COVID-19 places added prenatal stress on mother and child that could have lasting impact

An international consortium of researchers have identified particular sources of prenatal stress, as experienced by mothers, that have a direct effect on a child's subsequent mental health. The findings emerged from the DREAM-BIG (Developmental Research in Environmental Adversity, Mental health, BIological susceptibility and Gender) project, and are published in the Journal of the American Academy of Child & Adolescent Psychiatry.

"We already understood that the foundations for life-long mental health are laid in the very first years of life, but we have further validated the idea that prenatal stress, the mother's psychological well-being during pregnancy, is an important factor," said Dr. Ashley Wazana, the principal investigator on DREAM-BIG and Director of the Early Childhood Disorders Day Hospital at the Jewish General Hospital. "With data to support the impact of prenatal stress, we can look at protective measures that could help mothers to insulate their babies."

The paper identifies four prenatal maternal factors. A general affective symptoms factor and three specific factors: an anxiety/depression factor, a somatic factor, and a pregnancy-specific worries factor.

The authors conclude, "The findings in this paper underscore the importance of intervening in the prenatal period, including for pregnancy-specific worries. Currently, there are few prenatal interventions to reduce maternal depression, anxiety, or stress, and even fewer studies that track the long-term effects in the offspring whose mothers receive such interventions."

As much as anxiety and stress factor into pregnancy during normal times, the on-going COVID-19 pandemic is an added stressor and, furthermore, causes mothers-to-be to adapt to social distancing provisions.

"Of course, there are multiple factors at play, including genetics,sex and gender, and the environment after birth, but when you combine maternal stress with this particular environmental adversity, you have the potential for greater mental health challenges for children who are born into this post-pandemic world," said Dr. Eszter Szekely, a postdoctoral research scholar at the Lady Davis Institute (LDI) and McGill University's Department of Psychiatry, the first author on the paper.

The general affective symptoms, which relate to the overall mood of the mother, during pregnancy are predictive of mental health problems that emerge between the ages of four and eight. Some fifty-percent of mental health disorders emerge before the age of five, while seventy-five-percent are evident before adulthood. To offer perspective on the burden of mental health problems, on a global basis, they constitute the leading cause of disability.

"We believe that mental health ought to be a fundamental part of prenatal health," said Dr. Wazana, a researcher at the LDI and Assistant Professor of Psychiatry at McGill, speaking about DREAM-BIG's concern with the earliest environment which children experience. "Pregnancy is not a cocoon and stress can be an important factor in childhood mental health. We need to appreciate the importance of mental health needs across the lifespan, starting with pregnancy. We would like to see mothers have access to prenatal mental health resources, but, unfortunately, the wait time for such services can be longer than the gestation period."