Review of Prenatal Maternal Mental Health and the Development of Infant Temperament

Objective: To present a systematic review of literature and evaluate effects of prenatal maternal depression and anxiety on the development of infant temperament. Data Sources: A literature search for studies published between January 1981 and January 2017 was undertaken using the electronic databases PsycINFO and PubMed, as well as reference lists from select resources. Search terms included variations on infant temperament, prenatal/ pregnancy, depression, mood, and anxiety. Study Selection: Studies were included if researchers measured psychological distress during pregnancy as indicated by maternal depression, anxiety, pregnancy-specific anxiety, or a combination of these factors in relation to the development of infant temperament (i.e., parent report or laboratory observations of temperament from 1 to 12 months). In total, 34 articles met inclusion criteria. Data Extraction: Authors, year of publication, country of origin, sample information, methods, timing, and applicable results were summarized and compared across studies. Data Synthesis: No standardized data analysis was conducted because of methodologic differences across the identified studies. Of the 34 identified studies, 22 included an indicator of depression (11 with significant results), 26 included an indicator of anxiety (14 with significant results), and 9 included an indicator of pregnancy-specific anxiety (7 with significant results). Conclusion: Overall research outcomes were equivocal. Across studies on symptoms of depression and anxiety, findings related to the potential effect on infant temperament were mixed. Nonetheless, support for the role of prenatal psychological factors in the development of infant temperament emerged in a subset of population-based studies, including research to target the effects of pregnancy-specific anxiety. Future research is needed with greater consistency across studies with respect to methods (e.g., timing and assessment tools). Specific recommendations for nurses and providers include more routine screening and psychoeducation for expectant mothers about prenatal symptoms of depression and anxiety and about pregnancy-specific anxiety in particular.