Association between postnatal mental health-related hospitalisation and child development and education outcomes: a systematic review and meta-analysis

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Aim: This study consolidates existing knowledge regarding the association between postnatal mental health-related hospitalisation (MHrH) and childhood development and education outcomes. Methods: We searched MEDLINE, PsycINFO, CINAHL, Scopus, Embase, Google Scholar, and the reference list of accessed papers. A weighted random-effects meta-analysis was conducted. A trim and fill analysis was executed following the detection of publication bias. Quality assessment of included studies was performed using the Joanna Briggs Institute (JBI) tool. Results: Children whose mothers experienced postnatal MHrH had elevated odds of developmental vulnerability in any of five developmental domains (Pooled Odds Ratio (POR) = 1.53, 95% CI; 1.20-1.86), in the social domain (POR = 1.27, 95% CI; 1.18-1.35), emotional domain (POR = 1.34, 95% CI; 1.16-1.51), and physical domain (POR = 1.26, 95% CI; 1.14-1.38) compared to children whose mothers had no postnatal MHrH. Children whose mothers experienced postnatal MHrH had elevated odds of below-average academic performance on any of four measures (POR = 1.57, 95% CI; 1.07-2.07), spelling measure (POR = 1.48, 95% CI; 1.01-1.95), and writing measure (POR = 1.37, 95% CI; 1.04-1.70). A higher albeit statistically uncertain odds of developmental vulnerability in the cognitive domain was found to be associated with postnatal MHrH (POR = 2.41, 95% CI; 1.00-3.82). No statistically significant associations were observed between postnatal MHrH and vulnerability in the communication skill (POR = 1.21, 95%; CI 0.96-1.47), or with below-average academic performance in numeracy (POR = 2.02, 95%; CI 0.37-3.68) and reading (POR = 1.57, 95%; CI 0.59-2.55). Conclusion: This review found that children whose mothers experienced postnatal MHrH were at greater risk of vulnerability in at least one domain of development, as well as below-average performance in at least one area of academic outcomes. Whilst these results should be interpreted cautiously due to substantial heterogeneity among the included studies, there is sufficient evidence to support existing recommendations for early screening, diagnosis, and management of maternal mental health as part of routine postpartum care. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023446155.

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