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Kemp JVA, Bernier E, Lebel C, Kopala-Sibley DC. Associations Between Parental Mood and Anxiety Psychopathology and Offspring Brain Structure: A Scoping Review. Clin Child Fam Psychol Rev 2022; 25:222-247. [PMID: 35201543 DOI: 10.1007/s10567-022-00393-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 12/22/2022]
Abstract
A family history of mood and anxiety disorders is one of the most well-established risk factors for these disorders in offspring. A family history of these disorders has also been linked to alterations in brain regions involved in cognitive-affective processes broadly, and mood and anxiety disorders specifically. Results from studies of brain structure of children of parents with a history of mood or anxiety disorders (high-risk offspring) have been inconsistent. We followed the PRISMA protocol to conduct a scoping review of the literature linking parental mood and anxiety disorders to offspring brain structure to examine which structures in offspring brains are linked to parental major depressive disorder (MDD), anxiety, or bipolar disorder (BD). Studies included were published in peer-reviewed journals between January 2000 and July 2021. Thirty-nine studies were included. Significant associations between parental BD and offspring caudate volume, inferior frontal gyrus thickness, and anterior cingulate cortex thickness were found. Associations were also identified between parental MDD and offspring amygdala and hippocampal volumes, fusiform thickness, and thickness in temporoparietal regions. Few studies have examined associations between parental anxiety and high-risk offspring brain structure; however, one study found associations between parental anxiety symptoms and offspring amygdala structure, and another found similar associations with the hippocampus. The direction of grey matter change across studies was inconsistent, potentially due to the large age ranges for each study and the non-linear development of the brain. Children of parents with MDD and bipolar disorders, or elevated anxiety symptoms, show alterations in a range of brain regions. Results may further efforts to identify children at high risk for affective disorders and may elucidate whether alterations in specific brain regions represent premorbid markers of risk for mood and anxiety disorders.
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Affiliation(s)
- Jennifer V A Kemp
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada. .,Hotchkiss Brain Institute, Calgary, AB, Canada. .,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada. .,Faculty of Cumming School of Medicine, University of Calgary, Foothills Hospital Teaching Research and Wellness Building, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada.
| | - Emily Bernier
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada.,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada.,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada.,Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Daniel C Kopala-Sibley
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada.,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada
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52
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Silang KA, Sohal PR, Bright KS, Leason J, Roos L, Lebel C, Giesbrecht GF, Tomfohr-Madsen LM. eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis. JMIR Ment Health 2022; 9:e31116. [PMID: 35188471 PMCID: PMC8902665 DOI: 10.2196/31116] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/08/2021] [Accepted: 11/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pregnancy is associated with an increased risk for depression, anxiety, and insomnia. eHealth interventions provide a promising and accessible treatment alternative to face-to-face interventions. OBJECTIVE The objective of this systematic review and meta-analysis is to determine the effectiveness of eHealth interventions in preventing and treating depression, anxiety, and insomnia during pregnancy. Secondary aims are to identify demographic and intervention moderators of effectiveness. METHODS A total of 5 databases (PsycINFO, Medline, CINAHL, Embase, and Cochrane) were searched from inception to May 2021. Terms related to eHealth, pregnancy, randomized controlled trials (RCTs), depression, anxiety, and insomnia were included. RCTs and pilot RCTs were included if they reported an eHealth intervention for the prevention or treatment of depression, anxiety, or insomnia in pregnant women. Study screening, data extractions, and quality assessment were conducted independently by 2 reviewers from an 8-member research team (KAS, PRS, Hangsel Sanguino, Roshni Sohail, Jasleen Kaur, Songyang (Mark) Jin, Makayla Freeman, and Beatrice Valmana). Random-effects meta-analyses of pooled effect sizes were conducted to determine the effect of eHealth interventions on prenatal mental health. Meta-regression analyses were conducted to identify potential moderators. RESULTS In total, 17 studies were included in this review that assessed changes in depression (11/17, 65%), anxiety (10/17, 59%), and insomnia (3/17, 18%). Several studies included both depression and anxiety symptoms as outcomes (7/17, 41%). The results indicated that during pregnancy, eHealth interventions showed small effect sizes for preventing and treating symptoms of anxiety and depression and a moderate effect size for treating symptoms of insomnia. With the exception of intervention type for the outcome of depressive symptoms, where mindfulness interventions outperformed other intervention types, no significant moderators were detected. CONCLUSIONS eHealth interventions are an accessible and promising resource for treating symptoms of anxiety, depression, and insomnia during pregnancy. However, more research is necessary to identify ways to increase the efficacy of eHealth interventions for this population. TRIAL REGISTRATION PROSPERO (International Prospective Register of Systematic Reviews) CRD42020205954; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205954.
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Affiliation(s)
| | - Pooja R Sohal
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Katherine S Bright
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Women's Mental Health Clinic, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Jennifer Leason
- Department of Anthropology and Archaeology, University of Calgary, Calgary, AB, Canada
| | - Leslie Roos
- Department of Psychology and Pediatrics, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Catherine Lebel
- Department of Radiology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Department of Radiology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
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53
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Bright KS, Stuart S, Mcneil DA, Murray L, Kingston DE. Feasibility and Acceptability of Internet-based Interpersonal Psychotherapy for Stress, Anxiety, and Depression in Prenatal Women: Thematic Analysis Abstract (Preprint). JMIR Form Res 2022; 6:e23879. [PMID: 35687403 PMCID: PMC9233251 DOI: 10.2196/23879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Prenatal mental health is a global health concern. Despite the far-reaching impact of prenatal mental health issues, many women do not receive the psychological care they require. Women in their childbearing years are frequent users of the internet and smartphone apps. Prenatal women are prime candidates for internet-based support for mental health care. Objective This study aimed to examine the feasibility and acceptability of internet-based interpersonal psychotherapy (IPT) for prenatal women. Methods Semistructured interviews were conducted with women who had received internet-based IPT modules with guided support as a component of a randomized controlled trial evaluating the scale-up implementation of a digital mental health platform (The Healthy Outcomes of Pregnancy and Postpartum Experiences digital platform) for pregnant women. Qualitative thematic analysis was used to explore and describe women’s experiences. Data were analyzed for emerging themes, which were identified and coded. Results A total of 15 prenatal women were interviewed to examine their experiences and views on the feasibility and acceptability of internet-based IPT modules. Participants found the content informative and appreciated the ways in which the digital mental health platform made the IPT modules accessible to users. Participants voiced some differing requirements regarding the depth and the way information was presented and accessed on the digital mental health platform. The important areas for improvement that were identified were acknowledging greater depth and clarity of content, the need for sociability and relationships, and refinement of the digital mental health platform to a smartphone app. Conclusions This study provides useful evidence regarding treatment format and content preferences, which may inform future development. It also provides research data on the feasibility and acceptability of web-based applications for prenatal mental health care. Trial Registration ClinicalTrials.gov NCT01901796; https://clinicaltrials.gov/ct2/show/NCT01901796
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Affiliation(s)
- Katherine S Bright
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Women's Mental Health Clinic, Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Scott Stuart
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Deborah A Mcneil
- Maternal Newborn Child & Youth Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
| | - Lindsay Murray
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Dawn E Kingston
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
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Prenatal depression exposure alters white matter integrity and neurodevelopment in early childhood. Brain Imaging Behav 2022; 16:1324-1336. [PMID: 35000066 PMCID: PMC9107412 DOI: 10.1007/s11682-021-00616-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/02/2022]
Abstract
Prenatal exposure to maternal depression increases the risk for onset of emotional and behavioral disorders in children. We investigated the effects of exposure to prenatal depression on white matter microstructural integrity at birth and at 2-3 years, and associated neurodevelopment. Diffusion-weighted images were acquired for children of the Drakenstein Child Health Study at 2-4 weeks postpartum (n=70, 47% boys) and at 2-3 years of age (n=60, 58% boys). Tract-Based Spatial Statistics was used to compare, using an ROI based approach, diffusion tensor metrics across groups defined by presence (>19 on Beck's Depression Inventory and/or >12 on the Edinburgh Postnatal Depression Scale) or absence (below depression thresholds) of depression, and associations with neurodevelopmental measures at age 2-3 years were determined. We did not detect group differences in white matter integrity at neonatal age, but at 2-3 years, children in the exposed group demonstrated higher fractional anisotropy, and lower mean and radial diffusivity in association tracts compared to controls. This was notable in the sagittal stratum (radial diffusivity: p<0.01). Altered white matter integrity metrics were also observed in projection tracts, including the corona radiata, which associated with cognitive and motor outcomes in exposed 2-3-year-olds (p<0.05). Our findings of widespread white matter alterations in 2-3-year-old children with prenatal exposure to depression are consistent with previous findings, as well as with neuroimaging findings in adults with major depression. Further, we identified novel associations of altered white matter integrity with cognitive development in depression-exposed children, suggesting that these neuroimaging findings may have early functional impact.
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55
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Chen Y, Lin D. Maternal depression and preeclampsia: Effects on the maternal and offspring's mental and physical health. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_41_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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56
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Abraham E, Wang Y, Svob C, Semanek D, Gameroff MJ, Shankman SA, Weissman MM, Talati A, Posner J. Organization of the social cognition network predicts future depression and interpersonal impairment: a prospective family-based study. Neuropsychopharmacology 2022; 47:531-542. [PMID: 34162998 PMCID: PMC8674240 DOI: 10.1038/s41386-021-01065-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/13/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023]
Abstract
Deficits in social cognition and functioning are common in major depressive disorder (MDD). Still, no study into the pathophysiology of MDD has examined the social cognition-related neural pathways through which familial risk for MDD leads to depression and interpersonal impairments. Using resting-state fMRI, we applied a graph theoretical analysis to quantify the influence of nodes within the fronto-temporo-parietal cortical social cognition network in 108 generation 2 and generation 3 offspring at high and low-risk for MDD, defined by the presence or absence, respectively, of moderate to severe MDD in generation 1. New MDD episodes, future depressive symptoms, and interpersonal impairments were tested for associations with social cognition nodal influence, using regression analyses applied in a generalized estimating equations approach. Increased familial risk was associated with reduced nodal influence within the network, and this predicted new depressive episodes, worsening depressive symptomatology, and interpersonal impairments, 5-8 years later. Findings remained significant after controlling for current depressive/anxiety symptoms and current/lifetime MDD and anxiety disorders. Path-analysis models indicate that increased familial risk impacted offspring's brain function in two ways. First, high familial risk was indirectly associated with future depression, both new MDD episodes and symptomatology, via reduced nodal influence of the right posterior superior temporal gyrus (pSTG). Second, high familial risk was indirectly associated with future interpersonal impairments via reduced nodal influence of right inferior frontal gyrus (IFG). Finally, reduced nodal influence was associated with high familial risk in (1) those who had never had MDD at the time of scanning and (2) a subsample (n = 52) rescanned 8 years later. Together, findings reveal a potential pathway for the intergenerational transmission of vulnerability via the aberrant social cognition network organization and suggest using the connectome of neural network related to social cognition to identify intervention and prevention targets for those particularly at risk.
