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Zhang L, Huang R, Lei J, Liu Y, Liu D. Factors associated with stress among pregnant women with a second child in Hunan province under China's two-child policy: a mixed-method study. BMC Psychiatry 2024; 24:157. [PMID: 38388417 PMCID: PMC10885516 DOI: 10.1186/s12888-024-05604-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/10/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE The purpose of the study was to investigate the status of pregnancy stress and to explore factors associated with pregnancy stress among women by China's two-child policy. METHODS A mixed-method study involving both quantitative and qualitative methods was conducted using questionnaires and semi-structured interviews. The questionnaires encompassed socio-demographic and obstetric characteristics, as well as the Pregnancy Stress Rating Scale (PSRS) and the Social Support Rating Scale (SSRS). Initially, the participants were required to complete the questionnaires, enabling us to assess their respective pregnancy stress statuses. Subsequently, we selectively interviewed pregnant women with a second child and exhibited at least mild pregnancy stress. The qualitative study sought to uncover the factors contributing to their stress during pregnancy. RESULTS A total of 463 subjects were enrolled; of the subjects, 22 (4.8%) had no stress, 407 (87.9%) had mild stress, 34 (7.3%) had moderate stress. Generalized linear regression analysis revealed significant factors (P<0.05) related to pregnancy stress, including family financial burden, subjective support, fertility desire, gender of the first child, and gender preference. Additionally, 16 subjects were interviewed, and through analysis, three major themes emerged, each comprising 12 sub-themes associated with pregnancy stress. These themes were identified as fertility factors (worry about maternal and child health, birth experience, and parenting stress), family factors ( financial burden, second child care problems, first child's acceptance of the second child, family concerns, fertility desire, and gender preference) and social factors (involving life events, career development and workload). CONCLUSION The diver factors contribute to pregnancy stress among pregnant women under China's two-child policy. Our study could be used to develop appropriate interventions to reduce pregnancy stress and to enhance the mental health of women pregnant with a second child.
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Affiliation(s)
- Lijuan Zhang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, 410013, Changsha, Hunan, China
- Nursing Department, The Third Xiangya Hospital, Central South University, 410013, Changsha, Hunan, China
| | - Ruirui Huang
- School of Nursing, Hunan University of Medicine, Huaihua, Hunan, China.
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital, Central South University, 410013, Changsha, Hunan, China.
| | - Yongrong Liu
- Department of Operating room, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dan Liu
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Ormsby SM, Dahlen HG, Smith CA. Investigation of Hypothalamic Pituitary Adrenal Axis and Oxytocinergic System Changes in a Pragmatic Randomized Controlled Feasibility Trial of Acupuncture for Antenatal Depression. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:173-184. [PMID: 37566543 DOI: 10.1089/jicm.2023.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Background: Antenatal depression is common and associated with detrimental impacts on women and their families. Disrupted neuroendocrine functioning is reported in women experiencing perinatal mental health disturbances. Preliminary randomized controlled trial (RCT) evidence suggests acupuncture may provide a safe and effective adjunct treatment; however, underlying mechanisms of effect are unclear. We conducted an RCT examination of acupuncture for the management of antenatal depressive symptomologies, which included oxytocinergic and hypothalamic pituitary adrenal (HPA) axis system evaluations. This article reports postintervention changes to cortisol: dehydroepiandrosterone (DHEA) ratios, and oxytocin (OT) hormone concentrations. Methods: Fifty-seven women with Edinburgh Postnatal Depression Scale (EPDS) scores ≥13 were randomized to receive individually tailored depressed specific acupuncture, progressive muscle relaxation (PMR) attention comparator, or treatment as usual (TAU). Weekly 1-h sessions were conducted for 8 weeks (24-31 of pregnancy). Preintervention and postintervention saliva samples were collected. Results: Postintervention mean cortisol: DHEA ratio differences were not significantly predicted by group allocation (n = 46, p = 0.065). Two-group comparisons demonstrated cortisol: DHEA ratios were significantly increased and predicted by group allocation when acupuncture was compared to TAU (p = 0.039); however, not between acupuncture and PMR (p = 0.179), or PMR and TAU (p = 0.421). Postintervention OT concentrations were not significantly predicted by group allocation. Limitations: Small sample size and posthoc analysis Conclusion: Findings suggest positive regulation of the HPA axis may be an underlying mechanism by which acupuncture provided the significant improvements to antenatal depression, stress, and distress observed in this cohort. Trial Registration: Registered on March 19, 2015, with the Australian New Zealand Clinical Trials Registry (ACTRN12615000250538).
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Affiliation(s)
- Simone M Ormsby
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
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3
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Pinto TM, Nogueira-Silva C, Figueiredo B. Fetal heart rate variability and infant self-regulation: the impact of mother's prenatal depressive symptoms. J Reprod Infant Psychol 2023:1-14. [PMID: 37726914 DOI: 10.1080/02646838.2023.2257730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Foetal heart rate (FHR) variability is considered a marker of foetal neurobehavioral development associated with infant self-regulation and thus may be an early precursor of the adverse impact of mother's prenatal depressive symptoms on infant self-regulation. OBJECTIVE This study analysed the mediator role of FHR variability in the association between mother's prenatal depressive symptoms and infant self-regulation at three months. METHODS The sample comprised 86 first-born infants and their mothers. Mothers reported on depressive symptoms at the first trimester of pregnancy and on depressive symptoms and infant self-regulation at three months postpartum. FHR variability was recorded during routine cardiotocography at the third trimester of pregnancy. A mediation model was tested, adjusting for mother's postnatal depressive symptoms. RESULTS Higher levels of mother's prenatal depressive symptoms were associated with both lower FHR variability and lower infant self-regulation at three months. FHR variability was associated with infant self-regulation and mediated the association between mother's prenatal depressive symptoms and infant self-regulation at three months. CONCLUSION Findings suggested FHR variability as an early precursor of infant self-regulation that underlies the association between mother's prenatal depressive symptoms and infant self-regulation. Infants of mothers with higher levels of prenatal depressive symptoms could be at risk of self-regulation problems, partially due to their lower FHR variability.
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Affiliation(s)
- Tiago Miguel Pinto
- School of Psychology, University of Minho, Braga, Portugal
- HEI-Lab, Digital Human-Environment Interaction Lab, Lusófona University, Porto, Portugal
| | - Cristina Nogueira-Silva
- Department of Obstetrics and Gynecology, Hospital de Braga, Braga, Portugal
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Lu WT, Zhao XC, Wang R, Li N, Song M, Wang L, Yu LL, Gao YY, Wang YM, An CX, Wang XY. Long-term effects of early stress due to earthquake exposure on depression symptoms in adulthood: a cross-sectional study. Injury 2023; 54:207-213. [PMID: 35989117 DOI: 10.1016/j.injury.2022.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed to investigate the long-term effects of early stress by Tangshan earthquake on symptoms of depression in adulthood. METHOD A total of 1534 volunteers born and raised in Tangshan were investigated; finally, 1328 subjects were enrolled in the study. They were divided into three groups according to their birth dates: infant exposure, prenatal exposure, and non-exposure. The questionnaires and psychological evaluation of all subjects were completed using a one-on-one psychological test. RESULTS The rate of depressive symptoms in the prenatal exposure group was the highest, and the lowest in the non-exposure group, with statistical differences among the three groups (P = 0.002). Moreover, the incidences of depressed mood, suicide ideation and work and loss of interest in the prenatal exposure group were significantly higher than those in the infant exposure group and the non-exposure group (P = 0.008, P = 0.001, P = 0.038, respectively). Multiple logistic regression analysis showed that male could be a protective factor for symptoms of depression in adulthood, and earthquake exposure was an important predictor of the incidence of depression symptoms. CONCLUSIONS Fetal or infancy exposure to earthquake might correlate to depression symptoms in adulthood.
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Affiliation(s)
- Wen-Ting Lu
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xiao-Chuan Zhao
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ran Wang
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Na Li
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Mei Song
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lan Wang
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Lu-Lu Yu
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuan-Yuan Gao
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yu-Mei Wang
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Cui-Xia An
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Xue-Yi Wang
- Institute of Mental Health, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
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5
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Houdelier C, Charrier M, Le Bot O, Aigueperse N, Marasco V, Lumineau S. The presence of a mother counteracts prenatal stress in a precocial bird. Anim Behav 2022. [DOI: 10.1016/j.anbehav.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kamgang VW, Bennett NC, van der Goot AC, Majelantle TL, Ganswindt A. Patterns of faecal glucocorticoid metabolite levels in captive roan antelope (Hippotragus equinus) in relation to reproductive status and season. Gen Comp Endocrinol 2022; 325:114052. [PMID: 35568230 DOI: 10.1016/j.ygcen.2022.114052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 02/19/2022] [Accepted: 05/07/2022] [Indexed: 11/18/2022]
Abstract
Populations of roan antelope (Hippotragus equinus) in southern Africa have experienced a drastic decline over the past few decades and this situation has led to the development of intensive breeding programmes to support conservation efforts. However, little is known about related welfare aspects, including stress-related physiological biomarkers. The present study set out to establish a non-invasive method to monitor faecal glucocorticoid metabolite (fGCM) concentrations as a measure of stress and determine fGCM concentrations in relation to male reproductive activity and female reproductive status in the roan antelope. An adrenocorticotrophic hormone challenge was performed using two adult roan antelope (one male and one female) at Lapalala Wilderness Nature Reserve, South Africa, to determine the suitability of five enzyme immunoassays (EIA) for monitoring adrenocortical function in roan antelope. An 11-oxoaetiocholanolone I EIA detecting 11,17 dioxoandrostanes performed best showing 17-20 folds increases in fGCM concentrations after 12 h-17 h post-injection. The identified EIA was then used to monitor fGCM concentrations during active and non-active reproductive periods in males (n = 3), and during periods of cyclicity, gestation, and postpartum in females (n = 10). Males showed an overall 80% increase in fGCM concentrations when reproductively active and females showed a progressively significant increase in fGCM levels throughout pregnancy, with overall fGCM concentrations being 1.5 to 2.6-fold higher than the respective fGCM concentrations during periods of postpartum and cyclicity, respectively. Furthermore, fGCM concentrations remained above baseline for up to 21 days post-partum. A correlation between ecological parameters (rainfall and temperature) and fGCM concentrations revealed elevated fGCM concentrations during the dry season for males, but not females. The non-invasive method validated in this study provides a valuable tool to quantify stress-related biomarkers in roan antelope, and findings can be used to support management decisions in conservation breeding facilities.
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Affiliation(s)
- Vanessa W Kamgang
- Mammal Research Institute, Department of Zoology and Entomology, University of Pretoria, Hatfield 0028, South Africa.
| | - Nigel C Bennett
- Mammal Research Institute, Department of Zoology and Entomology, University of Pretoria, Hatfield 0028, South Africa
| | - Annemieke C van der Goot
- Lapalala Wilderness Nature Reserve, Vaalwater 0530, South Africa; Melkrivier Wildlife Veterinary Services, Melkrivier, Vaalwater 0530, South Africa
| | - Tshepiso L Majelantle
- Mammal Research Institute, Department of Zoology and Entomology, University of Pretoria, Hatfield 0028, South Africa
| | - Andre Ganswindt
- Mammal Research Institute, Department of Zoology and Entomology, University of Pretoria, Hatfield 0028, South Africa
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Rudd KL, Cheng SS, Cordeiro A, Coccia M, Karr CJ, LeWinn KZ, Mason WA, Trasande L, Nguyen RHN, Sathyanarayana S, Swan SH, Barrett ES, Bush NR. Associations Between Maternal Stressful Life Events and Perceived Distress during Pregnancy and Child Mental Health at Age 4. Res Child Adolesc Psychopathol 2022; 50:977-986. [PMID: 35258749 PMCID: PMC9395496 DOI: 10.1007/s10802-022-00911-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 11/26/2022]
Abstract
Accumulating evidence suggests that maternal exposure to objectively stressful events and subjective distress during pregnancy may have intergenerational impacts on children's mental health, yet evidence is limited. In a multisite longitudinal cohort (N = 454), we used multi-variable linear regression models to evaluate the predictive value of exposure to stressful events and perceived distress in pregnancy for children's internalizing problems, externalizing problems, and adaptive skills at age 4. We also explored two- and three-way interactions between stressful events, distress, and child sex. Both objective and subjective maternal stress independently predicted children's behavior, with more stressful events and higher distress predicting more internalizing and externalizing problems and worse adaptability; stress types did not significantly interact. There was some evidence that more stressful events predicted higher externalizing behaviors only for girls. Three-way interactions were not significant. The current findings highlight the importance of considering the type of stress measurement being used (e.g., counts of objective event exposure or subjective perceptions), suggest prenatal stress effects may be transdiagnostic, and meet calls for rigor and reproducibility by confirming these independent main effects in a relatively large group of families across multiple U.S. regions. Results point to adversity prevention having a two-generation impact and that pre- and postnatal family-focused intervention targets may help curb the rising rates of children's mental health problems.
