Physiotherapy Division, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
Occupational Therapy Division, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
J Affect Disord. 2020 May 1;268:158-172. doi: 10.1016/j.jad.2020.03.023. Epub 2020 Mar 6.
There is extensive lack of awareness of maternal mental health and its impact on child development in low- and middle-income countries (LAMICs). The aim of this systematic review was to analyze evidence for various maternal perinatal mental health disorders and their association with different domains of infant and toddler neurodevelopment during the first two postnatal years in LAMICs.
A comprehensive literature search was conducted within six databases from Jan 1990-April 2019. All included studies were narratively synthesized.
Twenty-four studies, nine cross sectional and 15 longitudinal cohort studies, were included. Three studies were conducted in low-income, 11 in lower-middle-income and ten in upper-middle-income countries. The majority of studies assessed maternal mental health postnatally and 14 of these 22 studies found a significant association with infant and toddler neurodevelopment. Five of the ten studies reporting on exposure to prenatal mental health found a significant association. The most common maternal mental health disorder studied was depression, while the main neurodevelopmental outcomes assessed were motor, cognitive and language development.
Meta-analysis could not be conducted due to the variability in the reported maternal mental health disorders and the different times of assessment of exposures and outcomes.
Maternal perinatal mental health disorders and their association with different domains of neurodevelopment in LAMICs is still inconclusive due to a limited number of papers. Mother-infant dyads in LAMICs are exposed to multiple and cumulative risk factors and causal pathways between maternal mental health and infant neurodevelopment are still poorly understood.
在中低收入国家（LMICs），人们对孕产妇心理健康及其对儿童发展的影响认识不足。本系统评价旨在分析孕产妇围产期各种精神健康障碍的证据，并分析其与 LMICs 中婴儿和幼儿头两年内不同神经发育领域的关联。
在 1990 年 1 月至 2019 年 4 月期间，我们在六个数据库中进行了全面的文献检索。所有纳入的研究均进行了叙述性综合。
共纳入 24 项研究，其中 9 项为横断面研究，15 项为纵向队列研究。有 3 项研究在低收入国家进行，11 项在中下收入国家进行，10 项在上中等收入国家进行。大多数研究在产后评估孕产妇心理健康，其中 22 项中有 14 项研究发现与婴儿和幼儿神经发育显著相关。10 项报告产前心理健康暴露的研究中有 5 项发现存在显著关联。研究最多的孕产妇精神健康障碍是抑郁症，而主要评估的神经发育结果是运动、认知和语言发育。
由于报告的孕产妇精神健康障碍以及暴露和结果评估的时间不同，因此无法进行荟萃分析。
由于论文数量有限，孕产妇围产期精神健康障碍及其与 LMICs 中不同神经发育领域的关联仍不确定。LMICs 中的母婴对子受到多种累积风险因素的影响，孕产妇心理健康与婴儿神经发育之间的因果关系仍知之甚少。
