Abstract
BACKGROUND: Preterm birth (PTB) and small for gestational age (SGA) are increasingly prevalent, with major consequences for health and development into later life. There is emerging evidence that some risk processes begin before pregnancy. We report on associations between maternal and paternal common mental disorders (CMD) before and during pregnancy and offspring PTB and SGA.
METHODS: 398 women with 609 infants and 267 men with 421 infants were assessed repeatedly for CMD symptoms before pregnancy between age 14 and 29 and during pregnancy. Associations between preconception and antenatal CMD symptoms and offspring gestational age/PTB and size for gestational age/SGA were estimated using linear and Poisson regression.
FINDINGS: In men, persistent preconception CMD across adolescence and young adulthood predicted offspring PTB after adjustment for ethnicity, education, BMI and adolescent substance use (adjusted RR 7·0, 95% CI 1·8,26·8), corresponding to a population attributable fraction of 31% of preterm births. In women, antenatal CMD symptoms predicted offspring PTB (adjusted RR 4·4, 95% CI 1·4,14·1). There was little evidence of associations with SGA.
INTERPRETATION: This first report of an association between paternal preconception mental health and offspring gestational age, while requiring replication in larger samples, complements earlier work on stress in animals, and further strengthens the case for expanding preconception mental health care to both men and women.
FUNDING: National Health and Medical Research Council (Australia), Victorian Health Promotion Foundation, Australian Rotary Health, Colonial Foundation, Perpetual Trustees, Financial Markets Foundation for Children (Australia), Royal Children's Hospital Foundation, Murdoch Children's Research Institute, Australian Research Council.
| Original language | English |
|---|---|
| Article number | 100564 |
| Number of pages | 10 |
| Journal | EClinicalMedicine |
| Volume | 27 |
| DOIs | |
| Publication status | Published - 12 Oct 2020 |
Bibliographical note
Data sharingEthics approvals for this study do not permit the data to be made publicly available, due to limitations of participant consent and concerns regarding potential re-identifiability. Upon request, following publication of this article, the dataset subset used for these analyses can be made available to a named individual for the purpose of replication of research findings. The study protocol and variable documentation will also be provided. Data requestors will need to sign a data access agreement. Contact details for data requests can be found at https://www.mcri.edu.au/research/projects/2000-stories.
Funding
This work was supported by the Australian Research Council (DP180102447). Data collection for VIHCS was supported by the National Health and Medical Research Council (Australia), Australian Rotary Health, Colonial Foundation, Perpetual Trustees, Financial Markets Foundation for Children (Australia), Royal Children's Hospital Foundation and the Murdoch Children's Research Institute. CAW is supported by a Medical Research Council (UK) Clinical Research Training Fellowship (MR/P019293/1). GCP is supported by an NHMRC Senior Principal Research Fellowship (APP1117873) and Career Development Fellowship to JLYC (1141354). SB is supported by an NHMRC Senior Research Fellowship (APP1103976) and CAO is supported by an NHMRC Investigator Grant (APP1175086). MMB is the recipient of an Australian Research Council Discovery Early Career Award (project number DE190101326) funded by the Australian Government. LMH receives salary support from the South London and Maudsley NHS Foundation Trust and King's College London Biomedical Research Centre. AJH is supported by an NHMRC Principal Research Fellowship (APP1117148). LAH is supported by the Wellcome Trust (UK). Research at the Murdoch Children's Research Institute is supported by the Victorian Government's Operational Infrastructure Program.