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Affiliation(s)
- Kristen L. Rudd
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
| | - Sylvia S. Cheng
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
| | - Alana Cordeiro
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
| | - Michael Coccia
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
| | | | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
- Weill Institute of Neuroscience, University of California San Francisco, San Francisco, CA USA
| | - W. Alex Mason
- Department of Preventative Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Langone Medical Center, New Yok, NY USA
- Departments of Population Health and Environmental Medicine, New York University, New York, NY USA
| | - Ruby H. N. Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN USA
| | | | - Shanna H. Swan
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, NJ USA
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA USA
- Weill Institute of Neuroscience, University of California San Francisco, San Francisco, CA USA
- Department of Pediatrics, University of California San Francisco, CA San Francisco, USA
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8
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Dahlen HG, Schmied V, Fowler C, Peters LL, Ormsby S, Thornton C. Characteristics and co-admissions of mothers and babies admitted to residential parenting services in the year following birth in NSW: a linked population data study (2000-2012). BMC Pregnancy Childbirth 2022; 22:428. [PMID: 35597917 PMCID: PMC9123292 DOI: 10.1186/s12884-022-04736-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background There is a tiered healthcare system in Australia to support maternal and child health, including, non-psychiatric day stay and residential parenting services (RPS) such as Tresillian and Karitane (in New South Wales [NSW]). RPS are unique to Australia, and currently there is limited information regarding the healthcare trajectory of women accessing RPS and if they are more likely to have admissions to other health facilities within the first-year post-birth. This study aimed to examine differences in hospital co-admissions for women and babies admitted to RPS in NSW in the year following birth compared to non-RPS admitted women. Methods A linked population data study of all women giving birth in NSW 2000–2012. Statistical differences were calculated using chi-square and student t-tests. Results Over the 12-year timeframe, 32,071 women and 33,035 babies were admitted to RPS, with 5191 of these women also having one or more hospital admissions (7607 admissions). The comparator group comprised of 99,242 women not admitted to RPS but having hospital admissions over the same timeframe (136,771 admissions). Statistically significant differences between cohorts were observed for the following parameters (p ≤ .001). Based upon calculated percentages, women who were admitted to RPS were more often older, Australian born, socially advantaged, private patients, and having their first baby. RPS admitted women also had more multiple births and labour and birth interventions (induction, instrumental birth, caesarean section, epidural, episiotomy). Their infants were also more often male and admitted to Special Care Nursery/Neonatal Intensive Care. Additionally, RPS admitted women had more admissions for mental health and behavioural disorders, which appeared to increase over time. There was no statistical difference between cohorts regarding the number of women admitted to a psychiatric facility; however, women attending RPS were more likely to have mood affective, or behavioural and personality disorder diagnoses. Conclusion Women accessing RPS in the year post-birth were more socially advantaged, had higher birth intervention and more co-admissions and treatment for mental health disorders than those not accessing RPS. More research is needed into the impact of birth intervention and mental health issues on subsequent parenting difficulties.
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Affiliation(s)
- Hannah Grace Dahlen
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Cathrine Fowler
- School of Nursing and Midwifery, University of Technology, Broadway, Sydney, NSW, 2007, Australia
| | - Lilian L Peters
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Department of Midwifery Science AVAG, Amsterdam UMC (location Vumc), Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Simone Ormsby
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Charlene Thornton
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
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Duan KM, Fang C, Yang SQ, Yang ST, Xiao JD, Chang H, Lin GX, Zhang LB, Peng MC, Liu ZQ, Wang SY. Genetic Polymorphism of rs13306146 Affects α2AAR Expression and Associated With Postpartum Depressive Symptoms in Chinese Women Who Received Cesarean Section. Front Genet 2021; 12:675386. [PMID: 34306020 PMCID: PMC8294467 DOI: 10.3389/fgene.2021.675386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/17/2021] [Indexed: 01/20/2023] Open
Abstract
Postpartum depressive symptom (PDS) is a common psychological and mental disorder after giving birth. Our previous studies showing the application of dexmedetomidine, an α2-AR agonist, can significantly improve maternal sleep, as well as relieve and reduce the incidence of PDS. This study investigated the association between α2 A AR gene polymorphisms and PDS. A total of 568 cesarean section patients were enrolled; the incidence of PDS is 18.13% (103 with PDS, 465 with non-PDS). The Edinburgh Postpartum Depression Scale score ≥10 was used to diagnose PDS at 42 days after delivery. The single-nucleotide polymorphisms of α2AR were sequenced by pyrosequencing. The effect of rs13306146 A > G polymorphism on α2AR transcription and the regulation of miR-646 on α2AR expression were assessed by dual luciferase reporter assays or gene transfection. Increased stress during pregnancy, poor relationship between mother-in-law and daughter-in-law, spousal relationship, domestic violence, antenatal depression, self-harm ideation, and stressful life events were all associated with increased PDS incidence (p < 0.05). The logistic regression analysis found that the α2AAR rs13306146 polymorphism was associated with PDS after adjusting confounding variables. The transcriptional function of the α2AAR rs13306146 A allele was decreased compared with the G allele, and the α2AAR expression level was correspondingly decreased (p < 0.05), as the strongest binding ability of miR-646 to the α2AAR rs13306146 AA genotype. The effect of α2AAR rs13306146 A > G polymorphism may change the binding ability of miR-646 at the 3'UTR of the α2AAR gene, affecting the expression of α2AAR. This study supports the involvement of the norepinephrine system in the pathogenesis of PDS. Genotypes of α2AAR may be novel and useful biomarkers for PDS.
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Affiliation(s)
- Kai Ming Duan
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Chao Fang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China.,Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Si Qi Yang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Shu Ting Yang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Ji Dong Xiao
- Department of Ultrasonography, Third Xiangya Hospital of Central South University, Changsha, China
| | - Huang Chang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Guo Xin Lin
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Liang Bin Zhang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Ming Chao Peng
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
| | - Zhao Qian Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha, China
| | - Sai Ying Wang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, China
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Kozieł S, Chakraborty R, Bose K, Ignasiak Z, Gomula A, Nowak-Szczepanska N. The effect of a natural disaster on handgrip strength in prepubertal Indian children exposed to a severe cyclone during the prenatal and early postnatal growth. Sci Rep 2021; 11:7473. [PMID: 33811238 PMCID: PMC8018953 DOI: 10.1038/s41598-021-86845-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 03/16/2021] [Indexed: 11/09/2022] Open
Abstract
Natural disasters (NDs) experienced by women and their children during prenatal and infant growth may have long-lasting effects on offspring’s development. Handgrip strength (HGS) is one of the measures of muscular strength and an indicator of health status. This study compared HGS in children exposed to cyclone Aila in India during their prenatal and infant growth compared to a control group from a non-affected, adjacent area. The total sample involved 444 boys and 423 girls aged 7–9 years, categorised into 3 groups: prenatally exposed to Aila, exposed to Aila in infancy, and the control group, non-exposed to Aila. Results revealed that prenatally exposed children of both sexes had significantly lower HGS than the controls (at least, p < 0.001 in boys; p < 0.05 in girls). On the other hand, the postnatally exposed boys, but not the girls, showed lower HGS than the controls. A significant effect of a group factor (ND exposure) on HGS was observed even after controlling for confounding variables (age, height, BMI, birth weight, gestational age; at least, p < 0.05). Our findings indicate that prenatal or early postnatal experience of a ND may have association with impaired HGS in prepubertal children.
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Affiliation(s)
- Sławomir Kozieł
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Raja Chakraborty
- Department of Anthropology, Dinabandhu Mahavidyalaya, Bongaon, West Bengal, India.
| | - Kaushik Bose
- Department of Anthropology, Vidyasagar University, Midnapore, West Bengal, India
| | - Zofia Ignasiak
- Department of Biostructure, University School of Physical Education in Wroclaw, Wroclaw, Poland
| | - Aleksandra Gomula
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Natalia Nowak-Szczepanska
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Variations in Relationships Between Perceived Stress and Birth Outcomes by Immigration Status. Matern Child Health J 2020; 24:1521-1531. [PMID: 33048312 DOI: 10.1007/s10995-020-03014-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Past research shows that stress during pregnancy predicts adverse birth outcomes. These patterns might differ based on immigration status. Our objective was to analyze differences in relationships between perceived stress during pregnancy and birth outcomes by immigration status. METHODS We recruited 81 pregnant women in Canada for a prospective longitudinal study of stress during pregnancy and infant development. Participants completed the Perceived Stress Questionnaire at 16-18, 24-26 and 32-34 weeks of pregnancy. Birth records were available for 73 women, including 24 non-immigrants, 18 long-term immigrants (≥ 5 years), and 31 recent immigrants (< 5 years). We used General Linear Models to test relationships between perceived stress and birthweight, birthweight for gestational age Z-scores, and gestational age, and differences based on immigration status. RESULTS Controlling for sociodemographic covariates, we observed interactive relationships between immigration status and perceived stress with birthweight at 16-18 (p = 0.032, partial η2 = 0.11) and 24-26 weeks pregnancy (p = 0.012, partial η2 = 0.15). Results were similar for birthweight for gestational age Z-scores at 16-18 weeks (p = 0.016, partial η2 = 0.13) and 24-26 weeks pregnancy (p = 0.013, partial η2 = 0.14). Perceived stress predicted smaller birthweight measurements among long-term immigrants. No relation was found between perceived stress, immigration status and gestational age. DISCUSSION Risk of adverse health outcomes, including birth outcomes, tends to increase with duration of residence among immigrants. Stress during pregnancy might represent one risk factor for adverse birth outcomes among long-term immigrant women. Promoting psychosocial health screening and care among immigrant women, and assuring continued care with acculturation, might improve both maternal and infant health outcomes.
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Relationships between Prenatal Distress and Infant Body Mass Index in the First Year of Life in a Lower-Middle Income Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197351. [PMID: 33050108 PMCID: PMC7579176 DOI: 10.3390/ijerph17197351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/02/2020] [Accepted: 10/04/2020] [Indexed: 11/17/2022]
Abstract
Prenatal stress affects body composition in childhood and later in life. However, few studies assess body composition in infancy. Furthermore, most are in high-income countries and do not consider interactive or curvilinear relationships. We assessed distress and diet during pregnancy via questionnaires among 310 women in Vanuatu, a lower-middle income country. We measured body mass index (BMI) among 54 infants at 4–12 months of age. We analyzed interactive relationships between prenatal distress and diet with BMI Z-scores, and curvilinear relationships between distress and BMI Z-scores. There were no direct linear or interactive relationships between prenatal distress or diet with BMI Z-scores. We observed curvilinear relationships between prenatal distress and BMI Z-scores (p = 0.008), explaining 13.3 percent of unique variance. Results highlight that relationships between prenatal stress and body composition are evident in infancy but might not be detected if only linear relationships are assessed. Analyses in more diverse samples might help to explain inconsistencies in past studies.
