Perinatal mental health and risk of child maltreatment: a systematic review and meta-analysis

Background: Mental health problems in parents have been identified as a risk factor for child maltreatment. The perinatal period (from conception to 1 year) is a critical period but it is unclear whether perinatal mental health problems are also associated with increased risk. Objective: To review evidence on perinatal mental health and risk of child maltreatment. Methods: Searches were conducted on six databases and 24 studies reported in 30 papers identified. Studies were conducted in seven countries, mainly the USA (n=14). Sample sizes ranged from 48-14,893 and most examined mothers (n=17). Studies were conducted in community (n=17) or high-risk (n=7) samples. Results: The majority of studies found a relationship between parental perinatal mental health problems and risk of child maltreatment, but inconsistent findings were observed between and within studies. The few studies that examined fathers (n=6) all found a relationship between fathers’ mental health and risk of child maltreatment. Meta-analysis of 17 studies (n=22,042) showed perinatal mental health problems increased risk of child maltreatment by OR 3.04 (95% CI 2.29–4.03). This relationship was moderated by type of sample, with larger effects for risk of child maltreatment in high-risk samples. The relationship was not moderated by type of mental illness, child maltreatment; methodological or measurement factors. Conclusion: The association between perinatal mental health and risk of child maltreatment is similar to that observed at other times during childhood. Methodological heterogeneity and inconsistent findings mean conclusions are tentative and need to be considered alongside other individual, family and social/cultural risk factors.