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Manning KY, Jaffer A, Lebel C. Windows of opportunity: how age and sex shape the influence of prenatal depression on the child brain. Biol Psychiatry 2024:S0006-3223(24)01490-2. [PMID: 39117167 DOI: 10.1016/j.biopsych.2024.07.022] [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: 02/05/2024] [Revised: 07/18/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024]
Abstract
Maternal prenatal depression can affect child brain and behavioural development. Specifically, altered limbic network structure and function is a likely mechanism through which prenatal depression impacts the life-long mental health of exposed children. While developmental trajectories are influenced by many factors that exacerbate risk or promote resiliency, the role of child age and sex in the relationship between prenatal depression and the child brain remains unclear. Here, we review studies of associations between prenatal depression and brain structure and function, with a focus on the role of age and sex in these relationships. After exposure to prenatal depression, altered amygdala, hippocampal and frontal cortical structure, as well as changes in functional and structural connectivity within the limbic network are evident during the fetal, infant, preschool, childhood, and adolescent stages of development. Sex appears to play a key role in this relationship, with evidence of differential findings particularly in infants, with males showing smaller and females larger hippocampal and amygdala volumes following prenatal depression. Longitudinal studies in this area have only begun to emerge within the last five years and will be key to understanding critical windows of opportunity. Future research focused on the role of age and sex in this relationship is essential to further inform screening, policy, and interventions for children exposed to prenatal depression, interrupt the intergenerational transmission of depression, and ultimately support healthy brain development.
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Affiliation(s)
- Kathryn Y Manning
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Aliza Jaffer
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
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2
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Al-Sabah R, Al-Taiar A, Ziyab AH, Akhtar S, Hammoud MS. Antenatal Depression and its Associated Factors: Findings from Kuwait Birth Cohort Study. J Epidemiol Glob Health 2024:10.1007/s44197-024-00223-7. [PMID: 38619741 DOI: 10.1007/s44197-024-00223-7] [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: 12/17/2023] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Pregnant and postpartum women are at high risk of depression due to hormonal and biological changes. Antenatal depression is understudied compared to postpartum depression and its predictors remain highly controversial. AIM To estimate the prevalence of depressive symptoms during pregnancy and investigate factors associated with this condition including vitamin D, folate and Vitamin B12 among participants in the Kuwait Birth Study. METHODS Data collection occurred as part of the Kuwait Birth Cohort Study in which pregnant women were recruited in the second and third trimester during antenatal care visits. Data on antenatal depression were collected using the Edinburgh Postnatal Depression Scale (EPDS), considering a score of ≥ 13 as an indicator of depression. Logistic regression was used to investigate factors associated with depressive symptoms in pregnant women. RESULTS Of 1108 participants in the Kuwait Birth Cohort study, 1070(96.6%) completed the EPDS. The prevalence of depressive symptoms was 21.03%(95%CI:18.62-23.59%) and 17.85%(95%CI:15.60-20.28%) as indicated by an EPDS ≥ 13 and EPDS ≥ 14 respectively. In the multivariable analysis, passive smoking at home, experiencing stressful life events during pregnancy, and a lower level of vitamin B12 were identified as predisposing factors. Conversely, having desire for the pregnancy and consumption of fruits and vegetables were inversely associated with depressive symptoms. CONCLUSION Approximately, one fifth of pregnant women had depressive symptoms indicating the need to implement screening program for depression in pregnant women, a measure not systematically implemented in Kuwait. Specifically, screening efforts should focus on pregnant women with unintended pregnancies, exposure to passive smoking at home, and recent stressful live events.