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Therrien AS, Buffa G, Roome AB, Standard E, Pomer A, Obed J, Taleo G, Tarivonda L, Chan CW, Kaneko A, Olszowy KM, Dancause KN. Relationships between mental health and diet during pregnancy and birth outcomes in a lower-middle income country: "Healthy mothers, healthy communities" study in Vanuatu. Am J Hum Biol 2020; 33:e23500. [PMID: 32918311 DOI: 10.1002/ajhb.23500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/15/2022] Open
Abstract
Poor maternal mental health during pregnancy is associated with adverse birth outcomes, including lower birthweight and gestational age. However, few studies assess both mental health and diet, which might have interactive effects. Furthermore, most studies are in high-income countries, though patterns might differ in low- and middle-income countries (LMICs). OBJECTIVES To analyze relationships between mental health and diet during pregnancy with birth outcomes in Vanuatu, a lower-middle income country. METHODS We assessed negative emotional symptoms of depression, anxiety, and stress (referred to as "distress") and dietary diversity during pregnancy, and infant weight and gestational age at birth, among 187 women. We used multivariate linear regression to analyze independent and interactive relationships between distress, dietary diversity, and birth outcomes, controlling for sociodemographic and maternal health covariates. RESULTS There were no direct linear relationships between dietary diversity or distress with infant birthweight or gestational age, and no curvilinear relationships between distress and infant outcomes. We observed interactive relationships between distress and dietary diversity on birthweight, explaining 2.1% of unique variance (P = .024). High levels of distress predicted lower birthweights among women with low dietary diversity. These relationships were not evident among women with moderate or high dietary diversity. CONCLUSIONS Relationships between mental health and diet might underlie inconsistencies in past studies of prenatal mental health and birthweight. Results highlight the importance of maternal mental health on birthweight in LMICs. Interactive relationships between mental health and diet might ultimately point to new intervention pathways to address the persistent problem of low birthweight in LMICs.
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Affiliation(s)
- Ann-Sophie Therrien
- Department of Physical Activity Sciences, University of Quebec in Montréal, Montreal, Quebec, Canada
| | - Giovanna Buffa
- Department of Anthropology, Binghamton University, Binghamton, New York, USA
| | - Amanda B Roome
- Bassett Research Institute, Mary Imogene Bassett Hospital, Cooperstown, New York, USA
| | - Elizabeth Standard
- Department of Anthropology, Binghamton University, Binghamton, New York, USA
| | - Alysa Pomer
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Jimmy Obed
- Ministry of Health, Port Vila, Republic of Vanuatu
| | - George Taleo
- Ministry of Health, Port Vila, Republic of Vanuatu
| | | | - Chim W Chan
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Akira Kaneko
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan.,Island Malaria Group, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Kathryn M Olszowy
- Department of Anthropology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Kelsey N Dancause
- Department of Physical Activity Sciences, University of Quebec in Montréal, Montreal, Quebec, Canada
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Stoica V, Gardan DA, Constantinescu I, Gardan IP, Calenic B, Diculescu M. Transgenerational Effects of Traumatic Historical Events on the Incidence of Metabolic Syndrome/ Nonalcoholic Fatty Liver Disease in the Romanian Population. J Med Life 2020; 13:475-483. [PMID: 33456595 PMCID: PMC7803300 DOI: 10.25122/jml-2020-0156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Concerns for successful public health management are integrated into the core business of government-responsible institutions. Diseases associated with metabolic syndrome are very common in the Romanian population. In our study, we focused on the cardiovascular and non-alcoholic fatty liver disease (NAFLD). The article starts from the hypothesis that the increased incidence of such diseases is determined today by the cumulative effect of traumatic historical events such as the famine of 1946-47 and the communist political regime specific to the 80s and 90s. This study aims to present the arguments that indicate the correlation of economic variables whose variation can be easily determined by traumatic events that affected the economy, with variables able to measure the incidence of various diseases usually associated with metabolic syndrome or NAFLD. A series of statistical data were analyzed from the official sources available in the form of consecutive value data for the 1995-2018 period. The results highlighted a direct and strong link between the variable gross domestic product (GDP) per capita in USD, 2011 purchasing power parity (PPP) and specific incidence of circulatory, nutritional endocrine and metabolic diseases, as well as a strong and inverse link between GDP and infant's deaths per 1000 live births. Conclusions highlight that the effects of traumatic historical events must be made aware through medical education of the population, supporting the idea according to which the incidence of various metabolic diseases is greater for the offspring of those who have actively suffered during such events.
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Affiliation(s)
- Victor Stoica
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy”, Bucharest, Romania,Department of Gastroenterology, Fundeni Clinical Institute, Bucharest, Romania
| | - Daniel Adrian Gardan
- Faculty of Economic Sciences, Spiru Haret University, Bucharest, Romania,* Corresponding Author: Daniel Adrian Gardan,Faculty of Economic Sciences,Spiru Haret University Phone/fax: +40721108979 E-mail:
| | - Ileana Constantinescu
- Department of Immunology and Transplant Immunology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,Center of Imunogenetics and Virusology, Fundeni Clinical Institute, Bucharest, Romania
| | | | - Bogdan Calenic
- Department of Biochemistry, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Mircea Diculescu
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy”, Bucharest, Romania,Department of Gastroenterology, Fundeni Clinical Institute, Bucharest, Romania
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Prenatal stress and child development: A scoping review of research in low- and middle-income countries. PLoS One 2018; 13:e0207235. [PMID: 30592715 PMCID: PMC6310253 DOI: 10.1371/journal.pone.0207235] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/27/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Past research has shown relationships between stress during pregnancy, and related psychosocial health measures such as anxiety and depressive symptoms, with infant, child, and adult outcomes. However, most research is from high-income countries. We conducted a scoping review to identify research studies on prenatal stress and outcomes of the pregnancy or offspring in low- and middle-income countries (LMICs), and to synthesize the stress measures and outcomes assessed, the findings observed, and directions for future research. METHODS We searched PubMed, Scopus, and PsycINFO for English-language abstracts published from Jan 1960-Jan 2017. Search terms were related to stress and psychosocial health; pregnancy; infant or child development; and LMICs. RESULTS 48 articles were identified. Sixty percent of studies were in upper-middle, 25% in lower-middle, and 15% in low income countries. Most studies used questionnaires, either existing or tailor-made, to assess stress. Eight assessed cortisol. Most studies (n = 31) assessed infant outcomes at birth, particularly gestational age or preterm birth (n = 22, 12 showing significant relationships), and birthweight (n = 21, 14 showing significant relationships). Five studies analyzed outcomes later in infancy such as temperament and motor development, all showing significant results; and nine in childhood such as behavioral development, asthma, and physical growth, with eight showing significant results. CONCLUSIONS Results highlight the importance of prenatal stress on infant and child outcomes in LMICs. Methods used in high-income countries are successfully employed in LMICs, but tailored tools remain necessary. Careful assessment of covariates is needed to foster analyses of interactive effects and pathways. Studies including longer-term follow-up should be prioritized.
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Coburn SS, Luecken LJ, Rystad IA, Lin B, Crnic KA, Gonzales NA. Prenatal Maternal Depressive Symptoms Predict Early Infant Health Concerns. Matern Child Health J 2018; 22:786-793. [PMID: 29427015 DOI: 10.1007/s10995-018-2448-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Recent research suggests that health disparities among low-SES and ethnic minority populations may originate from prenatal and early life exposures. Postpartum maternal depressive symptoms have been linked to poorer infant physical health, yet prenatal depressive symptoms not been thoroughly examined in relation to infant health. METHODS In a prospective study of low-income Mexican American mothers and their infants, women (N = 322, median age 27.23, IQR = 22.01-32.54) completed surveys during pregnancy (median gestation 39.50, IQR = 38.71-40.14 weeks) and 12 weeks after birth. We investigated (1) if prenatal depressive symptoms predicted infant physical health concerns at 12 weeks of age, (2) whether these associations occurred above and beyond concurrent depressive symptoms, and (3) if birth weight, gestational age, and breastfeeding were mediators of prenatal depression predicting subsequent infant health. RESULTS Higher prenatal depressive symptoms were associated with more infant physical health concerns at 12 weeks (p < .001), after accounting for 12-week maternal depressive symptoms, breastfeeding, gestational age, and birth weight. Twelve-week maternal depressive symptoms were concurrently associated with more infant health concerns (p < .01). Birth weight, gestational age, and breastfeeding were not associated with maternal depression or infant health concerns. DISCUSSION Results establish a link between prenatal depressive symptoms and an elevated risk of poor health evident shortly after birth. These findings underscore the importance of the prenatal period as a possible sensitive period for infants' health, and the need for effective interventions for depression during pregnancy to mitigate potentially teratogenic effects on the developing fetus and reduce risks for later health concerns.
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Affiliation(s)
- S S Coburn
- Department of Psychology, Arizona State University, Tempe, AZ, USA. .,Division of Gastroenterology, Hepatology, and Nutrition, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, USA.
| | - L J Luecken
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - I A Rystad
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - B Lin
- Department of Psychology, Arizona State University, Tempe, AZ, USA.,Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - K A Crnic
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - N A Gonzales
- Department of Psychology, Arizona State University, Tempe, AZ, USA
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Pomer A, Buffa G, Taleo F, Sizemore JH, Tokon A, Taleo G, Tarivonda L, Chan CW, Kaneko A, Dancause KN. Relationships between psychosocial distress and diet during pregnancy and infant birthweight in a lower-middle income country: ‘healthy mothers, healthy communities’ study in Vanuatu. Ann Hum Biol 2018; 45:220-228. [DOI: 10.1080/03014460.2018.1459837] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Alysa Pomer
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Giavana Buffa
- Ross University School of Medicine, Portsmouth, Dominica
| | | | | | - Apisai Tokon
- Ministry of Health, Port Vila, Republic of Vanuatu
| | - George Taleo
- Ministry of Health, Port Vila, Republic of Vanuatu
| | | | - Chim W. Chan
- Island Malaria Group, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Akira Kaneko
- Island Malaria Group, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Kelsey N. Dancause
- Départment des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
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Palmeiro-Silva YK, Orellana P, Venegas P, Monteiro L, Varas-Godoy M, Norwitz E, Rice G, Osorio E, Illanes SE. Effects of earthquake on perinatal outcomes: A Chilean register-based study. PLoS One 2018; 13:e0191340. [PMID: 29474413 PMCID: PMC5825031 DOI: 10.1371/journal.pone.0191340] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 01/03/2018] [Indexed: 12/30/2022] Open
Abstract
Background Natural disasters increase the level population stress, including pregnant women, who can experience prenatal maternal stress, affecting the fetus and triggering perinatal complications, such as low birth weight, smaller head circumference, etc. However, little is known about effects of earthquake on perinatal outcomes. Objective To evaluate the effect of earthquake occurred on February 27, 2010 and perinatal outcomes of Chilean pregnant women, and to examine these effects by timing of exposure during pregnancy and newborn gender. Methods A register-based study was performed using data collected from women who had a vaginal delivery in a large private health center in Santiago, Chile, during 2009 and 2010. The study population was categorized according to exposure to earthquake and timing during gestation. Primary perinatal outcomes were gestational age at birth, birth weight, length and head circumference. Analyses adjusted for gender, gestational age at exposure, parity, maternal age and income. Results A total of 1,966 eligible vaginal deliveries occurred during 2009 and 2,110 in 2010. Birth weight was not affected by the trimester of exposure; however, length, head circumference and gestational age at birth were significantly different according to trimester of exposure and gender of newborn. In multivariable analysis, newborns were shorter by 2 mm, 5 mm and 4.5 mm, if they were exposed during their first, second and third trimester, respectively. Furthermore, newborns had a smaller head circumference by 1.2 mm and 1.5 mm if they were exposed during first and second trimester of gestation. Conclusion In this cohort, exposure to the February 2010 earthquake resulted in earlier delivery and reduced length and head circumference in the offspring. This association varied according to trimester of exposure and fetal gender. Health workers should include exposed to high levels of stress associated with natural disasters when assessing pregnancy risk factors.
