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Rousseau S, Katz D, Schussheim A, Frenkel TI. Intergenerational transmission of maternal prenatal anxiety to infant fearfulness: the mediating role of mother-infant bonding. Arch Womens Ment Health 2024:10.1007/s00737-024-01475-9. [PMID: 38861169 DOI: 10.1007/s00737-024-01475-9] [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: 01/17/2024] [Accepted: 05/10/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE This study is the first to directly investigate the mechanistic role of maternal bonding toward her infant in the early intergenerational pathway of risk from maternal anxiety to infant fearfulness. METHODS Mothers (N = 216; Mage=32.78) reported on their anxiety and bonding at four time-points between pregnancy and ten-months postpartum. At four and ten-months postpartum, infant temperamental precursors of anxiety were assessed through maternal report and observation. RESULTS Cross-lagged longitudinal path modeling indicated a significant link between prenatal maternal anxiety and infant temperamental fearful withdrawal at 10-months postpartum (R2 = 0.117), which was fully explained by decreased maternal bonding at one-month postpartum and increased infant temperamental negative reactivity at 4-months postpartum. CONCLUSION Results support the need to foster maternal bonding in preventive perinatal care, particularly in the context of maternal anxiety.
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Affiliation(s)
- Sofie Rousseau
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
- School of Education, Ariel University, Ariel, Israel
| | - Danielle Katz
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, United States
| | - Avital Schussheim
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | - Tahl I Frenkel
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel.
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2
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Stolper H, van der Vegt M, van Doesum K, Steketee M. The Integrated Family Approach in Mental Health Care Services: A Study of Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:640. [PMID: 38791854 PMCID: PMC11121543 DOI: 10.3390/ijerph21050640] [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: 03/07/2024] [Revised: 04/30/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Parental mental disorders in families are frequently accompanied with other problems. These include family life, the development of children, and the social and economic environment. Mental health services often focus treatments on the individual being referred, with little attention to parenting, the family, child development, and environmental factors. This is despite the fact that there is substantial evidence to suggest that the children of these parents are at increased risk of developing a mental disorder throughout the course of their lives. Young children are particularly vulnerable to environmental influences given the level of dependency in this stage of development. OBJECTIVE The main objective of this study was to identify whether there were a complexity of problems and risks in a clinical sample of patients and their young children (0-6) in mental health care, and, if so, whether this complexity was reflected in the integrated treatment given. METHODS The data were collected for 26 risk factors, based on the literature, and then subdivided into the parental, child, family, and environmental domains. The data were obtained from the electronic case files of 100 patients at an adult mental health service and the corresponding 100 electronic case files of their infants at a child mental health service. RESULTS The findings evidenced a notable accumulation of risk factors within families, with a mean number of 8.43 (SD 3.2) risk factors. Almost all of the families had at least four risk factors, more than half of them had between six and ten risk factors, and a quarter of them had between eleven and sixteen risk factors. Furthermore, two-thirds of the families had at least one risk factor in each of the four domains. More than half of the families received support from at least two organizations in addition to the involvement of adult and child mental health services, which is also an indication of the presence of cumulative problems. CONCLUSION This study of a clinical sample shows clearly that the mental disorder among most of the patients, who were all parents of young children, was only one of the problems they had to deal with. The cumulation of risk factors-especially in the family domain-increased the risk of the intergenerational transmission of mental disorders. To prevent these parents and their young children being caught up in this intergenerational cycle, a broad assessment is needed. In addition, malleable risk factors should be addressed in treatment and in close collaboration with other services.
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Affiliation(s)
- Hanna Stolper
- Department of Psychology Education and Child Studies, Erasmus University Rotterdam (EUR), 3062 PA Rotterdam, The Netherlands;
- Jeugd ggz Dimencegroep, 8017 CA Zwolle, The Netherlands;
| | | | - Karin van Doesum
- Department of Clinical Psychology, Radboud University Nijmegen, 6525 XZ Nijmegen, The Netherlands;
- Impluz Dimencegroep, 7411 GT Deventer, The Netherlands
| | - Majone Steketee
- Department of Psychology Education and Child Studies, Erasmus University Rotterdam (EUR), 3062 PA Rotterdam, The Netherlands;
- Verwey-Jonker Instituut, 3522 KE Utrecht, The Netherlands
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3
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Lipschutz R, Kulesz PA, Elgbeili G, Biekman B, Laplante DP, Olson DM, King S, Bick J. Maternal mental health mediates the effect of prenatal stress on infant temperament: The Harvey Mom Study. Dev Psychopathol 2024; 36:893-907. [PMID: 37078447 DOI: 10.1017/s0954579423000160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Prenatal maternal stress and mental health problems are known to increase risk for developmental psychopathology in offspring, yet pathways leading to risk or resiliency are poorly understood. In a quasi-experimental design, we prospectively examined associations between disaster-related prenatal stress, maternal mental health symptoms, and infant temperament outcomes. Mothers who were pregnant during Hurricane Harvey (N = 527) reported on objective hardships (e.g., loss of belongings or income, evacuation, home flooding) related to the storm and subsequent mental health symptoms (anxiety/depression, posttraumatic stress) across time. At a postpartum assessment, mothers reported on their infant's temperament (negative affect, positive affect, orienting/regulatory capacity). Greater objective hardship indirectly predicted higher levels of infant orienting/regulatory capacity through its association with increased maternal posttraumatic stress symptoms. Greater objective hardship also indirectly predicted higher levels of infant negative affect through its association with increased maternal anxiety/depression symptoms across time. Our findings suggest a psychological mechanism linking prenatal stress with specific temperamental characteristics via maternal mental health symptoms. Findings point to the importance of high-quality assessment and mental health services for vulnerable women and young children.
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Affiliation(s)
| | - Paulina A Kulesz
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Brian Biekman
- Department of Psychology, University of Houston, Houston, TX, USA
| | - David P Laplante
- Lady Davis Institute - Jewish General Hospital, Montreal, Canada
| | | | - Suzanne King
- Psychosocial Research Unit, Douglas Research Centre, Verdun, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Johanna Bick
- Department of Psychology, University of Houston, Houston, TX, USA
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Nazzari S, Grumi S, Mambretti F, Villa M, Giorda R, Bordoni M, Pansarasa O, Borgatti R, Provenzi L. Sex-dimorphic pathways in the associations between maternal trait anxiety, infant BDNF methylation, and negative emotionality. Dev Psychopathol 2024; 36:908-918. [PMID: 36855816 DOI: 10.1017/s0954579423000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Maternal antenatal anxiety is an emerging risk factor for child emotional development. Both sex and epigenetic mechanisms, such as DNA methylation, may contribute to the embedding of maternal distress into emotional outcomes. Here, we investigated sex-dependent patterns in the association between antenatal maternal trait anxiety, methylation of the brain-derived neurotrophic factor gene (BDNF DNAm), and infant negative emotionality (NE). Mother-infant dyads (N = 276) were recruited at delivery. Maternal trait anxiety, as a marker of antenatal chronic stress exposure, was assessed soon after delivery using the Stait-Trait Anxiety Inventory (STAI-Y). Infants' BDNF DNAm at birth was assessed in 11 CpG sites in buccal cells whereas infants' NE was assessed at 3 (N = 225) and 6 months (N = 189) using the Infant Behavior Questionnaire-Revised (IBQ-R). Hierarchical linear analyses showed that higher maternal antenatal anxiety was associated with greater 6-month-olds' NE. Furthermore, maternal antenatal anxiety predicted greater infants' BDNF DNAm in five CpG sites in males but not in females. Higher methylation at these sites was associated with greater 3-to-6-month NE increase, independently of infants' sex. Maternal antenatal anxiety emerged as a risk factor for infant's NE. BDNF DNAm might mediate this effect in males. These results may inform the development of strategies to promote mothers and infants' emotional well-being.
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Affiliation(s)
- Sarah Nazzari
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Serena Grumi
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
| | - Fabiana Mambretti
- Molecular Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Marco Villa
- Molecular Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Roberto Giorda
- Molecular Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Matteo Bordoni
- Cellular Models and Neuroepigenetics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Orietta Pansarasa
- Cellular Models and Neuroepigenetics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
| | - Livio Provenzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
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Perez C, D'Anna-Hernandez KL. Effects of sociocultural stressors on maternal responsivity and the infant behavioral and neuroendocrine response to stress in families of Mexican descent. Psychoneuroendocrinology 2024; 163:106979. [PMID: 38308963 DOI: 10.1016/j.psyneuen.2024.106979] [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: 11/07/2022] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
Maternal stress is consistently linked to alterations in maternal behavior and infant neurodevelopmental outcomes. As the Latino population grows in the U.S., it is increasingly important to understand how culturally relevant factors affect this relationship. This study aimed to address the role of sociocultural stressors on maternal sensitivity and markers of infant emotional regulation and the neuroendocrine response to stress in mother/infant dyads of Mexican descent. Pregnant women of Mexican descent (n = 115) were recruited during early pregnancy and followed until their infants were 6 months old. Mothers completed measures of sociocultural stressors (acculturative stress and discrimination) at pre and postnatal time points. At 6 months, dyads underwent the Still Face procedure. Mothers were observed for behaviors exhibiting maternal responsivity, while negative vocalizations were observed in infants. Salivary cortisol was also collected from infants. Maternal responsivity was a salient risk factor for alterations in infant emotional regulation and cortisol activity. Postnatal experiences of discrimination were also negatively associated with infant negative affect. This work highlights maternal responsivity and points to a potential role for experiences of discrimination in the response to stress in the mother/child dyad that may have consequences for the development of emotional regulation in infants of Mexican descent.
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Affiliation(s)
- Christina Perez
- Department of Psychology, California State University San Marcos, San Marcos, CA, USA
| | - Kimberly L D'Anna-Hernandez
- Department of Psychology, California State University San Marcos, San Marcos, CA, USA; Department of Psychology, Marquette University, Milwaukee, CA, USA.
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Campbell SA, Dys SP, Henderson JMT, Bradley HA, Rucklidge JJ. Exploring the impact of antenatal micronutrients used as a treatment for maternal depression on infant temperament in the first year of life. Front Nutr 2024; 11:1307701. [PMID: 38711532 PMCID: PMC11073451 DOI: 10.3389/fnut.2024.1307701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/25/2024] [Indexed: 05/08/2024] Open
Abstract
Antenatal depression and maternal nutrition can influence infant temperament. Although broad-spectrum-micronutrients (BSM: vitamins and minerals) given above Recommended Dietary Allowances during pregnancy can mitigate symptoms of antenatal depression, their associated effects on infant temperament are unknown. One hundred and fourteen New Zealand mother-infant dyads (45 infants exposed to BSM during pregnancy (range of exposure during pregnancy: 12-182 days) to treat antenatal depressive symptoms (measured by Edinburgh Postnatal Depression Scale) and 69 non-exposed infants) were followed antenatally and for 12 months postpartum to determine the influence of in utero BSM exposure on infant temperament. The Infant Behavior Questionnaire-Revised: Very Short-Form assessed temperament at 4 (T1), 6 (T2) and 12 (T3) months postpartum via online questionnaire. Latent growth curve modeling showed BSM exposure, antenatal depression and infant sex did not statistically significantly predict initial levels or longitudinal changes in orienting/regulatory capacity (ORC), positive affectivity/surgency (PAS) or negative affectivity (NEG). Higher gestational age was positively associated with initial PAS, and smaller increases between T1 and T3. Breastfeeding occurrence was positively associated with initial NEG. Although not significant, BSM exposure exerted small, positive effects on initial NEG (β = -0.116) and longitudinal changes in ORC (β = 0.266) and NEG (β = -0.235). While BSM exposure did not significantly predict infant temperament, it may mitigate risks associated with antenatal depression. BSM-exposed infants displayed temperamental characteristics on par with typical pregnancies, supporting the safety of BSM treatment for antenatal depression.