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Affiliation(s)
- Reem Al-Sabah
- Department of Community Medicine and Behavioral Sciences, College of Medicine, Kuwait University, P.O. Box 24923, Safat, 13110, Kuwait
| | - Abdullah Al-Taiar
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, 3136 Health Sciences Building, 4608 Hampton Blvd, Norfolk, VA, 23508, USA
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, College of Medicine, Kuwait University, P.O. Box 24923, Safat, 13110, Kuwait.
| | - Saeed Akhtar
- Department of Community Medicine and Behavioral Sciences, College of Medicine, Kuwait University, P.O. Box 24923, Safat, 13110, Kuwait
| | - Majeda S Hammoud
- Department of Pediatrics, College of Medicine, Kuwait University, Safat, Kuwait
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3
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Gredebäck G, Dorji N, Sen U, Nyström P, Hellberg J, Wangchuk. Context dependent cognitive development in Bhutanese children. Sci Rep 2023; 13:19875. [PMID: 37963958 PMCID: PMC10645759 DOI: 10.1038/s41598-023-47254-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/10/2023] [Indexed: 11/16/2023] Open
Abstract
We assessed risk/protective factors for cognitive development of Bhutanese children (504 3-5 year-olds, 49% girls, major ethnicities Ngalop 26%, Tshangla 30%, Lhotsampa 34%) using a non-verbal test of cognitive capacity (SON-R) and primary caregiver interviews. Cognitive capacity was related to the family's SES and whether the family belonged to the primary Buddhist majority ethnic groups (Ngalop or Tshangla) or primarily Hindu minorities (Lhotsampa). In majority families more engagement in Buddhist practices was associated with higher cognitive capacity in children. Minority children were more impacted by parents autonomous-relatedness values. Results demonstrate that cognitive development is dependent on the financial and educational context of the family, societal events, and culture specific risk/protective factors that differ across sub-groups (majority/minority, culture/religion).
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Affiliation(s)
| | - Nidup Dorji
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Umay Sen
- Uppsala University, Uppsala, Sweden
| | | | | | - Wangchuk
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
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4
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Zhang Q, Liu S, Wang Z, Cheng N. Developmental cascades of behavior problems and cognitive ability from toddlerhood to middle childhood: A 9-year longitudinal study. Early Hum Dev 2023; 179:105731. [PMID: 36867982 DOI: 10.1016/j.earlhumdev.2023.105731] [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: 09/05/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023]
Abstract
Little is known about the direction, ordering, and uniqueness of longitudinal associations between behavior problems and cognitive ability, from toddlerhood to middle childhood. A developmental cascade model was tested in the present study to examine the transactional processes in 103 Chinese children at the ages of 1, 2, 7, and 9 years. Behavior problems were assessed using the maternal reported Infant-Toddler Social and Emotional Assessment at the ages of 1, 2 and parental reported Children Behavior Checklist at the ages of 7, 9. Cognitive ability was measured using Bayley Scales of Infant and Toddler Development at the ages of 1, 2 and Wechsler Intelligence Scale for Children at the ages of 7, 9. The results revealed the stability of behavior problems and cognitive ability from age 1 to age 9 years and concurrent associations between externalizing and internalizing problems. Unique longitudinal associations were identified between (1) age 1 cognitive ability and age 2 internalizing problems, (2) age 2 externalizing problems and age 7 internalizing problems, (3) age 2 externalizing problems and age 7 cognitive ability, (4) age 7 cognitive ability and age 9 externalizing problems. The results indicated essential targets for future interventions aimed at reducing children's behavior problems at 2 years old and promoting cognitive ability at 1 year old and 7 years old.
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Affiliation(s)
- Qing Zhang
- Beijing Key Lab of "Learning and Cognition", Research Center for Child Development, School of Psychology, Capital Normal University, 100037 Beijing, China; Key Laboratory of Behavioral Sciences, Institute of Psychology, Chinese Academy of Sciences, 100101 Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, 100101 Beijing, China
| | - Siman Liu
- School of Humanities and Social Sciences, Beijing Institute of Technology, Beijing, China
| | - Zhengyan Wang
- Beijing Key Lab of "Learning and Cognition", Research Center for Child Development, School of Psychology, Capital Normal University, 100037 Beijing, China
| | - Nanhua Cheng
- Beijing Key Lab of "Learning and Cognition", Research Center for Child Development, School of Psychology, Capital Normal University, 100037 Beijing, China.