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Affiliation(s)
- Eyal Abraham
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
- Divisions of Translational Epidemiology and New York State Psychiatric Institute, New York, NY, USA.
| | - Yun Wang
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Child Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Connie Svob
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Divisions of Translational Epidemiology and New York State Psychiatric Institute, New York, NY, USA
| | - David Semanek
- Child Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Marc J Gameroff
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Divisions of Translational Epidemiology and New York State Psychiatric Institute, New York, NY, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Evanston, USA
| | - Myrna M Weissman
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Divisions of Translational Epidemiology and New York State Psychiatric Institute, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ardesheer Talati
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Divisions of Translational Epidemiology and New York State Psychiatric Institute, New York, NY, USA
| | - Jonathan Posner
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
- Child Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
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57
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Turesky TK, Shama T, Kakon SH, Haque R, Islam N, Someshwar A, Gagoski B, Petri WA, Nelson CA, Gaab N. Brain morphometry and diminished physical growth in Bangladeshi children growing up in extreme poverty: A longitudinal study. Dev Cogn Neurosci 2021; 52:101029. [PMID: 34801857 PMCID: PMC8605388 DOI: 10.1016/j.dcn.2021.101029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/14/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022] Open
Abstract
Diminished physical growth is a common marker of malnutrition and it affects approximately 200 million children worldwide. Despite its importance and prevalence, it is not clear whether diminished growth relates to brain development and general cognitive ability. Further, diminished growth is more common in areas of extreme poverty, raising the possibility that it may mediate previously shown links between socioeconomic status (SES) and brain structure. To address these gaps, 79 children growing up in an extremely poor, urban area of Bangladesh underwent MRI at age six years. Structural brain images were submitted to Mindboggle software, a Docker-compliant and high-reproducibility tool for tissue segmentation and regional estimations of volume, surface area, cortical thickness, sulcal depth, and mean curvature. Diminished growth predicted brain morphometry and mediated the link between SES and brain morphometry most consistently for subcortical and white matter subcortical volumes. Meanwhile, brain volume in left pallidum and right ventral diencephalon mediated the relationship between diminished growth and full-scale IQ. These findings offer malnutrition as one possible pathway through which SES affects brain development and general cognitive ability in areas of extreme poverty.
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Affiliation(s)
- Ted K Turesky
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Talat Shama
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Rashidul Haque
- The International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Nazrul Islam
- National Institute of Neuroscience and Hospital, Dhaka, Bangladesh
| | - Amala Someshwar
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Borjan Gagoski
- Harvard Graduate School of Education, Cambridge, MA, United States; Fetal-Neonatal Neuroimaging and Development Science Center, Boston Children's Hospital, Boston, MA, United States
| | - William A Petri
- Division of Infectious Diseases and International Health, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Nadine Gaab
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, United States; Harvard Graduate School of Education, Cambridge, MA, United States; Harvard Medical School, Boston, MA, United States
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58
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Demers CH, Bagonis MM, Al-Ali K, Garcia SE, Styner MA, Gilmore JH, Hoffman MC, Hankin BL, Davis EP. Exposure to prenatal maternal distress and infant white matter neurodevelopment. Dev Psychopathol 2021; 33:1526-1538. [PMID: 35586027 PMCID: PMC9109943 DOI: 10.1017/s0954579421000742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The prenatal period represents a critical time for brain growth and development. These rapid neurological advances render the fetus susceptible to various influences with life-long implications for mental health. Maternal distress signals are a dominant early life influence, contributing to birth outcomes and risk for offspring psychopathology. This prospective longitudinal study evaluated the association between prenatal maternal distress and infant white matter microstructure. Participants included a racially and socioeconomically diverse sample of 85 mother-infant dyads. Prenatal distress was assessed at 17 and 29 weeks' gestational age (GA). Infant structural data were collected via diffusion tensor imaging at 42-45 weeks' postconceptional age. Findings demonstrated that higher prenatal maternal distress at 29 weeks' GA was associated with increased fractional anisotropy (b = .283, t(64) = 2.319, p = .024) and with increased axial diffusivity (b = .254, t(64) = 2.067, p = .043) within the right anterior cingulate white matter tract. No other significant associations were found with prenatal distress exposure and tract fractional anisotropy or axial diffusivity at 29 weeks' GA, nor earlier in gestation.
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Affiliation(s)
- Catherine H. Demers
- Department of Psychology University of Denver, Denver CO,
USA
- Department of Psychiatry, University of Colorado Anschutz
Medical Campus, Aurora CO, USA
| | - Maria M. Bagonis
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - Khalid Al-Ali
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - Sarah E. Garcia
- Department of Psychology University of Denver, Denver CO,
USA
| | - Martin A. Styner
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
- Department of Computer Science, University of North
Carolina at Chapel Hill, Chapel Hill NC, USA
| | - John H. Gilmore
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill NC, USA
| | - M. Camille Hoffman
- Department of Psychiatry, University of Colorado Anschutz
Medical Campus, Aurora CO, USA
- Department of Obstetrics and Gynecology, Division of
Maternal and Fetal Medicine, University of Colorado Denver School of Medicine,
Aurora, Colorado, USA
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois at
Urbana-Champaign, Champaign IL, USA
| | - Elysia Poggi Davis
- Department of Psychology University of Denver, Denver CO,
USA
- Department of Psychiatry and Human Behavior, University of
California, Irvine, CA, USA
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MacKay L, Benzies K, Raffin Bouchal S, Barnard C. Parental and Health Care Professionals' Experiences Caring for Medically Fragile Infants on Pediatric Inpatient Units. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1973900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lyndsay MacKay
- Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Karen Benzies
- Nursing, University of Calgary, Calgary, Alberta, Canada
| | | | - Chantelle Barnard
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Effect of parental depressive symptoms on offspring's brain structure and function: A systematic review of neuroimaging studies. Neurosci Biobehav Rev 2021; 131:451-465. [PMID: 34592256 DOI: 10.1016/j.neubiorev.2021.09.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/19/2022]
Abstract
Perinatal Depression (PND) is a severe mental disorder that appears during pregnancy or in the post-partum. Although PND has been associated with behavioral problems in the offspring, its effects on brain development are unclear. With this review we aimed at summarizing the existing literature on the effects of perinatal depressive symptoms on children's brains. A search on PubMed and Embase of structural, functional Magnetic Resonance Imaging (MRI) and Diffusion Tensor Imaging (DTI) studies exploring the effect of PND on offspring's brain was conducted. We selected twenty-six studies, ten structural MRI, five DTI, six fMRI and five with combined techniques. Overall, the studies showed: a) gray matter alterations in amygdala and fronto-temporal lobes; b) microstructural alterations in amygdala, frontal lobe, cingulum, longitudinal fasciculus and fornix; and c) functional alterations between limbic and mesocortical networks. The small sample size and the heterogeneity in populations and methodologies limit this review. In conclusion, PND seems to influence structure and function of offspring, that may contribute to the risk of behavioral disturbances later in life.
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61
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Gustafsson HC, Young AS, Doyle O, Nagel BJ, Mackiewicz Seghete K, Nigg JT, Sullivan EL, Graham AM. Trajectories of perinatal depressive symptoms in the context of the COVID-19 pandemic. Child Dev 2021; 92:e749-e763. [PMID: 34448493 PMCID: PMC8652588 DOI: 10.1111/cdev.13656] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study sought to advance understanding of the potential long‐term consequences of the COVID‐19 pandemic for child development by characterizing trajectories of maternal perinatal depression, a common and significant risk factor for adverse child outcomes. Data came from 393 women (86% White, 8% Latina; mean age = 33.51 years) recruited during pregnancy (n = 247; mean gestational age = 22.94 weeks) or during the first year postpartum (n = 146; mean child age = 4.50 months; 55% female). Rates of depression appear elevated, relative to published reports and to a pre‐pandemic comparison group (N = 155). This study also provides evidence for subgroups of individuals who differ in their depressive symptom trajectories over the perinatal period. Subgroup membership was related to differences in maternal social support, but not to child birth outcomes.
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Affiliation(s)
| | - Anna S Young
- Oregon Health & Science University, Portland, Oregon, USA
| | - Olivia Doyle
- Oregon Health & Science University, Portland, Oregon, USA
| | - Bonnie J Nagel
- Oregon Health & Science University, Portland, Oregon, USA
| | | | - Joel T Nigg
- Oregon Health & Science University, Portland, Oregon, USA
| | - Elinor L Sullivan
- Oregon Health & Science University, Portland, Oregon, USA.,Oregon National Primate Research Center, Beaverton, Oregon, USA
| | - Alice M Graham
- Oregon Health & Science University, Portland, Oregon, USA
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Abstract
This article provides an overview of the prevalence and cause of postpartum depression in women and postnatal depression among their male partners, as well as a review of related symptoms, risk factors, and effects on children. Evidence-based screening tools, management options, and resources for patients and providers are also presented.
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63
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Mareckova K, Marecek R, Andryskova L, Brazdil M, Nikolova YS. Impact of prenatal stress on amygdala anatomy in young adulthood: Timing and location matter. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:231-238. [PMID: 34358683 DOI: 10.1016/j.bpsc.2021.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Exposure to maternal stress in utero has long-term implications for the developing brain and has been linked with a higher risk of depression. The amygdala, which develops during the early embryonic stage and is critical for emotion processing, might be particularly sensitive. METHODS Using data from a neuroimaging follow-up of the ELSPAC prenatal birth cohort (n=129, 47% men, 23-24 years old), we studied the impact of prenatal stress during the first and second half of pregnancy on the volume of the amygdala and its nuclei in young adult offspring. We further evaluated the relationship between amygdala anatomy and offspring depressive symptomatology. Amygdala nuclei were parcellated using FreeSurfer's automated segmentation pipeline. Depressive symptoms were measured via self-report using the Beck Depression Inventory (BDI). RESULTS Exposure to stress during the first half of pregnancy was associated with smaller accessory basal (Cohen's f2=0.27, p(FDR)=0.03) and cortical (Cohen's f2=0.29, p(FDR)=0.03) nuclei volumes. This effect remained significant after correcting for sex, stress during the second half of pregnancy, as well as maternal age at birth, birth weight, maternal education, and offspring's age at MRI. These two nuclei showed a quadratic relationship with BDI scores in young adulthood, where both smaller and larger volume was associated with more depressive symptoms (Accessory basal nucleus: Adj R2=0.05. p(FDR)=0.015; Cortical nucleus: Adj R2=0.04, p(FDR)=0.015). CONCLUSIONS We conclude that exposure to stress during the first half of pregnancy might have long-term implications for amygdala anatomy, which may in turn predict the experience of depressive symptoms in young adulthood.
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Affiliation(s)
- Klara Mareckova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.
| | - Radek Marecek
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Lenka Andryskova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Milan Brazdil
- Brain and Mind Research, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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64
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Moog NK, Nolvi S, Kleih TS, Styner M, Gilmore JH, Rasmussen JM, Heim CM, Entringer S, Wadhwa PD, Buss C. Prospective association of maternal psychosocial stress in pregnancy with newborn hippocampal volume and implications for infant social-emotional development. Neurobiol Stress 2021; 15:100368. [PMID: 34355050 PMCID: PMC8319845 DOI: 10.1016/j.ynstr.2021.100368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/30/2021] [Accepted: 07/15/2021] [Indexed: 02/06/2023] Open
Abstract
Maternal psychosocial stress during pregnancy can impact the developing fetal brain and influence offspring mental health. In this context, animal studies have identified the hippocampus and amygdala as key brain regions of interest, however, evidence in humans is sparse. We, therefore, examined the associations between maternal prenatal psychosocial stress, newborn hippocampal and amygdala volumes, and child social-emotional development. In a sample of 86 mother-child dyads, maternal perceived stress was assessed serially in early, mid and late pregnancy. Following birth, newborn (aged 5–64 postnatal days, mean: 25.8 ± 12.9) hippocampal and amygdala volume was assessed using structural magnetic resonance imaging. Infant social-emotional developmental milestones were assessed at 6- and 12-months age using the Bayley-III. After adjusting for covariates, maternal perceived stress during pregnancy was inversely associated with newborn left hippocampal volume (β = −0.26, p = .019), but not with right hippocampal (β = −0.170, p = .121) or bilateral amygdala volumes (ps > .5). Furthermore, newborn left hippocampal volume was positively associated with infant social-emotional development across the first year of postnatal life (B = 0.01, p = .011). Maternal perceived stress was indirectly associated with infant social-emotional development via newborn left hippocampal volume (B = −0.34, 95% CIBC [-0.97, −0.01]), suggesting mediation. This study provides prospective evidence in humans linking maternal psychosocial stress in pregnancy with newborn hippocampal volume and subsequent infant social-emotional development across the first year of life. These findings highlight the importance of maternal psychosocial state during pregnancy as a target amenable to interventions to prevent or attenuate its potentially unfavorable neural and behavioral consequences in the offspring. Maternal perceived stress predicted smaller neonatal left hippocampal volume (HCV). Neonatal left HCV was positively associated with infant social-emotional function. Variation in HCV may mediate maternal stress-related effects on child mental health.