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Affiliation(s)
- S. A. Campbell
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - S. P. Dys
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - J. M. T. Henderson
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - H. A. Bradley
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - J. J. Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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Abe N, Baer RJ, Jelliffe-Pawlowski L, Chambers CD, Bandoli G. Maternal Mental Health Diagnoses and Infant Emergency Department Use, Hospitalizations, and Death. Acad Pediatr 2024; 24:451-460. [PMID: 38103588 DOI: 10.1016/j.acap.2023.11.021] [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: 05/08/2023] [Revised: 11/12/2023] [Accepted: 11/18/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The period surrounding childbirth is a uniquely vulnerable time for women and their mental health. We sought to describe the association between maternal mental health diagnoses in the year prior and after birth and infant Emergency Department (ED) utilization, hospitalization, and death. METHODS We studied mothers who gave singleton live birth in California (2011-2017) and their infants using linked infant birth and death certificates and maternal and infant discharge records. Maternal mental health diagnoses in the year before and after birth were identified using International Classification of Diseases (ICD) codes. We abstracted infant ED visits, hospitalizations, discharge diagnoses, deaths, and causes of death. Log-linear regression was used to compare relative risks of infant outcomes between mothers with and without mental health diagnoses, adjusting for maternal variables. RESULTS Of the 3,067,069 mother-infant pairs, 85,047 (2.8%) mothers had at least one mental health diagnosis in the year before and after birth. Infants of mothers with mental health diagnoses were more likely to visit the ED (aRR 1.2, CI:1.1-1.2), have three or more ED visits (aRR 1.4, CI:1.3-1.4), be hospitalized (aRR 1.1, CI:1.04-1.1), and die (aRR 1.7, CI:1.6-1.8) in the first year of life. These infants were also more likely to be diagnosed with accidental injuries, nonaccidental trauma, and non-specific descriptive diagnosis (fussiness/fatigue/brief resolved unexplained event). CONCLUSION This large administrative cohort study showed associations between maternal mental health diagnoses and infant acute ED visits, hospitalization, and death. This study underscores the urgent need to understand what is driving these findings and how to mitigate this risk.
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Affiliation(s)
- Naomi Abe
- Department of Pediatrics (N Abe, RJ Baer, CD Chambers, and G Bandoli), University of California San Diego School of Medicine, La Jolla, Calif; Division of Emergency Medicine (N Abe), Rady Children's Hospital San Diego, San Diego, Calif.
| | - Rebecca J Baer
- Department of Pediatrics (N Abe, RJ Baer, CD Chambers, and G Bandoli), University of California San Diego School of Medicine, La Jolla, Calif
| | - Laura Jelliffe-Pawlowski
- Department of Epidemiology and Biostatistics (L Jelliffe-Pawlowski), University of California San Francisco
| | - Christina D Chambers
- Department of Pediatrics (N Abe, RJ Baer, CD Chambers, and G Bandoli), University of California San Diego School of Medicine, La Jolla, Calif; Herbert Wertheim School of Public Health and Human Longevity Science (CD Chambers), University of California San Diego, La Jolla, Calif
| | - Gretchen Bandoli
- Department of Pediatrics (N Abe, RJ Baer, CD Chambers, and G Bandoli), University of California San Diego School of Medicine, La Jolla, Calif
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Korja R, Nolvi S, Scheinin NM, Tervahartiala K, Carter A, Karlsson H, Kataja EL, Karlsson L. Trajectories of maternal depressive and anxiety symptoms and child's socio-emotional outcome during early childhood. J Affect Disord 2024; 349:625-634. [PMID: 38184113 DOI: 10.1016/j.jad.2023.12.076] [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: 04/11/2023] [Revised: 12/08/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024]
Abstract
Maternal symptoms of depression and anxiety during pregnancy and early postnatal years are suggested to impose differential negative effects on child's socio-emotional development depending on the characteristics of the symptoms, such as timing, intensity, and persistence. The aim of this study was to identify trajectories of maternal depressive and anxiety symptoms from pregnancy until 2 years postpartum and to examine their relationship with child socio-emotional problems and competence at 2 and 5 years of age. The sample included 1208 mother-infant dyads from FinnBrain Birth Cohort study. Latent growth mixture modelling (LGMM) was utilized to model the trajectories of maternal depressive symptoms, measured using the Edinburgh Postnatal Depression Scale (EPDS), and general anxiety, measured with Symptom Checklist-90 (SCL-90) at 14, 24, and 34 weeks' gestation (gw) and at 3, 6 and 24 months postpartum. Maternal depression was also assessed at 12 months. Child socio-emotional problems and competence were evaluated using the Brief Infant Toddler Social Emotional Assessment (BITSEA) at 2 years and Strengths and Difficulties Questionnaire (SDQ) at 5 years. Relevant background factors and maternal concurrent symptomatology were controlled for. The trajectories of maternal depressive and anxiety symptoms were associated negatively with differential aspects of child long term socio-emotional outcomes from early toddlerhood to preschool years. The trajectories of depressive symptoms and high-level persistent symptoms that continued from pregnancy to two years of child age had the strongest negative association with child outcomes. This highlights the importance of identifying and treating maternal symptomatology, especially that of depression, as early as possible.
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Affiliation(s)
- Riikka Korja
- University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland; University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; The Centre of Excellence for Learning Dynamics and Intervention Research (InterLearn), University of Turku, Turku, Finland.
| | - Saara Nolvi
- University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland; University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; The Centre of Excellence for Learning Dynamics and Intervention Research (InterLearn), University of Turku, Turku, Finland
| | - Noora M Scheinin
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Department of Clinical Medicine, Psychiatry, Turku, Finland
| | - Katja Tervahartiala
- University of Turku, Department of Psychology and Speech-Language Pathology, Turku, Finland; University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Centre for Population Health Research, Turku, Finland; The Centre of Excellence for Learning Dynamics and Intervention Research (InterLearn), University of Turku, Turku, Finland
| | - Alice Carter
- Psychology Department, University of Massachusetts at Boston, Boston, USA
| | - Hasse Karlsson
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Department of Clinical Medicine, Psychiatry, Turku, Finland; University of Turku and Turku University Hospital, Centre for Population Health Research, Turku, Finland
| | - Eeva-Leena Kataja
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Centre for Population Health Research, Turku, Finland
| | - Linnea Karlsson
- University of Turku, Department of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Centre for Population Health Research, Turku, Finland; University of Turku and Turku University Hospital, Department of Clinical Medicine, Paediatrics and adolescent medicine, Turku, Finland
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Liu CH, Koire A, Ma C, Mittal L, Roffman JL, Erdei C. Prenatal mental health and emotional experiences during the pandemic: associations with infant neurodevelopment screening results. Pediatr Res 2024:10.1038/s41390-024-03100-y. [PMID: 38431665 DOI: 10.1038/s41390-024-03100-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/27/2023] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND This study determined whether parental mental health and emotional experiences during the prenatal period were linked to infant developmental outcomes through the Ages and Stages Questionnaire (ASQ-3) at 8-10 months. METHODS Participants included 133 individuals who were living in the US and were pregnant or had given birth within 6 months prior to enrollment. Respondents were majority White with high education and income levels. Online surveys were administered from May 2020 to September 2021; follow-up surveys were administered from November 2020 to August 2022. RESULTS Parent generalized anxiety symptoms were positively associated with infant communication (β = 0.34, 95% CI [0.15, 1.76], p < 0.05), while parent-fetal bonding was positively associated with infant communication (β = 0.20, 95% CI [0.05, 0.76], p < 0.05) and personal-social performance (β = 0.20, 95% CI [0.04, 0.74], p < 0.05). COVID-19-related worry was negatively associated with infant communication (β = -0.30, 95% CI [-0.75, -0.12], p < 0.05) and fine motor performance (β = -0.25, 95% CI [-0.66, -0.03], p < 0.05). CONCLUSION Parent mental health and emotional experiences may contribute to infant developmental outcomes in high risk conditions such as a pandemic. IMPACT STATEMENT Maternal SARS-CoV-2 infection has been evaluated in relation to child outcomes, however, parent psychosocial experiences should not be overlooked when considering pandemic risks to child development. Specific prenatal mental health and pandemic-related emotional experiences are associated with infant developmental performance, as assessed by the Ages and Stages. Questionnaire (ASQ-3) at 8 to 10 months old. Findings indicate that parental prenatal anxiety and emotional experiences from the pandemic should be assessed when evaluating child developmental delays.
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Affiliation(s)
- Cindy H Liu
- Brigham and Women's Hospital, 221 Longwood Ave., BLI 341, Boston, MA, 02115, USA.
- Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA.
| | - Amanda Koire
- Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA
| | - Candice Ma
- Brigham and Women's Hospital, 221 Longwood Ave., BLI 341, Boston, MA, 02115, USA
| | - Leena Mittal
- Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA
| | - Joshua L Roffman
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA
- Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Carmina Erdei
- Brigham and Women's Hospital, 221 Longwood Ave., BLI 341, Boston, MA, 02115, USA
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA
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Boerner KE, Keogh E, Inkster AM, Nahman-Averbuch H, Oberlander TF. A developmental framework for understanding the influence of sex and gender on health: Pediatric pain as an exemplar. Neurosci Biobehav Rev 2024; 158:105546. [PMID: 38272336 DOI: 10.1016/j.neubiorev.2024.105546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/07/2023] [Accepted: 11/06/2023] [Indexed: 01/27/2024]
Abstract
Sex differences are a robust finding in many areas of adult health, including cardiovascular disease, psychiatric disorders, and chronic pain. However, many sex differences are not consistently observed until after the onset of puberty. This has led to the hypothesis that hormones are primary contributors to sex differences in health outcomes, largely ignoring the relative contributions of early developmental influences, emerging psychosocial factors, gender, and the interaction between these variables. In this paper, we argue that a comprehensive understanding of sex and gender contributions to health outcomes should start as early as conception and take an iterative biopsychosocial-developmental perspective that considers intersecting social positions. We present a conceptual framework, informed by a review of the literature in basic, clinical, and social science that captures how critical developmental stages for both sex and gender can affect children's health and longer-term outcomes. The literature on pediatric chronic pain is used as a worked example of how the framework can be applied to understanding different chronic conditions.
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Affiliation(s)
- Katelynn E Boerner
- Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada.
| | - Edmund Keogh
- Department of Psychology & Centre for Pain Research, University of Bath, Bath, United Kingdom
| | - Amy M Inkster
- Department of Medical Genetics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Hadas Nahman-Averbuch
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Tim F Oberlander
- Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada
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Fairbrother N, Stagg B, Scoten O, Keeney C, Cargnelli C. Perinatal anxiety disorders screening study: a study protocol. BMC Psychiatry 2024; 24:162. [PMID: 38395837 PMCID: PMC10893673 DOI: 10.1186/s12888-024-05575-9] [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: 12/22/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The anxiety and their related disorders (AD) are the most common of all mental health conditions, and affect approximately 20% of pregnant and postpartum people. They are associated with significant distress and life interference for sufferers, as well as negative consequences for fetal and infant development. At present, little if any routine screening for prenatal AD is being conducted and data regarding the most effective tools to screen for these disorders is lacking. The majority of screening studies suffer from methodological difficulties which undermine the confidence needed to recommend measures for population distribution. The primary purpose of this research is to identify the most accurate self-report tool(s) to screen for perinatal AD. METHODS A large, prospective cohort of pregnant people (N = 1,000) is being recruited proportionally across health service delivery regions in British Columbia (BC). The screening accuracy of a broad range of perinatal AD self-report measures are being assessed using gold standard methodology. Consenting individuals are administered online questionnaires followed by a semi-structured diagnostic interview between 16- and 36-weeks' gestation, and again between 6 and 20 weeks postpartum. Questionnaires include all screening measures, measures of sleep and unpaid family work, and questions pertaining to demographic and reproductive history, COVID-19, gender role burden, and mental health treatment utilization. Interviews assess all current anxiety disorders, as well as obsessive-compulsive disorder, and posttraumatic stress disorder. DISCUSSION This research is in response to an urgent demand for accurate perinatal AD screening tools based on high quality evidence. AD among perinatal people often go unidentified and untreated, resulting in continued suffering and life impairment. Findings from this research will inform healthcare providers, policymakers, and scientists, about the most effective approach to screening for anxiety and related disorders in pregnancy in the postpartum period.
