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Harnett NG, Merrill LC, Fani N. Racial and ethnic socioenvironmental inequity and neuroimaging in psychiatry: a brief review of the past and recommendations for the future. Neuropsychopharmacology 2024:10.1038/s41386-024-01901-7. [PMID: 38902354 DOI: 10.1038/s41386-024-01901-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024]
Abstract
Neuroimaging is a major tool that holds immense translational potential for understanding psychiatric disorder phenomenology and treatment. However, although epidemiological and social research highlights the many ways inequity and representativeness influences mental health, there is a lack of consideration of how such issues may impact neuroimaging features in psychiatric research. More specifically, the potential extent to which racialized inequities may affect underlying neurobiology and impact the generalizability of neural models of disorders is unclear. The present review synthesizes research focused on understanding the potential consequences of racial/ethnic inequities relevant to neuroimaging in psychiatry. We first discuss historical and contemporary drivers of inequities that persist today. We then discuss the neurobiological consequences of these inequities as revealed through current research, and note emergent research demonstrating the impact such inequities have on our ability to use neuroimaging to understand psychiatric disease. We end with a set of recommendations and practices to move the field towards more equitable approaches that will advance our abilities to develop truly generalizable neurobiological models of psychiatric disorders.
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Affiliation(s)
- Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Livia C Merrill
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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2
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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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3
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Chan SY, Low XZ, Ngoh ZM, Ong ZY, Kee MZL, Huang P, Kumar S, Rifkin-Graboi A, Chong YS, Chen H, Tan KH, Chan JKY, Fortier MV, Gluckman PD, Zhou JH, Meaney MJ, Tan AP. Neonatal Nucleus Accumbens Microstructure Modulates Individual Susceptibility to Preconception Maternal Stress in Relation to Externalizing Behaviors. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00071-6. [PMID: 38423282 DOI: 10.1016/j.jaac.2023.12.011] [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: 03/16/2023] [Revised: 11/20/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Maternal stress influences in utero brain development and is a modifiable risk factor for offspring psychopathologies. Reward circuitry dysfunction underlies various internalizing and externalizing psychopathologies. This study examined (1) the association between maternal stress and microstructural characteristics of the neonatal nucleus accumbens (NAcc), a major node of the reward circuitry, and (2) whether neonatal NAcc microstructure modulates individual susceptibility to maternal stress in relation to childhood behavioral problems. METHOD K-means longitudinal cluster analysis was performed to determine trajectories of maternal stress measures (Perceived Stress Scale [PSS], hair cortisol) from preconception to the third trimester. Neonatal NAcc microstructural measures (orientation density index [ODI] and intracellular volume fraction [ICVF]) were compared across trajectories. We then examined the interaction between maternal stress and neonatal NAcc microstructure on child internalizing and externalizing behaviors, assessed between ages 3 and 4 years. RESULTS Two trajectories of maternal stress magnitude ("low"/"high") were identified for both PSS (n = 287) and hair cortisol (n = 336). Right neonatal NAcc ODI (rNAcc-ODI) was significantly lower in "low" relative to "high" PSS trajectories (n = 77, p = .04). PSS at preconception had the strongest association with rNAcc-ODI (r = 0.293, p = .029). No differences in NAcc microstructure were found between hair cortisol trajectories. A significant interaction between preconception PSS and rNAcc-ODI on externalizing behavior was observed (n = 47, p = .047). CONCLUSION Our study showed that the preconception period contributes to in utero NAcc development, and that NAcc microstructure modulates individual susceptibility to preconception maternal stress in relation to externalizing problems.
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Affiliation(s)
- Shi Yu Chan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Xi Zhen Low
- National University Health System, Singapore, Singapore
| | - Zhen Ming Ngoh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Zi Yan Ong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Michelle Z L Kee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Pei Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | | | - Anne Rifkin-Graboi
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore; National University Health System, Singapore, Singapore; National University of Singapore, Singapore, Singapore
| | - Helen Chen
- KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - Kok Hian Tan
- KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - Jerry K Y Chan
- KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - Marielle V Fortier
- KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | | | - Michael J Meaney
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore; National University of Singapore, Singapore, Singapore; Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore; National University Health System, Singapore, Singapore; National University of Singapore, Singapore, Singapore.