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Affiliation(s)
- Nora K Moog
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Medical Psychology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Saara Nolvi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Medical Psychology, Augustenburger Platz 1, 13353, Berlin, Germany.,Turku Institute for Advanced Studies, Department of Psychology and Speech-Language Pathology, University of Turku, Finland
| | - Theresa S Kleih
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Medical Psychology, Augustenburger Platz 1, 13353, Berlin, Germany.,Institute of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Martin Styner
- Departments of Psychiatry and Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John H Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jerod M Rasmussen
- Development, Health, and Disease Research Program, Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Christine M Heim
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Medical Psychology, Augustenburger Platz 1, 13353, Berlin, Germany.,Department of Biobehavioral Health, Pennsylvania State University, College of Health and Human Development, University Park, PA, USA
| | - Sonja Entringer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Medical Psychology, Augustenburger Platz 1, 13353, Berlin, Germany.,Development, Health, and Disease Research Program, Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA, USA.,Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, CA, USA
| | - Pathik D Wadhwa
- Development, Health, and Disease Research Program, Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA, USA.,Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, CA, USA.,Departments of Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Orange, CA, USA
| | - Claudia Buss
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Medical Psychology, Augustenburger Platz 1, 13353, Berlin, Germany.,Development, Health, and Disease Research Program, Departments of Pediatrics, Psychiatry and Human Behavior, Obstetrics and Gynecology, and Epidemiology, University of California, Irvine, School of Medicine, Irvine, CA, USA.,Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, CA, USA
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65
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Demissie DB, Bitew ZW. Mental health effect of COVID-19 pandemic among women who are pregnant and/or lactating: A systematic review and meta-analysis. SAGE Open Med 2021; 9:20503121211026195. [PMID: 34262762 PMCID: PMC8243107 DOI: 10.1177/20503121211026195] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The purpose of this study is to examine the effects of coronavirus disease 2019 pandemic on the prevalence of anxiety, depression, stress, insomnia, and social dysfunction among pregnant and/or lactating women and to measure the global pooled prevalence of mental health effects among these populations in the era of coronavirus disease 2019 pandemic. METHODS Comprehensive literature searching was conducted and studies published from 1 January 2020 to 30 September 2020 reporting the prevalence of anxiety, depression; stress, insomnia, and social dysfunctions were included. The pooled prevalence of anxiety, depression, stress, insomnia, and social dysfunctions was estimated using a random-effect model. In this study, all statistical analyses were performed using STATA (version 15) software. RESULTS There were a total of 19 studies included in the meta-analysis, of which 16, 14, 4, 2, and 2 studies were included in computing the pooled prevalence of anxiety, depression, stress, insomnia, and social dysfunction, respectively. The pooled prevalence of anxiety was 33% (95% confidence interval: 50%-61%), with significant heterogeneity between studies (I2 = 99.68%, p = 0.001). The pooled prevalence of depression was 27% (95% confidence interval: 9%-45%), with remarkable heterogeneity between studies (I2 = 99.29%, p = 0.001). Likewise, the pooled prevalence of stress was 56% (95% confidence interval: 30.07%-82.22%), with significant heterogeneity between studies (I2 = 98.8%, p = 0.0001). The pooled prevalence of social dysfunction was 24.3% (95% confidence interval: 13.41%-62.03%), with significant heterogeneity between studies (I2 = 97.5%, p = 0.0001) and finally, the pooled prevalence of insomnia was 33.53% (95% confidence interval: 3.05%-64.0%), with significant heterogeneity between studies (I2 = 99.6%, p = 0.0001). CONCLUSIONS In this study, the mental health effects of the COVID-19 pandemic among pregnant and lactating women were found to be significant. Stress was the most common mental health problem in these population groups. Therefore, policymakers and health planners should give great emphasis to addressing maternal mental well-being during and after this global health crisis. Maternal mental health must be one of the international and national public health priority agendas to enhance the well-being of pregnant and lactating women. Besides, giving psychological support to pregnant and lactating women may reduce the long-term negative effects of this pandemic.
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Affiliation(s)
| | - Zebenay Workneh Bitew
- School of Nursing, St. Paul’s Hospital Millennium
Medical College, Addis Ababa, Ethiopia
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66
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Assessment of Postpartum Depression in Adolescents Who Delivered during COVID-19 Social Restrictions: The Experience of a Tertiary Hospital from Bucharest, Romania. Healthcare (Basel) 2021; 9:healthcare9070807. [PMID: 34206891 PMCID: PMC8307397 DOI: 10.3390/healthcare9070807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022] Open
Abstract
In the context of the viral spread of COVID-19 in 2020, Romanian authorities declared national confinement for two months. Our country faces a public health issue regarding adolescent pregnancy. This study assessed the predisposition of teenage mothers to postpartum depression and the influence of the viral pandemic on their emotional status. This study enrolled patients 10 to 19 years old who delivered in our department between March-December 2020. Teenagers were attributed to the "lockdown group" (n = 30) and the "open group" (n = 171). All study participants agreed to take an interview based on a three-part questionnaire, including the Edinburgh Postnatal Depression Scale (EPDS). In the "lockdown group", 16.67% of patients felt stressed over the last year compared to 11.11% of individuals in the "open group", but there was no statistically significant difference between groups regarding overall EPDS scores (z value 0.51, Mann-Whitney U test). Predictable variables for postpartum depression were the use of cigarettes (OR = 1.08, 95% CI: 1.00-1.16), intended pregnancies (OR = 0.25, 95% CI: 0.09-0.68, p = 0.007) and absence of stressors in the last year (OR = 0.07, 95% CI: 0.02-0.30, p = 0.0002). More adolescents were stressed during confinement compared to those who delivered in the following time period; this aspect did not interfere with depression screening scores. A planned pregnancy, even during adolescence, can serve as a protective factor for postpartum depression.
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67
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Nolvi S, Tuulari JJ, Lavonius T, Scheinin NM, Lehtola SJ, Lavonius M, Merisaari H, Saunavaara J, Korja R, Kataja EL, Pelto J, Parkkola R, Karlsson L, Karlsson H. Newborn white matter microstructure moderates the association between maternal postpartum depressive symptoms and infant negative reactivity. Soc Cogn Affect Neurosci 2021; 15:649-660. [PMID: 32577747 PMCID: PMC7393309 DOI: 10.1093/scan/nsaa081] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/29/2020] [Accepted: 06/08/2020] [Indexed: 12/20/2022] Open
Abstract
Maternal postpartum depression is a prominent risk factor for aberrant child socioemotional development, but there is little understanding about the neural phenotypes that underlie infant sensitivity to maternal depression. We examined whether newborn white matter fractional anisotropy (FA), a measure of white matter maturity, moderates the association between maternal postpartum depressive symptoms and infant negative reactivity at 6 months. Participants were 80 mother–infant dyads participating in a prospective population-based cohort, and included families whose newborns underwent a magnetic resonance/diffusion tensor imaging scan at 2–5 weeks of age and whose mothers reported their own depressive symptoms at 3 and 6 months postpartum and infant negative emotional reactivity at 6 months. The whole-brain FA moderated the association between maternal depressive symptoms and mother-reported infant negative reactivity at 6 months after adjusting for the covariates. Maternal depressive symptoms were positively related to infant negative reactivity among infants with high or average FA in the whole brain and in corpus callosum and cingulum, but not among those with low FA. The link between maternal depressive symptoms and infant negative reactivity was moderated by newborn FA. The variation in white matter microstructure might play a role in child susceptibility to parental distress.
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Affiliation(s)
- Saara Nolvi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Medical Psychology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.,Turku Institute for Advanced Studies, University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Tuomas Lavonius
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Satu J Lehtola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Maria Lavonius
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Future Technologies, University of Turku, Turku, Finland.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Riitta Parkkola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Radiology, Turku University Hospital and University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Child Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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68
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Letourneau N, McDonald S, MacKay LJ, Bell RC, Hetherington E, Deane AJ, Dewey D, Edwards S, Field CJ, Giesbrecht GF, Graham S, Lebel C, Leung B, Madigan S, McArthur BA, McMorris C, Racine N, Ross KM, Wu M, Tough SC. Cross-Sectional Study Protocol for the COVID-19 Impact Survey of Mothers and Their 7-11 Year Old Children in Alberta, Canada. Front Psychiatry 2021; 12:597759. [PMID: 34239455 PMCID: PMC8260076 DOI: 10.3389/fpsyt.2021.597759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Our aim is to understand the effect of the COVID-19 pandemic on families who have been followed longitudinally in two cohorts studied in Alberta, Canada. We will examine household infections during the COVID-19 pandemic, financial impact, domestic violence, substance use, child school and daily life and relationships in the home. We will identify risk and protective factors for maternal mental health outcomes using longitudinal data that can inform policy and government resource allocation in future disasters. Methods: Mothers who are currently participating in two longitudinal studies, Alberta Pregnancy Outcomes and Nutrition (APrON; N = 1,800) and All Our Families (AOF: N = 2,534) were eligible to participate. Mothers were invited to complete the baseline COVID-19 Impact Survey (20-30 min) within 4 months of March 15, 2020, which was when the province of Alberta, Canada, implemented school closures and physical-distancing measures to prevent the spread of COVID-19. Mothers were asked to report on their own, their child's and their family's functioning. Mothers were re-surveyed at 6 months after completion of the initial COVID-19 Impact Survey, and will be re-surveyed again at 12 months. Results: Responses from participants in both cohorts will be examined in harmonized analyses as well as separately. Descriptive, multivariable analysis will be undertaken to examine risk and resiliency over time and factors that predict mental health and well-being. Conclusions: This study will provide timely information on the impact of COVID-19 for Albertan families. It will identify risk and protective factors for mental health and well-being among contemporary urban families supported by a publicly funded health care system to inform allocation of resources to support those most vulnerable during a global pandemic.
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Affiliation(s)
- Nicole Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheila McDonald
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Rhonda C. Bell
- Faculty of Agricultural, Life and Environmental Science, University of Alberta, Edmonton, AB, Canada
| | - Erin Hetherington
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrea J. Deane
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Deborah Dewey
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Sarah Edwards
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Catherine J. Field
- Faculty of Agricultural, Life and Environmental Science, University of Alberta, Edmonton, AB, Canada
| | - Gerald F. Giesbrecht
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Susan Graham
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Catherine Lebel
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Brenda Leung
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Public Health Program, Faculty Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Brae Anne McArthur
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Carly McMorris
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Nicole Racine
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Kharah M. Ross
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
- Psychology, Centre for Social Sciences, Athabasca University, Athabasca, AB, Canada
| | - Muci Wu
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Suzanne C. Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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69
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Dean DC, Madrid A, Planalp EM, Moody JF, Papale LA, Knobel KM, Wood EK, McAdams RM, Coe CL, Hill Goldsmith H, Davidson RJ, Alisch RS, Kling PJ. Cord blood DNA methylation modifications in infants are associated with white matter microstructure in the context of prenatal maternal depression and anxiety. Sci Rep 2021; 11:12181. [PMID: 34108589 PMCID: PMC8190282 DOI: 10.1038/s41598-021-91642-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/17/2021] [Indexed: 12/12/2022] Open
Abstract
Maternal and environmental factors influence brain networks and architecture via both physiological pathways and epigenetic modifications. In particular, prenatal maternal depression and anxiety symptoms appear to impact infant white matter (WM) microstructure, leading us to investigate whether epigenetic modifications (i.e., DNA methylation) contribute to these WM differences. To determine if infants of women with depression and anxiety symptoms exhibit epigenetic modifications linked to neurodevelopmental changes, 52 umbilical cord bloods (CBs) were profiled. We observed 219 differentially methylated genomic positions (DMPs; FDR p < 0.05) in CB that were associated with magnetic resonance imaging measures of WM microstructure at 1 month of age and in regions previously described to be related to maternal depression and anxiety symptoms. Genomic characterization of these associated DMPs revealed 143 unique genes with significant relationships to processes involved in neurodevelopment, GTPase activity, or the canonical Wnt signaling pathway. Separate regression models for female (n = 24) and male (n = 28) infants found 142 associated DMPs in females and 116 associated DMPs in males (nominal p value < 0.001, R > 0.5), which were annotated to 98 and 81 genes, respectively. Together, these findings suggest that umbilical CB DNA methylation levels at birth are associated with 1-month WM microstructure.