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Affiliation(s)
- Nichole Fairbrother
- Department of Family Practice, University of British Columbia, Vancouver, Canada.
| | - Bryn Stagg
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
| | - Olivia Scoten
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Cora Keeney
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Claudia Cargnelli
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
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12
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Schwarze CE, von der Heiden S, Wallwiener S, Pauen S. The role of perinatal maternal symptoms of depression, anxiety and pregnancy-specific anxiety for infant's self-regulation: A prospective longitudinal study. J Affect Disord 2024; 346:144-153. [PMID: 37832733 DOI: 10.1016/j.jad.2023.10.035] [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: 03/20/2023] [Revised: 09/10/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Maternal symptoms of anxiety and depression are highly prevalent during pregnancy and postpartum and have the potential to impact fetal development and offspring behavior. However, research on the effects of fetal exposure to maternal subclinical affective symptoms on infant self-regulation is still lacking. Self-regulation provides a fundamental precondition for healthy development and overall life success whereas dysfunctional self-regulation can lead to behavioral problems, poor academic achievement, social rejection, and physical/mental disorders. During pregnancy and infancy, children largely depend upon their mothers in order to successfully regulate their internal states. Given the high prevalence of mothers suffering from anxiety and depressive symptoms during pregnancy and after childbirth, the aim of the present study is to explore how maternal affective symptoms change during the pre- and postnatal period, and how measures obtained in pregnancy and beyond impact self-regulation in infants, as indicated by crying-, sleeping-, and/or feeding problems. METHODS This prospective longitudinal study investigates the effects of maternal symptoms of depression, anxiety, and pregnancy-specific anxiety on infant's self-regulation in N = 225 mother-infant dyads. Maternal affective symptoms were examined at five prenatal and three postnatal time-points using the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) and the Pregnancy Related Anxiety Questionnaire Revised (PRAQ-R2). Infant's self-regulation was assessed twice - at the age of three and six months - using the Crying Feeding Sleeping Scale (SFS). RESULTS Maternal pregnancy-specific anxiety was the most significant predictor for infant self-regulatory problems. It predicted crying-, sleeping, and feeding problems and explained up to 18 % of the variance. Even when controlling for maternal postpartum affective symptoms, pregnancy-specific anxiety remained a significant predictor for infant self-regulation problems. LIMITATIONS Rather homogenous sample (high socioeconomic status). Data based on maternal reports of infant behavior. CONCLUSIONS Our results suggest that fetal exposure to maternal affective symptoms - specifically pregnancy-related anxiety - plays a substantial role in the development of infant self-regulation problems, potentially mediated by epigenetic modifications. Importantly, even though maternal symptoms of depression and anxiety only reached subclinical levels, they were predictive for infant crying-, sleeping-, and feeding problems. Our findings underline the importance of early prevention and clearly tailored interventions during pregnancy and postpartum to prevent adverse outcome for mother, child and family.
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Affiliation(s)
- Cornelia E Schwarze
- Heidelberg University, Department of Psychology, Developmental and Biological Psychology Unit, Heidelberg, Germany.
| | - Sina von der Heiden
- Heidelberg University, Department of Psychology, Developmental and Biological Psychology Unit, Heidelberg, Germany
| | - Stephanie Wallwiener
- University Hospital Heidelberg, Department of Gynecology and Obstetrics, Heidelberg, Germany; University of Halle-Wittenberg, Department of Obstetrics and Prenatal Medicine, Halle, Germany
| | - Sabina Pauen
- Heidelberg University, Department of Psychology, Developmental and Biological Psychology Unit, Heidelberg, Germany
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13
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Hennessey EMP, Swales DA, Markant J, Hoffman MC, Hankin BL, Davis EP. Maternal anxiety during pregnancy predicts infant attention to affective faces. J Affect Disord 2024; 344:104-114. [PMID: 37802320 PMCID: PMC10841611 DOI: 10.1016/j.jad.2023.09.031] [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: 04/21/2023] [Revised: 08/24/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Prenatal maternal anxiety is a known influence on offspring development. General anxiety and pregnancy-related anxiety (a distinct type of anxiety encompassing fears associated with pregnancy) are associated with offspring socioemotional development, with potential consequences for later emotional and behavioral problems. This study examines whether maternal pregnancy-related and general anxiety relate to infant attention to affective faces, a process which plays an integral role in early socioemotional development. METHODS Participants included 86 mothers and their 6-month-old infants (56.3 % female). Mothers completed measures of pregnancy-related and general anxiety three times through gestation. Infants' attention to affective faces was assessed with an eye-tracking task during which a series of face pairs were presented (happy, angry, or sad face paired with a neutral face). Overall attention measures included attention-holding (total looking time) and attention-orienting (latency to faces); affect-biased attention measures included proportion of total looking time to emotional faces and latency difference score. RESULTS Higher maternal pregnancy-related anxiety across gestation predicted decreased infant attention-holding to affective faces [F(1,80) = 7.232, p = .009, partial η2 = 0.083]. No differences were found in infant attention-orienting or affect-biased attention. LIMITATIONS Reliance on a correlational study design precludes the ability to make causal inferences. CONCLUSIONS Maternal pregnancy-related anxiety is an important predictor of child outcomes. We provide novel evidence that pregnancy-related anxiety predicts infant attention to emotional faces, behaviors which have important implications for socioemotional development. Providers may consider pregnancy-related anxiety as a target for screening and treatment that may benefit both pregnant individual and offspring.
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Affiliation(s)
| | - Danielle A Swales
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julie Markant
- Department of Psychology & Tulane Brain Institute, Tulane University, New Orleans, LA, USA
| | - M Camille Hoffman
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, USA; Department of Pediatrics, University of California, Irvine, CA, USA
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14
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Maxwell JR, DiDomenico J, Roberts MH, Marquez LE, Rai R, Weinberg J, Jacobson SW, Stephen J, Bakhireva LN. Impact of low-level prenatal alcohol exposure and maternal stress on autonomic regulation. Pediatr Res 2024; 95:350-358. [PMID: 37674025 PMCID: PMC11089775 DOI: 10.1038/s41390-023-02799-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/07/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) impacts the neurodevelopment of the fetus, including the infant's ability to self-regulate. Heart rate variability (HRV), that is, the beat-to-beat variability in heart rate, is a non-invasive measurement that can indicate autonomic nervous system (ANS) function/dysfunction. METHODS The study consisted of a subset of our ENRICH-2 cohort: 80 participants (32 PAE and 48 Controls) who had completed three visits during pregnancy. The participants completed a comprehensive assessment of PAE and other substances throughout pregnancy and assessments for stress, anxiety, and depression in the third trimester. At 24 h of age, infant HRV was assessed in the hospital during the clinically indicated heel lance; 3- to 5-min HRV epochs were obtained during baseline, heel lancing, and recovery episodes. RESULTS Parameters of HRV differed in infants with PAE compared to Controls during the recovery phase of the heel lance (respiratory sinus arrhythmia (RSA) and high-frequency (HF), p < 0.05). Increased maternal stress was also strongly associated with abnormalities in RSA, HF, and low-frequency / high-frequency (LF/HF, p's < 0.05). CONCLUSIONS Alterations in ANS regulation associated with PAE and maternal stress may reflect abnormal development of the hypothalamic-pituitary-adrenal axis and have long term implications for infant responsiveness and self-regulation. IMPACT Previous studies have focused on effects of moderate to heavy prenatal alcohol exposure (PAE) on autonomic dysregulation, but little is known about the effects of lower levels of PAE on infant self-regulation and heart rate variability (HRV). Prenatal stress is another risk factor for autonomic dysregulation. Mild PAE impacts infant self-regulation, which can be assessed using HRV. However, the effect of prenatal stress is stronger than that of mild PAE or other mental health variables on autonomic dysregulation.
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Affiliation(s)
- Jessie R Maxwell
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, Mexico.
- Department of Neurosciences, University of New Mexico, Albuquerque, NM, Mexico.
| | - Jared DiDomenico
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
| | - Melissa H Roberts
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
| | - Lidia Enriquez Marquez
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
| | - Rajani Rai
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
| | - Joanne Weinberg
- Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Sandra W Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Julia Stephen
- The Mind Research Network, a Division of Lovelace Biomedical Research Institute, University of New Mexico, Albuquerque, NM, Mexico
| | - Ludmila N Bakhireva
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM, Mexico
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15
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Mattera JA, Campagna AX, Goodman SH, Gartstein MA, Hancock GR, Stowe ZN, Newport DJ, Knight BT. Associations between mothers' and fathers' depression and anxiety prior to birth and infant temperament trajectories over the first year of life: Evidence from diagnoses and symptom severity. J Affect Disord 2023; 343:31-41. [PMID: 37741466 PMCID: PMC10672733 DOI: 10.1016/j.jad.2023.09.023] [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: 04/22/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Developmental shifts in infant temperament predict distal outcomes including emerging symptoms of psychopathology in childhood. Thus, it is critical to gain insight into factors that shape these developmental shifts. Although parental depression and anxiety represent strong predictors of infant temperament in cross-sectional research, few studies have examined how these factors influence temperament trajectories across infancy. METHODS We used latent growth curve modeling to examine whether mothers' and fathers' anxiety and depression, measured in two ways - as diagnostic status and symptom severity - serve as unique predictors of developmental shifts in infant temperament from 3 to 12 months. Participants included mothers (N = 234) and a subset of fathers (N = 142). Prior to or during pregnancy, both parents were assessed for lifetime diagnoses of depression and anxiety as well as current severity levels. Mothers rated their infants' temperament at 3, 6, and 12 months of age. RESULTS Mothers' depression and anxiety primarily predicted initial levels of temperament at 3 months. Controlling for mothers' symptoms, fathers' depression and anxiety largely related to temperament trajectories across infancy. Lifetime diagnoses and symptom severities were associated with distinct patterns. LIMITATIONS Infant temperament was assessed using a parent-report measure. Including an observational measure would provide a more comprehensive picture of the infants' functioning. CONCLUSIONS These results indicate that mothers' and fathers' mental health are uniquely associated with infant temperament development when measured using diagnostic status and/or symptom severity. Future studies should examine whether these temperament trajectories mediate intergenerational transmission of risk for depression and anxiety.
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Affiliation(s)
| | | | | | - Maria A Gartstein
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Gregory R Hancock
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Zachary N Stowe
- Department of Psychiatry and Behavioral Sciences, University of Wisconsin at Madison, Madison, WI, USA
| | - D Jeffrey Newport
- Departments of Psychiatry & Behavioral Sciences and Women's Health, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Bettina T Knight
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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16
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Kahya Y, Uluç S, Lee SH, Beebe B. Associations of maternal postpartum depressive and anxiety symptoms with 4-month infant and mother self- and interactive contingency of gaze, affect, and touch. Dev Psychopathol 2023:1-18. [PMID: 37791539 DOI: 10.1017/s0954579423001190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Maternal depression and anxiety are associated with infant and mother self- and interactive difficulties. Although maternal depression and anxiety usually co-occur, studies taking this comorbidity into account are few. Despite some literature, we lack a detailed understanding of how maternal depressive and anxiety symptoms may be associated with patterns of mother-infant interaction. We examined associations of maternal postpartum depressive and anxiety symptoms with infant and mother self- and interactive patterns by conducting multi-level time-series models in a sample of 56 Turkish mothers and their 4-month infants. Time-series models assessed the temporal dynamics of interaction via infant and mother self- and interactive contingency. Videotaped face-to-face interaction was coded on a 1s time base for infant and mother gaze and facial affect, infant vocal affect, and mother touch. Results indicated that mothers with high depressive symptoms were vulnerable to infants looking away, reacting with negative touch; their infants remained affectively midrange, metaphorically distancing themselves from mothers' affect. Mothers with high anxiety symptoms were vulnerable to infants becoming facially dampened and mothers reacted with negative facial affect. Altered infant and mother self-contingency patterns were largely opposite for maternal depressive and anxiety symptoms. These patterns describe foundational processes by which maternal postpartum mood is transmitted to the infant and which may affect infant development.