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Affiliation(s)
| | - Pelusa Orellana
- School of Education, Universidad de los Andes, Santiago, Chile
| | - Pia Venegas
- Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - Lara Monteiro
- Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | | | - Errol Norwitz
- School of Medicine, Tufts University, Boston, Massachusetts, United States of America
| | - Gregory Rice
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Eduardo Osorio
- Department of Obstetrics and Gynecology, Clinica Dávila, Santiago, Chile
| | - Sebastián E. Illanes
- Faculty of Medicine, Universidad de los Andes, Santiago, Chile
- Department of Obstetrics and Gynecology, Clinica Dávila, Santiago, Chile
- * E-mail:
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DNA methylation mediates the effect of maternal cognitive appraisal of a disaster in pregnancy on the child's C-peptide secretion in adolescence: Project Ice Storm. PLoS One 2018; 13:e0192199. [PMID: 29401509 PMCID: PMC5798828 DOI: 10.1371/journal.pone.0192199] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 01/19/2018] [Indexed: 12/31/2022] Open
Abstract
Animal and human studies suggest that prenatal exposure to stress is associated with adverse health outcomes such as type 2 diabetes. Epigenetic modification, such as DNA methylation, is considered one possible underlying mechanism. The 1998 Quebec ice storm provides a unique opportunity to study an independent prenatal stressor on child outcomes. C-peptide is the best measure of endogenous insulin secretion and is widely used in the clinical management of patients with diabetes. The objectives of this study are to determine 1) the extent to which prenatal exposure to disaster-related stress (maternal objective hardship and maternal cognitive appraisal) influences children’s C-peptide secretion, and 2) whether DNA methylation of diabetes-related genes mediates the effects of prenatal stress on C-peptide secretion. Children’s (n = 30) C-peptide secretion in response to an oral glucose tolerance test were assessed in blood at 13½ years. DNA methylation levels of selected type 1 and 2 diabetes-related genes were chosen based upon the genes associated with prenatal maternal objective hardship and/or cognitive appraisal levels. Bootstrapping analyses were performed to determine the mediation effect of DNA methylation. We found that children whose mothers experienced higher objective hardship exhibited higher C-peptide secretion. Cognitive appraisal was not directly associated with C-peptide secretion. DNA methylation of diabetes-related genes had a positive mediation effect of objective hardship on C-peptide secretion: higher objective hardship predicted higher C-peptide secretion through DNA methylation. Negative mediation effects of cognitive appraisal were observed: negative cognitive appraisal predicted higher C-peptide secretion through DNA methylation. However, only one gene, LTA, remained a significant mediator of cognitive appraisal on C-peptide secretion after the conservative Bonferroni multiple corrections. Our findings suggest that DNA methylation could act as an intervening variable between prenatal stress and metabolic outcomes, highlighting the importance of epigenetic mechanisms in response to environmental factors.
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Wang HJ, Xu X, Xie RH, Rui YY, Zhang PA, Zhu XJ, Xu GY. Prenatal maternal stress induces visceral hypersensitivity of adult rat offspring through activation of cystathionine-β-synthase signaling in primary sensory neurons. Mol Pain 2018; 14:1744806918777406. [PMID: 29712513 PMCID: PMC5967159 DOI: 10.1177/1744806918777406] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/08/2018] [Accepted: 04/20/2018] [Indexed: 12/29/2022] Open
Abstract
Irritable bowel syndrome is a disorder of unknown etiology characterized by widespread, chronic abdominal pain associated with altered bowel movements. Increasing amounts of evidence indicate that stressors presented during gestational periods could have long-term effects on the offspring's tissue structure and function, which may predispose to gastrointestinal diseases. The aim of the present study is to determine whether prenatal maternal stressis a adverse factor affecting gastrointestinal sensitivity and to investigate possible mechanisms underlying prenatal maternal stress-induced visceral hypersensitivity in adult offspring. Prenatal maternal stress was induced in pregnant Sprague-Dawley rats by exposure to heterotypic intermitent stress from gestational day 7 to delivery. Prenatal maternal stress significantly increased visceromotor response to colorectal distention in adult offspring from the age of 6 weeks to 10 weeks. Prenatal maternal stress also enhanced neuronal excitability including depolarization of resting membrane potentials, reduction in rheobase, and an increase in the number of action potentials evoked by 2× and 3× rheobase current stimultion of colon-specific dorsal root ganglion neurons. Prenatal maternal stress remarkably enhanced expression of cystathionine-β-synthase and Nav1.7 in T13-L2 thoracolumbar dorsal root ganglions both at protein and mRNA levels. Intraperitoneal injection of aminooxyacetic acid, an inhibitor of cystathionine-β-synthase, attenuated prenatal maternal stress-induced visceral hypersensitivity in a dose-dependent manner. A consecutive seven-day administration of aminooxyacetic acid reversed the hyperexcitability of colon-specific dorsal root ganglion neurons and markedly reduced Nav1.7 expression. These results indicate that the presence of multiple psychophysical stressors during pregnancy is associated with visceral hypersensitivity in offspring, which is likely mediated by an upregualtion of cystathionine-β-synthase and Nav1.7 expression. Prenatal maternal stress might be a significant contributor to irritable bowel syndrome, and cystathionine-β-synthase might be a potential target for treatment for chronic visceral hypersensitivity in patients with irritable bowel syndrome.
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Affiliation(s)
- Hong-Jun Wang
- Center for Translational Medicine, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, P. R. China
- Institute of Neuroscience, Soochow University, Soochow University, Suzhou, P. R. China
- Jiangsu Key Laboratory of Anesthesiology & Jiangsu Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou, P. R. China
| | - Xue Xu
- Institute of Neuroscience, Soochow University, Soochow University, Suzhou, P. R. China
| | - Rui-Hua Xie
- Institute of Neuroscience, Soochow University, Soochow University, Suzhou, P. R. China
| | - Yun-Yun Rui
- Institute of Neuroscience, Soochow University, Soochow University, Suzhou, P. R. China
| | - Ping-An Zhang
- Center for Translational Medicine, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, P. R. China
- Institute of Neuroscience, Soochow University, Soochow University, Suzhou, P. R. China
| | - Xiao-Jue Zhu
- Center for Translational Medicine, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, P. R. China
| | - Guang-Yin Xu
- Center for Translational Medicine, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, P. R. China
- Institute of Neuroscience, Soochow University, Soochow University, Suzhou, P. R. China
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Lin B, Crnic KA, Luecken LJ, Gonzales NA. Ontogeny of emotional and behavioral problems in a low-income, Mexican American sample. Dev Psychol 2017; 53:2245-2260. [PMID: 28933887 PMCID: PMC5873968 DOI: 10.1037/dev0000391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Clinically meaningful behavior problems are thought to be present beginning in the early toddler years, yet few studies have investigated correlates of behavior problems assessed before age 2 years. The current study investigated the direct and interactive contributions of early infant and caregiver characteristics thought to play an important role in the ontogeny of behavior problems. Specifically, the study examined: (a) the links between infant temperamental reactivity and toddler behavioral symptoms, (b) whether maternal sensitivity moderated associations between temperamental reactivity and behavioral symptoms, (c) whether variability in temperamental reactivity was explained by exposure to maternal stressful life events (SLEs) in utero, and (d) whether child sex moderated these pathways. Data were collected from 322 low-income, Mexican American families. Mother reports of SLEs were obtained between 23 and 40 weeks gestation; temperamental negativity and surgency at 6 weeks and 12 months; and internalizing and externalizing behaviors at 18 months. Maternal sensitivity during structured mother-infant interaction tasks at a 12-month visit was assessed by objective raters. Results indicated that significant paths linked maternal prenatal SLEs with 6-week negativity, 6-week negativity with 12-month negativity, and 12-month negativity with 18-month behavioral symptoms. Sex-specific effects were also observed. Maternal SLEs were directly associated with internalizing behaviors for girls only. Surgency and maternal sensitivity moderated the associations of negativity with subsequent externalizing behaviors for girls only. Results suggest that ecological stressors associated with sociodemographic risk factors such as low-income and ethnic minority status begin to exert cascades of influence on children's developmental outcomes even before birth. (PsycINFO Database Record
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Affiliation(s)
- Betty Lin
- Department of Psychology, Arizona State University
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Impact of prenatal stress on the dyadic behavior of mothers and their 6-month-old infants during a play situation: role of different dimensions of stress. J Neural Transm (Vienna) 2017; 124:1251-1260. [DOI: 10.1007/s00702-017-1770-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/23/2017] [Indexed: 01/13/2023]
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Dancause KN, Mutran D, Elgbeili G, Laplante DP, Kildea S, Stapleton H, McIntyre D, King S. Dietary change mediates relationships between stress during pregnancy and infant head circumference measures: the QF2011 study. MATERNAL & CHILD NUTRITION 2017; 13:e12359. [PMID: 27562643 PMCID: PMC6866224 DOI: 10.1111/mcn.12359] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 06/10/2016] [Accepted: 06/21/2016] [Indexed: 12/15/2022]
Abstract
Prenatal maternal stress can adversely affect birth outcomes, likely reflecting effects of maternal stress hormones on fetal development. Maternal stress might also induce behavioural changes, such as dietary change, that might influence fetal development. Few studies have documented relationships between stress and dietary change in pregnancy. We analysed stress and dietary change among 222 pregnant women exposed to the 2011 Queensland Floods. We assessed women's objective hardship, subjective distress and cognitive appraisal of the disaster; changes in their diets and their associations with infants' gestational age, weight, length and head circumference at birth, head circumference to birth length ratio (HC/BL) and ponderal index. Greater objective hardship was correlated with more negative dietary change, skipped meals and skipped multivitamins. There were no direct effects of stress or dietary change on birth outcomes. However, we observed an interactive effect of dietary change and exposure timing on head circumference for gestational age (HC for GA) (p = 0.010) and a similar trend for HC/BL (p = 0.064). HC for GA and HC/BL were larger among children whose mothers experienced negative changes to their diet in early pregnancy compared with later pregnancy, consistent with a 'head-sparing' response with early gestation exposure. Further analyses indicated that dietary change mediates the relationship between objective hardship because of the floods and these outcomes. This is the first report of relationships among an independent stressor, dietary change and birth outcomes. It highlights another possible mechanism in the relationship between prenatal maternal stress and child development that could guide future research and interventions.