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Affiliation(s)
- Douglas C Dean
- Department of Pediatrics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, USA.,Department of Medical Physics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Andy Madrid
- Department of Neurosurgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Elizabeth M Planalp
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jason F Moody
- Department of Medical Physics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Ligia A Papale
- Department of Neurosurgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Karla M Knobel
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Elizabeth K Wood
- Harlow Center for Biological Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Ryan M McAdams
- Department of Pediatrics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, USA
| | - Christopher L Coe
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Harlow Center for Biological Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - H Hill Goldsmith
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Richard J Davidson
- Waisman Center, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Center for Healthy Minds, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychiatry, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Reid S Alisch
- Department of Neurosurgery, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, WI, USA.
| | - Pamela J Kling
- Department of Pediatrics, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, USA
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70
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Kautz-Turnbull C, Petrenko CLM, Handley ED, Coles CD, Kable JA, Wertelecki W, Yevtushok L, Zymak-Zakutnya N, Chambers CD. Partner influence as a factor in maternal alcohol consumption and depressive symptoms, and maternal effects on infant neurodevelopmental outcomes. Alcohol Clin Exp Res 2021; 45:1265-1275. [PMID: 33999430 DOI: 10.1111/acer.14612] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/16/2021] [Accepted: 03/26/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Few studies have investigated the partner's influence on risk factors such as alcohol consumption and depression during pregnancy. Partner substance use and lower relationship satisfaction predict higher maternal alcohol use and depressive symptoms. Because prenatal alcohol use and maternal depression affect infant outcomes, it is imperative to examine how the partner affects these maternal risk factors. The current study examined the effect of a latent construct of partner influence on maternal alcohol use and depressive symptoms, and the effects on infant development of these maternal factors. METHODS Participants were 246 pregnant women from 2 sites in Western Ukraine from whom longitudinal data were collected as part of a multisite study. In the first trimester, mothers reported on relationship satisfaction, partner substance use, and socioeconomic status (SES). In the third trimester, they reported on alcohol use and depressive symptoms. Infants were assessed using the Bayley Scale of Infant Development (average age = 6.93 months). A latent construct titled partner influence was formed using partner substance use and measures of relationship satisfaction, including the frequency of quarreling, happiness in the relationship, and the ease of talking with the partner. Using structural equation modeling, a model was specified in which partner influence and SES predicted maternal alcohol use and depressive symptoms, which in turn predicted infant neurodevelopmental outcomes. RESULTS Higher partner influence significantly predicted lower prenatal alcohol use and lower depressive symptoms, controlling for the effect of SES. Higher maternal prenatal alcohol use significantly predicted lower infant mental and psychomotor development. Maternal depressive symptoms did not predict infant development over and above the effect of alcohol use. CONCLUSIONS Partner influence is an important contributor to prenatal alcohol use and maternal depressive symptoms, over and above the effect of SES. The significant paths from prenatal alcohol exposure to infant neurodevelopmental outcomes underscore the importance of partner influence during pregnancy.
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Affiliation(s)
| | | | | | - Claire D Coles
- Departments of Psychiatry and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Julie A Kable
- Departments of Psychiatry and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Wladimir Wertelecki
- Department of Medical Genetics, University of South Alabama, Mobile, AL, USA.,OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Rivne Province, Ukraine.,OMNI-Net for Children International Charitable Fund, Khmelnytsky Perinatal Center, Khmelnytsky, Khmelnytsky Province, Ukraine
| | | | - Natalya Zymak-Zakutnya
- OMNI-Net for Children International Charitable Fund, Khmelnytsky Perinatal Center, Khmelnytsky, Khmelnytsky Province, Ukraine
| | - Christina D Chambers
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
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71
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The Impact of Perinatal Life Stress on Infant Temperament and Child Development: A 2-Year Follow-Up Cohort Study. J Dev Behav Pediatr 2021; 42:299-306. [PMID: 33229970 DOI: 10.1097/dbp.0000000000000887] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 10/01/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Accumulating evidence suggests a persistent impact of perinatal exposure to maternal stress on the infant. In utero, the fetus is particularly vulnerable to maternal stress and mental health complications with various long-term consequences. This study examines the prospective relationship of subclinical maternal perinatal life stress based on individual responses to stressful life events and infant temperament and child development. METHODS Data were derived from the Akershus Birth Cohort, a longitudinal cohort study including 3,752 women scheduled to give birth at Akershus University Hospital, Norway. Psychometric measures pertained to perinatal life stress, maternal perinatal depression (Edinburgh Postnatal Depression Scale), difficult infant temperament at 8 weeks (Infant Characteristics Questionnaire), and child development 2 years after birth (Ages & Stages Questionnaire). RESULTS Perinatal life stress predicted difficult infant temperament at 8 weeks and challenges in social-emotional development at 2 years above and beyond demographics, pregnancy, and childbirth-related and postpartum factors. CONCLUSION Life events perceived as severely distressing in the peripartum period pose a burden on mothers and may have potentially detrimental long-term effects on neurobiological and social-emotional child development. Our findings highlight the need for person-centered perinatal care and support of mothers facing difficult life events. Clinical awareness of in utero development and its relationship to maternal psychological health is warranted to intervene effectively. Future research should consider the timing of in utero exposure and neurobiological and environmental mechanisms pertaining to the relationship between maternal perinatal life stress and child development.
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Mennes M, Stiers P, Lagae L, Van den Bergh BRH. Antenatal maternal anxiety modulates the BOLD response in 20-year-old men during endogenous cognitive control. Brain Imaging Behav 2021; 14:830-846. [PMID: 30617784 DOI: 10.1007/s11682-018-0027-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Evidence is building for an association between the level of anxiety experienced by a mother during pregnancy and offspring cognition and structural and functional brain correlates. The current study uses fMRI to examine the association between prenatal exposure to maternal anxiety and brain activity associated with endogenous versus exogenous cognitive control in 20-year-old males. Endogenous cognitive control refers to the ability to generate control over decisions, strategies, conflicting information and so on, from within oneself without external signals, while exogenous control is triggered by external signals. In line with previous results of this long-term follow-up study we found that 20-year-olds of mothers reporting high levels of anxiety during weeks 12-22 of pregnancy exhibited a different pattern of decision making in a Gambling paradigm requiring endogenous cognitive control, compared to adults of mothers reporting low to average levels of anxiety. Moreover, the blood oxygenation level dependent (BOLD) response in a number of prefrontal cortical areas was modulated by the level of antenatal maternal anxiety. In particular, a number of right lateralized clusters including inferior frontal junction, that were modulated in the adults of mothers reporting low to average levels of anxiety during pregnancy by a task manipulation of cognitive control, were not modulated by this manipulation in the adults of mothers reporting high levels of anxiety during pregnancy. These differences in brain functional correlates provide a neurobiological underpinning for the hypothesis of an association between exposure to maternal anxiety in the prenatal life period and a deficit in endogenous cognitive control in early adulthood.
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Affiliation(s)
- Maarten Mennes
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Peter Stiers
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Lieven Lagae
- Section Paediatric Neurology, Department Development and Regeneration, University Hospitals KU Leuven, Leuven, Belgium
| | - Bea R H Van den Bergh
- Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven - KU Leuven, Tiensestraat 102 - bus 3726, 3000, Leuven, Belgium. .,Department of Welfare, Public Health and Family, Flemish Government, Brussels, Belgium.
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73
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Lautarescu A, Hadaya L, Craig MC, Makropoulos A, Batalle D, Nosarti C, Edwards AD, Counsell SJ, Victor S. Exploring the relationship between maternal prenatal stress and brain structure in premature neonates. PLoS One 2021; 16:e0250413. [PMID: 33882071 PMCID: PMC8059832 DOI: 10.1371/journal.pone.0250413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/06/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Exposure to maternal stress in utero is associated with a range of adverse outcomes. We previously observed an association between maternal stress and white matter microstructure in a sample of infants born prematurely. In this study, we aimed to investigate the relationship between maternal trait anxiety, stressful life events and brain volumes. METHODS 221 infants (114 males, 107 females) born prematurely (median gestational age = 30.43 weeks [range 23.57-32.86]) underwent magnetic resonance imaging around term-equivalent age (mean = 42.20 weeks, SD = 1.60). Brain volumes were extracted for the following regions of interest: frontal lobe, temporal lobe, amygdala, hippocampus, thalamus and normalized to total brain volume. Multiple linear regressions were conducted to investigate the relationship between maternal anxiety/stress and brain volumes, controlling for gestational age at birth, postmenstrual age at scan, socioeconomic status, sex, days on total parenteral nutrition. Additional exploratory Tensor Based Morphometry analyses were performed to obtain voxel-wise brain volume changes from Jacobian determinant maps. RESULTS AND CONCLUSION In this large prospective study, we did not find evidence of a relationship between maternal prenatal stress or trait anxiety and brain volumes. This was the case for both the main analysis using a region-of-interest approach, and for the exploratory analysis using Jacobian determinant maps. We discuss these results in the context of conflicting evidence from previous studies and highlight the need for further research on premature infants, particularly including term-born controls.
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Affiliation(s)
- Alexandra Lautarescu
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Laila Hadaya
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Michael C. Craig
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- National Female Hormone Clinic, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Antonis Makropoulos
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Dafnis Batalle
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Chiara Nosarti
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - A. David Edwards
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Serena J. Counsell
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Suresh Victor
- Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
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Zhang H, Wong TY, Broekman BFP, Chong YS, Shek LP, Gluckman PD, Tan KH, Meaney MJ, Fortier MV, Qiu A. Maternal Adverse Childhood Experience and Depression in Relation with Brain Network Development and Behaviors in Children: A Longitudinal Study. Cereb Cortex 2021; 31:4233-4244. [PMID: 33825872 DOI: 10.1093/cercor/bhab081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/14/2021] [Accepted: 03/10/2021] [Indexed: 01/28/2023] Open
Abstract
Maternal childhood maltreatment and depression increase risks for the psychopathology of the offspring. This study employed a longitudinal dataset of mother-child dyads to investigate the developmental trajectories of brain functional networks and behaviors of children in relation with maternal childhood adverse experience and depression. Maternal childhood trauma was retrospectively assessed via childhood trauma questionnaire, whereas maternal depressive symptoms were prospectively evaluated during pregnancy and after delivery (n = 518). Child brain scans were acquired at age of 4.5, 6, and 7.5 years (n = 163) and behavioral problems were measured at 7.5 years using the Child Behavior Checklist. We found the functional connectivity of the language network with the sensorimotor, frontal, and attentional networks as a function of maternal adverse experience that interacted with sex and age. Girls exposed to mothers with depressive symptoms or childhood abuse showed the increased development of the functional connectivity of the language network with the visual networks, which was associated with social problems. Girls exposed to mothers with depressive symptoms showed the slower growth of the functional connectivity of the language network with the sensorimotor networks. Our findings, in a community sample, suggest the language network organization as neuroendophenotypes for maternal childhood trauma and depression.
