The importance of perinatal mental health for child development; the individual, social and economic costs.
Vivette Glover spoke at the LSE on 18th February on the importance of perinatal mental health.
Mental health is the most neglected aspect of maternity care. This is important both for the mother herself and for the development of her foetus and her child. Anxiety and depression are as common during pregnancy as postnatally, and can have long lasting effects on foetal development, by foetal programming. There is an increased risk of a wide range of emotional, behavioural and cognitive problems in the child. Some of these are risk factors in turn for late criminal behaviour. If the mother is in the top 15% of the population for symptoms of antenatal anxiety or depression, this doubles the risk of her child having a probable mental disorder at the age of 13 years, after allowing for a wide range of confounders including postnatal maternal mood and parenting style. Most children are not affected and those that are can be affected in different ways. This depends, at least in part, on the particular genetic vulnerabilities of each child, and the quality of the postnatal care.
We are starting to understand some of the biological mechanisms that underlie foetal programming. The function of the placenta, for example, changes in response to maternal anxiety and depression, allowing more of the stress hormone cortisol to pass through; this in turn changes the development of the foetal brain. Possible evolutionary explanations for this will be discussed. The recent LSE report “The costs of perinatal mental health problems” has estimated that perinatal mental health per year’s births in the UK costs a total of £8.1 billion. Over two thirds of this is because of long term effects on the child. Improving the quality of perinatal mental health care would considerably reduce costs to the public sector as well as improving the health of the next generation.