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Boots A, Wiegersma AM, Vali Y, van den Hof M, Langendam MW, Limpens J, Backhouse EV, Shenkin SD, Wardlaw JM, Roseboom TJ, de Rooij SR. Shaping the risk for late-life neurodegenerative disease: A systematic review on prenatal risk factors for Alzheimer's disease-related volumetric brain biomarkers. Neurosci Biobehav Rev 2023; 146:105019. [PMID: 36608918 DOI: 10.1016/j.neubiorev.2022.105019] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/08/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023]
Abstract
Environmental exposures including toxins and nutrition may hamper the developing brain in utero, limiting the brain's reserve capacity and increasing the risk for Alzheimer's disease (AD). The purpose of this systematic review is to summarize all currently available evidence for the association between prenatal exposures and AD-related volumetric brain biomarkers. We systematically searched MEDLINE and Embase for studies in humans reporting on associations between prenatal exposure(s) and AD-related volumetric brain biomarkers, including whole brain volume (WBV), hippocampal volume (HV) and/or temporal lobe volume (TLV) measured with structural magnetic resonance imaging (PROSPERO; CRD42020169317). Risk of bias was assessed using the Newcastle Ottawa Scale. We identified 79 eligible studies (search date: August 30th, 2020; Ntotal=24,784; median age 10.7 years) reporting on WBV (N = 38), HV (N = 63) and/or TLV (N = 5) in exposure categories alcohol (N = 30), smoking (N = 7), illicit drugs (N = 14), mental health problems (N = 7), diet (N = 8), disease, treatment and physiology (N = 10), infections (N = 6) and environmental exposures (N = 3). Overall risk of bias was low. Prenatal exposure to alcohol, opioids, cocaine, nutrient shortage, placental dysfunction and maternal anemia was associated with smaller brain volumes. We conclude that the prenatal environment is important in shaping the risk for late-life neurodegenerative disease.
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Affiliation(s)
- A Boots
- Amsterdam UMC location University of Amsterdam, Department of Epidemiology and Data Science, Meibergdreef 9, Amsterdam, the Netherlands; Aging and later life, Amsterdam Public Health, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands.
| | - A M Wiegersma
- Amsterdam UMC location University of Amsterdam, Department of Epidemiology and Data Science, Meibergdreef 9, Amsterdam, the Netherlands; Aging and later life, Amsterdam Public Health, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands
| | - Y Vali
- Amsterdam UMC location University of Amsterdam, Department of Epidemiology and Data Science, Meibergdreef 9, Amsterdam, the Netherlands; Methodology, Amsterdam Public Health, Amsterdam, the Netherlands
| | - M van den Hof
- Amsterdam UMC location University of Amsterdam, Department of Epidemiology and Data Science, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands
| | - M W Langendam
- Amsterdam UMC location University of Amsterdam, Department of Epidemiology and Data Science, Meibergdreef 9, Amsterdam, the Netherlands; Methodology, Amsterdam Public Health, Amsterdam, the Netherlands
| | - J Limpens
- Amsterdam UMC location University of Amsterdam, Medical Library, Meibergdreef 9, the Netherlands
| | - E V Backhouse
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - S D Shenkin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Ageing and Health Research Group and Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh EH16 4UX, UK
| | - J M Wardlaw
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK
| | - T J Roseboom
- Amsterdam UMC location University of Amsterdam, Department of Epidemiology and Data Science, Meibergdreef 9, Amsterdam, the Netherlands; Aging and later life, Amsterdam Public Health, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Department of Obstetrics and Gynecology, Meibergdreef 9, Amsterdam, the Netherlands
| | - S R de Rooij
- Amsterdam UMC location University of Amsterdam, Department of Epidemiology and Data Science, Meibergdreef 9, Amsterdam, the Netherlands; Aging and later life, Amsterdam Public Health, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam, the Netherlands
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6