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Affiliation(s)
- Han Zhang
- School of Computer Engineering and Science, Shanghai University, Shanghai 200444, China.,Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Ting-Yat Wong
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Singapore 117609, Singapore.,Department of Psychiatry, OLVG and Amsterdam UMC, VU University, Amsterdam 1081 HJ, the Netherlands
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Singapore 117609, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 119228, Singapore
| | - Lynette P Shek
- Department of Pediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University of Singapore, Singapore 119228, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Singapore 117609, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, Singapore 117609, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.,Douglas Mental Health University Institute, McGill University, Montreal H4H 1R3, Canada
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore 229899, Singapore
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore.,The N.1 Institute for Health, National University of Singapore, Singapore 117456, Singapore.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
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75
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Ortega VA, Mercer EM, Giesbrecht GF, Arrieta MC. Evolutionary Significance of the Neuroendocrine Stress Axis on Vertebrate Immunity and the Influence of the Microbiome on Early-Life Stress Regulation and Health Outcomes. Front Microbiol 2021; 12:634539. [PMID: 33897639 PMCID: PMC8058197 DOI: 10.3389/fmicb.2021.634539] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Stress is broadly defined as the non-specific biological response to changes in homeostatic demands and is mediated by the evolutionarily conserved neuroendocrine networks of the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system. Activation of these networks results in transient release of glucocorticoids (cortisol) and catecholamines (epinephrine) into circulation, as well as activation of sympathetic fibers innervating end organs. These interventions thus regulate numerous physiological processes, including energy metabolism, cardiovascular physiology, and immunity, thereby adapting to cope with the perceived stressors. The developmental trajectory of the stress-axis is influenced by a number of factors, including the gut microbiome, which is the community of microbes that colonizes the gastrointestinal tract immediately following birth. The gut microbiome communicates with the brain through the production of metabolites and microbially derived signals, which are essential to human stress response network development. Ecological perturbations to the gut microbiome during early life may result in the alteration of signals implicated in developmental programming during this critical window, predisposing individuals to numerous diseases later in life. The vulnerability of stress response networks to maladaptive development has been exemplified through animal models determining a causal role for gut microbial ecosystems in HPA axis activity, stress reactivity, and brain development. In this review, we explore the evolutionary significance of the stress-axis system for health maintenance and review recent findings that connect early-life microbiome disturbances to alterations in the development of stress response networks.
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Affiliation(s)
- Van A Ortega
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada
| | - Emily M Mercer
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Owerko Centre, The Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Marie-Claire Arrieta
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
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76
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Bright KS, Wajid A, McNeil DA, Stuart S, Kingston D. Profiles of women participating in an internet-based prenatal mental health platform (HOPE – Healthy Outcomes of Prenatal and Postnatal Experiences). JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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77
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Krzeczkowski JE, Schmidt LA, Van Lieshout RJ. Changes in infant emotion regulation following maternal cognitive behavioral therapy for postpartum depression. Depress Anxiety 2021; 38:412-421. [PMID: 33464686 DOI: 10.1002/da.23130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/04/2020] [Accepted: 12/11/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Exposure to maternal postpartum depression (PPD) increases the risk for emotion regulatory and psychiatric problems in offspring. This study aimed to determine if maternal cognitive behavioral therapy (CBT) for PPD improves infant emotion regulatory capacity. METHODS Participants were 40 infants of mothers with a primary diagnosis of major depressive disorder matched 1:1-40 healthy control infants of nondepressed mothers on infant age, sex, and socioeconomic status. Mothers with PPD received nine weeks of group CBT. Dyads were tested at two time points. Visit 1 occurred following the first CBT session (baseline visit for control infants). Visit 2 took place after CBT (nine weeks post-baseline for controls). At both visits, infant emotion regulation was assessed using resting-state frontal electroencephalography alpha asymmetry (FAA), heart rate variability (HRV), and maternal and partner ratings of orientation or regulation behaviors (infant behavior questionnaire-revised [short form]). Changes in maternal characteristics (depression, bonding, and emotion regulation) from pretreatment to posttreatment were examined to determine if they explained infant changes. RESULTS At Visit 1, infants of women with PPD exhibited poorer emotion regulation relative to the healthy control infants. At Visit 2, following maternal PPD treatment, infants exhibited improved emotion regulation (shifted from right to left FAA [p = .01, d = 0.60], increased HRV [p = .003, d = 0.56], mother [p = .015, d = 0.29] and partner [p = .049, d = 0.35] reported orientation or regulation behaviors) such that they no longer differed from the healthy control infants. Changes in maternal characteristics did not appear to account for these changes. CONCLUSION Treating PPD may promote adaptive changes in physiological and behavioral systems underlying infant emotion regulation.
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Affiliation(s)
| | - Louis A Schmidt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, Canada
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78
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Emerging Evidence for Putative Neural Networks and Antecedents of Pediatric Anxiety in the Fetal, Neonatal, and Infant Periods. Biol Psychiatry 2021; 89:672-680. [PMID: 33518264 PMCID: PMC8087150 DOI: 10.1016/j.biopsych.2020.11.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/12/2020] [Accepted: 11/22/2020] [Indexed: 12/20/2022]
Abstract
Anxiety disorders are the most prevalent psychiatric disorders in youth and are associated with profound individual impairment and public health costs. Research shows that clinically significant anxiety symptoms manifest in preschool-aged children, and correlates of anxiety symptoms are observable in infancy. Yet, predicting who is at risk for developing anxiety remains an enduring challenge. Predictive biomarkers of anxiety are needed before school age when anxiety symptoms typically consolidate into diagnostic profiles. Increasing evidence indicates that early neural measures implicated in anxiety and anxious temperament may be incorporated with traditional measures of behavioral risk (i.e., behavioral inhibition) to provide more robust classification of pediatric anxiety problems. This review examines the phenomenology of anxiety disorders in early life, highlighting developmental research that interrogates the putative neurocircuitry of pediatric anxiety. First, we discuss enduring challenges in identifying and predicting risk for pediatric anxiety. Second, we summarize emerging evidence for putative neural antecedents and networks underlying risk for pediatric anxiety in the fetal, neonatal, and infant periods that represent novel potential avenues for risk identification and prediction. We focus on evidence examining the importance of early amygdala and extended amygdala circuitry development to the emergence of anxiety. Finally, we discuss the utility of integrating developmental psychopathology and neuroscience to facilitate future research and clinical work.
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79
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Canonical TGF-β signaling regulates the relationship between prenatal maternal depression and amygdala development in early life. Transl Psychiatry 2021; 11:170. [PMID: 33723212 PMCID: PMC7961018 DOI: 10.1038/s41398-021-01292-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 02/04/2023] Open
Abstract
Canonical transforming growth factor-beta (TGF-β) signaling exerts neuroprotection and influences memory formation and synaptic plasticity. It has been considered as a new target for the prevention and treatment of depression. This study aimed to examine its modulatory role in linking prenatal maternal depressive symptoms and the amygdala volumes from birth to 6 years of age. We included mother-child dyads (birth: n = 161; 4.5 years: n = 131; 6 years: n = 162) and acquired structural brain images of children at these three time points. Perinatal maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) questionnaire to mothers at 26 weeks of pregnancy and 3 months postpartum. Our findings showed that the genetic variants of TGF-β type I transmembrane receptor (TGF-βRI) modulated the association between prenatal maternal depressive symptoms and the amygdala volume consistently from birth to 6 years of age despite a trend of significance at 4.5 years of age. Children with a lower gene expression score (GES) of TGF-βRI exhibited larger amygdala volumes in relation to greater prenatal maternal depressive symptoms. Moreover, children with a lower GES of the TGF-β type II transmembrane receptor (TGF-βRII), Smad4, and Smad7 showed larger amygdala volumes at 6 years of age in relation to greater prenatal maternal depressive symptoms. These findings support the involvement of the canonical TGF-β signaling pathway in the brain development of children in the context of in utero maternal environment. Such involvement is age-dependent.
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Abstract
PURPOSE OF REVIEW To synthesize findings from studies of neurocognitive complications in children with type 1 diabetes (T1D) and highlight potential risk and protective factors. RECENT FINDINGS Emerging evidence suggests that hyperglycemia and time in range may be more important for brain development than episodes of hypoglycemia. Further, diabetic ketoacidosis (DKA) at the time of T1D diagnosis appears to be a particular risk factor for neurocognitive complications, particularly deficits in executive function skills and memory, with differences in cerebral white matter microstructure seen via advanced magnetic resonance imaging methods, and lower scores on measures of attention and memory observed among children who were diagnosed in DKA. Other factors that may influence neurocognitive development include child sleep, caregiver distress, and diabetes device use, presumably due to improved glycemic control. We highlight neurocognitive risk and protective factors for children with T1D and priorities for future research in this high-risk population.
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Affiliation(s)
- Sarah S Jaser
- Department of Pediatrics, Vanderbilt University Medical Center, 2525 West End Ave., Suite 1200, Nashville, TN, 37203, USA.
| | - Lori C Jordan
- Department of Pediatrics, Vanderbilt University Medical Center, 2525 West End Ave., Suite 1200, Nashville, TN, 37203, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Radiology and Radiological Science, Vanderbilt University Medical Center, Nashville, TN, USA
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81
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Borchers LR, Dennis EL, King LS, Humphreys KL, Gotlib IH. Prenatal and postnatal depressive symptoms, infant white matter, and toddler behavioral problems. J Affect Disord 2021; 282:465-471. [PMID: 33422824 PMCID: PMC7889716 DOI: 10.1016/j.jad.2020.12.075] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Maternal depression is prevalent during and following pregnancy and is related to adverse outcomes in offspring. Perinatal depression is associated with risk for difficulties in offspring; however, the mechanisms underlying this association are not clear. We examined whether maternal prenatal and postnatal depressive symptoms were associated with infant white matter organization and with behavioral problems in toddlerhood. METHODS 37 mother-infant dyads (20 male; ages 5.95-7.66 months) participated in this study. We conducted diffusion MRI with infants during natural sleep. Mothers reported on their prenatal and postnatal depressive symptoms at six months postpartum. We calculated fractional anisotropy (FA), radial, axial, and mean diffusivity, and assessed offspring behavioral problems at age 18 months. RESULTS Prenatal depressive symptoms were associated with FA of the corpus callosum; postnatal depressive symptoms were not associated with FA of limbic tracts or corpus callosum segmentations. Higher levels of prenatal depressive symptoms were associated with higher FA and lower radial diffusivity of the corpus callosum genu; FA of this region was positively associated with behavioral problems at age 18 months. LIMITATIONS This study had a small sample size; therefore, findings should be replicated. Further, we used retrospective reports of maternal prenatal depression, but validated them in this study. CONCLUSIONS Depressive symptoms during pregnancy may affect infant corpus callosum development and, in turn, offspring behaviors. These findings suggest that early maternal stress accelerates infant neurodevelopment in a manner that may increase risk for behavioral problems. Thus, efforts to reduce maternal prenatal depression should be a public health priority.
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Affiliation(s)
- Lauren R Borchers
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, United States.
| | - Emily L Dennis
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, United States; Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, 84132, United States
| | - Lucy S King
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, United States
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, #552, Nashville, TN, 37203, United States
| | - Ian H Gotlib
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, United States
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82
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Donnici C, Long X, Dewey D, Letourneau N, Landman B, Huo Y, Lebel C. Prenatal and postnatal maternal anxiety and amygdala structure and function in young children. Sci Rep 2021; 11:4019. [PMID: 33597557 PMCID: PMC7889894 DOI: 10.1038/s41598-021-83249-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/01/2021] [Indexed: 12/19/2022] Open
Abstract
Anxiety symptoms are relatively common during pregnancy and are associated with behavioural problems in children. The amygdala is involved in emotion regulation, and its volume and function are associated with exposure to prenatal maternal depression. The associations between perinatal maternal anxiety and children's amygdala structure and function remain unclear. The objective of this study was to determine associations between prenatal and postnatal maternal anxiety and amygdala structure and function in children. Maternal anxiety was measured during the second trimester of pregnancy and 12 weeks postpartum. T1-weighted anatomical data and functional magnetic resonance imaging data were collected from 54 children (25 females), between the ages of 3-7 years. Amygdala volume was calculated and functional connectivity maps were created between the amygdalae and the rest of the brain. Spearman correlations were used to test associations between amygdala volume/functional connectivity and maternal anxiety symptoms, controlling for maternal depression symptoms. Second trimester maternal anxiety symptoms were negatively associated with functional connectivity between the left amygdala and clusters in bilateral parietal regions; higher maternal anxiety was associated with increased negative connectivity. Postnatal maternal anxiety symptoms were positively associated with child amygdala volume, but this finding did not remain significant while controlling for total brain volume. These functional connectivity differences may underlie behavioral outcomes in children exposed to maternal anxiety during pregnancy.
