Gaining a better understanding of how mental health during pregnancy affects children’s development through a Quebec database

THE CONTEXT

Perinatal mental health disorders, particularly depression and anxiety during pregnancy and after childbirth, are among the most common complications of the perinatal period. They affect up to one in five pregnant women and can have significant consequences for the mother’s health, the pregnancy, and the child’s development. When not identified and treated promptly, these disorders are associated with an increased risk of obstetric complications, difficulties with parent-child attachment, cognitive and socio-emotional development problems in the child, and increased costs for health care systems.

At the same time, a major multi-site database project led by the Center of Excellence in Fetal-Maternal Medicine (CEFM) is currently under development to consolidate and standardize fetal-maternal data collected at several university medical centers in Quebec, including CHU Sainte-Justine (CHUSJ), the McGill University Health Center (MUHC), the CHU de Sherbrooke, and the CHU de Québec. This infrastructure aims to support research, improve care, and enable the early identification of risk factors that may affect the health of mothers and children.

Toutefois, cette banque de données ne contient actuellement aucune information systématique sur la santé mentale périnatale. Cette lacune limite la compréhension de l’interaction entre la santé psychologique maternelle, les issues de grossesse et le développement de l’enfant. L’intégration de ces données constitue donc une étape essentielle pour enrichir cette infrastructure de recherche et répondre aux priorités identifiées dans le Plan d’action en périnatalité et petite enfance 2023-2028 du gouvernement du Québec.

THE PROJECT

The researchers hypothesize that the systematic integration of perinatal mental health data into the fetal-maternal data warehouse will improve the identification of maternal risk factors associated with perinatal outcomes and child development, while also facilitating the future development of multicenter research projects.

OBJECTIVES

• Conduct retrospective and prospective collection of perinatal mental health screening data, including results from the Edinburgh Postnatal Depression Scale (EPDS), completed during pregnancy and the postpartum period.
• Integrate these data into the multisite fetal-maternal database at two participating centers: CHU Sainte-Justine and the MUHC.
• Develop and standardize a methodology for extracting, coding, and integrating mental health data that can be replicated at other sites in the network.
• Create a research infrastructure that will eventually enable the study of links between maternal mental health, pregnancy complications, and developmental outcomes in children.

The project first aims to identify relevant variables in perinatal mental health, including screening scores, diagnoses, treatments, use of specialized services, and certain sociodemographic data. A standardized electronic form will then be developed to facilitate data extraction. Medical records will be reviewed according to a uniform procedure, and the data will then be anonymized, cleaned, and harmonized. Finally, the data will be securely integrated into the data warehouse to ensure its quality, traceability, and use for research purposes.

EXPECTED RESULTS

The project will help fill a significant gap in the CEFM’s multisite database by incorporating standardized indicators of perinatal mental health for the first time.

Expected outcomes include:

• The creation of an enriched and harmonized data infrastructure at two major university centers;
• Improved capacity to identify psychological risk factors during pregnancy and after childbirth;
• Support for the development of multicenter research projects focused on maternal, fetal, and child health;
• Generating knowledge to promote early and better-targeted interventions for vulnerable families;
• Establishing a replicable model that can be implemented across all participating sites in the network.

In the longer term, this initiative will help improve perinatal mental health, support children’s optimal development, and reduce the social and economic impacts associated with untreated mental health disorders during the perinatal period.

POTENTIAL IMPACT ON CHILDREN’S HEALTH

This project will expand the Feto-Maternal database by incorporating information on perinatal mental health. In the short term, it will facilitate better identification of risk factors in mothers and children. In the long term, it will support research on child development trajectories and the prevention of chronic diseases. This infrastructure will contribute to more personalized care, a more efficient use of health resources, and the sustainable development of a collaborative research network in Quebec.