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Parental mental health before and during pregnancy and offspring birth outcomes: a 20-year preconception cohort of maternal and paternal exposure

Research output: Contribution to journalArticle

Elizabeth Spry , Claire Wilson, Melissa Middleton , Margarita Moreno-Betancur , Lex W Doyle, Louise Howard, Anthony J Hannan , Mary E Wlodek , Jeanie LY Cheong , Lindsey A Hines , Carolyn Coffey , Stephanie Brown , Craig A Olsson , George C Patton

Original languageEnglish
JournalEClinicalMedicine
Accepted/In press11 Sep 2020

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Abstract

Evidence before this study
Consistent evidence links maternal antenatal symptoms of common mental disorders (CMD) with offspring preterm birth and small for gestational age. Although findings from animal studies implicate both maternal and paternal preconception stress in offspring birth outcomes, the extent to which maternal and paternal history of preconception CMD predict offspring preterm birth and small for gestational age in humans is unknown.

Added value of this study
In this population-based preconception cohort study, we prospectively assessed maternal and paternal CMD over 15 years from adolescence to young adulthood and in the third trimester of subsequent pregnancies. Our findings that up to 31% of preterm births may be attributable to processes relating to persistent preconception CMD symptoms in men heralds a paradigm shift for the developmental origins of health and disease. It highlights a need to further explore paternal CMD and other preconception risk factors as determinants of early life health, growth and development.

Implications of all the available evidence
Paternal mental health represents a neglected and potentially novel risk factor for preterm birth. While they require replication in other populations and a greater understanding of potential mechanisms, our findings support expansion of the focus of preconception care to include both men and women. Therefore new and potentially innovative approaches to preconception interventions will be necessary to optimise the health of future generations.

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