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Zhan Y, Zhao Y, Qu Y, Yue H, Shi Y, Chen Y, Liu X, Liu R, Lyu T, Jing A, Meng Y, Huang J, Jiang Y. Longitudinal association of maternal dietary patterns with antenatal depression: Evidence from the Chinese Pregnant Women Cohort Study. J Affect Disord 2022; 308:587-595. [PMID: 35427717 DOI: 10.1016/j.jad.2022.04.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 03/25/2022] [Accepted: 04/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Limited evidence to show the longitudinal associations between maternal dietary patterns and antenatal depression (AD) from cohort studies across the entire gestation period. METHODS Data came from the Chinese Pregnant Women Cohort Study. The qualitative food frequency questionnaire (Q-FFQ) and Edinburgh Postnatal Depression Scale (EPDS) were used to collect diet and depression data. Dietary patterns were derived by using factor analysis. Generalized estimating equation models were used to analyze the association between diet and AD. RESULTS A total of 4139 participants finishing 3-wave of follow-up were finally included. Four constant diets were identified, namely plant-based, animal-protein, vitamin-rich and oily-fatty patterns. The prevalence of depression was 23.89%, 21.12% and 22.42% for the first, second and third trimesters. There were reverse associations of plant-based pattern (OR:0.85, 95%CI:0.75-0.97), animal-protein pattern (OR:0.85, 95%CI:0.74-0.99) and vitamin-rich pattern (OR:0.58, 95%CI:0.50-0.67) with AD, while a positive association between oily-fatty pattern and AD (OR:1.47, 95%CI:1.29-1.68). Except for the plant-based pattern, other patterns had linear trend relationships with AD (Ptrend < 0.05). Moreover, a 1-SD increase in vitamin-rich pattern scores was associated with a 20% lower AD risk (OR:0.80, 95%CI:0.76-0.84), while a 1-SD increase in oily-fatty pattern scores was associated with a 19% higher risk (OR:1.19, 95%CI:1.13-1.24). Interactions between dietary patterns and lifestyle habits were observed. LIMITATIONS The self-reported Q-FFQ and EPDS may cause recall bias. CONCLUSIONS There are longitudinal associations between maternal dietary patterns and antenatal depression. Our findings are expected to provide evidence for a dietary therapy strategy to improve or prevent depression during pregnancy.
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Affiliation(s)
- Yongle Zhan
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yafen Zhao
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Yimin Qu
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hexin Yue
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yingjie Shi
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunli Chen
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuan Liu
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ruiyi Liu
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tianchen Lyu
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ao Jing
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yaohan Meng
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junfang Huang
- Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China.
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Antipsychotic Use in Pregnancy: Patient Mental Health Challenges, Teratogenicity, Pregnancy Complications, and Postnatal Risks. Neurol Int 2022; 14:62-74. [PMID: 35076595 PMCID: PMC8788503 DOI: 10.3390/neurolint14010005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/11/2021] [Accepted: 09/15/2021] [Indexed: 02/01/2023] Open
Abstract
Pregnant women constitute a vulnerable population, with 25.3% of pregnant women classified as suffering from a psychiatric disorder. Since childbearing age typically aligns with the onset of mental health disorders, it is of utmost importance to consider the effects that antipsychotic drugs have on pregnant women and their developing fetus. However, the induction of pharmacological treatment during pregnancy may pose significant risks to the developing fetus. Antipsychotics are typically introduced when the nonpharmacologic approaches fail to produce desired effects or when the risks outweigh the benefits from continuing without treatment or the risks from exposing the fetus to medication. Early studies of pregnant women with schizophrenia showed an increase in perinatal malformations and deaths among their newborns. Similar to schizophrenia, women with bipolar disorder have an increased risk of relapse in antepartum and postpartum periods. It is known that antipsychotic medications can readily cross the placenta, and exposure to antipsychotic medication during pregnancy is associated with potential teratogenicity. Potential risks associated with antipsychotic use in pregnant women include congenital abnormalities, preterm birth, and metabolic disturbance, which could potentially lead to abnormal fetal growth. The complex decision-making process for treating psychosis in pregnant women must evaluate the risks and benefits of antipsychotic drugs.