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Affiliation(s)
- Yasemin Kahya
- Department of Psychology, Social Sciences University of Ankara, Ankara, Turkey
| | - Sait Uluç
- Department of Psychology, Hacettepe University, Ankara, Turkey
| | - Sang Han Lee
- Center for Biomedical Imaging and Neuromodulation, The Nathan Kline Institute, Orangeburg, NY, USA
| | - Beatrice Beebe
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
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17
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Lahtela H, Nolvi S, Flykt M, Kataja EL, Eskola E, Pelto J, Bridgett DJ, Karlsson H, Karlsson L, Korja R. Mother-infant interaction and maternal postnatal psychological distress are associated with negative emotional reactivity among infants and toddlers- A FinnBrain Birth Cohort study. Infant Behav Dev 2023; 72:101843. [PMID: 37285708 DOI: 10.1016/j.infbeh.2023.101843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/07/2023] [Accepted: 05/18/2023] [Indexed: 06/09/2023]
Abstract
Studies have reported mixed findings regarding the effects of mother-infant interaction and maternal distress on children's negative emotional reactivity. In the current study (N = 134 and 107), we examined the effects of maternal Emotional Availability (sensitivity, structuring, non-intrusiveness and non-hostility) and maternal psychological distress on negative reactivity among children in the FinnBrain birth cohort study. In addition, the possible moderating effect of mother-infant interaction on the associations between maternal psychological distress and children's negative reactivity was examined. We used questionnaires to asses maternal psychological distress, observations of mother-infant interaction and observations as well maternal reports of child temperament to overcome the key limitations of many studies relying on single-method assessments. Our results showed that higher maternal sensitivity and structuring at 8 months of child's age were associated with lower mother-reported negative reactivity among children at 24 months. Higher maternal postnatal distress associated with higher parent-reported negative reactivity in children at 12 and 24 months of age when the effects of prenatal distress and the quality of mother-infant interaction were controlled for. Mother-infant interaction and maternal psychological distress did not associate with observations of child negative reactivity. We found no moderation effects of mother-infant interaction regarding the associations between maternal distress and children's negative emotional reactivity. Our findings reflect the importance of developing interventions to reduce the maternal distress symptoms while enhancing maternal sensitivity and structuring to prevent the possible harmful effects of these on child negative reactivity.
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Affiliation(s)
- Hetti Lahtela
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychology, University of Turku, Finland.
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychology, University of Turku, Finland; Turku Institute for Advanced Studies, University of Turku, Finland
| | - Marjo Flykt
- Faculty of Medicine, department of Psychology, University of Helsinki, Finland; University of Tampere, Department of Psychology
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychology, University of Turku, Finland
| | - Eeva Eskola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychology, University of Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; University of Turku, Department of Mathematics and Statistics
| | | | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Finland; Department of Pediatrics, Turku University Hospital and University of Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychology, University of Turku, Finland
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18
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Sunderji A, Gallant HD, Hall A, Davis AD, Pokhvisneva I, Meaney MJ, Silveira PP, Sassi RB, Hall GB. Serotonin transporter (5-HTT) gene network moderates the impact of prenatal maternal adversity on orbitofrontal cortical thickness in middle childhood. PLoS One 2023; 18:e0287289. [PMID: 37319261 PMCID: PMC10270637 DOI: 10.1371/journal.pone.0287289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 06/03/2023] [Indexed: 06/17/2023] Open
Abstract
In utero, the developing brain is highly susceptible to the environment. For example, adverse maternal experiences during the prenatal period are associated with outcomes such as altered neurodevelopment and emotion dysregulation. Yet, the underlying biological mechanisms remain unclear. Here, we investigate whether the function of a network of genes co-expressed with the serotonin transporter in the amygdala moderates the impact of prenatal maternal adversity on the structure of the orbitofrontal cortex (OFC) in middle childhood and/or the degree of temperamental inhibition exhibited in toddlerhood. T1-weighted structural MRI scans were acquired from children aged 6-12 years. A cumulative maternal adversity score was used to conceptualize prenatal adversity and a co-expression based polygenic risk score (ePRS) was generated. Behavioural inhibition at 18 months was assessed using the Early Childhood Behaviour Questionnaire (ECBQ). Our results indicate that in the presence of a low functioning serotonin transporter gene network in the amygdala, higher levels of prenatal adversity are associated with greater right OFC thickness at 6-12 years old. The interaction also predicts temperamental inhibition at 18 months. Ultimately, we identified important biological processes and structural modifications that may underlie the link between early adversity and future deviations in cognitive, behavioural, and emotional development.
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Affiliation(s)
- Aleeza Sunderji
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Heather D. Gallant
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Alexander Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Andrew D. Davis
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Irina Pokhvisneva
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Michael J. Meaney
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences and Brain–Body Initiative, Agency for Science, Technology and Research (A*STAR), Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Patricia P. Silveira
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Roberto B. Sassi
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Geoffrey B. Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
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19
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Comparing prenatal and postpartum stress among women with previous adverse pregnancy outcomes and normal obstetric histories: A longitudinal cohort study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100820. [PMID: 36774741 DOI: 10.1016/j.srhc.2023.100820] [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: 10/06/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The aim of this study was to compare subjectively and objectively measured stress during pregnancy and the three months postpartum in women with previous adverse pregnancy outcomes and women with normal obstetric histories. METHODS We recruited two cohorts in southwestern Finland for this longitudinal study: (1) pregnant women (n = 32) with histories of preterm births or late miscarriages January-December 2019 and (2) pregnant women (n = 30) with histories of full-term births October 2019-March 2020. We continuously measured heart rate variability (HRV) using a smartwatch from 12 to 15 weeks of pregnancy until three months postpartum, and subjective stress was assessed with a smartphone application. RESULTS We recruited the women in both cohorts at a median of 14.2 weeks of pregnancy. The women with previous adverse pregnancy outcomes delivered earlier and more often through Caesarean section compared with the women with normal obstetric histories. We found differences in subjective stress between the cohorts in pregnancy weeks 29 and 34. The cohort of women with previous adverse pregnancy outcomes had a higher root mean square of successive differences between normal heartbeats (RMSSD), a well-known HRV parameter, compared with the other cohort in pregnancy weeks 26 (64.9 vs 55.0, p = 0.04) and 32 (63.0 vs 52.3, p = 0.04). Subjective stress did not correlate with HRV parameters. CONCLUSIONS Women with previous adverse pregnancy outcomes do not suffer from stress in subsequent pregnancies more than women with normal obstetric histories. Healthcare professionals need to be aware that interindividual variation in stress during pregnancy is considerable.
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20
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Nazzari S, Grumi S, Biasucci G, Decembrino L, Fazzi E, Giacchero R, Magnani ML, Nacinovich R, Scelsa B, Spinillo A, Capelli E, Roberti E, Provenzi L. Maternal pandemic-related stress during pregnancy associates with infants' socio-cognitive development at 12 months: A longitudinal multi-centric study. PLoS One 2023; 18:e0284578. [PMID: 37068062 PMCID: PMC10109481 DOI: 10.1371/journal.pone.0284578] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/04/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Prenatal maternal stress is a key risk factor for infants' development. Previous research has highlighted consequences for infants' socio-emotional and cognitive outcomes, but less is known for what regards socio-cognitive development. In this study, we report on the effects of maternal prenatal stress related to the COVID-19 pandemic on 12-month-old infants' behavioral markers of socio-cognitive development. METHODS Ninety infants and their mothers provided complete longitudinal data from birth to 12 months. At birth, mothers reported on pandemic-related stress during pregnancy. At infants' 12-month-age, a remote mother-infant interaction was videotaped: after an initial 2-min face-to-face episode, the experimenter remotely played a series of four auditory stimuli (2 human and 2 non-human sounds). The auditory stimuli sequence was counterbalanced among participants and each sound was repeated three times every 10 seconds (Exposure, 30 seconds) while mothers were instructed not to interact with their infants and to display a neutral still-face expression. Infants' orienting, communication, and pointing toward the auditory source was coded micro-analytically and a socio-cognitive score (SCS) was obtained by means of a principal component analysis. RESULTS Infants equally oriented to human and non-human auditory stimuli. All infants oriented toward the sound during the Exposure episode, 80% exhibited any communication directed to the auditory source, and 48% showed at least one pointing toward the sound. Mothers who reported greater prenatal pandemic-related stress had infants with higher probability of showing no communication, t = 2.14 (p = .035), or pointing, t = 1.93 (p = .057). A significant and negative linear association was found between maternal prenatal pandemic-related stress and infants' SCS at 12 months, R2 = .07 (p = .010), while adjusting for potential confounders. CONCLUSIONS This study suggests that prenatal maternal stress during the COVID-19 pandemic might have increased the risk of an altered socio-cognitive development in infants as assessed through an observational paradigm at 12 months. Special preventive attention should be devoted to infants born during the pandemic.
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Affiliation(s)
- Sarah Nazzari
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Serena Grumi
- Developmental Psychobiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Giacomo Biasucci
- Pediatrics & Neonatology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | | | - Elisa Fazzi
- Department of Clinical And Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child and Adolescence Neuropsychiatry, Azienda Ospedaliera Spedali Civili of Brescia, Brescia, Italy
| | | | | | - Renata Nacinovich
- Child and Adolescent Neuropsychiatry, Fondazione IRCCS San Gerardo dei Tintori Monza, Monza, Italy
- School of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), Università Bicocca, Milan, Italy
| | - Barbara Scelsa
- Unit of Pediatric Neurology, Buzzi Children's Hospital, Milan, Italy
| | - Arsenio Spinillo
- Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Capelli
- Developmental Psychobiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Elisa Roberti
- Developmental Psychobiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Livio Provenzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Developmental Psychobiology, IRCCS Mondino Foundation, Pavia, Italy
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21
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Rajasilta O, Häkkinen S, Björnsdotter M, Scheinin NM, Lehtola SJ, Saunavaara J, Parkkola R, Lähdesmäki T, Karlsson L, Karlsson H, Tuulari JJ. Maternal psychological distress associates with alterations in resting-state low-frequency fluctuations and distal functional connectivity of the neonate medial prefrontal cortex. Eur J Neurosci 2023; 57:242-257. [PMID: 36458867 PMCID: PMC10108202 DOI: 10.1111/ejn.15882] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
Prenatal stress exposure (PSE) has been observed to exert a programming effect on the developing infant brain, possibly with long-lasting consequences on temperament, cognitive functions and the risk for developing psychiatric disorders. Several prior studies have revealed that PSE associates with alterations in neonate functional connectivity in the prefrontal regions and amygdala. In this study, we explored whether maternal psychological symptoms measured during the 24th gestational week had associations with neonate resting-state network metrics. Twenty-one neonates (nine female) underwent resting-state fMRI scanning (mean gestation-corrected age at scan 26.95 days) to assess fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo). The ReHo/fALFF maps were used in multiple regression analysis to investigate whether maternal self-reported anxiety and/or depressive symptoms associate with neonate functional brain features. Maternal psychological distress (composite score of depressive and anxiety symptoms) was positively associated with fALFF in the neonate medial prefrontal cortex (mPFC). Anxiety and depressive symptoms, assessed separately, exhibited similar but weaker associations. Post hoc seed-based connectivity analyses further showed that distal connectivity of mPFC covaried with PSE. No associations were found between neonate ReHo and PSE. These results offer preliminary evidence that PSE may affect functional features of the developing brain during gestation.
