Migrant Mother Mental Health (MiMoMent): epidemiology and neurobiological correlates of perinatal mental health among migrant mother-child dyads living in the Netherlands

Over half of the 2.6 million migrants that reside in the Netherlands are women.
Women in the perinatal period who are displaced, as migrants or as refugees,
have a higher risk of poor mental health. Evidence suggests that one in four
pregnant migrant women, experience perinatal depression, one in five perinatal
anxiety, and one in eleven experience post-traumatic stress disorder (PTSD)
perinatally. These rates are among women who migrated from low or middle-income
countries (LMICs).
In addition to affecting the wellbeing and quality of life of women, these
perinatal mental conditions (PMCs), also impact the development and overall
health of their un/newborn children. The mechanisms that might be driving this
potential intergenerational transmission of negative health outcomes are
complex. Emerging evidence suggests the implication of maladaptive changes to
the stress-response system and to neurodevelopmental pathways. Nevertheless,
the currently available evidence is still fragmented and few studies have
replicated findings in diverse groups. This scarcity of high quality evidence
can also be observed in relation to the epidemiological assessments of PMCs
among migrant and refugee women, especially among those who resettled in
high-income countries such as the Netherlands.

With this study we aim to increase our understanding of perinatal mental health
in migrant and refugee mothers, exploring potential risk and protective factors
for PMCs from pregnancy up to 6 months after birth. We also aim to explore the
trajectories from low to severe symptomatology of PMCs across this timespan,
and the impact that PMCs may have on child-level outcomes. We will also study
the association between relevant neurobiological markers in mothers and PMCs
symptoms as well as the relation of these markers in mother-child dyads. Taken
together, reaching these objectives can help us increase our understanding of
the trajectory from root causes to impact as well as treatment of PMCs.

This study consists of a prospective cohort where about 200 perinatal migrant
and refugee women (and their un/newborn children) will be enrolled as
participants. Women will be recruited between 18 and 24 weeks pregnancy. Three
additional assessments take place: at 35 weeks pregnancy, at delivery (8 weeks
after birth) and 6 months post-partum. Self-report data on PMCs (i.e.,
depression, anxiety and PTSD) will be collected at all time-points. At 6 months
post-partum additional child outcomes will be collected. In a sub-sample of 60
mothers, collection of hair samples will take place at enrolment and in
mother-child dyads at delivery (8 weeks after birth).

Given the observational nature of the study, the risks associated with the
investigation are negligible and the burden is minimal. Interested participants
will be invited for a total of four assessments from circa 20 weeks of
gestation until 6 months post-birth. The assessments consist of questionnaires
on experiences of perinatal mental conditions symptoms, life events and
child-level development. surveys will last on 15 to 30 minutes depending on the
timepoint. Additionally, concentrations of relevant neuro-biomarkers will be
conducted on hair samples, which are collected in both mother and children, in
a non-invasive manner..