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8
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Charnay M, Gardette V, Raynaud JP, Parant O, Franchitto L. [Preventive staff meetings in maternity ward for women at high medico-psycho-social risk: Qualitative study between 2012 and 2018]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2021; 49:830-837. [PMID: 33757929 DOI: 10.1016/j.gofs.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the effectiveness of a multidisciplinary consultation meeting created in collaboration between a perinatal psychiatry team and professionals from a level 3 maternity hospital, whose purpose is to prepare the delivery and postpartum of pregnant women at high medico-psycho-social risk. I) Study the functioning of these multidisciplinary meetings. II) Assess the concordance between the decisions made in antenatal care and the actual management of the delivery and postpartum care. METHODS This is a retrospective study of 140 files for which the opinion of the multidisciplinary meeting was requested in the years 2012, 2014, 2016 and 2018. We looked at the psychiatric files of the patients, as well as the summary sheets written after staff meetings. RESULTS The selection of files is compliant in 98% of cases and the traceability of information in the summary sheet is over 80% for half of the process indicators. The overall compliance rate between the decisions taken at meetings and their implementation in the post-partum period is 68%. Acute psychiatric episode and reporting could be anticipated. CONCLUSION This multidisciplinary consultation meeting is efficient in the early detection of risk situations. The decisions taken during the multidisciplinary meetings in antenatal care are mostly applied postpartum in the Maternity Ward. In cases where they are not applied, the system offers great reactivity to postpartum professionals.
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Affiliation(s)
- M Charnay
- Service universitaire de psychiatrie de l'enfant et de l'adolescent, CHU Purpan, place du Docteur-Baylac, 31059 Toulouse cedex 9, France.
| | - V Gardette
- Service d'épidémiologie, pôle santé publique et médecine sociale, CHU Purpan, 37, allées Jules-Guesde, 31073 Toulouse cedex, France
| | - J-P Raynaud
- Service universitaire de psychiatrie de l'enfant et de l'adolescent, CHU Purpan, place du Docteur-Baylac, 31059 Toulouse cedex 9, France
| | - O Parant
- Service de gynécologie-obstétrique, hôpital Paule-de-Viguier, CHU Purpan, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France
| | - L Franchitto
- Service universitaire de psychiatrie de l'enfant et de l'adolescent, CHU Purpan, place du Docteur-Baylac, 31059 Toulouse cedex 9, France
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9
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Czarzasta K, Wojciechowska M, Segiet-Swiecicka A, Borodzicz-Jazdzyk S, Niedziela M, Sajdel-Sulkowska EM. The effect of depressive-like behavior in pregnant rat dams on the cardiovascular system in their offspring. Stress 2021; 24:652-658. [PMID: 33222571 DOI: 10.1080/10253890.2020.1845646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Maternal depression during pregnancy affects 18-20% of women and is often associated with comorbidities and adverse health outcomes for the offspring. We have previously reported on neurodevelopmental delays in a rat model of maternal depression during pregnancy; current report presents echocardiographic (ECHO) data derived from the same experiment and focuses on cardiovascular response in the offspring to maternal perinatal depression. Rat dams were exposed to chronic mild stress (CMS) with repeated restraint before pregnancy. Cardiac functions were assessed in the 35-day-old offspring, derived from control (CO, n = 11) and stress-exposed dams (SO, n = 16), using echocardiography (ECHO). The expression of cardiac failure marker - B-type natriuretic peptide (BNP) was measured in the myocardium by RT-PCR. ECHO analysis revealed a significant increase in heart rate (HR) and impairment of left ventricular diastolic function parameters. Importantly, a significant increase in mitral valve flow E wave velocity (MVE) and a decrease of mitral valve deceleration time of E wave (MV DT) were observed in SO. The expression of BNP was significantly higher in SO. These results suggest that maternal depression during pregnancy impacts offspring cardiovascular function, and specifically the diastolic cardiac functions of the left ventricle.