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Huizink AC, Lammassaari D, Nolvi S, Korja R, Karlsson L, Karlsson H, Kataja EL. Antecedents of maternal pregnancy-related anxiety trajectories: The FinnBrain birth cohort study. Acta Psychiatr Scand 2024. [PMID: 38369812 DOI: 10.1111/acps.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE Little is known about the normative courses of pregnancy-related anxiety throughout pregnancy and their antecedents. We examined in a large scale pregnancy cohort which potentially distinct trajectories of pregnancy-related anxiety across pregnancy can be identified, and which factors predict these trajectories. METHODS A general sample of pregnant women (n = 2928) from the FinnBrain Birth Cohort participated in this study. Several questionnaires were filled in at 14, 24, and 34 weeks of gestation, including the pregnancy-related anxiety questionnaire-revised as main outcome. Latent Growth Mixture Modeling was applied to identify the trajectories of pregnancy-related anxiety across pregnancy, and t-tests and chi-quare tests were conducted to find antecedents of these trajectories. RESULTS Two distinct trajectories were identified: (1) a low symptoms group, N = 2594 (88.6%), with lower and slightly increasing levels of pregnancy-related anxiety (2) a moderately-high symptoms group, N = 334 (11.4%) reported higher and slightly decreasing levels of anxiety. Correlates of the moderately-high anxious group included a lower monthly income, drinking alcohol or smoking in early pregnancy, more daily hassles and less joy, more early life adversities, younger age, primiparity, single parenthood, using depression medication, and having higher scores on depression and general anxiety. CONCLUSIONS Although the majority of pregnant women fall within a low risk trajectory of pregnancy-related anxiety, another group with consistently higher levels of pregnancy anxiety throughout pregnancy may need more clinical attention, as their high pregnancy-related anxiety scores may indicate a risk profile that includes a variety of general and more pregnancy-specific risk factors, which together can negatively affect fetal and infant development and behavior.
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Affiliation(s)
- Anja C Huizink
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dora Lammassaari
- Department of Psychology and Speech Pathology, University of Turku, Turku, Finland
| | - Saara Nolvi
- Department of Psychology and Speech Pathology, University of Turku, Turku, Finland
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Riikka Korja
- Department of Psychology and Speech Pathology, University of Turku, Turku, Finland
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Linnea Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
- Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eeva Leena Kataja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
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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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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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Kumpulainen V, Copeland A, Pulli EP, Silver E, Kataja EL, Saukko E, Merisaari H, Lewis JD, Karlsson L, Karlsson H, Tuulari JJ. Prenatal and Postnatal Maternal Depressive Symptoms Are Associated With White Matter Integrity in 5-Year-Olds in a Sex-Specific Manner. Biol Psychiatry 2023; 94:924-935. [PMID: 37220833 DOI: 10.1016/j.biopsych.2023.05.014] [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: 11/30/2022] [Revised: 04/18/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Prenatal and postnatal maternal psychological distress predicts various detrimental consequences on social, behavioral, and cognitive development of offspring, especially in girls. Maturation of white matter (WM) continues from prenatal development into adulthood and is thus susceptible to exposures both before and after birth. METHODS WM microstructural features of 130 children (mean age, 5.36 years; range, 5.04-5.79 years; 63 girls) and their association with maternal prenatal and postnatal depressive and anxiety symptoms were investigated with diffusion tensor imaging, tract-based spatial statistics, and regression analyses. Maternal questionnaires were collected during first, second, and third trimesters and at 3, 6, and 12 months postpartum with the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms and Symptom Checklist-90 for general anxiety. Covariates included child's sex; child's age; maternal prepregnancy body mass index; maternal age; socioeconomic status; and exposures to smoking, selective serotonin reuptake inhibitors, and synthetic glucocorticoids during pregnancy. RESULTS Prenatal second-trimester EPDS scores were positively associated with fractional anisotropy in boys (p < .05, 5000 permutations) after controlling for EPDS scores 3 months postpartum. In contrast, postpartum EPDS scores at 3 months correlated negatively with fractional anisotropy (p < .01, 5000 permutations) in widespread areas only in girls after controlling for prenatal second-trimester EPDS scores. Perinatal anxiety was not associated with WM structure. CONCLUSIONS These results suggest that prenatal and postnatal maternal psychological distress is associated with brain WM tract developmental alterations in a sex- and timing-dependent manner. Future studies including behavioral data are required to consolidate associative outcomes for these alterations.