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Affiliation(s)
- Claire Donnici
- Neuroscience Program, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Xiangyu Long
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Deborah Dewey
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Nicole Letourneau
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Bennett Landman
- Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Yuankai Huo
- Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
- Department of Radiology, University of Calgary, Calgary, AB, Canada.
- Hotchkiss Brain Institute, Calgary, AB, Canada.
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83
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Fitzgerald E, Parent C, Kee MZL, Meaney MJ. Maternal Distress and Offspring Neurodevelopment: Challenges and Opportunities for Pre-clinical Research Models. Front Hum Neurosci 2021; 15:635304. [PMID: 33643013 PMCID: PMC7907173 DOI: 10.3389/fnhum.2021.635304] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
Pre-natal exposure to acute maternal trauma or chronic maternal distress can confer increased risk for psychiatric disorders in later life. Acute maternal trauma is the result of unforeseen environmental or personal catastrophes, while chronic maternal distress is associated with anxiety or depression. Animal studies investigating the effects of pre-natal stress have largely used brief stress exposures during pregnancy to identify critical periods of fetal vulnerability, a paradigm which holds face validity to acute maternal trauma in humans. While understanding these effects is undoubtably important, the literature suggests maternal stress in humans is typically chronic and persistent from pre-conception through gestation. In this review, we provide evidence to this effect and suggest a realignment of current animal models to recapitulate this chronicity. We also consider candidate mediators, moderators and mechanisms of maternal distress, and suggest a wider breadth of research is needed, along with the incorporation of advanced -omics technologies, in order to understand the neurodevelopmental etiology of psychiatric risk.
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Affiliation(s)
- Eamon Fitzgerald
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
| | - Carine Parent
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
| | - Michelle Z. L. Kee
- Translational Neuroscience Programme, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Michael J. Meaney
- Department of Psychiatry, Faculty of Medicine, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, QC, Canada
- Translational Neuroscience Programme, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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84
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Cattane N, Räikkönen K, Anniverno R, Mencacci C, Riva MA, Pariante CM, Cattaneo A. Depression, obesity and their comorbidity during pregnancy: effects on the offspring's mental and physical health. Mol Psychiatry 2021; 26:462-481. [PMID: 32632208 PMCID: PMC7850968 DOI: 10.1038/s41380-020-0813-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/20/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
Depression and obesity represent two of the most common complications during pregnancy and are associated with severe health risks for both the mother and the child. Although several studies have analysed the individual effects of depression or obesity on the mothers and their children, the effects associated with the co-occurrence of both disorders have so far been poorly investigated. The relationship between depression and obesity is very complex and it is still unclear whether maternal depression leads to obesity or vice versa. It is well known that the intrauterine environment plays an important role in mediating the effects of both depression and obesity in the mother on the fetal programming, increasing the child's risk to develop negative outcomes.
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Affiliation(s)
- Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Roberta Anniverno
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Marco A Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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85
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Income disparity in school readiness and the mediating role of perinatal maternal mental health: a longitudinal birth cohort study. Epidemiol Psychiatr Sci 2021; 30:e6. [PMID: 33416045 PMCID: PMC8057379 DOI: 10.1017/s204579602000102x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIMS There is compelling evidence for gradient effects of household income on school readiness. Potential mechanisms are described, yet the growth curve trajectory of maternal mental health in a child's early life has not been thoroughly investigated. We aimed to examine the relationships between household incomes, maternal mental health trajectories from antenatal to the postnatal period, and school readiness. METHODS Prospective data from 505 mother-child dyads in a birth cohort in Singapore were used, including household income, repeated measures of maternal mental health from pregnancy to 2-years postpartum, and a range of child behavioural, socio-emotional and cognitive outcomes from 2 to 6 years of age. Antenatal mental health and its trajectory were tested as mediators in the latent growth curve models. RESULTS Household income was a robust predictor of antenatal maternal mental health and all child outcomes. Between children from the bottom and top household income quartiles, four dimensions of school readiness skills differed by a range of 0.52 (95% Cl: 0.23, 0.67) to 1.21 s.d. (95% CI: 1.02, 1.40). Thirty-eight percent of pregnant mothers in this cohort were found to have perinatal depressive and anxiety symptoms in the subclinical and clinical ranges. Poorer school readiness skills were found in children of these mothers when compared to those of mothers with little or no symptoms. After adjustment of unmeasured confounding on the indirect effect, antenatal maternal mental health provided a robust mediating path between household income and multiple school readiness outcomes (χ2 126.05, df 63, p < 0.001; RMSEA = 0.031, CFI = 0.980, SRMR = 0.034). CONCLUSIONS Pregnant mothers with mental health symptoms, particularly those from economically-challenged households, are potential targets for intervention to level the playing field of their children.
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86
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Editorial: Mental Health in Pregnancy and Child Development: Implications for Mental Health Service Delivery. J Am Acad Child Adolesc Psychiatry 2021; 60:32-34. [PMID: 32682895 DOI: 10.1016/j.jaac.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/28/2020] [Accepted: 07/09/2020] [Indexed: 11/23/2022]
Abstract
Perinatal mood and anxiety disorders (PMADs) are a significant and prevalent group of mental health concerns, and there are growing expectations for them to be identified and addressed in both obstetric and pediatric primary care settings.1,2 Adversity during pregnancy, including maternal stress, depression, and/or anxiety, has been shown to be associated with adverse outcomes for the child, including emotional and behavioral functioning and changes in brain development such as cortical thickening and white matter structural differences.3,4 There are multiple potential mechanisms to explain these associations, including ontogenetic vulnerabilities (ie, developmental changes in the fetal period) resulting from physiological effects of PMADs in pregnancy, as well as disruption of the early parent-child bonding relationship that often occurs with PMAD symptoms.5.
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Wu Y, Zhang H, Wang C, Broekman BFP, Chong YS, Shek LP, Gluckman PD, Meaney MJ, Fortier MV, Qiu A. Inflammatory modulation of the associations between prenatal maternal depression and neonatal brain. Neuropsychopharmacology 2021; 46:470-477. [PMID: 32688365 PMCID: PMC7852623 DOI: 10.1038/s41386-020-0774-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/26/2020] [Accepted: 07/13/2020] [Indexed: 11/09/2022]
Abstract
Inflammatory signaling has a role in sensing intrauterine environment, which may be moderators in altering fetal brain development upon maternal environment. This study integrated cytokine transcriptome of post-mortem fetal brains, neonatal brain imaging and genetic variants (n = 161) to examine whether cytokines are candidates for modulating the relationship between prenatal maternal depression and fetal brain development. This study obtained the transcriptome data of 208 cytokine genes in 12 fetal brain regions from the BrainSpan database. We also included 161 mother-child dyads with prenatal maternal depressive symptoms assessed at 26 weeks of gestation, cytokine genotype data extracted from umbilical cord specimens, and neonatal brain images from a longitudinal prospective birth cohort. We revealed that 22 cytokine genes are expressed in specific brain regions in utero, whose variants have roles in modulating the effects of the prenatal environment on the accelerated fetal development of the hippocampus, auditory, parietal, orbitofrontal, and dorsal prefrontal cortex. Neonates high in the genetic expression score (GES) of TNFRSF19 and IL17RB showed a larger right hippocampal volume, high in the GES of BMPR1B showed the thicker thickness of the sensorimotor cortex, and high in the GES of IL1RAP and CXCR4 demonstrated the thicker thickness of the dorsal and orbital prefrontal cortex in relation with greater prenatal maternal depressive symptoms. Our findings suggest that in humans, the cytokine genes are expressed in a brain region-specific manner in utero and may have potential roles in modulating the fetal development of the corresponding brain regions in response to the maternal environment.
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Affiliation(s)
- Yonghui Wu
- grid.4280.e0000 0001 2180 6431Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Han Zhang
- grid.4280.e0000 0001 2180 6431Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Changqing Wang
- grid.4280.e0000 0001 2180 6431Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Birit F. P. Broekman
- grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Singapore, Singapore
| | - Yap-Seng Chong
- grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Lynette P. Shek
- grid.4280.e0000 0001 2180 6431Department of Pediatrics, Khoo Teck Puat – National University Children’s Medical Institute, National University of Singapore, Singapore, Singapore
| | - Peter D. Gluckman
- grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Singapore, Singapore
| | - Michael J. Meaney
- grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Singapore, Singapore ,grid.14709.3b0000 0004 1936 8649Ludmer Centre for Neuroinformatics and Mental Health, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
| | - Marielle V. Fortier
- grid.414963.d0000 0000 8958 3388Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore. .,The N.1 Institute for Health, National University of Singapore, Singapore, Singapore.
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Aberrant Maturation of the Uncinate Fasciculus Follows Exposure to Unpredictable Patterns of Maternal Signals. J Neurosci 2020; 41:1242-1250. [PMID: 33328295 DOI: 10.1523/jneurosci.0374-20.2020] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 01/31/2023] Open
Abstract
Across species, unpredictable patterns of maternal behavior are emerging as novel predictors of aberrant cognitive and emotional outcomes later in life. In animal models, exposure to unpredictable patterns of maternal behavior alters brain circuit maturation and cognitive and emotional outcomes. However, whether exposure to such signals in humans alters the development of brain pathways is unknown. In mother-child dyads, we tested the hypothesis that exposure to more unpredictable maternal signals in infancy is associated with aberrant maturation of corticolimbic pathways. We focused on the uncinate fasciculus, the primary fiber bundle connecting the amygdala to the orbitofrontal cortex and a key component of the medial temporal lobe-prefrontal cortex circuit. Infant exposure to unpredictable maternal sensory signals was assessed at 6 and 12 months. Using high angular resolution diffusion imaging, we quantified the integrity of the uncinate fasciculus using generalized fractional anisotropy (GFA). Higher maternal unpredictability during infancy presaged greater uncinate fasciculus GFA in children 9-11 years of age (n = 69, 29 female). In contrast to the uncinate, GFA of a second corticolimbic projection, the hippocampal cingulum, was not associated with maternal unpredictability. Addressing the overall functional significance of the uncinate and cingulum relationships, we found that the resulting imbalance of medial temporal lobe-prefrontal cortex connectivity partially mediated the association between unpredictable maternal sensory signals and impaired episodic memory function. These results suggest that unbalanced maturation of corticolimbic circuits is a mechanism by which early unpredictable sensory signals may impact cognition later in life.SIGNIFICANCE STATEMENT Our prior work across species demonstrated that unpredictable patterns of maternal care are associated with compromised memory function. However, the neurobiological mechanisms by which this occurs in humans remain unknown. Here, we identify an association of exposure to unpredictable patterns of maternal sensory signals with the integrity of corticolimbic circuits involved in emotion and cognition using state-of-the-art diffusion imaging techniques and analyses. We find that exposure to early unpredictability is associated with higher integrity of the uncinate fasciculus with no effect on a second corticolimbic pathway, the cingulum. The resulting imbalance of corticolimbic circuit development is a novel mediator of the association between unpredictable patterns of maternal care and poorer episodic memory.