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Affiliation(s)
- Katarzyna Czarzasta
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Malgorzata Wojciechowska
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Segiet-Swiecicka
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Sonia Borodzicz-Jazdzyk
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Niedziela
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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Sethna V, Siew J, Gudbrandsen M, Pote I, Wang S, Daly E, Deprez M, Pariante CM, Seneviratne G, Murphy DGM, Craig MC, McAlonan G. Maternal depression during pregnancy alters infant subcortical and midbrain volumes. J Affect Disord 2021; 291:163-170. [PMID: 34038833 DOI: 10.1016/j.jad.2021.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Maternal depression in pregnancy increases the risk for adverse neurodevelopmental outcomes in the offspring. The reason for this is unknown, however, one plausible mechanism may include the impact of maternal antenatal depression on infant brain. Nevertheless, relatively few studies have examined the brain anatomy of infants born to clinically diagnosed mothers. METHODS A legacy magnetic resonance imaging (MRI) dataset was used to compare regional brain volumes in 3-to-6-month-old infants born to women with a clinically confirmed diagnosis of major depressive disorder (MDD) during pregnancy (n = 31) and a reference sample of infants born to women without a current or past psychiatric diagnosis (n = 33). A method designed for analysis of low-resolution scans enabled examination of subcortical and midbrain regions previously found to be sensitive to the parent-child environment. RESULTS Compared with infants of non-depressed mothers, infants exposed to maternal antenatal depression had significantly larger subcortical grey matter volumes and smaller midbrain volumes. There was no association between gestational medication exposure and the infant regional brain volumes examined in our sample. LIMITATIONS Our scanning approach did not allow for an examination of fine-grained structural differences, and without repeated measures of brain volume, it is unknown whether the direction of reported associations are dependent on developmental stage. CONCLUSIONS Maternal antenatal depression is associated with an alteration in infant brain anatomy in early postnatal life; and that this is not accounted for by medication exposure. However, our study cannot address whether anatomical differences impact on future outcomes of the offspring.
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Affiliation(s)
- Vaheshta Sethna
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | - Jasmine Siew
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Experimental Clinical and Health Psychology, Research in Developmental Disorders Lab, Ghent University, Belgium
| | - Maria Gudbrandsen
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Inês Pote
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Siying Wang
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, UK
| | - Eileen Daly
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Maria Deprez
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, UK
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology & Perinatal Psychiatry Laboratory, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Declan G M Murphy
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and King's College London, UK
| | - Michael C Craig
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Grainne McAlonan
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and King's College London, UK
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11
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The codevelopment of internalizing symptoms, externalizing symptoms, and cognitive ability across childhood and adolescence. Dev Psychopathol 2021; 32:1375-1389. [PMID: 31588887 DOI: 10.1017/s0954579419001330] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cognitive ability, externalizing symptoms, and internalizing symptoms are correlated in children. However, it is not known why they combine in the general child population over time. To address this, we used data on 17,318 children participating in the UK Millennium Cohort Study and followed-up five times between ages 3 and 14 years. We fitted three parallel-process latent growth curve models to identify the parallel unfolding of children's trajectories of internalizing symptoms, externalizing symptoms, and cognitive ability across this period. We also examined the effects of time-invariant (ethnicity, birth weight, maternal education and age at birth, and breastfeeding status) and time-varying covariates (maternal psychological distress and socioeconomic disadvantage) on the growth parameters of the trajectories. The results showed that the intercepts of the trajectories of cognitive ability and, particularly, externalizing symptoms were inversely correlated. Their linear slopes were also inversely correlated, suggesting parallel development. Internalizing symptoms were correlated positively with externalizing symptoms and inversely (and more modestly) with cognitive ability at baseline, but the slope of internalizing symptoms correlated (positively) only with the slope of externalizing symptoms. The covariates predicted 9% to 41% of the variance in the intercepts and slopes of all domains, suggesting they are important common risk factors. Overall, it appears that externalizing symptoms develop in parallel with both cognitive ability and internalizing symptoms from early childhood through to middle adolescence. Children on an increasing trajectory of externalizing symptoms are likely both increasing in internalizing symptoms and decreasing in cognitive skills as well, and are thus an important group to target for intervention.