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Affiliation(s)
- Olli Rajasilta
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Suvi Häkkinen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Malin Björnsdotter
- The Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Satu J Lehtola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Jani Saunavaara
- Department of Medical Physics, University of Turku and Turku University Hospital, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Tuire Lähdesmäki
- Department of Pediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Center for Population Health Research, University of Turku and Turku University Hospital, Finland
- Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Center for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Department of Psychiatry, University of Oxford (Sigrid Juselius Fellowship), Oxford, UK
- Turku Collegium for Science and Medicine, University of Turku, Turku, Finland
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22
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Carpinelli L, Savarese G. Negative/Positive Emotions, Perceived Self-Efficacy and Transition to Motherhood during Pregnancy: A Monitoring Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15818. [PMID: 36497892 PMCID: PMC9738849 DOI: 10.3390/ijerph192315818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Several studies have investigated the topic of emotion regulation and self-perception in women during pregnancy, which turns out to be a critical event for the woman approaching psycho-physical changes. The objectives of the study were the evaluation and monitoring, during pregnancy, of emotional states and levels of self-efficacy and the analysis of the representations of self and the child. METHODS Twenty women (M = 34.60; SD = 4.60) in the 28-week gestation period participated in the research. We performed three administrations (T0-1-2) of an ad hoc questionnaire containing: personal data; Maternal Representations in Pregnancy Interview-IRMAG; Multidimensional Emotion Questionnaire-MEQ; Perceived Self-Efficacy in Complex Situations Scale. RESULTS Both qualitative and quantitative analyses show that the future mother's strategies and functional resources focus on perceiving herself as effective in the acquired role, despite the pregnancy itself being a highly stressful critical event. Positive emotions tend to increase, just as the frequency, intensity, persistence and regulation of emotion undergo a linear and constant increase with respect to the first and second administration. CONCLUSIONS Qualitative research has produced significant results with regard to the representations of mothers-to-be as they attempt to cope with states of change during pregnancy with their own personal adaptive resources.
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23
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Ramos AM, Shewark EA, Reiss D, Leve LD, Natsuaki MN, Shaw DS, Ganiban JM, Neiderhiser JM. Family interactions in toddlerhood influence social competence in preschool age: Accounting for genetic and prenatal influences. Front Psychol 2022; 13:975086. [PMID: 36518964 PMCID: PMC9742492 DOI: 10.3389/fpsyg.2022.975086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/17/2022] [Indexed: 12/20/2023] Open
Abstract
Identification of early promotive and risk factors for social competence is important for fostering children's successful social development; particularly given social competence is essential for children's later academic and psychological well-being. While research suggests that the early parent-child relationship, genetics, and prenatal influences are associated with social competence, there is less research considering how these factors may operate together to shape children's social competence in early childhood. Using a genetically informed sample from the Early Growth and Development Study (N = 561), we examined multiple levels of influence (i.e., genetic, prenatal, parenting, and child characteristics) on children's social competence at 4.5 years old. Results from structural equation models showed adoptive mother overreactivity at 18 months was positively associated with child dysregulation at 27 months, which, in turn, was associated with lower levels of social competence at 4.5 years. Also, child reactivity at 18 months was independently associated with higher levels of adoptive mother overreactivity at 27 months, which, in turn, was associated with lower levels of social competence at 4.5 years. Finally, we found an evocative effect on adoptive fathers' overreactivity at 18 months such that prenatal birth mother distress was negatively associated with adoptive fathers' overreactivity at 18 months. Overall, this study found evidence for genetic influences, and bidirectional associations between parent and child in toddlerhood that are related to lower levels of social competence when children were 4.5 years old. We also found that the prenatal environment was associated with parenting, but not with child behavior directly. This study's ability to simultaneously examine multiple domains of influence helps provide a more comprehensive picture of important mechanisms and developmental periods for children's early social competence.
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Affiliation(s)
- Amanda M. Ramos
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Elizabeth A. Shewark
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | - David Reiss
- Child Study Center, Yale University, New Haven, CT, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jody M. Ganiban
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
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24
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López-Morales H, Gelpi Trudo R, del-Valle MV, Canet-Juric L, Biota M, Andrés ML, Urquijo S. The Pandemial babies: effects of maternal stress on temperament of babies gestated and born during the pandemic. CURRENT PSYCHOLOGY 2022:1-13. [PMID: 36437907 PMCID: PMC9676865 DOI: 10.1007/s12144-022-03976-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic may configure an adverse prenatal context for early development. The aim of this study was to analyze the effects of pandemic-related negative experiences, prenatal anxiety and depression on the temperament of six-month-old babies. The sample consisted of 105 mother-child dyads. A longitudinal evaluation was carried out using pre- and postnatal online surveys. Mothers completed the State-Trait Anxiety Inventory, the Beck Depression Inventory - II, the Pandemic Impact Questionnaire and the Infant Behavior Questionnaire Revised. Serial mediation models were tested, in which the pandemic-related negative experiences constituted the independent variable, the prenatal anxiety and depression were the mediators, and the children's temperament dimensions were the dependent variables. Pandemic-related negative experiences were indirectly associated with the offspring's negative affect and surgency through anxious symptomatology, which acted as a mediating variable. This was the first study to identify the effects of the COVID-19 pandemic on temperament. Such an adverse context implies risks for child development. Public health policies aiming to evaluate socioemotional variables during early childhood become necessary to allow on-time interventions for lessening these risks.
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Affiliation(s)
- Hernán López-Morales
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | - Rosario Gelpi Trudo
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Macarena Verónica del-Valle
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Lorena Canet-Juric
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Magdalena Biota
- Unidad Ejecutora de Estudios en Neurociencias Y Sistemas Complejos (CONICET - Hospital El Cruce - Universidad Nacional Arturo Jauretche), Buenos Aires, Argentina
| | - María Laura Andrés
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Sebastián Urquijo
- Instituto de Psicología Básica Aplicada Y Tecnología (IPSIBAT), Mar del Plata, Argentina
- Universidad Nacional de Mar del Plata (UNMDP), Mar del Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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25
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The Potential Role of PPARs in the Fetal Origins of Adult Disease. Cells 2022; 11:cells11213474. [PMID: 36359869 PMCID: PMC9653757 DOI: 10.3390/cells11213474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
The fetal origins of adult disease (FOAD) hypothesis holds that events during early development have a profound impact on one’s risk for the development of future adult disease. Studies from humans and animals have demonstrated that many diseases can begin in childhood and are caused by a variety of early life traumas, including maternal malnutrition, maternal disease conditions, lifestyle changes, exposure to toxins/chemicals, improper medication during pregnancy, and so on. Recently, the roles of Peroxisome proliferator-activated receptors (PPARs) in FOAD have been increasingly appreciated due to their wide variety of biological actions. PPARs are members of the nuclear hormone receptor subfamily, consisting of three distinct subtypes: PPARα, β/δ, and γ, highly expressed in the reproductive tissues. By controlling the maturation of the oocyte, ovulation, implantation of the embryo, development of the placenta, and male fertility, the PPARs play a crucial role in the transition from embryo to fetus in developing mammals. Exposure to adverse events in early life exerts a profound influence on the methylation pattern of PPARs in offspring organs, which can affect development and health throughout the life course, and even across generations. In this review, we summarize the latest research on PPARs in the area of FOAD, highlight the important role of PPARs in FOAD, and provide a potential strategy for early prevention of FOAD.
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26
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Nazir H, Rowther AA, Rauf N, Atiq M, Kazi AK, Malik A, Atif N, Surkan PJ. 'Those whom I have to talk to, I can't talk to': Perceived social isolation in the context of anxiety symptoms among pregnant women in Pakistan. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5885-e5896. [PMID: 36121172 PMCID: PMC11075807 DOI: 10.1111/hsc.14019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 07/26/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Anxiety during pregnancy is highly prevalent in low- and middle-income countries. The relative importance of different sources and types of perceived support in the Pakistani context is unknown. We explored social support during pregnancy and the role of social isolation in Pakistani women's experiences of antenatal anxiety. We conducted semi-structured interviews with 19 pregnant women with symptoms of anxiety and 10 female healthcare providers at a public urban hospital. We used inductive and deductive thematic coding to analyse the data. Many pregnant women reported feelings of physical and social isolation, even when living in joint families with larger social networks. Often fearing censure by their in-laws and peers for sharing or seeking help with pregnancy-related anxieties, women reported relying on husbands or natal family members. Normative expectations around pregnancy such as male gender preference, perceived immutability of wives' domestic responsibilities and expectations of accompanied travel by women may serve as sources of disconnectedness in the antenatal period. Providers viewed social isolation and deficits in social support during pregnancy as contributing to worse anxiety symptoms, reduced access to care and poorer health behaviours. One limitation is that the hospital setting for this study may have resulted in underreporting of abuse or neglect and limited inclusion of pregnant women who do not utilise facility-based antenatal care. In conclusion, husbands and natal families were key in reducing social isolation in pregnancy and mitigating anxiety, while in-laws did not always confer support. Targeted strategies should enhance existing support and strengthen in-law family relationships in pregnancy.
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Affiliation(s)
- Huma Nazir
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Armaan A Rowther
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
| | - Nida Rauf
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Maria Atiq
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Asiya K Kazi
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
| | - Abid Malik
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Najia Atif
- Human Development Research Foundation, House No 06, Street No 55, F-7/4, Islamabad 44000, Pakistan
| | - Pamela J. Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
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27
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Liu R, DeSerisy M, Fox NA, Herbstman JB, Rauh VA, Beebe B, Margolis AE. Prenatal exposure to air pollution and maternal stress predict infant individual differences in reactivity and regulation and socioemotional development. J Child Psychol Psychiatry 2022; 63:1359-1367. [PMID: 35174891 PMCID: PMC9381652 DOI: 10.1111/jcpp.13581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Humans are ubiquitously exposed to air pollutants including polycyclic aromatic hydrocarbons (PAH). Although most studies of prenatal exposures have focused on psychopathology in childhood or adolescence, the effects of air pollutants on early emerging individual differences in reactivity and regulation are of growing concern. Our study is the first to report effects of prenatal exposure to PAH and maternal stress on infant reactivity and regulation. METHODS Participants included 153 infants (74 girls and 79 boys). Prenatal exposure to PAH was measured via personal air monitoring during the third trimester of pregnancy. Maternal perceived stress was measured via self-report. We assessed infant orienting/regulation (OR), surgency (SE), and negative affectivity (NA) at 4 months using the Infant Behavior Questionnaire. We measured infant socioemotional outcomes at 12 months using the Brief Infant-Toddler Social & Emotional Assessment Questionnaire. RESULTS Infants with higher prenatal PAH exposure and of mothers with higher stress had lower OR at 4 months, which predicted lower competence at 12 months. Infants with higher prenatal PAH exposure had lower SE at 4 months, which predicted more behavioral problems at 12 months. Prenatal exposure to PAH had no effects on infant NA at 4 months, although NA was associated with greater behavioral problems at 12 months. CONCLUSIONS Infant reactivity and regulation, as early makers of child psychopathology, can facilitate timely and targeted screening and possibly prevention of disorders caused, in part, by environmental pollution. A multifaceted approach to improve environmental quality and reduce psychosocial stress is necessary to improve the developmental outcomes of children and most specially children from disadvantaged communities that disproportionately experience these environmental exposures.
