Cited by 297Maternal Mental Health During Pregnancy and PostpartumBirth, Development, and HealthMaternal and Neonatal Healthcare

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Pregnancy as a period of risk, adaptation, and resilience for mothers and infants

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Davis, Elysia Poggi, Narayan, Angela J.·2020·Development and Psychopathology

DOI 10.1017/s0954579420001121PMC PMC7863987

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Abstract

The pregnancy period represents a unique window of opportunity to identify risks to both the fetus and mother and to deter the intergenerational transmission of adversity and mental health problems. Although the maternal–fetal dyad is especially vulnerable to the effects of stress during pregnancy, less is known about how the dyad is also receptive to salutary, resilience-promoting influences. The present review adopts life span and intergenerational perspectives to review four key areas of research. The first part describes how pregnancy is a sensitive period for both the mother and fetus. In the second part, the focus is on antecedents of maternal prenatal risks pertaining to prenatal stress response systems and mental health. The third part then turns to elucidating how these alterations in prenatal stress physiology and mental health problems may affect infant and child outcomes. The fourth part underscores how pregnancy is also a time of heightened fetal receptivity to maternal and environmental signals, with profound implications for adaptation. This section also reviews empirical evidence of promotive and protective factors that buffer the mother and fetus from developmental and adaptational problems and covers a sample of rigorous evidence-based prenatal interventions that prevent maladaptation in the maternal–fetal dyad before babies are born. Finally, recommendations elaborate on how to further strengthen understanding of pregnancy as a period of multilevel risk and resilience, enhance comprehensive prenatal screening, and expand on prenatal interventions to promote maternal–fetal adaptation before birth.