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Nielsen JD, Mennies RJ, Olino TM. Application of a diathesis-stress model to the interplay of cortical structural development and emerging depression in youth. Clin Psychol Rev 2020; 82:101922. [PMID: 33038741 PMCID: PMC8594424 DOI: 10.1016/j.cpr.2020.101922] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 08/28/2020] [Accepted: 09/17/2020] [Indexed: 12/21/2022]
Abstract
Cross-sectional studies in adults have long identified differences in cortical structure in adults with depression compared to healthy adults, with most studies identifying reductions in grey matter volume, cortical thickness, and surface area in primarily frontal cortical regions including the OFC, ACC, and variable sub-regions of the PFC. However, when, why, and for whom these neural correlates of depression emerge remains poorly understood, necessitating developmental study of associations between depression and cortical structure. We systematically reviewed studies examining these associations in child/adolescent samples, and applied a developmentally-focused diathesis-stress model to understand the impacts of depressogenic risk-factors and stressors on the development of structural neural correlates of depression. Cross-sectional findings in youth are generally similar to those found in adults, but vary in magnitude and direction of effects. Preliminary evidence suggests that age, sex, severity, and comorbidity moderate these associations. Longitudinal studies show depression prospectively predicting cortical structure and structure predicting emerging depression. Consistent with a diathesis-stress model, associations have been noted between risk-factors for depression (e.g., genetic risk, family risk) and environmental stressors (e.g., early life stress) and structural neural correlates. Further investigation of these associations across development with attention to vulnerability factors and stressors is indicated.
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Affiliation(s)
- Johanna D Nielsen
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA..
| | - Rebekah J Mennies
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA..
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA..
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De Asis-Cruz J, Krishnamurthy D, Zhao L, Kapse K, Vezina G, Andescavage N, Quistorff J, Lopez C, Limperopoulos C. Association of Prenatal Maternal Anxiety With Fetal Regional Brain Connectivity. JAMA Netw Open 2020; 3:e2022349. [PMID: 33284334 DOI: 10.1001/jamanetworkopen.2020.22349] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Maternal psychological distress during pregnancy is associated with adverse obstetric outcomes and neuropsychiatric deficits in children. Currently unavailable in vivo interrogation of fetal brain function could provide critical insights into the onset and timing of altered neurodevelopmental trajectories. OBJECTIVE To investigate the association between prenatal maternal stress, anxiety, and depression and in vivo fetal brain resting state functional connectivity. DESIGN, SETTING, AND PARTICIPANTS This cohort study included pregnant women scanned between January 2016 and April 2019. A total of 50 pregnant women with healthy pregnancies were prospectively recruited from low-risk obstetric clinics in the Washington DC area and were scanned at Children's National in Washington DC. EXPOSURES Maternal stress, anxiety, and depression. MAIN OUTCOMES AND MEASURES The association of prenatal maternal stress, anxiety, and depression with whole-brain connectivity was analyzed using multivariate distance matrix regression. Prenatal maternal stress, anxiety, and depression were assessed using the Perceived Stress Scale, Spielberger State Anxiety Inventory and Spielberger Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale, respectively. Whole-brain connectivity was measured from 100 functionally defined regions of interest. RESULTS This study analyzed 59 resting-state functional connectivity magnetic resonance image data sets from the fetuses (mean [SD] gestational age, 33.52 [4 weeks]) of 50 healthy pregnant women (mean [SD] age, 33.77 [5.51]). Mean (SD) scores for the questionnaires were as follows: Spielberger State Anxiety Inventory, 26.66 (6.72) (range, 20-48); Spielberger Trait Anxiety Inventory, 28.09 (6.62) (range, 20-50); Perceived Stress Scale, 9.27 (5.13) (range, 1-25); and Edinburgh Postnatal Depression Scale 3.24 (2.84) (range, 0-14). Prenatal maternal anxiety scores measured using the Spielberger Trait and State Anxiety Inventories were associated with differences in fetal connectivity (Spielberger State Anxiety Inventory: pseudo-R2 = 0.019, P = .04; Spielberger Trait Anxiety Inventory: pseudo-R2 = 0.021, P = .007). Interhemispheric connections, such as those involving the parietofrontal and occipital association cortices, were associated with reduced maternal prenatal anxiety, and those between the brainstem and sensorimotor areas were associated with higher anxiety scores. CONCLUSIONS AND RELEVANCE In this cohort study, an association was found between prenatal maternal anxiety and disturbances in fetal brain functional connectivity, suggesting altered fetal programming. Early onset of functional deviations suggests the need for more widespread screening of pregnant women for symptoms of anxiety.
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Affiliation(s)
| | | | - Li Zhao
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | - Kushal Kapse
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | | | - Jessica Quistorff
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | - Catherine Lopez
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | - Catherine Limperopoulos
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
- Department of Pediatrics, The George Washington University School of Medicine, Washington DC
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91
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Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord 2020; 277:5-13. [PMID: 32777604 PMCID: PMC7395614 DOI: 10.1016/j.jad.2020.07.126] [Citation(s) in RCA: 515] [Impact Index Per Article: 128.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Anxiety and depression symptoms in pregnancy typically affect between 10 and 25% of pregnant individuals. Elevated symptoms of depression and anxiety are associated with increased risk of preterm birth, postpartum depression, and behavioural difficulties in children. The current COVID-19 pandemic is a unique stressor with potentially wide-ranging consequences for pregnancy and beyond. METHODS We assessed symptoms of anxiety and depression among pregnant individuals during the current COVID-19 pandemic and determined factors that were associated with psychological distress. 1987 pregnant participants in Canada were surveyed in April 2020. The assessment included questions about COVID-19-related stress and standardized measures of depression, anxiety, pregnancy-related anxiety, and social support. RESULTS We found substantially elevated anxiety and depression symptoms compared to similar pre-pandemic pregnancy cohorts, with 37% reporting clinically relevant symptoms of depression and 57% reporting clinically relevant symptoms of anxiety. Higher symptoms of depression and anxiety were associated with more concern about threats of COVID-19 to the life of the mother and baby, as well as concerns about not getting the necessary prenatal care, relationship strain, and social isolation due to the COVID-19 pandemic. Higher levels of perceived social support and support effectiveness, as well as more physical activity, were associated with lower psychological symptoms. CONCLUSION This study shows concerningly elevated symptoms of anxiety and depression among pregnant individuals during the COVID-19 pandemic, that may have long-term impacts on their children. Potential protective factors include increased social support and exercise, as these were associated with lower symptoms and thus may help mitigate long-term negative outcomes.
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Affiliation(s)
- Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada; Hotchkiss Brain Institute, University of Calgary, Canada.
| | - Anna MacKinnon
- Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada,Department of Psychology, University of Calgary, Canada
| | - Mercedes Bagshawe
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada,Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada,Hotchkiss Brain Institute, University of Calgary, Canada
| | - Lianne Tomfohr-Madsen
- Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada,Department of Psychology, University of Calgary, Canada,Department of Pediatrics, University of Calgary, Canada
| | - Gerald Giesbrecht
- Alberta Children's Hospital Research Institute, University of Calgary, 28 Oki Drive, Alberta T3B 6A8, Canada,Department of Psychology, University of Calgary, Canada,Department of Pediatrics, University of Calgary, Canada
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92
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Yan H, Ding Y, Guo W. Mental Health of Pregnant and Postpartum Women During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis. Front Psychol 2020; 11:617001. [PMID: 33324308 PMCID: PMC7723850 DOI: 10.3389/fpsyg.2020.617001] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/04/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Prenatal and postnatal mental disorders can exert severe adverse influences on mothers, fetuses, and children. However, the effect of the coronavirus disease 2019 (COVID-19) pandemic on the mental health of pregnant and postpartum women remains unclear. Methods: Relevant studies that were published from January 1, 2019 to September 19, 2020 were identified through the systematic search of the PubMed, EMBASE, and Web of Science databases. Quality assessment of included studies, random-effects meta-analysis, sensitivity analysis, and planned subgroup analysis were performed. Results: A total of 23 studies conducted with 20,569 participants during the COVID-19 pandemic and with 3,677 pregnant women before the COVID-19 pandemic were included. The prevalence rates of anxiety, depression, psychological distress, and insomnia among pregnant women during the COVID-19 pandemic were 37% (95% confidence interval [CI] 25-49%), 31% (95% CI 20-42%), 70% (95% CI 60-79%), and 49% (95% CI 46-52%), respectively. The prevalence of postpartum depression was 22% (95% CI 15-29%). Multigravida women and women in the first and third trimesters of pregnancy were more vulnerable than other pregnant women. The assessment of the associations between the COVID-19 pandemic and mental health problems revealed that the pooled relative risks of anxiety and depression in pregnant women were 1.65 (95% CI: 1.25-2.19) and 1.08 (95% CI: 0.80-1.46), respectively. Conclusions: The prevalence rates of mental disorders among pregnant and postpartum women during the COVID-19 pandemic were high. Timely and tailored interventions should be applied to mitigate mental problems among this population of women, especially multigravida women and women in the first and third trimesters of pregnancy.
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Affiliation(s)
- Haohao Yan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yudan Ding
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
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Clinical and Obstetric Risk Factors for Postnatal Depression in HIV Positive Women: A Cross Sectional Study in Health Facilities in Rural KwaZulu-Natal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228425. [PMID: 33202528 PMCID: PMC7697934 DOI: 10.3390/ijerph17228425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
Postnatal depression (PND) remains underdiagnosed and undertreated in different socio-economic backgrounds in South Africa. This study determined the prevalence of and clinical and obstetric risk factors for PND symptoms among HIV positive women in health facilities in a rural health district in South Africa. The Edinburgh Postnatal Depression Scale was used to measure PND from 386 women who had delivered a live infant. More than half (58.5%) tested HIV positive during the current pregnancy. The prevalence of PND symptoms was 42.5%. Logistic regression analysis yielded significant associations between clinical and obstetric variables of pre-term baby (p-value < 0.01), baby health status p-value < 0.01), baby hospitalization, (p-value < 0.01), and knowing the baby’s HIV status (p-value = 0.047). Maternal variables associated with PND were level of education (p-value < 0.01), monthly income (p-value < 0.01), and source of income (p-value = 0.05). At multivariate analysis, none of the clinical and obstetrical risk factors were independently associated with the PND. The high prevalence of PND symptoms underscore the need to integrate routine screening for PND in prevention of mother to child transmission of HIV programmes to enable early diagnosing and treatment of PND.
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H A, Jj T, Nm S, N H, O R, Ti L, J P, V S, R P, T L, L K, H K. Prenatal maternal depressive symptoms are associated with smaller amygdalar volumes of four-year-old children. Psychiatry Res Neuroimaging 2020; 304:111153. [PMID: 32771833 DOI: 10.1016/j.pscychresns.2020.111153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
Prenatal maternal depressive symptoms are related to an increased offspring susceptibility to psychiatric disorders over the life course. Alterations in fetal brain development might partly mediate this association. The relation of prenatal depressive symptoms with child's amygdalar volumes is still underexplored, and this study aimed to address this gap. We explored the association of prenatal maternal depressive symptoms with amygdalar volumes in 28 4-year-old children (14 female). Amygdalar volumes were assessed using the volBrain pipeline and manual segmentation. Prenatal depressive symptoms were self-reported by mothers at gestational weeks 14, 24 and 34 (Edinburgh Postnatal Depression Scale). Sex differences were probed, and possible pre- and postnatal confounders, such as maternal general anxiety, were controlled for. We observed that elevated depressive symptoms of the early second trimester, after controlling for prenatal maternal general anxiety, were significantly related to smaller right amygdalar volumes in the whole sample. Higher depressive symptoms of the third trimester were associated with significantly smaller right amygdalar volumes in boys compared to girls. Altogether, our data suggest that offspring limbic brain development might be affected by maternal depressive symptoms in early pregnancy, and might also be more vulnerable to depressive symptoms in late pregnancy in boys compared to girls.