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Affiliation(s)
- Ran Liu
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Mariah DeSerisy
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Nathan A. Fox
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Mailman School of Public Health, Columbia Center for Children’s Environmental Health, Columbia University, New York, NY, USA
| | - Virginia A. Rauh
- Mailman School of Public Health, Columbia Center for Children’s Environmental Health, Columbia University, New York, NY, USA
- Heilbrunn Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Beatrice Beebe
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Amy E. Margolis
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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28
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Foss S, So RP, Petty CR, Waber DP, Wright RJ, Bosquet Enlow M. Effects of Maternal and Child Lifetime Traumatic Stress Exposures, Infant Temperament, and Caregiving Quality on Preschoolers' Executive Functioning. Dev Neuropsychol 2022; 47:327-352. [PMID: 36475997 PMCID: PMC9837737 DOI: 10.1080/87565641.2022.2147180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We examined effects of maternal and child lifetime traumatic stress exposures, infant temperament, and caregiving quality on parent ratings of preschoolers' executive functioning (EF). Maternal lifetime trauma was associated with preschoolers' EF problems; this association was mediated by greater child trauma exposure. Infant temperament was associated with EF abilities, particularly among females. Among males, infant extraversion/surgency mediated the association of maternal lifetime trauma with poorer child EF. Caregiving quality was negatively associated with maternal and child trauma exposures but did not predict child EF. Findings have implications for interventions to identify children at risk for poor EF and optimize outcomes.
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Affiliation(s)
- Sophie Foss
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel P. So
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Carter R. Petty
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Deborah P. Waber
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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29
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Rosenblad AK, Funkquist EL. Self-efficacy in breastfeeding predicts how mothers perceive their preterm infant's state-regulation. Int Breastfeed J 2022; 17:44. [PMID: 35690825 PMCID: PMC9188724 DOI: 10.1186/s13006-022-00486-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mothers of preterm infants often perceive the infant as having problems with crying, sleeping and feeding, sometimes summarised as ‘state-regulation’. Breastfeeding rates are lower among preterm infants, and the mother’s self-efficacy in breastfeeding is central to understanding which mothers are going to breastfeed their infants. We have previously shown that mothers with higher self-efficacy have an easier time adapting to the infant and in this study we hypothesised that the degree of self-efficacy also is associated with how difficult the mother believes it is to take care of the infant. The aim of this study was to investigate whether the late preterm infant’s mother’s self-efficacy in breastfeeding was associated with how the mother experienced her infant’s state-regulation at three months of corrected age. Methods The study had a prospective and longitudinal design with a consecutive data collection through questionnaires. Inclusion criteria were mothers (n = 105) with a singleton infant born between 34 + 0 and 36 + 6 weeks of gestation. At term age, the mothers completed the Breastfeeding Self-efficacy Scale-Short Form and at the three months corrected age follow-up, mothers completed the Infant state-regulation index: questions related to whether the infant had difficulties with colic, persistent crying, comforting, falling asleep, sleep problems, breastfeeding, eating or poor weight gain. Results The analyses showed that being an older mother, perceiving breastfeeding support, and having a higher breastfeeding self-efficacy were all significantly associated with identifying the infant as having better state-regulation. Conclusions There was an association between mothers’ self-efficacy in breastfeeding and her perceptions of how good state-regulation the infant had. This is an important finding, as self-efficacy is a manageable factor that could positively affect how the mother perceives taking care of her infant. Clinical implication: Improved self-efficacy is known to be an important factor in increased breastfeeding prevalence and healthcare professionals should also target mother’s self-efficacy in breastfeeding to improve mother-infant relationship.
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Affiliation(s)
- Andreas Karlsson Rosenblad
- Department of Medical Sciences, Division of Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Solna, Sweden
| | - Eva-Lotta Funkquist
- Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14 B, 752 37, Uppsala, Sweden.
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30
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Mudra S, Göbel A, Möhler E, Stuhrmann LY, Schulte-Markwort M, Arck P, Hecher K, Diemert A. Behavioral Inhibition in the Second Year of Life Is Predicted by Prenatal Maternal Anxiety, Overprotective Parenting and Infant Temperament in Early Infancy. Front Psychiatry 2022; 13:844291. [PMID: 35722567 PMCID: PMC9203734 DOI: 10.3389/fpsyt.2022.844291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background Behavioral inhibition, characterized by shyness, fear and avoidance of novel stimuli, has been linked with internalizing personality traits in childhood, adolescence and early adulthood, and particularly later social anxiety disorder. Little is known about the relevance of potential prenatal precursors and early predictors for the development of inhibited behavior, such as infant vulnerability and family risk factors like parental anxiety and overprotection. Pregnancy-related anxiety has been associated with both infant temperament and maternal overprotective parenting. Thus, the aim of this study was investigating the predictive relevance of prenatal pregnancy-related anxiety for behavioral inhibition in toddlerhood, by considering the mediating role of maternal overprotection and infant distress to novelty. Materials and Methods As part of a longitudinal pregnancy cohort, behavioral inhibition at 24 months postpartum was assessed in N = 170 mother-child pairs. Maternal pregnancy-related anxiety was examined in the third trimester of pregnancy, and maternal overprotection and infant distress to novelty at 12 months postpartum. Results Mediation analysis with two parallel mediators showed that the significant direct effect of pregnancy-related anxiety on child behavioral inhibition was fully mediated by infant distress to novelty p < 0.001 and maternal overprotection (p < 0.05). The included variables explained 26% of variance in behavioral inhibition. A subsequent explorative mediation analysis with serial mediators further showed a significant positive association between distress to novelty and maternal overprotective parenting (p < 0.05). Conclusion Results indicate a predictive relevance of both infant and maternal factors for the development of behavioral inhibition in toddlerhood. Mothers who perceived more pregnancy-related anxiety showed more overprotective parenting and had infants with more distress to novelty. Further, mothers being more overprotective reported their child to be more inhibited in toddlerhood. Our findings also indicate the stability of reported infant distress to novelty as one aspect of later behavioral inhibition. Addressing specific forms of parental anxiety from pregnancy on and in interaction with child-related variables seems to be a promising approach for future studies and clinical interventions.
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Affiliation(s)
- Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Saarland University Medical Center, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Schulte-Markwort
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra Arck
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Fairbrother N, Albert A, Collardeau F, Keeney C. The Childbirth Fear Questionnaire and the Wijma Delivery Expectancy Questionnaire as Screening Tools for Specific Phobia, Fear of Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084647. [PMID: 35457513 PMCID: PMC9028446 DOI: 10.3390/ijerph19084647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/14/2022] [Accepted: 04/02/2022] [Indexed: 12/04/2022]
Abstract
Background: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. Objectives: The purpose of this research was to evaluate the accuracy of the Childbirth Fear Questionnaire (CFQ) and the Wijma Delivery Expectations Questionnaire (W-DEQ) of FoB as screening tools for a specific phobia, FoB. Methods: A total of 659 English-speaking pregnant women living in Canada and over the age of 18 were recruited for the study. Participants completed an online survey of demographic, current pregnancy and reproductive history information, as well as the CFQ and the W-DEQ, and a telephone interview to assess specific phobia FoB. Results: Symptoms meeting full and subclinical diagnostic criteria for a specific phobia, FoB, were reported by 3.3% and 7.1% of participants, respectively. The W-DEQ met or exceeded the criteria for a “good enough” screening tool across several analyses, whereas the CFQ only met these criteria in one analysis and came close in three others. Conclusions: The W-DEQ demonstrated high performance as a screening tool for a specific phobia, FoB, with accuracy superior to that of the CFQ. Additional research to ensure the stability of these findings is needed.
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Affiliation(s)
- Nichole Fairbrother
- Department of Family Practice, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
- Correspondence: ; Tel.: +1-250-0519-5390 (ext. 36439)
| | - Arianne Albert
- Women’s Health Research Institute, Vancouver, BC V6H 2N9, Canada;
| | - Fanie Collardeau
- Department of Psychology, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Cora Keeney
- Department of Family Practice, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
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Oxytocin receptor genotype moderates the association between maternal prenatal stress and infant early self-regulation. Psychoneuroendocrinology 2022; 138:105669. [PMID: 35063684 DOI: 10.1016/j.psyneuen.2022.105669] [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: 09/27/2021] [Revised: 12/22/2021] [Accepted: 01/12/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Maternal prenatal stress may have long-term adverse consequences for child development. Accumulating evidence shows that the oxytocin-receptor genotype may play a role in differential susceptibility to early-life adversity, but no studies have examined whether this moderation extends to the prenatal stress exposures. METHODS In the FinnBrain Birth Cohort Study, a sample of 1173 mother-child dyads were examined. We studied the possible moderating effect of the cumulative effect of infant oxytocin-receptor risk genotypes (rs53576GG and rs2254298A) in the association between maternal prenatal stress, and infant negative reactivity and emerging self-regulation at 6 months of age. RESULTS The number of OTr risk genotypes moderated the association between maternal prenatal anxiety and infant self-regulation, implying a cumulative effect of genotype, although effects sizes were small. In infants with two risk genotypes, a negative association between prenatal anxiety and self-regulation was observed, whereas in infants with one or no risk genotypes, the association between maternal prenatal anxiety and temperament was non-significant. CONCLUSION Oxytocin-receptor genotype may moderate the association of maternal stress during pregnancy and child social-emotional development. Possible mechanisms for this moderation effect are discussed. Further studies with a more comprehensive polygenic approach are needed to confirm these results.
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Perez A, Göbel A, Stuhrmann LY, Schepanski S, Singer D, Bindt C, Mudra S. Born Under COVID-19 Pandemic Conditions: Infant Regulatory Problems and Maternal Mental Health at 7 Months Postpartum. Front Psychol 2022; 12:805543. [PMID: 35153928 PMCID: PMC8826543 DOI: 10.3389/fpsyg.2021.805543] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
Background The SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems (RPs) have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental health and the early parent–infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic. Methods As part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables. Results Compared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs. Limitations Due to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis. Conclusions The pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged.
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Affiliation(s)
- Anna Perez
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steven Schepanski
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Developmental Neurophysiology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hendrix CL, Brown AL, McKenna BG, Dunlop AL, Corwin EJ, Brennan PA. Prenatal distress links maternal early life adversity to infant stress functioning in the next generation. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:117-129. [PMID: 35230857 PMCID: PMC9031909 DOI: 10.1037/abn0000688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Maternal stress in pregnancy exerts powerful programming effects into the next generation. Yet it remains unclear whether and how adversity from other times in the woman's life influences her prenatal stress and her offspring's stress functioning. In a sample of 217 Black American mother-infant dyads, we examined whether different types of maternal stress were differentially related to her infant's stress functioning within the first few months after birth. We prospectively assessed maternal distress (perceived stress, depression, and anxiety) early and late in pregnancy, infant behavioral adaption in the context of a mild stressor at 2 weeks of age, and infant diurnal cortisol at 3-6 months of age. We additionally collected retrospective reports of maternal experiences of lifetime discrimination and childhood adversity. Maternal distress experienced late, but not early, in pregnancy predicted lower infant attention in the context of a stressor. Moreover, lifetime experiences of discrimination indirectly impacted infant attention by increasing maternal distress late in pregnancy. These effects were specific to infant behavioral adaptation and were not related to infant diurnal cortisol levels. However, infant diurnal cortisol levels were associated with maternal experiences of discrimination from prior to pregnancy and adversity from the mother's childhood even after controlling for prenatal distress. Our results underscore the cascading nature of stress across the mother's life span and across generations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Caparros-Gonzalez RA, Lynn F, Alderdice F, Peralta-Ramirez MI. Cortisol levels versus self-report stress measures during pregnancy as predictors of adverse infant outcomes: a systematic review. Stress 2022; 25:189-212. [PMID: 35435113 DOI: 10.1080/10253890.2022.2059348] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Systematically review existing evidence to (1) identify the association between self-report stress and cortisol levels measured during pregnancy; and, (2) assess their association with adverse infant outcomes to determine which is the better predictor. A systematic review was conducted in accordance with PRISMA guidelines. Search terms focused on pregnancy, psychological stress and cortisol. Nine electronic databases were searched, in addition to reference lists of relevant papers. Eligibility criteria consisted of studies that included measurement of self-reported psychological stress, cortisol and assessed their associations with any infant-related outcome. Further limits included studies published in English or Spanish with human female participants. A meta-regression was not feasible due to differences in study samples, measurement tools employed, types of cortisol assessed and outcomes reported. A narrative synthesis was provided. 28 studies were eligible for inclusion. Convergent validity between self-report measures and cortisol was reported by three studies (range r = 0.12-0.41). Higher levels of self-report stress were significantly associated with intrauterine growth restriction (fetal biparietal diameter, low fetal head circumference, abdominal circumference), low gestational age at birth, low anthropometric measures (birth length, head circumference, length of the neonate), poor infant neurodevelopment (cognitive development) and potentially pathogenic gut microbiota (Clostridiaceae Clostridium, Haemophilus) in six studies. Higher cortisol levels were significantly associated with intrauterine growth restriction (fetal biparietal diameter, low fetal head circumference, abdominal circumference), low gestational age at birth, low infant birth weight, poor infant neurodevelopment (attention scores on the Network Neurobehavioral Scale) and low levels of potentially protective gut microbiota (Lactobacillus, Slackia and Actinobaculum) in 13 studies. Of the studies that assessed which type of measure was a better predictor of infant outcomes (n = 6), there was agreement that cortisol levels were statistically better at predicting adverse outcomes than self-reported stress. Self-report stress measures appear to be modest predictors of adverse infant outcomes in comparison to cortisol. A number of methodological limitations need to be addressed in future studies to help understand the relationship between cortisol and self-reported stress and how they are related to adverse infant outcomes.