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Background
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No relationship found between dental fluctuating asymmetry, birthweight, and birth term in two modern North American samples
McPherson, C. B., O’Donnell, L., Moes, E., & Edgar, H. J. H. (2024) · American Journal of Human Biology · doi:10.1002/ajhb.24114 · Cited by 2
“Gestation itself is often conceptualized as a sensitive window (Davis & Narayan, 2020; Plante et al., 2022), although more discrete SDWs impacting specific systems and tissues are nested within this period of early development (Carmichael & Shaw, 2000; Coussons-Read, 2013; Entringer, 2013;…”
Psychometric Reliability to Assess the Perception of Women’s Fulfillment of Maternity Rights
Silva-Fernández, C. S., de la Calle, M., Camacho, P. A., Arribas, S. M., Garrosa, E., & Ramiro‐Cortijo, D. (2024) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe14080150 · Cited by 2
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Background
Depression in the time of COVID-19: Examination of prenatal and postpartum depression, rurality, and the impact of COVID-19
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Protective Effects of Phycobiliproteins from Arthrospira maxima (Spirulina) Against Cyclophosphamide-Induced Embryotoxicity and Genotoxicity in Pregnant CD1 Mice
García-Martínez, Y., Razo-Estrada, A. C., Pérez-Pastén-Borja, R., Galván-Colorado, C., Chamorro, G., Chanona‐Pérez, J. J., López-Canales, O. A., Islas‐Flores, H., Pérez‐Gutiérrez, S., Cordero‐Martínez, J., et al. (2025) · Pharmaceuticals · doi:10.3390/ph18010101 · Cited by 2
“Pregnancy is a multifaceted biological and physiological state that supports the development of a fertilized egg into a fetus within a woman’s uterus, beginning at conception and lasting around 266 days until childbirth [1].”
A systematic review on the assessment of pregnancy-specific psychological trauma during pregnancy: A call to action
Givrad, S., Wall, K. M., Goldman, L. W., Shin, J. Y., Novak, E. H., Lowell, A. F., Penner, F., Day, M. J., Papa, L., Wright, D., et al. (2025) · AJOG Global Reports · doi:10.1016/j.xagr.2025.100451 · Cited by 3
Harnessing behavioral interventions to enhance micronutrient intake in pregnancy: A comprehensive review
Ilangovan, P., Subramaniam, A., Josephine, S. P., Thirunavukkarasu, V., & Anand, T. (2025) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_684_24 · Cited by 2
“[1,2] The complex interaction between macronutrients and micronutrients in this timeframe highlights the significance of maintaining a well‑balanced, nutrient‑dense dietary regimen.”
Examining cross-lag associations between perceived stress and hair cortisol from pregnancy to 15 months postpartum
Khoury, J. E., Jambon, M. M., González, A., & Atkinson, L. R. (2025) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2025.107556 · Cited by 2
“Pregnancy and the early postpartum period represent a unique transition characterized by heightened vulnerability to stress, driven by pregnancy-related changes, lifestyle adjustments, and the demands of caring for an infant (Coussons-Read, 2013; Davis & Narayan, 2020).”
Impact of Maternal SARS-CoV-2 Infection During Pregnancy on Offspring Neurodevelopment: Signature Cohort 12 Month Follow-Up.Preprint
Torres, N. G., Román‐Jarrín, A., Rider, J., Alemany-Navarro, M., Gibson, B. A., de-Felipe, B., Pérez‐Gómez, A., Cerrillos, L., Duque-Sánchez, C., Alameda, L., et al. (2024) · Research Square · doi:10.21203/rs.3.rs-4782550/v1 · Cited by 2
Parental Substance Use: Implications for Infant Mental Health
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Adaptation of Pregnant Women in the Context of Socio-Demographic Factors and Labour Law
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Fuzzy‑set qualitative comparative analysis and fuzzy cognitive maps: Exploring pregnancy outcomes and maternal depression
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“The perinatal period is a time of great change for mothers, in which mothers experience changes in role, self-concept, mental health, and neuroanatomy (Davis & Narayan, 2020; Muzik et al., 2016; Paulson et al., 2023; Pritschet et al., 2024), with key implications for their infants ’ development.”
Long-term mental health disorders and suicidal behaviors linked to excessive vomiting during pregnancy: Evidence from the UK biobank
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Influential
How Risky Pregnant Women Achieve Positive Antenatal Experience: A Cross‐Sectional Study of Examination of the Sense of Coherence, Prenatal Distress, and Pregnancy Acceptance
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Measurement of Racial Microaggressions During Pregnancy and While Receiving Prenatal Care: a Validation Study of the Daily Life Experiences Scale Among Black Postpartum Women
Haight, S. C., Misra, D. P., Miller, L. A., Price, M., & Slaughter‐Acey, J. (2025) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-025-02777-z · Cited by 1
“…within the context of identity development and education and career aspirations [40, 41], pregnant individuals may process these experiences amid complex shifts in not only identity, health, and increased sense of responsibility, but also physiological and psychological responses [42–44].”
Positive Mental Health, Anxiety and Prenatal Bonding: A Contextual Approach
Ballesteros-Andrés, L. X., González, R. L., Rodríguez‐Rojo, I. C., García-Sastre, M., Cuesta‐Lozano, D., González, J. L. G., Martínez‐Hortelano, J. A., & Peñacoba, C. (2025) · Healthcare · doi:10.3390/healthcare13243300 · Cited by 1
“Stress during pregnancy has consequences for both the development of pregnancy and the subsequent development of the baby, which persists throughout the child’s life [18,23].”
Influential
