Introduction: Little is known about the effects of parental mental health burdens during pregnancy on infant health among military families, who are subject to various stressors unique to military life. The present study leveraged infant data from the DoD Birth and Infant Health Research (BIHR) program and self-reported parental survey data from the Millennium Cohort Study (MCS) to examine associations of parental mental health conditions with adverse infant health outcomes.
Materials and methods: Subjects included singleton infants captured in BIHR program data, born between July 2001 and December 2012, to MCS women and men who completed a baseline or follow-up survey from 1 year before pregnancy start through infant birth date. Survey assessment included mental health screenings and behavioral health measures (e.g., smoking and alcohol use). Mental health exposures included post-traumatic stress disorder, major depression, and panic/anxiety disorder and were assessed as "any mental health condition" (yes or no) and "count of mental health conditions" (0, 1, 2, or 3). Infant outcomes included birth defects, low birth weight, and preterm birth and were assessed individually and as a composite measure of "any adverse outcome." Descriptive statistics were calculated for the maternal and the paternal study populations stratified by exposure status. Log-binomial models estimated risk ratios (RRs) and confidence intervals (CIs) for all outcomes.
Results: Among 9489 infants born to MCS women, 1006 (10.6%) were born to women who screened positive for any mental health condition; 571 (6.0%), 268 (2.8%), and 167 (1.8%) were born to women who screened positive for 1, 2, and 3 mental health conditions, respectively. Of the 9377 of these infants included in analyses, 256 (2.7%) had a birth defect, 331 (3.5%) were low birth weight, and 596 (6.4%) were born preterm. Among 19,149 infants born to MCS men, 1433 (7.5%) were born to men who screened positive for any mental health condition; 838 (4.4%), 351 (1.8%), and 244 (1.3%) were born to men who screened positive for 1, 2, and 3 mental health conditions, respectively. Of the 18,983 of these infants included in analyses, 54 (2.8%) had a birth defect, 649 (3.4%) were low birth weight, and 1,359 (7.2%) were born preterm. Infants born to men or women who screened positive for all 3 mental health conditions vs. none exhibited elevated risk estimates for each individual infant outcome, but CIs included the null. Increased risk for any adverse infant outcome, however, was observed for women with all 3 mental health conditions (RR = 1.70, CI, 1.12-2.59), but not men (RR = 1.29, CI, 0.89-1.88).
Conclusions: Findings suggest an association between parental mental health and adverse infant health outcomes, particularly for maternal mental health. Future research would benefit from larger sample sizes to detect potentially small effects of parental mental health on birth outcomes.
Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2025. This work is written by (a) US Government employee(s) and is in the public domain in the US.