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Affiliation(s)
- Rafael A Caparros-Gonzalez
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Fiona Lynn
- Medical Biology Center, School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Maternal Psychological Problems During Pregnancy and Child Externalizing Problems: Moderated Mediation Model with Child Self-regulated Compliance and Polygenic Risk Scores for Aggression. Child Psychiatry Hum Dev 2022; 53:654-666. [PMID: 33743096 PMCID: PMC9287202 DOI: 10.1007/s10578-021-01154-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 12/05/2022]
Abstract
A potential pathway underlying the association between prenatal exposure to maternal psychological problems and childhood externalizing problems is child self-regulation. This prospective study (N = 687) examined whether self-regulated compliance mediates the relation between maternal affective problems and hostility during pregnancy and childhood externalizing problems, and explored moderation by child polygenic risk scores for aggression and sex. Self-regulated compliance at age 3 was observed in mother-child interactions, and externalizing problems at age 6 were reported by mothers and teachers. Polygenic risk scores were calculated based on a genome-wide association study of aggressive behavior. Self-regulated compliance mediated the associations between maternal psychological problems and externalizing problems. Aggression PRS was associated with higher externalizing problems reported by mothers. No evidence was found of moderation by aggression PRS or sex. These findings support the hypothesis that maternal psychological problems during pregnancy might influence externalizing problems through early self-regulation, regardless of child genetic susceptibility or sex.
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Stolper H, van Doesum K, Steketee M. How to Support Parents of Infants and Young Children in Mental Health Care: A Narrative Review. Front Psychol 2021; 12:745800. [PMID: 34867627 PMCID: PMC8634941 DOI: 10.3389/fpsyg.2021.745800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/15/2021] [Indexed: 01/30/2023] Open
Abstract
Objective: The aim of this narrative review is to gain insight into the appropriate intervention targets when parents of infants and young children suffer from psychopathology. Background: Psychopathology in parents is a risk factor for maladaptive parenting and is strongly related to negative cascade effects on parent-child interactions and relations in the short and long term. Children in their first years of life are especially at risk. However, in adult mental health care, this knowledge is rarely translated into practice, which is a missed opportunity for prevention. Methods: Electronic databases were searched for reviews and meta-analysis. In addition, sources were obtained via manual search, reference mining, expert opinion, and communications from conferences. In total, 56 papers, whereof 23 reviews and 12 meta-analyses were included. Results: Findings regarding targets of intervention were identified in different interacting domains, namely the parental, family, child, and environmental domains as well as the developing parent-child relationship. A "one size fits all" intervention is not appropriate. A flexible, tailored, resource-oriented intervention program, multi-faceted in addressing all modifiable risk factors and using different methods (individual, dyadic, group), seems to provide the best results. Conclusion: To address the risk factors in different domains, adult and child mental health care providers should work together in close collaboration to treat the whole family including mental disorders, relational, and contextual problems. A multi-agency approach that includes social services is needed.
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Affiliation(s)
- Hanna Stolper
- Department of Psychology Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Karin van Doesum
- Department of Clinical Psychology, Radboud University, Nijmegen, Netherlands
| | - Majone Steketee
- Department of Psychology Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
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Jones LB, Hall BA, Kiel EJ. Systematic review of the link between maternal anxiety and overprotection. J Affect Disord 2021; 295:541-551. [PMID: 34509069 PMCID: PMC8551038 DOI: 10.1016/j.jad.2021.08.065] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 08/10/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Theoretical and empirical evidence suggests that maternal anxiety relates to overprotection, yet studies have found conflicting evidence. The literature would benefit from a systematic review. METHODS In April 2020, a systematic review on the relation between maternal anxiety and overprotection was conducted. The search was updated in January 2021. A total of 13 articles were included. RESULTS Of 16 reported bivariate correlations, 12 showed that maternal anxiety accounted for significant variance in overprotection (7 reported a small effect and 5 reported a medium effect). In a group differences study, mothers with anxiety showed greater overprotection. Additionally, in 4 out of 7 multivariate relations maternal anxiety accounted for significant variance in overprotection over and above other factors while 3 suggested that maternal anxiety did not account for significant variance in overprotection. In a multivariate, longitudinal study, maternal anxiety predicted overprotection, over and above other factors. Given conflicting evidence, we evaluated article's methodological strength and found stronger evidence supporting a small to medium size relation compared to evidence supporting no significant relation. LIMITATIONS We report ranges of coefficients and effect sizes, but meta-analytic results are needed to determine the magnitude of these relations based on various factors. More longitudinal studies are needed to determine directionality. CONCLUSIONS Although the literature shows conflicting results, the present review supports that maternal anxiety relates to overprotection, though the effect of this relation is small to medium. It may be beneficial to incorporate mental health for parents into existing parenting interventions.
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Affiliation(s)
- Lauren B. Jones
- Lauren B. Jones may be contacted at or 513-529-2400. Additionally, she may be contacted at Miami University, 90 N. Patterson Ave., Oxford, OH, 45056
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Ölmestig TK, Siersma V, Birkmose AR, Kragstrup J, Ertmann RK. Infant crying problems related to maternal depressive and anxiety symptoms during pregnancy: a prospective cohort study. BMC Pregnancy Childbirth 2021; 21:777. [PMID: 34789174 PMCID: PMC8597256 DOI: 10.1186/s12884-021-04252-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/25/2021] [Indexed: 12/24/2022] Open
Abstract
Background Infant crying may cause concerns among new parents and is a frequent reason for seeking help from their general practitioner (GP). The etiology of crying problems in infancy is not fully understood, but recent studies have found associations with maternal mental factors. It is well-established that postpartum depression is related to infant crying problems while the influence of maternal mental problems in pregnancy on infant crying is less investigated. We aimed to explore whether maternal depressive symptoms or maternal anxiety during pregnancy were related to crying problems by the newborn child. Methods In this prospective cohort study, 1290 pregnant women and their newborn children were followed throughout pregnancy until 8 weeks postpartum. Depressive symptoms and anxiety symptoms were assessed three times during pregnancy and again 8 weeks postpartum with the Major Depressive Inventory (MDI) and the Anxiety Symptoms Scale (ASS). Eight weeks postpartum the mothers were also asked whether their child cried in a way they found problematic. Multivariable regression was used to assess the association between depressive and anxiety symptoms during pregnancy and crying problems, and to adjust for potential confounders. Results We found statistically significant associations between high scores of depressive symptoms and anxiety symptoms in pregnancy and infant crying problems. Previously reported strong associations postpartum between depressive symptoms, anxiety symptoms and infant crying problems were also observed in the present data. Conclusion These results indicate that mental problems during pregnancy are associated with having a child with crying problems after birth. If more focus is given to maternal mental problems during pregnancy, the healthcare system might be able to detect and help these women, which would be beneficial for both mother and child.
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Affiliation(s)
- Tabitha Krogh Ölmestig
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark.
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| | - Anna Rubach Birkmose
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| | - Jakob Kragstrup
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
| | - Ruth Kirk Ertmann
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark
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Rodríguez-Soto NC, Buxó CJ, Morou-Bermudez E, Pérez-Edgar K, Ocasio-Quiñones IT, Surillo-González MB, Martinez KG. The impact of prenatal maternal stress due to potentially traumatic events on child temperament: A systematic review. Dev Psychobiol 2021; 63:e22195. [PMID: 34674245 PMCID: PMC8549868 DOI: 10.1002/dev.22195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 07/21/2021] [Accepted: 08/18/2021] [Indexed: 12/11/2022]
Abstract
The objective of the current study was to complete a systematic review of the relationship between prenatal maternal stress due to potentially traumatic events (PTEs) and child temperament. Eligible studies through June 2020 were identified utilizing a search strategy in PubMed and PsycInfo. Included studies examined associations between prenatal maternal stress due to PTE and child temperament. Two independent coders extracted study characteristics and three coders assessed study quality. Of the 1969 identified studies, 20 met full inclusion criteria. Studies were classified on two dimensions: (1) disaster-related stress and (2) intimate partner violence during pregnancy. For disaster-related prenatal maternal stress, 75% (nine out of 12) of published reports found associations with increased child negative affectivity, 50% (five out of 10) also noted associations with lower effortful control/regulation, and 38% (three out of eight) found associations with lower positive affectivity. When considering prenatal intimate partner violence stress, 80% (four out of five) of published reports found associations with higher child negative affectivity, 67% (four out of six) found associations with lower effortful control/regulation, and 33% (one out of three) found associations with lower positive affectivity. Prenatal maternal stress due to PTEs may impact the offspring's temperament, especially negative affectivity. Mitigating the effects of maternal stress in pregnancy is needed in order to prevent adverse outcomes on the infant's socioemotional development.
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Affiliation(s)
- Nayra C. Rodríguez-Soto
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
- Carlos Albizu University, San Juan, PR
| | - Carmen J. Buxó
- University of Puerto Rico, Medical Sciences Campus, San Juan, PR
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Stuhrmann LY, Göbel A, Mudra S. Peripartale psychische Belastung und Auswirkungen auf die frühe Elternschaft. PSYCHOTHERAPEUT 2021. [DOI: 10.1007/s00278-021-00540-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Zusammenfassung
Hintergrund
Peripartale elterliche Angst und Depressivität zeigten Zusammenhänge mit kindlichen emotionalen und Verhaltensauffälligkeiten. Mögliche Erklärungsansätze umfassen pränatal prägende Einflüsse auf das Ungeborene sowie das postpartale Fortwirken psychischer Belastung auf die Eltern-Kind-Beziehung. Dabei kommt dem elterlichen Vertrauen in die eigenen Fähigkeiten eine mögliche protektive Rolle zu, das wiederum durch die eigene psychische Belastung und das kindliche Verhalten maßgeblich beeinträchtigt sein kann.
Fragestellung
Diese Studie untersucht, wie sich pränatale schwangerschaftsspezifische Ängste auf das Vertrauen in die eigenen Fähigkeiten als Mutter in der frühen Elternschaft auswirken und wodurch dieser Effekt vermittelt wird.
Material und Methoden
Als Teil einer prospektiven Längsschnittstudie beantworteten 116 Mütter im letzten Schwangerschaftsdrittel (T0) und der 3. Woche (T1) postpartal Fragebögen zu schwangerschaftsspezifischen Ängsten, mütterlichem Selbstvertrauen, postpartaler Depressivität und kindlicher Irritabilität.
Ergebnisse
Es zeigte sich, dass der Zusammenhang zwischen pränatalen Ängsten und mangelndem mütterlichen Selbstvertrauen nicht über das Erleben kindlicher Irritabilität, sondern entscheidend über das Erleben postpartaler Depressivität vermittelt wurde. Die mütterliche Parität spielte ebenfalls eine Rolle.
