Preconception Predictors of Next Generation Early Relational Health: A Living Review of Prospective Cohort Studies

Intergenerational studies suggest that the developmental foundations of children's early relational health are seeded well before conception. Here, we present studies that report on associations between factors in the parental preconception life course (across childhood, adolescence, and young adulthood), and indicators of the child's early relational ecology (e.g., infant-to-parent attachment, parent-to-infant bonds). We searched MEDLINE, PsycINFO and Embase databases for peer-reviewed articles, published in English, that reported on prospectively assessed factors at any stage of a parent's life course prior to conception, and associations with offspring relational health from conception to end of age 3 years. No date restrictions were imposed. A total of 13,594 articles were screened of which 30 met inclusion criteria, reporting data from 17 separate cohorts. Next generation child relational health was assessed using both coded observations and parent reports, with most studies focused on the mother-child relationship (70%). Most preconception predictors were assessed at the individual level (63%) or within the family microsystem (53%) and were measured during adolescence (60%). Few studies assessed other microsystems or broader ecological systems, with no studies investigating workplaces, online interactions, or cultural belief systems as predictors of next generation relational health. We conclude that longitudinal cohorts that track individuals into parenthood can provide critical insights into the preconception origins of early relational health; however, the existing body of prospective studies is heterogeneous and reflects a nascent field of enquiry. We present five recommendations for future investment in public health approaches that promote early relational health.