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Affiliation(s)
| | | | | | | | - Sue Kildea
- University of QueenslandBrisbaneQueenslandAustralia
- Mater Medical Research InstituteBrisbaneQueenslandAustralia
| | - Helen Stapleton
- University of QueenslandBrisbaneQueenslandAustralia
- Mater Medical Research InstituteBrisbaneQueenslandAustralia
| | - David McIntyre
- University of QueenslandBrisbaneQueenslandAustralia
- Mater Medical Research InstituteBrisbaneQueenslandAustralia
| | - Suzanne King
- McGill UniversityMontrealQuebecCanada
- Douglas Mental Health University InstituteVerdunQuebecCanada
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Genetic variants of the kynurenine-3-monooxygenase and postpartum depressive symptoms after cesarean section in Chinese women. J Affect Disord 2017; 215:94-101. [PMID: 28319697 DOI: 10.1016/j.jad.2017.03.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/27/2017] [Accepted: 03/05/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND New conceptualizations of depression have emphasized the role of the kynurenine pathway (KP) in the pathogenesis of postpartum depressive symptoms (PDS). Kynurenine 3-monooxygenase (KMO) is a rate-limiting enzyme of the KP, where it catalyzes the conversion of kynurenine (KYN) to 3-hydroxykynurenine (3-HK). Previous work indicates that KMO is closely linked to the pathophysiology of depressive disorders. The purpose of this study is to investigate whether variations in the KMO gene affect PDS development after cesarean section. METHODS A total of 710 Chinese women receiving cesarean section were enrolled in this study. PDS was determined by an Edinburgh Postnatal Depression Scale (EPDS) score ≥13. Subsequently, 24 women with PDS and 48 matched women without PDS were randomly selected for investigation of perinatal serum concentrations of KYN, 3-HK and the 3-HK/KYN ratio. The 3-HK/KYN ratio indicates the activity of KMO. In addition, 6 single nucleotide polymorphisms of the KMO gene were examined. Following this genotyping, 36 puerperant women carrying the KMO rs1053230 AG genotype and 72 matched puerperant women carrying the KMO rs1053230 GG genotype were selected for comparisons of KYN, 3-HK and 3-HK/KYN ratio levels. RESULTS The results show the incidence of PDS in the Chinese population to be 7.3%, with PDS characterized by increased serum 3-HK concentration and 3-HK/KYN ratio, versus matched postpartum women without PDS (P<0.05). Furthermore, polymorphisms of KMO rs1053230 are significantly associated with the incidence of PDS (P<0.05). The serum concentrations of 3-HK and the 3-HK/KYN ratio in postpartum women carrying the KMO rs1053230 AG genotype are significantly higher than those in matched postpartum women carrying the KMO rs1053230 GG genotype. CONCLUSIONS The presented data highlight the contribution of alterations in the KP to the pathogenesis of postpartum depression. Heightened KMO activity, including as arising from KMO rs1053230 G/A genetic variations, are indicated as one possible mechanism driving the biological underpinnings of PDS.
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Othman H, Ammari M, Sakly M, Abdelmelek H. Effects of prenatal exposure to WIFI signal (2.45GHz) on postnatal development and behavior in rat: Influence of maternal restraint. Behav Brain Res 2017; 326:291-302. [PMID: 28288806 DOI: 10.1016/j.bbr.2017.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/28/2017] [Accepted: 03/06/2017] [Indexed: 10/20/2022]
Abstract
The present study was carried out to investigate the potential combined influence of maternal restraint stress and 2.45GHz WiFi signal exposure on postnatal development and behavior in the offspring of exposed rats. 24 pregnant albino Wistar rats were randomly assigned to four groups: Control, WiFi-exposed, restrained and both WiFi-exposed and restrained groups. Each of WiFi exposure and restraint occurred 2h/day along gestation till parturition. The pups were evaluated for physical development and neuromotor maturation. Moreover, elevated plus maze test, open field activity and stationary beam test were also determined on postnatal days 28, 30 and 31, respectively. After behavioral tests, the rats were anesthetized and their brains were removed for biochemical analysis. Our main findings showed no detrimental effects on gestation progress and outcomes at delivery in all groups. Subsequently, WiFi and restraint, per se and mainly in concert altered physical development of pups with slight differences between genders. Behaviorally, the gestational WiFi irradiation, restraint and especially the associated treatment affected the neuromotor maturation mainly in male progeny. At adult age, we noticed anxiety, motor deficit and exploratory behavior impairment in male offspring co-exposed to WiFi radiation and restraint, and in female progeny subjected to three treatments. The biochemical investigation showed that, all three treatments produced global oxidative stress in brain of both sexes. As for serum biochemistry, phosphorus, magnesium, glucose, triglycerides and calcium levels were disrupted. Taken together, prenatal WiFi radiation and restraint, alone and combined, provoked several behavioral and biochemical impairments at both juvenile and adult age of the offspring.
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Affiliation(s)
- Haifa Othman
- University of Carthage, Faculty of Sciences of Bizerte, Laboratory of Integrative Physiology, Jarzouna 7021, Tunisia
| | - Mohamed Ammari
- University of Carthage, Faculty of Sciences of Bizerte, Laboratory of Integrative Physiology, Jarzouna 7021, Tunisia; University of Tunis El Manar, Higher Institute of Applied Biological Sciences of Tunis, 9, Rue Zouhair Essafi, 1006 Tunis, Tunisia.
| | - Mohsen Sakly
- University of Carthage, Faculty of Sciences of Bizerte, Laboratory of Integrative Physiology, Jarzouna 7021, Tunisia
| | - Hafedh Abdelmelek
- University of Carthage, Faculty of Sciences of Bizerte, Laboratory of Integrative Physiology, Jarzouna 7021, Tunisia
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Polanska K, Krol A, Merecz-Kot D, Jurewicz J, Makowiec-Dabrowska T, Chiarotti F, Calamandrei G, Hanke W. Maternal stress during pregnancy and neurodevelopmental outcomes of children during the first 2 years of life. J Paediatr Child Health 2017; 53:263-270. [PMID: 28168801 DOI: 10.1111/jpc.13422] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 07/13/2016] [Accepted: 10/06/2016] [Indexed: 01/18/2023]
Abstract
AIM A growing body of literature documents associations between maternal stress in pregnancy and child development, but findings across studies are often inconsistent. The aim of this study was to estimate the association between exposure to different kinds of prenatal stress and child psychomotor development. METHODS The study population consisted of 372 mother-child pairs from Polish Mother and Child Cohort. The analysis was restricted to the women who worked at least 1 month during pregnancy period. Maternal psychological stress during pregnancy was assessed based on: the Subjective Work Characteristics Questionnaire, Perceived Stress Scale and Social Readjustment Rating Scale. The level of satisfaction with family functioning and support was evaluated by APGAR Family Scale. Child psychomotor development was assessed at the 12th and 24th months of age by Bayley Scales of Infant and Toddler Development. RESULTS Negative impact on child cognitive development at the age of two was observed for the Perceived Stress Scale (β = -0.8; P = 0.01) and the Social Readjustment Rating Scale (β = -0.4; P = 0.03) after adjusting for the variety of confounders. Occupational stress, as well as satisfaction with family functioning, was not significantly associated with child psychomotor development (P > 0.05). CONCLUSIONS The study supports the findings that prenatal exposure to maternal stress is significantly associated with decreased child cognitive functions. In order to further understand and quantify the effects of prenatal stress on child neurodevelopment further studies are needed. This will be important for developing interventions that provide more assistance to pregnant women, including emotional support or help to manage psychological stress.
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Affiliation(s)
- Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Anna Krol
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Dorota Merecz-Kot
- Department of Health and Work Psychology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Joanna Jurewicz
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Teresa Makowiec-Dabrowska
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Flavia Chiarotti
- Unit of Neurotoxicology and Neuroendocrinology, Department of Cell Biology and Neuroscience, National Institute of Health, Rome, Italy
| | - Gemma Calamandrei
- Unit of Neurotoxicology and Neuroendocrinology, Department of Cell Biology and Neuroscience, National Institute of Health, Rome, Italy
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
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Figueiredo B, Pinto TM, Pacheco A, Field T. Fetal heart rate variability mediates prenatal depression effects on neonatal neurobehavioral maturity. Biol Psychol 2017; 123:294-301. [DOI: 10.1016/j.biopsycho.2016.10.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 10/03/2016] [Accepted: 10/25/2016] [Indexed: 12/11/2022]
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Tamayo Y Ortiz M, Téllez-Rojo MM, Trejo-Valdivia B, Schnaas L, Osorio-Valencia E, Coull B, Bellinger D, Wright RJ, Wright RO. Maternal stress modifies the effect of exposure to lead during pregnancy and 24-month old children's neurodevelopment. ENVIRONMENT INTERNATIONAL 2017; 98:191-197. [PMID: 27865525 PMCID: PMC5221478 DOI: 10.1016/j.envint.2016.11.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/12/2016] [Accepted: 11/03/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Lead and psychosocial stress disrupt similar but not completely overlapping mechanisms. Exposure during the prenatal period to each of these insults singularly has been found to alter normal neurodevelopment; however, longitudinal associations with stress modifying the effect of lead have not been sufficiently analyzed in epidemiologic studies. OBJECTIVE To evaluate prenatal stress as an effect modifier of gestational lead neurotoxicity. METHODS We used a structural equations modeling approach with a trivariate response to evaluate cognitive, language and motor scores of the Bayley Scales of Infant Development-III in 24month-old children (n=360). Maternal blood lead levels were measured at the 2nd and 3rd trimester and psychosocial stress during pregnancy was assessed using a negative life events (NLE) scale derived from the CRYSIS questionnaire. RESULTS 3rd trimester lead (mean 3.9±3.0 SDμg/dL) and stress (median=3 NLE) were negatively associated with Bayley III scores. Using the model's results we generated profiles for 0, 2, 4 and 6 NLE across lead levels (up to 10μg/dL) and observed a dose-response for the developmental scores when lead levels were below 2μg/dL. Each NLE curve had a different shape across increasing lead levels. Higher stress (NLE=6) resulted in lower cognitive scores for both sexes, in lower language scores in girls but not boys. In the absence of stress we saw a negative association with lead for all scores, however for language and motor scores, higher stress seemed to mask this association. CONCLUSIONS Our work examined and confirmed prenatal stress exposure as a modifier of the well-known neurotoxic effects of prenatal lead. It adds to the existing evidence pointing at the importance of studying the co-exposure of chemical and non-chemical exposures, specifically of considering the emotional environment of children at early developmental stages of life.
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Affiliation(s)
- Marcela Tamayo Y Ortiz
- National Council of Science and Technology, Avenida Insurgentes Sur 1582, Benito Juárez, Crédito Constructor, 03940 Ciudad de México, D.F., México.
| | - Martha María Téllez-Rojo
- National Institute of Public Health, Universidad No. 655 Colonia Santa María, Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, México.
| | - Belem Trejo-Valdivia
- National Institute of Public Health, Universidad No. 655 Colonia Santa María, Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, México.
| | - Lourdes Schnaas
- National Institute of Perinatology, Calle Montes Urales #800, Miguel Hidalgo, Lomas Virreyes, 11000 Ciudad de México, D.F., México.
| | - Erika Osorio-Valencia
- National Institute of Perinatology, Calle Montes Urales #800, Miguel Hidalgo, Lomas Virreyes, 11000 Ciudad de México, D.F., México.
| | - Brent Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States.
| | - David Bellinger
- Department Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States.
| | - Rosalind J Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, United States.
| | - Robert O Wright
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029, United States.
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Long-term consequences of prenatal stress and neurotoxicants exposure on neurodevelopment. Prog Neurobiol 2016; 155:21-35. [PMID: 27236051 DOI: 10.1016/j.pneurobio.2016.05.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 02/19/2016] [Accepted: 05/24/2016] [Indexed: 11/20/2022]
Abstract
There is a large consensus that the prenatal environment determines the susceptibility to pathological conditions later in life. The hypothesis most widely accepted is that exposure to insults inducing adverse conditions in-utero may have negative effects on the development of target organs, disrupting homeostasis and increasing the risk of diseases at adulthood. Several models have been proposed to investigate the fetal origins of adult diseases, but although these approaches hold true for almost all diseases, particular attention has been focused on disorders related to the central nervous system, since the brain is particularly sensitive to alterations of the microenvironment during early development. Neurobiological disorders can be broadly divided into developmental, neurodegenerative and neuropsychiatric disorders. Even though most of these diseases share genetic risk factors, the onset of the disorders cannot be explained solely by inheritance. Therefore, current understanding presumes that the interactions of environmental input, may lead to different disorders. Among the insults that can play a direct or indirect role in the development of neurobiological disorders are stress, infections, drug abuse, and environmental contaminants. Our laboratories have been involved in the study of the neurobiological impact of gestational stress on the offspring (Dr. Antonelli's lab) and on the effect of gestational exposure to toxicants, mainly methyl mercury (MeHg) and perfluorinated compounds (PFCs) (Dr. Ceccatelli's lab). In this focused review, we will review the specialized literature but we will concentrate mostly on our own work on the long term neurodevelopmental consequences of gestational exposure to stress and neurotoxicants.