Schlussfolgerung
Pränatale schwangerschaftsspezifische Ängste können postpartaler Depressivität vorausgehen und so indirekt das mütterliche Vertrauen in die eigenen Fähigkeiten beeinträchtigen. Die Wachsamkeit für elterliche psychische Belastung und die Weiterentwicklung von Behandlungsansätzen mit Beginn in der Schwangerschaft sind notwendig und erfordern eine enge interprofessionelle Zusammenarbeit zwischen eltern- und kindbezogenen Disziplinen.
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Yatziv T, Vancor EA, Bunderson M, Rutherford HJV. Maternal perinatal anxiety and neural responding to infant affective signals: Insights, challenges, and a road map for neuroimaging research. Neurosci Biobehav Rev 2021; 131:387-399. [PMID: 34563563 DOI: 10.1016/j.neubiorev.2021.09.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022]
Abstract
Anxiety symptoms are common among women during pregnancy and the postpartum period, potentially having detrimental effects on both mother and child's well-being. Perinatal maternal anxiety interferes with a core facet of adaptive caregiving: mothers' sensitive responsiveness to infant affective communicative 'cues.' This review summarizes the current research on the neural correlates of maternal processing of infant cues in the presence of perinatal anxiety, outlines its limitations, and offers next steps to advance future research. Functional neuroimaging studies examining the neural circuitry involved in, and electrophysiological studies examining the temporal dynamics of, processing infant cues during pregnancy and postpartum are reviewed. Studies have generally indicated mixed findings, although emerging themes suggest that anxiety may be implicated in several stages of processing infant cues- detection, interpretation, and reaction- contingent upon cue valence. Limitations include inconsistent designs, lack of differentiation between anxiety and depression symptoms, and limited consideration of parenting-specific (versus domain-general) anxiety. Future studies should incorporate longitudinal investigation of multiple levels of analysis spanning neural, cognitive, and observed aspects of sensitive caregiving.
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Grumi S, Provenzi L, Accorsi P, Biasucci G, Cavallini A, Decembrino L, Falcone R, Fazzi EM, Gardella B, Giacchero R, Guerini P, Grossi E, Magnani ML, Mariani EM, Nacinovich R, Pantaleo D, Pisoni C, Prefumo F, Sabatini C, Scelsa B, Spartà MV, Spinillo A, Giorda R, Orcesi S, Borgatti R. Depression and Anxiety in Mothers Who Were Pregnant During the COVID-19 Outbreak in Northern Italy: The Role of Pandemic-Related Emotional Stress and Perceived Social Support. Front Psychiatry 2021; 12:716488. [PMID: 34539466 PMCID: PMC8446509 DOI: 10.3389/fpsyt.2021.716488] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/09/2021] [Indexed: 12/28/2022] Open
Abstract
The COVID-19 pandemic is a collective trauma that is threatening citizens' mental health resulting in increased emotional stress, reduced social support, and heightened risk for affective symptoms. The present study aimed to investigate the effects of antenatal pandemic-related emotional stress and perceived social support on the symptoms of depression and anxiety of mothers who were pregnant during the initial COVID-19 outbreak in northern Italy. A sample of 281 mothers was enrolled at eight maternity units in the first hotspot region of the COVID-19 outbreak in northern Italy. Participants filled out online questionnaires assessing the direct or indirect exposure to the SARS-CoV-2 virus, pandemic-related stress, perceived social support, as well as symptoms of depression and anxiety. Depressive and anxious symptomatology was above clinical concern, respectively, in 26 and 32% of the respondents. Mothers who reported no exposure to SARS-CoV-2 during pregnancy and those who reported at least one direct or indirect exposure did not differ in terms of affective symptoms. Continuous scores and risk for severe depression and anxiety were positively associated with prenatal pandemic-related emotional stress and negatively linked with perceived social support during pregnancy. Women who become mothers during the COVID-19 emergency may be at high risk for affective problems. Dedicated preventive programs are needed to provide adequate preventive support and care for maternal mental health during and after the COVID-19 pandemic.
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Affiliation(s)
- Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Patrizia Accorsi
- Unit of Child and Adolescence Neuropsychiatry, ASST Spedali Civili, Brescia, Italy
| | - Giacomo Biasucci
- Pediatrics & Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Anna Cavallini
- Child and Adolescent Mental Health, San Gerardo Hospital, Monza, Italy
| | | | | | - Elisa Maria Fazzi
- Unit of Child and Adolescence Neuropsychiatry, ASST Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Barbara Gardella
- Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Paola Guerini
- Pediatric Unit and Neonatal Unit, ASST Pavia, Pavia, Italy
| | - Elena Grossi
- Pediatrics & Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | | | - Renata Nacinovich
- Child and Adolescent Mental Health, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery and Milan Center for Neuroscience, Università Bicocca, Milan, Italy
| | - Dario Pantaleo
- Pediatric Unit and Neonatal Unit, ASST Pavia, Pavia, Italy
| | - Camilla Pisoni
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federico Prefumo
- Unit of Child and Adolescence Neuropsychiatry, ASST Spedali Civili, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Barbara Scelsa
- Pediatric Neurology Unit, V. Buzzi Children's Hospital, Milan, Italy
| | | | - Arsenio Spinillo
- Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Roberto Giorda
- Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Simona Orcesi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Renato Borgatti
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Korja R, McMahon C. Maternal prenatal mood problems and lower maternal emotional availability associated with lower quality of child's emotional availability and higher negative affect during still-face procedure. INFANCY 2021; 26:901-919. [PMID: 34370394 DOI: 10.1111/infa.12428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 01/20/2023]
Abstract
Our aim was to study the effects of maternal perinatal mood and maternal emotional availability on child emotional availability and negative affect during the still-face procedure (SFP). The sample included 214 women who participated in a prospective study. We assessed maternal mood problems using the Mini International Neuropsychiatric Interview and PRAQ questionnaire during pregnancy and using STAI and EPDS questionnaires during pregnancy and at 6 months after delivery. Maternal and child emotional availability were studied using the Emotional Availability Scales during the SFP at 6 months. We observed and quantified child's negative affect during SFP episodes. We found that mothers with maternal mood problems (anxiety and/or depression) during pregnancy, but not postnatally, showed less optimal maternal structuring during the SFP, and the children showed lower involvement and responsiveness during interactions with their mothers. Furthermore, lower maternal emotional availability was related to the child's higher negative affect during the SFP. Our findings underline the independent roles of both prenatal stress exposure and maternal caregiving behavior in a child's socioemotional development.
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Affiliation(s)
- Riikka Korja
- Department of Psychology, University of Turku, Turku, Finland.,The Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Catherine McMahon
- The Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
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45
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Beck CT. Perinatal Mood and Anxiety Disorders: Research and Implications for Nursing Care. Nurs Womens Health 2021; 25:e8-e53. [PMID: 34099430 DOI: 10.1016/j.nwh.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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46
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Maternal caregiving ameliorates the consequences of prenatal maternal psychological distress on child development. Dev Psychopathol 2021; 34:1376-1385. [PMID: 34311804 DOI: 10.1017/s0954579421000286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Children exposed to prenatal maternal psychological distress are at elevated risk for a range of adverse outcomes; however, it remains poorly understood whether postnatal influences can ameliorate impairments related to prenatal distress. The current study evaluated if sensitivematernal care during the first postnatal year could mitigate child cognitive and emotional impairments associated with prenatal psychological distress. Prenatal maternal psychological distress was assessed via self-reports of anxiety, depression, and perceived stress for 136 mothers at five prenatal and four postpartum time points. Quality of maternal care (sensitivity to nondistress, positive regard, and intrusiveness reverse-scored) were assessed during a mother-child play interaction at 6 and 12 months. Child cognitive function and negative emotionality were assessed at 2 years, using The Bayley Scales and the Early Childhood Behavior Questionnaire. Elevated prenatal distress was associated with poorer child cognitive function and elevated negative emotionality. Children exposed to elevated prenatal maternal distress did not, however, display these outcomes if they received high-quality caregiving. Specifically, maternal care moderated the relation between prenatal psychological distress and child cognitive function and negative emotionality. This association remained after consideration of postnatal maternal psychological distress and relevant covariates. Sensitive maternal care was associated with altered offspring developmental trajectories, supporting child resilience following prenatal distress exposure.
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Barger MK. Current Resources for Evidence-Based Practice, May/June 2021. J Midwifery Womens Health 2021; 66:413-421. [PMID: 34166576 DOI: 10.1111/jmwh.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Mary K Barger
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, California
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48
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Bayless AK, Wyatt TH, Raynor H. Self-Regulation in Pediatric Nursing Literature: An Evolutionary Concept Exploration. Res Theory Nurs Pract 2021; 35:RTNP-D-20-00084. [PMID: 34162760 DOI: 10.1891/rtnp-d-20-00084] [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] [Indexed: 11/25/2022]
Abstract
The concept of self-regulation appears frequently in nursing literature. Although the concept is well developed in nonnursing theories, its application in nursing has not been explored adequately. Most nursing authors address self-regulation in one of two ways. Some publish findings without a strong theoretical understanding of self-regulation. Others publish studies using a conglomeration of theorists' self-regulatory explanations without properly contextualizing the theoretical elements for nursing practice. For this concept exploration, the authors used Rodgers, B. L. (2005). Developing nursing knowledge: Philosophical traditions and influences Lippincott, Williams & Wilkins, evolutionary concept analysis method to determine the current use of self-regulation in pediatric nursing literature and trace the concept's recent development, changes, and expansion. This work provides a representation of self-regulation based on existing healthcare studies and suggests steps for concept clarification that could promote accurate use of the concept in future research.
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Affiliation(s)
| | - Tami H Wyatt
- College of Nursing, University of Tennessee, Knoxville, TN
| | - Hollie Raynor
- College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN
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Beck CT. Perinatal Mood and Anxiety Disorders: Research and Implications for Nursing Care. J Obstet Gynecol Neonatal Nurs 2021; 50:e1-e46. [PMID: 34099348 DOI: 10.1016/j.jogn.2021.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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50
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Frigerio A, Nazzari S. Antenatal maternal anxiety, maternal sensitivity and toddlers' behavioral problems: An investigation of possible pathways. Early Hum Dev 2021; 157:105364. [PMID: 33813323 DOI: 10.1016/j.earlhumdev.2021.105364] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/14/2021] [Accepted: 03/20/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND While evidence exists of an association between maternal antenatal anxiety and offspring's behavioral outcomes, the role played by maternal care in explaining this link has been poorly investigated. AIM The current study aimed to investigate the mediating/moderating role of maternal sensitivity in the association between maternal antenatal trait anxiety and toddlers' behavioral problems and temperament, taking also into account potential confounders. Analyses were also replicated for maternal antenatal state anxiety and depression. METHODS Ninety women filled in the State-Trait Anxiety Questionnaire and the Edinburgh Postnatal Depression Scale to assess anxiety/depressive symptoms during the third trimester of pregnancy (34-36 weeks of gestation) and 14 months post-partum. They also filled in the Child Behavior Checklist and the Infant Behavior Questionnaire to evaluate their 14-month-olds' behavioral problems and negative affectivity, respectively. Maternal sensitivity was assessed through the Emotional Availability Scales. RESULTS Maternal antenatal trait anxiety was associated with internalizing, but not externalizing, problems. Interestingly, maternal sensitivity moderated the association between antenatal trait anxiety and externalizing problems. Conversely, antenatal maternal depression was significantly associated with toddlers' negative affectivity. CONCLUSIONS Our findings contribute to shed light on the association between maternal antenatal anxiety and child behaviors, as well as on the role played by parenting in moderating this link, with promising implications for targeted interventions.
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Affiliation(s)
- Alessandra Frigerio
- Scientific Institute, IRCCS Eugenio Medea, Child Psychopathology Unit, Bosisio Parini, Lecco, Italy.
| | - Sarah Nazzari
- Scientific Institute, IRCCS Eugenio Medea, Child Psychopathology Unit, Bosisio Parini, Lecco, Italy
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