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Affiliation(s)
- Acosta H
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry and Psychotherapy, Philipps University of Marburg, Rudolf-Bultmann-St. 8, 35039, Marburg, Germany.
| | - Tuulari Jj
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Turku Collegium for Science and Medicine, University of Turku, Turku, Finland; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Scheinin Nm
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.
| | - Hashempour N
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Rajasilta O
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Lavonius Ti
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Pelto J
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Saunavaara V
- Department of Medical Physics, Turku University Hospital, Turku, Finland; Turku PET Center, University of Turku and Turku University Hospital, Turku, Finland
| | - Parkkola R
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Lähdesmäki T
- Department of Pediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - Karlsson L
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Karlsson H
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Ross KM, Letourneau N, Climie E, Giesbrecht G, Dewey D. Perinatal Maternal Anxiety and Depressive Symptoms and Child Executive Function and Attention at Two-years of Age. Dev Neuropsychol 2020; 45:380-395. [PMID: 33081504 DOI: 10.1080/87565641.2020.1838525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective was to investigate whether perinatal maternal anxiety and depressive symptoms predicted child attention and executive function (EF). Mothers (N = 614) reported pregnancy and three-months postnatal anxiety and depressive symptoms. Attention and EF were measured at two-years-of-age. Covariates were demographics, alcohol use, mood disorder history, and pregnancy factors. Higher prenatal anxiety, b(SE) =.020(.005), p<.001, and postnatal depressive symptoms, b(SE) =.009(.004), p=.04, predicted poorer child attention. A prenatal-by-postnatal depressive symptom interaction emerged, b(SE) = -.005(.003), p=.04: When pregnancy depressive symptoms were low, higher postnatal symptoms predicted poorer attention. No distress variables predicted EF, p's>.22. Perinatal distress timing, kind, and change were important for child attention.
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Affiliation(s)
- Kharah M Ross
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Nicole Letourneau
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Emma Climie
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Gerald Giesbrecht
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Deborah Dewey
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
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96
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Franke K, Van den Bergh BRH, de Rooij SR, Kroegel N, Nathanielsz PW, Rakers F, Roseboom TJ, Witte OW, Schwab M. Effects of maternal stress and nutrient restriction during gestation on offspring neuroanatomy in humans. Neurosci Biobehav Rev 2020; 117:5-25. [PMID: 32001273 PMCID: PMC8207653 DOI: 10.1016/j.neubiorev.2020.01.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 01/06/2023]
Abstract
Cognitive and mental health are major determinants of quality of life, allowing integration into society at all ages. Human epidemiological and animal studies indicate that in addition to genetic factors and lifestyle, prenatal environmental influences may program neuropsychiatric disorders in later life. While several human studies have examined the effects of prenatal stress and nutrient restriction on brain function and mental health in later life, potentially mediating effects of prenatal stress and nutrient restriction on offspring neuroanatomy in humans have been studied only in recent years. Based on neuroimaging and anatomical data, we comprehensively review the studies in this emerging field. We relate prenatal environmental influences to neuroanatomical abnormalities in the offspring, measured in utero and throughout life. We also assess the relationship between neuroanatomical abnormalities and cognitive and mental disorders. Timing- and gender-specific effects are considered, if reported. Our review provides evidence for adverse effects of an unfavorable prenatal environment on structural brain development that may contribute to the risk for cognitive, behavioral and mental health problems throughout life.
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Affiliation(s)
- Katja Franke
- Department of Neurology, Jena University Hospital, Jena, Germany.
| | - Bea R H Van den Bergh
- Research Group on Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Department for Welfare, Public Health and Family, Flemish Government, Brussels, Belgium
| | - Susanne R de Rooij
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands
| | - Nasim Kroegel
- Department of Neurology, Jena University Hospital, Jena, Germany; acatech - National Academy of Science and Engineering, Berlin, Germany
| | - Peter W Nathanielsz
- Texas Pregnancy & Life Course Health Research Center, Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, United States; Dept. of Animal Science, University of Wyoming, Laramie, WY, United States
| | - Florian Rakers
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Tessa J Roseboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands
| | - Otto W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Matthias Schwab
- Department of Neurology, Jena University Hospital, Jena, Germany
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97
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Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neurosci Biobehav Rev 2020; 117:26-64. [DOI: 10.1016/j.neubiorev.2017.07.003] [Citation(s) in RCA: 438] [Impact Index Per Article: 109.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 04/09/2017] [Accepted: 07/11/2017] [Indexed: 01/17/2023]
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98
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VanderWall R, Haefner J, Wehbe-Alamah H. Use of an educational intervention to increase screening for antenatal depression in an obstetrics and gynecology practice. J Am Assoc Nurse Pract 2020; 33:1093-1099. [PMID: 32976252 DOI: 10.1097/jxx.0000000000000494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Depression affects approximately 12% of pregnant women and increases maternal and fetal risk during pregnancy and the postpartum period. The United States Preventative Services Task Force and the American College of Obstetricians and Gynecologists recommend that all prenatal care include depression screening. This study assessed the effectiveness of an educational intervention to increase screening for depression during prenatal care. LOCAL PROBLEM The clinical site serves a socioeconomically and culturally high-risk population. Prior to the intervention, prenatal depression screening was not incorporated into prenatal care. METHODS Health records of patients presenting for prenatal care to an obstetrics and gynecology clinic were analyzed before an educational intervention on prenatal depression was delivered to providers at the practice site. Data for prenatal depression screening rates, treatment plans, and patient demographic information were extracted and compared to determine compliance with antenatal depression screening guidelines. INTERVENTIONS The primary intervention of this initiative is the provision of education on the importance of and techniques for prenatal depression screening, diagnosis, and treatment. RESULTS Prenatal depression screening increased from 0% to 27% of patients following the intervention. No significant correlation was found between factors of age, gestational age, gravidity, parity, or marital status. A total of 2.8% of screened patients scored positive for severe depression, 5.7% indicated moderate depression, and 51% indicated mild depression. CONCLUSIONS Education and training improves provision of prenatal depression screening, but further work is needed to improve the accurate and timely identification of depression, as well as its appropriate treatment, referral, and follow-up.
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Affiliation(s)
- Rachel VanderWall
- University of Michigan-Flint, Flint, Michigan. Dr. VanderWall is now at the Jamesfield Drive, Hudsonville, Michigan
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99
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Graham RM, Jiang L, McCorkle G, Bellando BJ, Sorensen ST, Glasier CM, Ramakrishnaiah RH, Rowell AC, Coker JL, Ou X. Maternal Anxiety and Depression during Late Pregnancy and Newborn Brain White Matter Development. AJNR Am J Neuroradiol 2020; 41:1908-1915. [PMID: 32912873 DOI: 10.3174/ajnr.a6759] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/06/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE Anxiety and depression during pregnancy have been associated with an increased risk of adverse neurodevelopmental outcomes in offspring. We aimed to study the in utero effects of maternal anxiety and depression on early brain development. MATERIALS AND METHODS Pregnant women were recruited at ∼36 weeks of gestation for this prospective study. They were assessed for anxiety symptoms by the State-Trait Anxiety Inventory and for depression symptoms by the Beck Depression Inventory, 2nd Edition. After delivery, infant underwent an MR imaging examination of the brain without sedation, including DTI, for evaluation of white matter (WM) development. Infant fractional anisotropy values, a putative marker of WM integrity, were correlated with the mothers' State-Trait Anxiety Inventory and Beck Depression Inventory scores by using both tract-based spatial statistics and ROI methods. RESULTS Thirty-four infants were included in this study. Both maternal State-Anxiety and Trait-Anxiety scores negatively correlated (P < .05, corrected) with fractional anisotropy values in widespread brain WM regions; Beck Depression Inventory scores also negatively correlated (P < .05) with fractional anisotropy values in one cluster in the brain. Further ROI analyses confirmed significant negative correlations between average fractional anisotropy values in ROIs including left and right prefrontal WM, left and right middle frontal gyrus WM, and the fornix, and State-Anxiety (R values, -0.47 to -0.67; P values, .008 to <.001), Trait-Anxiety (R, -0.37 to -0.59; P, .04 to <.001), and Beck Depression Inventory (R values, -0.36 to -0.55; P, .05 to .002) scores. CONCLUSIONS Higher maternal anxiety and depression symptom scores during late pregnancy were associated with lower estimated infant brain WM development, which indicated in utero influences of maternal mental health during pregnancy on the developing brain.
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Affiliation(s)
- R M Graham
- From the Departments of Radiology (R.M.G., L.J., C.M.G., R.H.R., A.C.R., X.O.)
| | - L Jiang
- From the Departments of Radiology (R.M.G., L.J., C.M.G., R.H.R., A.C.R., X.O.)
| | - G McCorkle
- Arkansas Children's Nutrition Center (G.M., X.O.), Little Rock, Arkansas
| | - B J Bellando
- Pediatrics (B.J.B., S.T.S., C.M.G., R.H.R., X.O.)
| | - S T Sorensen
- Pediatrics (B.J.B., S.T.S., C.M.G., R.H.R., X.O.)
| | - C M Glasier
- From the Departments of Radiology (R.M.G., L.J., C.M.G., R.H.R., A.C.R., X.O.).,Pediatrics (B.J.B., S.T.S., C.M.G., R.H.R., X.O.)
| | - R H Ramakrishnaiah
- From the Departments of Radiology (R.M.G., L.J., C.M.G., R.H.R., A.C.R., X.O.).,Pediatrics (B.J.B., S.T.S., C.M.G., R.H.R., X.O.)
| | - A C Rowell
- From the Departments of Radiology (R.M.G., L.J., C.M.G., R.H.R., A.C.R., X.O.)
| | - J L Coker
- Psychiatry, and Obstetrics and Gynecology (J.L.C.), University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - X Ou
- From the Departments of Radiology (R.M.G., L.J., C.M.G., R.H.R., A.C.R., X.O.) .,Pediatrics (B.J.B., S.T.S., C.M.G., R.H.R., X.O.).,Arkansas Children's Nutrition Center (G.M., X.O.), Little Rock, Arkansas.,Arkansas Children's Research Institute (X.O.), Little Rock, Arkansas
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100
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Seiiedi-Biarag L, Mirghafourvand M, Ghanbari-Homayi S. The effect of cognitive-behavioral therapy on psychological distress in the mothers of preterm infants: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2020; 41:167-176. [PMID: 31619096 DOI: 10.1080/0167482x.2019.1678019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Introduction: The birth of a preterm infant has the potential to cause stress, anxiety, depression and Post-Traumatic Stress Disorder (PTSD) in mothers. Numerous interventions have been developed for the parents of preterm infants to deal with these problems. Cognitive-Behavioral Therapy (CBT) is a client-centered intervention for improving mental health and alleviating psychological distress by transforming unconstructive thoughts and behaviors. The present systematic review was conducted to evaluate the effect of CBT on anxiety, depression and PTSD (the primary outcomes) and stress (the secondary outcome) in the mothers of preterm infants.Methods: A search was carried out of all the articles published by 30 Sep. 2018 in English and Persian databases including Medline (via PubMed), Scopus, Embase (via Ovid), Web of Science, Psycinfo, Google Scholar, SID, Magiran and Iran Medex. The risk of bias was assessed for the studies based on the Cochrane Handbook. The meta-analysis results were reported as Standardized Mean Difference (SMD). The heterogeneity of the studies was examined using I2, T2 and Chi2.Results: Four clinical trials on 455 mothers with preterm infants were systematically reviewed. The meta-analysis results revealed a lower mean depression score in the CBT group compared to the controls (SMD = -0.45; 95% CI: -0.98 to 0.08), but this difference was not statistically significant (p = .09). The mean scores of PTSD (MD = -11.69; 95% CI: -19.45 to -3.94; p = .003) and anxiety (SMD = -0.38; 95% CI: -0.61 to -0.15; p = .001) were significantly lower in the CBT group too.Conclusion: CBT was effective in decreasing the level of PTSD and anxiety in the mothers of preterm infants. Due to the small number of included studies and the small sample size, clinical trials with large sample sizes and a low risk of bias are recommended to provide evidence for the implementation of interventions affecting psychological distress in the mothers of preterm infants in clinical settings.
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Affiliation(s)
- Leila Seiiedi-Biarag
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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