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The comparative effects of group prenatal care on psychosocial outcomes. Arch Womens Ment Health 2016; 19:259-69. [PMID: 26260037 DOI: 10.1007/s00737-015-0564-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
To compare the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care, we conducted a prospective cohort study of women who chose CP group (N = 124) or individual prenatal care (N = 124). Study participants completed the first survey at study recruitment (mean gestational age 12.5 weeks), with 89% completing the second survey (mean gestational age 32.7 weeks) and 84% completing the third survey (6 weeks' postpartum). Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress, prenatal planning-preparation and avoidance coping, perceived stress, affect and depressive symptoms, pregnancy-related empowerment, and postpartum maternal-infant attachment and maternal functioning. Using intention-to-treat models, group prenatal care participants demonstrated a 3.2 point greater increase (p < 0.05) in their use of prenatal planning-preparation coping strategies. While group participants did not demonstrate significantly greater positive outcomes in other measures, women who were at greater psychosocial risk benefitted from participation in group prenatal care. Among women reporting inadequate social support in early pregnancy, group participants demonstrated a 2.9 point greater decrease (p = 0.03) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum (p = 0.03). Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 point greater increase (p < 0.01) in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease (p = 0.02) in postpartum depressive symptom scores. This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping resources. Large randomized studies are needed to establish conclusively the biological and psychosocial benefits of group prenatal care for all women.
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Marco EM, Velarde E, Llorente R, Laviola G. Disrupted Circadian Rhythm as a Common Player in Developmental Models of Neuropsychiatric Disorders. Curr Top Behav Neurosci 2016; 29:155-181. [PMID: 26728169 DOI: 10.1007/7854_2015_419] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The environment in which individuals develop and mature is critical for their physiological and psychological outcome; in particular, the intrauterine environment has reached far more clinical relevance given its potential influence on shaping brain function and thus mental health. Gestational stress and/or maternal infection during pregnancy has been related with an increased incidence of neuropsychiatric disorders, including depression and schizophrenia. In this framework, the use of animal models has allowed a formal and deep investigation of causal determinants. Despite disruption of circadian clocks often represents a hallmark of several neuropsychiatric disorders, the relationship between disruption of brain development and the circadian system has been scarcely investigated. Nowadays, there is an increasing amount of studies suggesting a link between circadian system malfunction, early-life insults and the appearance of neuropsychiatric diseases at adulthood. Here, we briefly review evidence from clinical literature and animal models suggesting that the exposure to prenatal insults, i.e. severe gestational stress or maternal immune activation, changes the foetal hormonal milieu increasing the circulating levels of both glucocorticoids and pro-inflammatory cytokines. These two biological events have been reported to affect genes expression in experimental models and critically interfere with brain development triggering and/or exacerbating behavioural anomalies in the offspring. Herein, we highlight the importance to unravel the individual components of the body circadian system that might also be altered by prenatal insults and that may be causally associated with the disruption of neural and endocrine developmental programming.
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Affiliation(s)
- Eva M Marco
- Department Physiology (Animal Physiology II), Faculty of Biological Sciences, Universidad Complutense de Madrid (UCM), 28040, Madrid, Spain.
| | - Elena Velarde
- Department Basic Biomedical Sciences, Faculty of Biomedical Sciences, Universidad Europea (UE), Villaviciosa de Odón, Madrid, Spain
| | - Ricardo Llorente
- Department Basic Biomedical Sciences, Faculty of Biomedical Sciences, Universidad Europea (UE), Villaviciosa de Odón, Madrid, Spain
| | - Giovanni Laviola
- Section of Behavioral Neuroscience, Department Cell Biology and Neurosciences, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
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O'Donnell MH, Behie AM. Effects of wildfire disaster exposure on male birth weight in an Australian population. EVOLUTION MEDICINE AND PUBLIC HEALTH 2015; 2015:344-54. [PMID: 26574560 PMCID: PMC4697771 DOI: 10.1093/emph/eov027] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 11/06/2015] [Indexed: 01/15/2023]
Abstract
Background and objectives: Maternal stress can depress birth weight and gestational age, with potential health effects. A growing number of studies examine the effect of maternal stress caused by environmental disasters on birth outcomes. These changes may indicate an adaptive response. In this study, we examine the effects of maternal exposure to wildfire on birth weight and gestational age, hypothesising that maternal stress will negatively influence these measures. Methodology: Using data from the Australian Capital Territory, we employed Analysis of Variance to examine the influence of the 2003 Canberra wildfires on the weight of babies born to mothers resident in fire-affected regions, while considering the role of other factors. Results: We found that male infants born in the most severely fire-affected area had significantly higher average birth weights than their less exposed peers and were also heavier than males born in the same areas in non-fire years. Higher average weights were attributable to an increase in the number of macrosomic infants. There was no significant effect on the weight of female infants or on gestational age for either sex. Conclusions and implications: Our findings indicate heightened environmental responsivity in the male cohort. We find that elevated maternal stress acted to accelerate the growth of male fetuses, potentially through an elevation of maternal blood glucose levels. Like previous studies, our work finds effects of disaster exposure and suggests that fetal growth patterns respond to maternal signals. However, the direction of the change in birth weight is opposite to that of many earlier studies.
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Affiliation(s)
- M H O'Donnell
- School of Archaeology and Anthropology, College of Arts and Social Sciences, the Australian National University, Canberra 0200, Australia
| | - A M Behie
- School of Archaeology and Anthropology, College of Arts and Social Sciences, the Australian National University, Canberra 0200, Australia
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Brotnow L, Reiss D, Stover CS, Ganiban J, Leve LD, Neiderhiser JM, Shaw DS, Stevens HE. Expectant Mothers Maximizing Opportunities: Maternal Characteristics Moderate Multifactorial Prenatal Stress in the Prediction of Birth Weight in a Sample of Children Adopted at Birth. PLoS One 2015; 10:e0141881. [PMID: 26544958 PMCID: PMC4636431 DOI: 10.1371/journal.pone.0141881] [Citation(s) in RCA: 9] [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: 03/12/2015] [Accepted: 09/22/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mothers' stress in pregnancy is considered an environmental risk factor in child development. Multiple stressors may combine to increase risk, and maternal personal characteristics may offset the effects of stress. This study aimed to test the effect of 1) multifactorial prenatal stress, integrating objective "stressors" and subjective "distress" and 2) the moderating effects of maternal characteristics (perceived social support, self-esteem and specific personality traits) on infant birthweight. METHOD Hierarchical regression modeling was used to examine cross-sectional data on 403 birth mothers and their newborns from an adoption study. RESULTS Distress during pregnancy showed a statistically significant association with birthweight (R2 = 0.032, F(2, 398) = 6.782, p = .001). The hierarchical regression model revealed an almost two-fold increase in variance of birthweight predicted by stressors as compared with distress measures (R2Δ = 0.049, F(4, 394) = 5.339, p < .001). Further, maternal characteristics moderated this association (R2Δ = 0.031, F(4, 389) = 3.413, p = .009). Specifically, the expected benefit to birthweight as a function of higher SES was observed only for mothers with lower levels of harm-avoidance and higher levels of perceived social support. Importantly, the results were not better explained by prematurity, pregnancy complications, exposure to drugs, alcohol or environmental toxins. CONCLUSIONS The findings support multidimensional theoretical models of prenatal stress. Although both objective stressors and subjectively measured distress predict birthweight, they should be considered distinct and cumulative components of stress. This study further highlights that jointly considering risk factors and protective factors in pregnancy improves the ability to predict birthweight.
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Affiliation(s)
- Line Brotnow
- Dept of Psychiatry, University of Iowa College of Medicine, Iowa City, IA, United States of America
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States of America
| | - David Reiss
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States of America
| | - Carla S. Stover
- Dept. of Mental Health Law & Policy, University of South Florida, Tampa, FL, United States of America
| | - Jody Ganiban
- Dept. of Psychology, George Washington University, Washington DC, United States of America
| | - Leslie D. Leve
- Dept. of Counseling Psychology & Human Services, University of Oregon, Eugene, OR, United States of America
| | - Jenae M. Neiderhiser
- Dept. of Psychology, Penn State University, University Park, PA, United States of America
| | - Daniel S. Shaw
- Dept. of Psychology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Hanna E. Stevens
- Dept of Psychiatry, University of Iowa College of Medicine, Iowa City, IA, United States of America
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States of America
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Grace T, Bulsara M, Robinson M, Hands B. The Impact of Maternal Gestational Stress on Motor Development in Late Childhood and Adolescence: A Longitudinal Study. Child Dev 2015; 87:211-20. [DOI: 10.1111/cdev.12449] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Tegan Grace
- School of Health Sciences; University of Notre Dame, Australia
| | - Max Bulsara
- Institute for Health Research; University of Notre Dame, Australia
| | | | - Beth Hands
- Institute for Health Research; University of Notre Dame, Australia
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Agrati D, Browne D, Jonas W, Meaney M, Atkinson L, Steiner M, Fleming AS. Maternal anxiety from pregnancy to 2 years postpartum: transactional patterns of maternal early adversity and child temperament. Arch Womens Ment Health 2015; 18:693-705. [PMID: 25627018 DOI: 10.1007/s00737-014-0491-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/24/2014] [Indexed: 01/07/2023]
Abstract
The aims of this study were to examine the anxiety trajectories of women from pregnancy to 2 years postpartum and to assess the influence of their early life experiences and the temperament of the child on these trajectories. We evaluated state anxiety (State-Trait Anxiety Inventory) at pregnancy and 3, 6, 12, 18, and 24 months postpartum and determined its course as a function of self-reported early adverse experiences (Childhood Trauma Questionnaire) and the temperament of the child at 18 months (Early Child Behavior Questionnaire). Based on growth curve modeling, we found that anxiety followed a general U-shape pattern from gestation to 2 years postpartum, which was modified by early life experience of women. Greater early adversity was associated with higher gestational anxiety, followed by a marked decrease once the baby was born, and subsequent increase during the later postpartum period. The temperament of the child also modulated anxiety trajectories. Thus, mothers of children high in negative affectivity and who also experienced greater early adversity had elevated and flat anxiety trajectories, while child extraversion was associated with increasing anxiety courses approaching 2 years postpartum. These results show that maternal anxiety dynamically changes through the postpartum period with a course that is affected by previous and current experiences.
