Parents’ mental health and the social-emotional development of their children aged between 24 and 59 months in low-and middle-income countries: A systematic review and meta-analyses

Aim: To synthesize the evidence about the relationships between parents’ mental health and the social-emotional development of their children aged 24 to 59 months in low and middle-income countries (LMICs). Methods: We used a systematic strategy to search six databases for studies from LMICs, published between 2010 and 2021, of mental health problems experienced by parents and the social-emotional development of their children. We followed the standard methods for systematic reviews and meta-analyses set down in the PRISMA, MOOSE and COSMOS-E guidelines. Data were reported in a narrative synthesis. Meta-analysis was undertaken to calculate pooled odds ratios (ORs) and standard mean differences (SMD). Results: Overall, 26 papers reporting 15 cross-sectional studies and secondary analyses and 11 prospective cohort studies, from seven LMICs met inclusion criteria. The parent mental health problems studied were depression, anxiety, common mental disorders, stress, and mood disorders. Almost all the studies that assessed either perinatal or contemporaneous exposure to parental mental health problems found a significant association with increased child social-emotional development problems when aged 24 to 59 months. The use of harsh discipline in parenting mediated the relationship between maternal depression and higher prevalence of child's externalizing behaviours. The children of parents with mental health problems were at nearly twice the odds of having social-emotional development problems (OR: 1.92, 95% CI: 1.47, 2.37), compared to children of parents without them. The pooled size of the effect (SMD) of parents' symptoms of mental health problem on child social-emotional development scores was 0.14 (95% CI: 0.04; 0.24). Conclusion: In LMICs, interventions to optimize early childhood social-emotional development need to address the mental health of parents. Rigorous prospective studies are needed to identify mechanisms and causal pathways, including modifiable risk and protective factors in the many LMICs which lack evidence to inform local policies, programs, and practices.