruption in relation to maternal depressive, anxiety and stress symptoms. J Affect Disord 130:280–284. https://doi.org/10.1016/j.jad.2010.07.024 - DOI - PubMed

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