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Affiliation(s)
- Daniella Agrati
- Physiology & Nutrition Department, Facultad de Ciencias, Universidad de la Republica, Igua 4225, Montevideo, ZC 11400, Uruguay,
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Levesque ML, Fahim C, Ismaylova E, Verner MP, Casey KF, Vitaro F, Brendgen M, Dionne G, Boivin M, Tremblay RE, Booij L. The Impact of the in utero and Early Postnatal Environments on Grey and White Matter Volume: A Study with Adolescent Monozygotic Twins. Dev Neurosci 2015; 37:489-96. [DOI: 10.1159/000430982] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/28/2015] [Indexed: 11/19/2022] Open
Abstract
Prenatal and early postnatal adversities have been shown to be associated with brain development. However, we do not know how much of this association is confounded by genetics, nor whether the postnatal environment can moderate the impact of in utero adversity. This study used a monozygotic (MZ) twin design to assess (1) the association between birth weight (BW) and brain volume in adolescence, (2) the association between within-twin-pair BW discordance and brain volume discordance in adolescence, and (3) whether the association between BW and brain volume in adolescence is mediated or moderated by early negative maternal parenting behaviours. These associations were assessed in a sample of 108 MZ twins followed longitudinally since birth and scanned at age 15. The total grey matter (GM) and white matter (WM) volumes were obtained using the Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra (DARTEL) toolbox in the Statistical Parametric Mapping version 8 (SPM8). We found that the BW was significantly associated with the total GM and WM volumes, particularly in the superior frontal gyrus and thalamus. Within-twin-pair discordance in BW was also significantly associated with within-pair discordance in both the GM and the WM volumes, supporting the hypothesis that the specific in utero environment is associated with brain development independently of genetics. Early maternal hostile parenting behaviours and depressive symptoms were associated with total GM volume but not WM volume. Finally, greater early maternal hostility may moderate the association between the BW and GM volume in adolescence, since the positive association between the BW and total GM volume appeared stronger at higher levels of maternal hostility (trend). Together, these findings support the importance of the in utero and early environments for brain development.
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Coburn SS, Crnic KA, Ross EK. Mother-Infant Dyadic State Behaviour: Dynamic Systems in the Context of Risk. INFANT AND CHILD DEVELOPMENT 2015. [DOI: 10.1002/icd.1913] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Fejzo MS, Magtira A, Schoenberg FP, Macgibbon K, Mullin PM. Neurodevelopmental delay in children exposed in utero to hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 2015; 189:79-84. [PMID: 25898368 DOI: 10.1016/j.ejogrb.2015.03.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 03/20/2015] [Accepted: 03/23/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The purpose of this study is to determine the frequency of emotional, behavioral, and learning disorders in children exposed in utero to hyperemesis gravidarum (HG) and to identify prognostic factors for these disorders. STUDY DESIGN Neurodevelopmental outcomes of 312 children from 203 mothers with HG were compared to neurodevelopmental outcomes from 169 children from 89 unaffected mothers. Then the clinical profiles of patients with HG and a normal child outcome were compared to the clinical profiles of patients with HG and a child with neurodevelopmental delay to identify prognostic factors. Binary responses were analyzed using either a Chi-square or Fisher Exact test and continuous responses were analyzed using a t-test. RESULTS Children exposed in utero to HG have a 3.28-fold increase in odds of a neurodevelopmental diagnosis including attention disorders, learning delay, sensory disorders, and speech and language delay (P<0.0005). Among characteristics of HG pregnancies, only early onset of symptoms (prior to 5 weeks gestation) was significantly linked to neurodevelopmental delay. We found no evidence for increased risk of 13 emotional, behavioral, and learning disorders, including autism, intellectual impairment, and obsessive-compulsive disorder. However, the study was not sufficiently powered to detect rare conditions. Medications, treatments, and preterm birth were not associated with an increased risk for neurodevelopmental delay. CONCLUSION Women with HG are at a significantly increased risk of having a child with neurodevelopmental delay. Common antiemetic treatments were not linked to neurodevelopmental delay, but early symptoms may play a role. There is an urgent need to address whether aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea of pregnancy decreases the risk of neurodevelopmental delay.
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Affiliation(s)
- Marlena S Fejzo
- University of California, Los Angeles, Department of Obstetrics, Gynecology, and Medicine, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Department of Maternal-Fetal Medicine, Los Angeles, CA, USA.
| | - Aromalyn Magtira
- University of California, Los Angeles, Department of Statistics, Los Angeles, CA, USA
| | | | - Kimber Macgibbon
- Hyperemesis Education and Research Foundation, Leesburg, VA, USA
| | - Patrick M Mullin
- Keck School of Medicine, University of Southern California, Department of Maternal-Fetal Medicine, Los Angeles, CA, USA
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Birtwell B, Hammond L, Puckering C. 'Me and my bump': an interpretative phenomenological analysis of the experiences of pregnancy for vulnerable women. Clin Child Psychol Psychiatry 2015; 20:218-38. [PMID: 24154683 DOI: 10.1177/1359104513506427] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Eight pregnant women, considered to be 'vulnerable' due to exposure to a number of underlying risk factors, participated in semi-structured interviews regarding their experiences of pregnancy and of Mellow Bumps, a 6-week targeted antenatal intervention. Interview transcripts were explored using interpretative phenomenological analysis. The analysis revealed five superordinate themes: pregnancy as a time of reflection; the body being taken over; pregnancy as an emotional rollercoaster; relationships as important; separating identities. Pre- and post-natal attachment theories were found to be useful in interpreting the data. Findings suggest that pregnancy may be 'normalising' and provide an important opportunity for building more positive representations of the self. Findings also provide clinical support for the assertion that the attachment relationship begins before birth. The Mellow Bumps intervention was uniformly seen as helpful. It appeared to nurture prenatal attachment relationships, playing a potentially protective role, by helping to establish the foundations for secure mother-infant relationships in the future. Meeting similar women and engaging in ordinary, supportive conversation during Mellow Bumps seemed to reduce feelings of isolation and stigma. Implications for clinical practice are considered.
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Cao-Lei L, Elgbeili G, Massart R, Laplante DP, Szyf M, King S. Pregnant women's cognitive appraisal of a natural disaster affects DNA methylation in their children 13 years later: Project Ice Storm. Transl Psychiatry 2015; 5:e515. [PMID: 25710121 PMCID: PMC4445750 DOI: 10.1038/tp.2015.13] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/12/2014] [Accepted: 12/19/2014] [Indexed: 12/20/2022] Open
Abstract
Prenatal maternal stress (PNMS) can impact a variety of outcomes in the offspring throughout childhood and persisting into adulthood as shown in human and animal studies. Many of the effects of PNMS on offspring outcomes likely reflect the effects of epigenetic changes, such as DNA methylation, to the fetal genome. However, no animal or human research can determine the extent to which the effects of PNMS on DNA methylation in human offspring is the result of the objective severity of the stressor to the pregnant mother, or her negative appraisal of the stressor or her resulting degree of negative stress. We examined the genome-wide DNA methylation profile in T cells from 34 adolescents whose mothers had rated the 1998 Québec ice storm's consequences as positive or negative (that is, cognitive appraisal). The methylation levels of 2872 CGs differed significantly between adolescents in the positive and negative maternal cognitive appraisal groups. These CGs are affiliated with 1564 different genes and with 408 different biological pathways, which are prominently featured in immune function. Importantly, there was a significant overlap in the differentially methylated CGs or genes and biological pathways that are associated with cognitive appraisal and those associated with objective PNMS as we reported previously. Our study suggests that pregnant women's cognitive appraisals of an independent stressor may have widespread effects on DNA methylation across the entire genome of their unborn children, detectable during adolescence. Therefore, cognitive appraisals could be an important predictor variable to explore in PNMS research.
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Affiliation(s)
- L Cao-Lei
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Psychosocial Research Division, Douglas Hospital Research Centre, Montreal, QC, Canada
| | - G Elgbeili
- Psychosocial Research Division, Douglas Hospital Research Centre, Montreal, QC, Canada
| | - R Massart
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - D P Laplante
- Psychosocial Research Division, Douglas Hospital Research Centre, Montreal, QC, Canada
| | - M Szyf
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
- Sackler Program for Epigenetics and Developmental Psychobiology, McGill University, Montreal, QC, Canada
| | - S King
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Psychosocial Research Division, Douglas Hospital Research Centre, Montreal, QC, Canada
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Dancause KN, Laplante DP, Hart KJ, O'Hara MW, Elgbeili G, Brunet A, King S. Prenatal stress due to a natural disaster predicts adiposity in childhood: the Iowa Flood Study. J Obes 2015; 2015:570541. [PMID: 25874124 PMCID: PMC4383437 DOI: 10.1155/2015/570541] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/27/2014] [Accepted: 12/11/2014] [Indexed: 11/24/2022] Open
Abstract
Prenatal stress can affect lifelong physical growth, including increased obesity risk. However, human studies remain limited. Natural disasters provide models of independent stressors unrelated to confounding maternal characteristics. We assessed degree of objective hardship and subjective distress in women pregnant during severe flooding. At ages 2.5 and 4 years we assessed body mass index (BMI), subscapular plus triceps skinfolds (SS + TR, an index of total adiposity), and SS : TR ratio (an index of central adiposity) in their children (n = 106). Hierarchical regressions controlled first for several potential confounds. Controlling for these, flood exposure during early gestation predicted greater BMI increase from age 2.5 to 4, as well as total adiposity at 2.5. Greater maternal hardship and distress due to the floods, as well as other nonflood life events during pregnancy, independently predicted greater increase in total adiposity between 2.5 and 4 years. These results support the hypothesis that prenatal stress increases adiposity beginning in childhood and suggest that early gestation is a sensitive period. Results further highlight the additive effects of maternal objective and subjective stress, life events, and depression, emphasizing the importance of continued studies on multiple, detailed measures of maternal mental health and experience in pregnancy and child growth.
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Affiliation(s)
| | | | | | | | | | - Alain Brunet
- Douglas Hospital Research Centre, Montreal, QC, Canada H4H 1R3
- McGill University, Montreal, QC, Canada H3A 0G4
| | - Suzanne King
- Douglas Hospital Research Centre, Montreal, QC, Canada H4H 1R3
- McGill University, Montreal, QC, Canada H3A 0G4
- *Suzanne King:
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24-h urinary free cortisol from mid-pregnancy to 3-months postpartum: gender and parity differences and effects. Psychoneuroendocrinology 2014; 50:264-73. [PMID: 25247747 DOI: 10.1016/j.psyneuen.2014.08.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 08/18/2014] [Accepted: 08/25/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Pregnancy and postpartum have been associated to several physiological changes; however, empirical evidence was almost exclusively obtained in primiparous women and few studies focus on hormonal changes in men and second-time parents. The main aim of this study is to examine 24-h urinary free cortisol from mid-pregnancy to 3-months postpartum, comparing women/men and first/second-time parents. METHODS Twenty-six women and 22 men (N=48) were recruited from an antenatal obstetric unit in Porto, Portugal. 24-h urinary free cortisol was measured at the 2nd and 3rd trimester and at 3-months postpartum. Repeated measures analyses of variance were conducted, in order to analyze 24-h urinary free cortisol patterns of change over this period. Gender and parity were included in the analyses as potential modifiers, in order to compare women and men, and first- and second-time parents. RESULTS An increase from the 2nd to the 3rd trimester (p=.006) and a decrease from the 3rd trimester to 3-months postpartum (p=.005) were reported in all parents' 24-h urinary free cortisol. The interaction effects for Time*Gender (p=.03) and Time*Parity (p=.02) were found. Women and first-time parents revealed higher levels, while men and second-time parents showed lower 24-h urinary free cortisol levels at the 2nd trimester than at 3-months postpartum. CONCLUSIONS Findings appear to clarify the direction, as well as, the timing, gender and parity extension of 24-h urinary free cortisol changes from mid-pregnancy to 3-months postpartum. The same pattern of change in all parents' 24-h urinary free cortisol from mid-pregnancy to 3-months postpartum is consistent with the proposed role of hormones in preparation to parenting. Gender and parity differences and effects on 24-h urinary free cortisol are also consistent with cortisol as a stress biomarker for higher challenges associated to pregnancy and childbirth in women and first-time parents versus higher demands related to after childbirth parenting in men and second-time parents.
