Introduction: Prenatal and postpartum mental health has important implications for maternal well-being, and for infant development outcomes such as birthweight and later physical growth. Risk factors for poor maternal mental health and relationships with infant development might differ in low- and middle-income countries (LMICs) compared to high-income countries. Our objectives were to assess relationships between prenatal distress and infant development outcomes at birth, and risk factors for distress during pregnancy and postpartum, in Vanuatu, a lower-middle income country.
Methods: We have developed prospective longitudinal studies of maternal mental health during pregnancy and infant development in Vanuatu. We analyzed symptoms of stress, anxiety, and depression among 531 women during pregnancy and 121 women postpartum. We analyzed infant outcomes at birth such as birthweight. We repeated analyses of maternal mental health and assessed infant development one year later among 77 mother-infant pairs.
Results: Distress was higher among younger women (p=0.031). We observed a trend between lower dietary diversity and higher distress (p=0.080). We observed a curvilinear relationship between distress and infant birthweight (p=0.041), such that birthweight was lower among infants with both low and high levels of prenatal distress exposure. Controlling for confounding variables, greater distress during pregnancy predicted greater distress postpartum (p=0.041). We observed a trend suggesting that a greater number of prenatal visits predicted reduced distress postpartum (p=0.078
Conclusion: In addition to sociodemographic factors such as age, poor dietary patterns might be a risk factor for distress in LMICs. The curvilinear relationships observed between distress and infant outcomes at birth mirror those in high-income countries suggesting that high prenatal stress and anxiety symptoms have detrimental effects but that moderate stress promotes some aspects of development. Promoting prenatal care is already a priority in LMICs, and this might have longer-term benefits on postpartum mental health.
Kelsey Dancause– Professor, Université du Québec à Montréal
Kathryn Olszowy– Assistant professor, New Mexico State University
Len Tarivonda– N/A, Vanuatu Ministry of Health
Giavana Buffa– N/A, Binghamton University
Elisabeth Standard– Student, Binghamton University
George Taleo– N/A, Vanuatu Ministry of Health
Amanda Roome– Research Scientist, Bassett Research Institute