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Zhan Y, Ma H, Feng Y, Wang Y, Wu S, Cai S, Shi Y, Chen Y, Ma L, Jiang Y. Dietary patterns in relation to gestational depression and sleep disturbance in Chinese pregnant women. J Obstet Gynaecol Res 2020; 46:2618-2628. [PMID: 33021001 DOI: 10.1111/jog.14508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/26/2020] [Accepted: 09/17/2020] [Indexed: 01/26/2023]
Abstract
AIM To investigate the association of dietary patterns with gestational depression and sleep disturbance. METHODS Women in early pregnancy were recruited from the Chinese Pregnant Women Cohort Study (CPWCS) through July 25th, 2017 to November 26th, 2018, and eventually 7615 participants were included in this study. The qualitative food frequency questionnaire (Q-FFQ), Edinburgh Postnatal Depression Scale (EPDS), and the Pittsburgh Sleep Quality Index (PSQI) were used to assess dietary, depression and sleep quality during pregnancy, respectively. Dietary patterns were derived by factor analysis. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each outcome according to quartiles of each dietary pattern. RESULTS Five dietary patterns were identified. Participants with the highest quartile in plant-based pattern had a significantly lower likelihood of mental problems (OR: 95% CI for depression: 0.66, 0.55-0.79; sleep disturbance: 0.80, 0.68-0.93); Similar results were observed in vitamin-rich pattern (OR: 95% CI for depression: 0.46, 0.38-0.55; sleep disturbance: 0.76, 0.65-0.89); However, contrary results were found in high-fat pattern (OR: 95% CI for depression: 2.15, 1.25-1.85; sleep disturbance: 1.43, 1.22-1.67); In animal protein-rich pattern, participants with the highest quartile had a decreased likelihood of depression (OR: 0.80, 95% CI: 0.67-0.96). As for bean products pattern, participants with the highest quartile had an increased risk of depression (OR: 1.28, 95% CI:1.06-1.53). Interactions of dietary patterns and lifestyles on mental disorders were observed. CONCLUSION Dietary patterns were associated with gestational depression and sleep disturbance. Relevant departments and maternal and child health personnel should conduct health education for pregnant women and guide them to eat properly.
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Affiliation(s)
- Yongle Zhan
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haihui Ma
- Tongzhou Maternal and Child Health Hostipal of Beijing, Beijing, China
| | - Yahui Feng
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yawen Wang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sansan Wu
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuya Cai
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yingjie Shi
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunli Chen
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liangkun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort. Infant Behav Dev 2019; 57:101336. [PMID: 31404801 DOI: 10.1016/j.infbeh.2019.101336] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 12/17/2022]
Abstract
Pregnancy and the early post partum period are widely understood as a critical period for the infant's emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children's social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.
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Giardinelli L, Lelli L, Ugolini V, Lazzeretti L, Burian I, Lino G, Lunardi C, Castellini G, Ricca V. Comparison of two different treatments in depressed pregnant women: fetal growth characteristics and neonatal outcomes. J Perinat Med 2018; 47:134-137. [PMID: 30024856 DOI: 10.1515/jpm-2017-0367] [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: 11/21/2017] [Accepted: 06/25/2018] [Indexed: 11/15/2022]
Abstract
Background In this pilot study, the effects of selective serotonin reuptake inhibitors (SSRIs) and psychological intervention on fetal growth characteristics and neonatal outcomes were evaluated in two different groups of women affected by prenatal depression. Methods Forty-seven pregnant women diagnosed with major depression were divided into two different treatment groups according to the severity of their depression. The first group was treated with a combination of pharmacotherapy and psychological support. The second group (milder depression) was treated with psychological support only. The control group (CG) was made up of 26 healthy pregnant women. All of the patients and controls were assessed by means of a structured clinical interview and different self-reported questionnaires. Fetal ultrasonography assessments were performed in the second and third trimesters. Neonatal outcomes were evaluated at delivery. Results The infants of both treatment groups showed significant alterations in fetal biometry and a higher rate of low birth weight (LBW) with respect to controls. The infants of the patients treated with psychological support showed only a significantly higher rate of head circumference, <10th percentile with respect to controls. No significant difference was found between the two patient groups when fetal growth characteristics and neonatal outcomes were taken into account. Conclusion The data obtained from this study shed light on the effects of pharmacological and psychological treatment of prenatal depression on fetal growth.