Trajectories of maternal bonding over the perinatal period: Associations with demographic, obstetric, psychological, and infant variables
de Waal, N., Hulsbosch, L. P., Schwabe, I., Nyklíček, I., Bogaerts, S., & Boekhorst, M. G. B. M. (2025) · Infant Mental Health Journal · doi:10.1002/imhj.70059 · Cited by 1
Swedish massage as an adjunct approach to Help suppOrt individuals Pregnant after Experiencing a prior Stillbirth (HOPES): feasibility and acceptability findings from a convergent parallel mixed-methods single-arm trial
Fogarty, S., Heazell, A., Munk, N., & Hay, P. (2026) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-026-05244-2 · Cited by 2
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Complications Following Late Second-Trimester Dilatation and Evacuation: A Retrospective Cohort Comparison of Missed and Induced Abortions
Farhadian, Y., Friedman, M., Tarashandegan, D., Mor, L., Cohen, I., Gluck, O., Kerner, R., Keidar, R., Weiner, E., & Sagiv, R. (2026) · International Journal of Women s Health · doi:10.2147/ijwh.s561941 · Cited by 1
The Relationship Between Depression and Coping Insight Dimensions in the Transition to Motherhood
Maxwell, A., Karin, E., Scopano, L., McMahon, C., & Crane, M. F. (2026) · Stress and Health · doi:10.1002/smi.70144 · Cited by 1
“Pregnant women experience mental health problems at rates two to three times higher than non‐pregnant women (E. P. Davis and Narayan 2020).”
Integrative perspective on the maternal gut-brain-breast axis: Linking dietary polyphenols, mental health, and human milk composition
Miranda, A. R., Barral, P. E., Serra, S. V., & Soria, E. A. (2026) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2026.110334 · Cited by 1
Pandemic-related stressors and social resources differentially predict competence and problem behavior trajectories of young children born during the pandemic
Gray, S. A. O., Mulligan, D. J., Carter, A. S., McCarthy, K. J., Goldstein, B. L., Drury, S. S., Grasso, D. J., & Briggs‐Gowan, M. J. (2026) · Child Development · doi:10.1093/chidev/aacaf041 · Cited by 1
Validation of the adapted pregnancy-related anxiety scale in Northern Ghana (PrAS-NG)
Qannita, M. K., Abiiro, G. A., Akaateba, D., Hadfield, K., & Hadfield, K. (2026) · European Journal of Midwifery · doi:10.18332/ejm/215188 · Cited by 1
Pilates during pregnancy for maternal musculoskeletal pain and discomfort: a systematic review and meta-analysis
Song, C., Shen, Y., Tang, X., Li, Z., Li, X., Zhang, X., Xiang, Y., Ma, J., Tian, X. Q., Li, H., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-112441 · Cited by 1
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An Analysis of Pregnancy-Related Anxiety Using a Biopsychosocial Approach
Wulandatika, D., Fatimah, S., Hariyono, D. S., Afifah, R. A. N., & Azkiya, N. (2026) · Journal of Public Health Sciences · doi:10.56741/iistr.jphs.001081 · Cited by 1
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Induced labour in pregnancy with congenital abnormalities: clinical indications or patient demand
Pribadi, A. (2022) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20221960 · Cited by 1
Depressive symptomatology in pregnant adolescents: considerations for care
Wittenberg, M. F., Fitzgerald, S., & Pluhar, E. (2023) · Current Opinion in Pediatrics · doi:10.1097/mop.0000000000001250 · Cited by 1
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Background
Paternal age and perinatal outcomes: an observational study
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Riskli gebeliği olan ve olmayan kadınlarda prenatal bağlanma ve prenatal distresin değerlendirilmesi
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Childhood Maltreatment and Electrodermal Reactivity to Stress Among Pregnant Women
Speck, B., Kaliush, P. R., Tacana, T., Conradt, E., Crowell, S. E., & Raby, K. L. (2024) · Developmental Psychobiology · doi:10.1002/dev.22553 · Cited by 1
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Adverse Childhood Experiences in the First 1000 Days of Life and Dental Caries Experience From Age 31 to 61 Months
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The Effects of EMDR Therapy on Pregnant Clients With Substance Use Disorders: A Narrative, Scoping Literature Review
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Background
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Authors: Davis, E. P., & Narayan, A. J.
Affiliations: University of Denver (US)
Corresponding author: Davis, Elysia Poggi
ORCID: Davis, Elysia Poggi
Narayan, Angela J.
Venue: Development and Psychopathology
Publisher: Cambridge University Press (CUP)
Published: 2020-12
Volume: 32
Issue: 5
Pages: 1625-1639
ISSN: 0954-5794 (ISSN-L)
1469-2198
DOI: 10.1017/s0954579420001121
PMC: PMC7863987
OpenAlex: W3119751906
Cited by: 297
References: 169
Citations by year: 2026: 72 · 2025: 72 · 2024: 60 · 2023: 49 · 2022: 26 · 2021: 16 · 2020: 1
FWCI: 3.84
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified, 41 d)
Locations: Development and Psychopathology (publishedVersion, cc-by)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Society for Research in Child Development
National Institutes of Health (MH096889)
National Heart, Lung, and Blood Institute (R01HL155744)
National Institute of Mental Health (P50MH096889, R01MH109662)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Keywords: pregnancy, maternal-fetal dyad, prenatal stress, resilience, prenatal mental health, prenatal intervention, fetal development, infant outcomes, child outcomes, prenatal screening, protective factors
MeSH terms: Child, Female, Humans, Infant, Mothers, Pregnancy, Protective Factors

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Pregnancy as a period of risk, adaptation, and resilience for mothers and infants

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