NURS 751 LU EVIDENCE-BASED ARTICLE REVIEW _2025.pdf

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Evidence-Based Review Article Review:

Fetal and Infant Outcomes in the Offspring of Parents with Perinatal Mental Disorders:

Earliest Influences

Group I

Department of Nursing, Liberty University

NURS 751: Neurobiology and Differential Diagnosis of Mental Disorders (B01)

Dr. Forlashade Odedina

June 22, 2025

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child psychopathology, which is impacted by mom’s psychopathology during pregnancy, beyond

postpartum, and well into adulthood. Moreover, this article studies efforts for intervention to

mitigate intergenerational transmission of psychopathology, i.e., childhood emotional abuse and

neglect (Aktar et al., 2019).

psychopathology (Aktar et al., 2019). It explores the needs and experiences of people with

chronic and severe mental disorders in reproductive age, highlighting the transition to

parenthood as a vulnerable phase for both parents and infants; and for infants alone, the impact

on the ongoing brain development, altering function and structure (Aktar et al., 2019).

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Behavioral Pathways

disorder and early indices of infant psychobehavioral functioning, (b) parental mental illness and

parents’ behavior and affect in early interactions, (c) parental mental illness and infant expression

and regulation of emotions in early face-to-face interactions, and (d) parental mental illness and

infant attachment. Caregivers/Parents are of key importance for the socio-emotional

development of the infants, who are heavily dependent on exposure to emotional expressions via

interactions with their caregivers (Aktar et al., 2019).

negative; they detect fewer facial expressions, and they are less engaging with their infant. Their

(Newland, 2021). Positive emotional and social connections are paramount for humans (Center

for Disease Control (CDC), 2024). Erikson, a developmental psychologist, provided the

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is seen as an adaptive strategy in response to the depressed parent, and infants are less likely to

seek input from the depressed parent. The child of the anxious parent is less likely to express less

negative affect, but their response to the stranger is dependent on if they observed the parents’

response first (Aktar et al., 2019).

disoriented. The authors discuss this topic in relation to being separated from mom or their

caregiver and parenting behaviors that have developed because of unresolved posttraumatic

experiences. The findings reported in this article suggest that it is reasonable to associate

behaviors in parents with mental illness with a certain level of insecure attachments, fostering a

defenselessness to the cycle for generations to come (Aktar et al., 2019).

Biological Pathways

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anxiety are poor outcomes due to problems in the cognitive domain of development, problems in

emotional reactivity and problems in physical health. Physiological factors that can trigger stress

are discomfort, unpleasantness or if startled (Rogers, 2024). Aktar et al. state in recent studies,

cortisol does impact the developing brain and is related to changes in hypothalamus-pituitary-

adrenal (HPA) axis regulation. The infants’ microstructures and hippocampal growth experience

maternal cortisol levels. This enzyme is inhibited in prenatal stress, thereby rendering fetal

protection. The impact the maternal stress (perceived or experienced) response has on the

developing fetal brain is remarkable. In anxious moms, their preterm neonates experienced

dysregulation in the HPA axis and a higher cortisol reactivity. In moms with depression, their

infants had an increased baseline of cortisol levels (Aktar et al., 2019).

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regulation (Newland, 2021). The authors explain supporting evidence that transmission of

anxiety and depression from parents to their offsprings is tied to the parasympathetic nervous

system (Aktar et. al., 2019). In an immature or poorly developed vagal system, infants will have

only elementary defensive strategies, i.e., temper tantrum, shutdown behavior, fight-flight

response, to regulate social behaviors (Aktar et al., 2019). Infants of moms with depression have

lower baseline RSA, which does not increase as normal with time (Aktar et al., 2019). A higher

baseline RSA is linked to moms with both anxiety and depression, and has maladaptive

outcomes, (i.e., sleep problems, disorganized attachment) (Aktar et al., 2019).

from that event (Aktar et al., 2019). Children of parents with mood disorders are less likely to

possess RSA regulation as their parents, having depression and/or anxiety, have not aided the

development of downregulating negative arousals (Aktar et al., 2019). There is only indirect

evidence that infants are likely to develop physiological dysregulation when born to parents with

a mood disorder (Aktar et al., 2019).

amygdala connectivity in infants, due to high maternal circulating cortisol and the infants’ large

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transmission. There is no study that addresses paternal mental disorders and infant outcomes.

Furthermore, to date, there are no paternal interventions related to infant outcomes.

therapy, and nondirective counseling versus primary care to mom and baby, and the treatment

was primarily focused on maternal postnatal depression. The treatment was beneficial for moms,

as they reported feeling less depressed, having less problems in their relationships and had

increased maternal sensitivity to their child. However, these interventions had no effect on the

child postnatally (Aktar et al., 2019).

controlled trials (RCT). The treatments were video feedback or telephone practical parenting

advice promoting. For the children whose mom received the video feedback intervention, there

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moms to identify and respond to infant behavioral cues. In this RCT, there were no significant

outcomes in this study. The reason offered for no significance in this intervention was due to the

low severity of depression. The mean Edinburgh Postnatal Depression Scale score was under 13

for both groups (Aktar et al., 2019).

depression, anxiety, and other mental health challenges experienced by parents during the

perinatal period. The authors present evidence that parental perinatal mental health plays a

critical role in shaping early developmental outcomes, with particular emphasis on factors such

as social interaction, regulating negative emotions, changes in brain development due to

pivotal period. By addressing these mental health concerns, the author advocates for further

study of enhanced long-term outcomes for both parents and their children.

Usefulness of the Information

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exposure to parent psychopathology. All these factors affect and shapes the child’s emotional

regulations, stress responses, and the possibility of having mental illness in the future.

Additionally, the article not only highlights the time of occurrence of the mental disorder, but it

also highlights the need for early intervention to treat the mental issues of the parents. Treating

parents can reduce prolonged adverse effects in the infants (Aktar et al., 2019).I

by diverting attention to intergenerational transmission of psychopathology, a theme commonly

neglected in routine pediatric care. The review from Aktar et al. reinforces the biological

plausibility of these effects, like changed infant HPA axis functioning and amygdala connectivity.

the integrated treatment of pediatric mental health (Stolper et al., 2021).II