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Affiliation(s)
- Lisa Giardinelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Lorenzo Lelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valentina Ugolini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Lisa Lazzeretti
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Iuliia Burian
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giuliana Lino
- Department of Obstetrics and Gynecology, University of Florence, Florence, Italy
| | - Clara Lunardi
- Department of Obstetrics and Gynecology, University of Florence, Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
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Assanangkornchai S, Saingam D, Apakupakul N, Edwards JG. Alcohol consumption, smoking, and drug use in pregnancy: Prevalence and risk factors in Southern Thailand. Asia Pac Psychiatry 2017; 9. [PMID: 27491493 DOI: 10.1111/appy.12247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 05/11/2016] [Accepted: 06/15/2016] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Substance use during pregnancy contributes to the risk of adverse health outcomes in mothers and children-in utero and during later development. In this study, we investigated the prevalence of substance use and associated factors in pregnant women receiving antenatal care in public hospitals in Thailand. METHODS Women (3578) attending 7 antenatal care clinics in Songkhla for the first time during their current pregnancy were interviewed with a structured questionnaire focusing on demographic data, obstetric history, use of alcohol, tobacco, and other substances, and the General Health Questionnaire was administered. The use of substances was confirmed with the ultrarapid version of the Alcohol, Smoking, and Substance Involvement Screening Test and urine tests, which were also administered to 1 in 5 to 10 randomly selected women whose screening results were negative. RESULTS Based on self-reports and General Health Questionnaire results, the weighted prevalence of alcohol, tobacco, or illicit substance use and that of "mental health problems" were 5.6% (95% confidence interval [CI], 4.9-6.4) and 29.2% (95% CI, 27.5-30.9), respectively. On the basis of the ultrarapid version of the Alcohol, Smoking, and Substance Involvement Screening Test and urine tests, the prevalence of likely substance use disorder during the 3 months prior to assessment was 1.2% (95% CI, 0.8-1.5) and 7.7% (95% CI, 4.6-10.7), respectively. Factors associated with substance use were religion, unmarried status, unplanned pregnancy, previous abortion, and current mental health problem. DISCUSSION Our results emphasize the need for identification of substance use and mental health problems, with the help of questionnaires and biological markers, followed by early intervention.
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Affiliation(s)
- Sawitri Assanangkornchai
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Darika Saingam
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Nualta Apakupakul
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - J Guy Edwards
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Department of Psychiatry, Royal South Hants Hospital and Southampton University Hospitals, Southampton, UK
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Abstract
A sensitive, secure, and consistent relationship with their mother is critical for young children. There is a dearth of knowledge about the quality of mothering of young children by women with bipolar disorder. These mothers are frequently challenged, unable to provide consistency, and are at risk for loss of child custody. The model described in this article reflects a critical analysis of conceptual and empirical literature regarding mothering quality, resourcefulness, disorder severity, medication adherence, social supports, and child-rearing beliefs. The model can provide a conceptual framework for research, direct the selection of research instruments, and hypothesize the relationships among constructs.
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Affiliation(s)
- Linda C Lewin
- a Wayne State University , College of Nursing , Detroit , Michigan , USA
| | - Thomas N Templin
- a Wayne State University , College of Nursing , Detroit , Michigan , USA
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Untreated depression during pregnancy: Short- and long-term effects in offspring. A systematic review. Neuroscience 2015; 342:154-166. [PMID: 26343292 DOI: 10.1016/j.neuroscience.2015.09.001] [Citation(s) in RCA: 259] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 08/28/2015] [Accepted: 09/01/2015] [Indexed: 01/22/2023]
Abstract
Aim of this systematic review is to assess short- and long-lasting effects of antenatal exposure to untreated maternal depressive symptoms. Pertinent articles were identified through combined searches of Science.gov, Cochrane library, and PubMed databases (through August 2015). Forty-three, selected articles revealed that untreated gestational depression and even depressive symptoms during pregnancy may have untoward effects on the developing fetus (hyperactivity, irregular fetal heart rate), newborns (increased cortisol and norepinephrine levels, decreased dopamine levels, altered EEG patterns, reduced vagal tone, stress/depressive-like behaviors, and increased rates of premature deaths and neonatal intensive care unit admission), and children (increased salivary cortisol levels, internalizing and externalizing problems, and central adiposity). During adolescence, an independent association exists between maternal antenatal mood symptoms and a slight increase in criminal behaviors. In contrast, the relationship between gestational depression and increased risks of prematurity and low birth weight remains controversial. Given this background, when making clinical decisions, clinicians should weigh the growing evidences suggesting the detrimental and prolonged effects in offspring of untreated antenatal depression and depressive symptoms during pregnancy against the known and emerging concerns associated with in utero exposure to antidepressants.
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