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Abstract
OBJECTIVE The objective of this study was to explore the association between sexual violence and neonatal outcomes. DESIGN National cohort study. SETTING Women were recruited to the Norwegian Mother and Child Cohort Study (MoBa) while attending routine ultrasound examinations from 1999 to 2008. POPULATION A total of 76 870 pregnant women. METHODS Sexual violence and maternal characteristics were self-reported in postal questionnaires during pregnancy. Neonatal outcomes were retrieved from the Medical Birth Registry of Norway (MBRN). Risk estimations were performed with linear and logistic regression analysis. OUTCOME MEASURES gestational age at birth, birth weight, preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). RESULTS Of 76 870 women, 18.4% reported a history of sexual violence. A total of 4.7% delivered prematurely, 2.7% had children with a birth weight <2500 g and 8.1% children were small for their gestational age. Women reporting moderate or severe sexual violence (rape) had a significantly reduced gestational length (2 days) when the birth was provider-initiated in an analysis adjusted for age, parity, education, smoking, body mass index and mental distress. Those exposed to severe sexual violence had a significantly reduced gestational length of 0.51 days with a spontaneous start of birth. Crude estimates showed that severe sexual violence was associated with PTB, LBW and SGA. When controlling for the aforementioned sociodemographic and behavioural factors, the association was no longer significant. CONCLUSIONS Sexual violence was not associated with adverse neonatal outcomes. Moderate and severe violence had a small but significant effect on gestational age; however, the clinical influence of this finding is most likely limited. Women exposed to sexual violence in this study reported more of the sociodemographic and behavioural factors associated with PTB, LBW and SGA compared with non-abused women.
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Affiliation(s)
- Lena Henriksen
- Section of Obstetrics, Department for Women's and Children's Health, Oslo University Hospital, Oslo, Norway
| | - Berit Schei
- Department of Public Health and General Practice, Faculty of Medicine, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Siri Vangen
- Department for Women's and Children's Health, National Resource Centre for Women's Health, Oslo University Hospital, Oslo, Norway
| | - Mirjam Lukasse
- Department of Health, Nutrition and Management, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Leis JA, Heron J, Stuart EA, Mendelson T. Associations between maternal mental health and child emotional and behavioral problems: does prenatal mental health matter? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 42:161-71. [PMID: 23748337 DOI: 10.1007/s10802-013-9766-4] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10-11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers' but not teachers' reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.
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Affiliation(s)
- Julie A Leis
- Department of Pediatrics, Johns Hopkins University School of Medicine, 200 North Wolfe Street, Baltimore, MD, 21287, USA,
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Tragea C, Chrousos GP, Alexopoulos EC, Darviri C. A randomized controlled trial of the effects of a stress management programme during pregnancy. Complement Ther Med 2014; 22:203-11. [DOI: 10.1016/j.ctim.2014.01.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 01/14/2014] [Accepted: 01/22/2014] [Indexed: 11/25/2022] Open
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Amugongo S, Hlusko LJ. Impact of maternal prenatal stress on growth of the offspring. Aging Dis 2014; 5:1-16. [PMID: 24490112 DOI: 10.14336/ad.2014.05001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/25/2013] [Accepted: 08/26/2013] [Indexed: 11/01/2022] Open
Abstract
Unperturbed fetal development is essential for future health of an individual. Previous studies have linked diseases of aging to harmful alterations that happen during fetal development. Given the significant long-term impact that intrauterine environment has on an individual's life, it was hypothesized that maternal stress during pregnancy will have negative effects on the offspring's prenatal and postnatal growth. To test this, twenty-eight female and seven male Wistar rats (Rattus norvegicus) were purchased and bred to produce 176 offspring. During pregnancy, dams were randomly divided into four groups (n=7, per group) and immobilization stress induced as follows; Group 1 (GW1): immobilization stress on days 1-7 of pregnancy, Group 2 (GW2): on days 8-14, Group 3 (GW3): on days 15-21, Group 4 (Controls): left undisturbed. Maternal cortisol hormone, food intake, and weight gain were monitored during pregnancy. Pups were raised under normal laboratory conditions and sacrificed at ages: 4, 8, 12, and 16 weeks to determine the effect of prenatal stress. At necropsy, the tibia was removed and processed for histology. Differences among groups were determined by T-test or analysis of variance (ANOVA). Linear regression analysis was performed to establish the relationship between stress in utero and indicators of bone development in offspring. P values ≤ 0.05 were considered significant. Cortisol hormone levels in controls were lower than those of stressed animals. Stressed dams consumed 12.5% less food per day compared to controls. Animals in GW1 and GW2 gained less weight during pregnancy but had larger litters than did GW3 or the control group. Offspring born to GW3 were heavier compared to all other groups. GW3 offspring had a higher rate of bone formation. In conclusion, stress during pregnancy resulted in increased cortisol and reduced food intake in mothers, but faster growth and higher weight gain in offspring compared to controls.
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Affiliation(s)
| | - Leslea J Hlusko
- Department of Integrative Biology, University of California, Berkeley, CA 94720, USA
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Luecken LJ, Lin B, Coburn SS, MacKinnon DP, Gonzales NA, Crnic KA. Prenatal stress, partner support, and infant cortisol reactivity in low-income Mexican American families. Psychoneuroendocrinology 2013; 38:3092-101. [PMID: 24090585 PMCID: PMC3844006 DOI: 10.1016/j.psyneuen.2013.09.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 09/05/2013] [Accepted: 09/06/2013] [Indexed: 11/22/2022]
Abstract
Maternal exposure to significant prenatal stress can negatively affect infant neurobiological development and increase the risk for developmental and health disturbances. These effects may be pronounced in low SES and ethnic minority families. We explored prenatal partner support as a buffer of the impact of prenatal stress on cortisol reactivity of infants born to low-income Mexican American women. Women (N=220; age 18-42; 84% Spanish-speaking; 89% foreign born; modal family income $10,000-$15,000) reported on economic stress and satisfaction with spousal/partner support during the prenatal period (26-38 weeks gestation), and infant salivary cortisol reactivity to mildly challenging mother-infant interaction tasks was assessed at women's homes at six weeks postpartum. Multilevel models estimated the interactive effect of prenatal stress and partner support on cortisol reactivity, controlling for covariates and potential confounds. Infants born to mothers who reported high prenatal stress and low partner support exhibited higher cortisol reactivity relative to those whose mothers reported high support or low stress. The effects did not appear to operate through birth outcomes. For low-income Mexican American women, partner support may buffer the impact of prenatal stress on infant cortisol reactivity, potentially promoting more adaptive infant health and development.
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Affiliation(s)
- Linda J Luecken
- Department of Psychology, Arizona State University, United States.
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Pinsonneault JK, Sullivan D, Sadee W, Soares CN, Hampson E, Steiner M. Association study of the estrogen receptor gene ESR1 with postpartum depression--a pilot study. Arch Womens Ment Health 2013; 16:499-509. [PMID: 23917948 PMCID: PMC3833886 DOI: 10.1007/s00737-013-0373-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 07/09/2013] [Indexed: 12/17/2022]
Abstract
Perinatal mood disorders, such as postpartum depression (PPD), are costly for society, with potentially serious consequences for mother and child. While multiple genes appear to play a role in PPD susceptibility, the contributions of specific genetic variations remain unclear. Previously implicated as a candidate gene, the estrogen receptor alpha gene (ESR1) is a key player in mediating hormonal differences during pregnancy and the postpartum period. This study addresses genetic factors in perinatal mood disorders, testing nine polymorphisms in ESR1. Two hundred fifty-seven postpartum women were screened for mood disorders, including 52 women with PPD and 32 without any symptoms of mood disorders. We detected a significant association for the upstream TA microsatellite repeat with Edinburgh Postnatal Depression Scale scores (p = 0.007). The same variant was also associated with the occurrence of PPD. Separately, 11 candidate functional polymorphisms in 7 additional genes were genotyped to investigate gene-gene interaction with the ESR1 TA repeat, identifying a potential interaction with the serotonin transporter. Our results support a role for ESR1 in the etiology of PPD, possibly through the modulation of serotonin signaling. Our findings for ESR1 could have broad implications for other disorders and therapies that involve estrogens.
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Affiliation(s)
- Julia K. Pinsonneault
- Department of Pharmacology and Program in Pharmacogenomics, The Ohio State University
| | - Danielle Sullivan
- Department of Pharmacology and Program in Pharmacogenomics, The Ohio State University,The Department of Biostatistics, College of Public Health, The Ohio State University
| | - Wolfgang Sadee
- Department of Pharmacology and Program in Pharmacogenomics, The Ohio State University
| | - Claudio N. Soares
- Women's Health Concerns Clinic, St. Joseph's Healthcare, Department of Psychiatry & Behavioral Neurosciences and Obstetrics & Gynecology, McMaster University
| | - Elizabeth Hampson
- Department of Psychology and Graduate Program in Neuroscience, University of Western Ontario
| | - Meir Steiner
- Women's Health Concerns Clinic, St. Joseph's Healthcare, Department of Psychiatry & Behavioral Neurosciences and Obstetrics & Gynecology, McMaster University
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Dancause KN, Veru F, Andersen RE, Laplante DP, King S. Prenatal stress due to a natural disaster predicts insulin secretion in adolescence. Early Hum Dev 2013; 89:773-6. [PMID: 23830724 PMCID: PMC3855052 DOI: 10.1016/j.earlhumdev.2013.06.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 06/06/2013] [Accepted: 06/13/2013] [Indexed: 11/25/2022]
Abstract
Prenatal stress might increase cardiometabolic disease risk. We measured prenatal stress due to an ice storm in 1998, and measured glucose tolerance among a subsample of 32 exposed adolescents in 2011. Severity of stress was positively associated with insulin secretion, suggesting that prenatal stress independently predicts metabolic outcomes in adolescence.
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Affiliation(s)
- Kelsey N. Dancause
- McGill University, Faculty of Medicine,Douglas Hospital Research Center, Psychosocial Research Division
| | - Franz Veru
- McGill University, Faculty of Medicine,Douglas Hospital Research Center, Psychosocial Research Division
| | - Ross E. Andersen
- McGill University, Faculty of Medicine,McGill University, Department of Kinesiology and Physical Education
| | | | - Suzanne King
- McGill University, Faculty of Medicine,Douglas Hospital Research Center, Psychosocial Research Division
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50
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Nast I, Bolten M, Meinlschmidt G, Hellhammer DH. How to measure prenatal stress? A systematic review of psychometric instruments to assess psychosocial stress during pregnancy. Paediatr Perinat Epidemiol 2013; 27:313-22. [PMID: 23772932 DOI: 10.1111/ppe.12051] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND A growing body of literature documents associations of maternal psychosocial stress during pregnancy with fetal, infant and child behaviour and development. However, findings across studies are often inconsistent, which may in part be due to differences in stress definitions and assessments. METHODS We systematically reviewed methods applied to assess maternal psychosocial stress during pregnancy in studies looking at associations with biobehavioural outcomes in the offspring. A systematic literature search was performed on Web of Science and PubMed for the time period between January 1999 and October 2009. Psychometric instruments assessing maternal psychosocial stress during pregnancy were identified and described if data on psychometric properties were available. RESULTS We identified 115 publications that assessed psychosocial stress during pregnancy with validated methods. These publications applied overall 43 different instruments assessing constructs falling under seven categories, ordered according to their frequency of use: anxiety, depression, daily hassles, aspects of psychological symptomatology (not reduced to anxiety or depression), life events, specific socio-environmental stressors and stress related to pregnancy and parenting. If available, we provide information on validity and reliability of the instruments for samples of pregnant women. CONCLUSIONS Within the 'prenatal stress' research, a broad range of instruments is applied to assess psychosocial stress during pregnancy. Prenatal stress research should take into consideration that the variety of methods in use might hamper the comparability of stress research results. In each category of stress constructs, one instrument with good psychometric properties in pregnant women is highlighted as the best currently available measure.
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Affiliation(s)
- Irina Nast
- NCCR sesam-Swiss Etiological Study of Adjustment and Mental Health, Department of Psychology, University of Basel, Basel, Switzerland
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