Pregnancy and child development are impacted by a myriad of factors encompassing physical and mental health, biological and genetic influences, and external and environmental exposures. These various influences can impact the health and wellness of both mothers and offspring during pregnancy and postpartum. The body of literature examining these factors and providing guidelines and best practices for women and healthcare providers is ever-growing. In this March 2024 issue on Pregnancy and Child Development of the Yale Journal of Biology and Medicine (YJBM), we present ten manuscripts and one interview that discuss many of the factors which influence pregnancy and perinatal development for mother and baby.
Of particular importance during pregnancy and postpartum, is maternal mental health. In this issue, Iyengar conducted an interview with Jessie Hunt to capture the lived experience of postpartum psychosis. This piece provides an insight into what it is like to undergo postpartum psychosis, the familial and medical supports needed during this time, and the barriers women face when seeking treatment. This work also includes information on a charity, Action for Postpartum Psychosis, aimed at supporting and advocating for mothers and families affected by postpartum psychosis. Kay and colleagues also discuss the importance of perinatal mental health, and the critical role of social support. Kay et al., find that perceived social support predicts depression and post-traumatic stress symptoms in a cohort of women at 3 months postpartum highlighting the significance of a strong social network during the transition to motherhood. Furthermore, a literature mini-review by Nowland et al. examine the impacts, outcomes, and costs of loneliness in pregnancy and parenthood. Findings evidence that loneliness in parenthood effects not only mental and physical health and wellbeing, but can also have lasting, intergenerational impacts in children.
Maternal physical health also plays a critical role in pregnancy and child development. Chandra and Paray outline the many natural physiological changes which occur during pregnancy across the respiratory, musculoskeletal, reproductive, endocrine, neurological, gastrointestinal, cardiovascular, and immunological systems in the body. Moreover, Silva et al. utilize a meta-analysis to explore the effects of prenatal care on perinatal outcomes of diabetes mellitus (DM) among pregnant women. Prenatal care and nutritional therapy were found to reduce risk of DM and associated complications. Likewise, Gadhia and Loyal review genetic predictors and artificial intelligence strategies for improving gestational diabetes mellitus (GDM) screening and diagnosis in sub-Saharan Africa amplifying the role of artificial intelligence (AI) in healthcare screening and treatment.
External factors and exposures can similarly influence the trajectory of pregnancy health and child development. Saxena investigates associations between maternal prenatal exposure to household air pollution (HAP) (eg, ultrafine particles (UFP), polycyclic aromatic hydrocarbons (PAH), ozone (O3)) and child respiratory health (eg, asthma, allergies, etc.). Saxena calls attention to a need for increased public health strategies for combatting air quality issues, such as improved household air ventilation, better cooking practices, and campaigns for awareness of the harmful effects air pollution can have on children both during pregnancy and during childhood. Kim and colleagues consider external disruptions more broadly on a specific aspect of fetal development. This review examines the role of external factors during pregnancy and their impacts on ocular development in utero. Metabolic factors, medication use, infection, and other environmental factors are examined for their influence on human ocular development.
In a perspectives piece on breast pumps as a tool to promote equitable lactation outcomes, Nardella discusses the rising rate of mortality among pregnant individuals and their infants. Chest/breastfeeding has been associated with lowered risk of conditions associated with morbidity and mortality and therefore is well-positioned to decrease negative health outcomes for high-risk groups. This work calls attention to the inequity in lactation and pump access and illuminates and need for policy, scholarship, and education on pump use.
I am pleased to present the YJBM March 2024 issue on Pregnancy and Child Development which includes the aforementioned and other thought-provoking works highlighting the importance of physical and mental health, environmental exposures, and equity during the perinatal period on maternal and child development. I hope these works will bring valuable insights to our readers.
Glossary
- DM
diabetes mellitus
- GDM
gestational diabetes mellitus
- AI
artificial intelligence
- HAP
household air pollution
- UFP
ultrafine particles
- PAH
polycyclic aromatic hydrocarbons
- O3
ozone