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Affiliation(s)
- Venla Kumpulainen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland.
| | - Anni Copeland
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Elmo P Pulli
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eero Silver
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Radiology, Turku University Hospital, Turku, Finland
| | - John D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Cassidy AR, Neumann AA. [Formula: see text] Optimizing neurodevelopmental outcomes following fetal diagnosis of congenital heart disease: a call for primary prevention neuropsychology. Child Neuropsychol 2023; 29:1155-1177. [PMID: 36942716 DOI: 10.1080/09297049.2023.2190966] [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: 07/08/2022] [Accepted: 03/07/2023] [Indexed: 03/23/2023]
Abstract
Critical congenital heart disease (CHD) presents a lasting threat to quality of life through its adverse impact on neurodevelopmental and psychosocial outcomes. As recognition of this threat has increased, so too has an appreciation for the role of pediatric neuropsychologists in supporting families affected by CHD. But there is more to offer these families than traditional neuropsychological services, which tend to focus on secondary/tertiary forms of prevention. Now that many children with CHD are diagnosed prenatally, it may be possible to begin mitigating CHD-related risks and promoting positive outcomes earlier than ever before. Through primary prevention-oriented fetal neuropsychological consultation, as well as close collaboration with allied specialists, pediatric neuropsychology has an opportunity to re-envision its typical borders and more familiar practice models; to forge early and enduring partnerships with families; and to help promote the best possible neurodevelopmental trajectories, beginning before children are even born. In this conceptual review, we survey and integrate evidence from developmental science, developmental origins of health and disease, maternal-fetal medicine, and cardiac neurodevelopmental literatures, along with current practice norms, arriving ultimately at two central conclusions: 1) there is an important role to fill on multidisciplinary teams for the pediatric neuropsychologist in fetal cardiac care and 2) role expansion (e.g., through valuing broader-based training, flexing more generalist skills) can likely improve neuropsychological outcomes earlier than has been standard for pediatric neuropsychologists. Such a reimagining of our practice may be considered primary prevention neuropsychology. Implications for care in various settings and pragmatic barriers to implementation are discussed.
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Affiliation(s)
- Adam R Cassidy
- Departments of Psychiatry & Psychology and Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alyssa A Neumann
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
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Siegmann EM, Eichler A, Buchholz VN, Gerlach J, Pontones CA, Titzmann A, Arnaud N, Consortium IMACM, Mühle C, Beckmann MW, Fasching PA, Kratz O, Moll GH, Kornhuber J, Lenz B. Effects of an App-Based Mindfulness Intervention during Pregnancy on the Infant's Prenatal Androgen Exposure: A Randomized Controlled Pilot Trial. J Clin Med 2023; 12:6142. [PMID: 37834786 PMCID: PMC10573842 DOI: 10.3390/jcm12196142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
Prenatal androgen exposure modulates the development of the brain, with lasting effects on its function and behavior over the infant's life span. Environmental factors during pregnancy, in particular maternal stress, have been shown to influence the androgen load of the unborn child. We here addressed the research gap on whether a mindfulness intervention or a pregnancy education administered to pregnant women more affects the androgen exposure of the unborn child (quantified by the proxies of second-to-fourth digit length ratio (2D:4D) and anogenital distance assessed one year after delivery and at delivery, respectively). Moreover, we tested the mindfulness intervention's effects on maternal perceived stress, anxiety, depressiveness, and mindfulness. Pregnant women (gestation weeks 8-14) were randomized to a 15-week app-based mindfulness-oriented intervention (N = 72) or a pregnancy education intervention (control condition; N = 74). The mindfulness-oriented group did not significantly differ from the pregnancy education group in infants' 2D:4D or anogenital distance (partial η2 ≤ 0.01) or in maternal stress, anxiety, depressiveness, or mindfulness. However, the descriptive results indicate that across pregnancy, stress and anxiety decreased and mindfulness increased in both groups. Overall, this study did not show that the mindfulness intervention (relative to the pregnancy education) reduced the prenatal androgen exposure of the unborn children or improved the maternal outcomes significantly.
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Affiliation(s)
- Eva-Maria Siegmann
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Verena Nadine Buchholz
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Jennifer Gerlach
- Department of Child and Adolescent Mental Health, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Constanza A. Pontones
- Department of Obstetrics and Gynecology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Adriana Titzmann
- Department of Obstetrics and Gynecology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg–Eppendorf, 20246 Hamburg, Germany
| | | | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Matthias W. Beckmann
- Department of Obstetrics and Gynecology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Peter A. Fasching
- Department of Obstetrics and Gynecology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Gunther H. Moll
- Department of Child and Adolescent Mental Health, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Bernd Lenz
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
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Phua DY, Chew CSM, Tan YL, Ng BJK, Lee FKL, Tham MMY. Differential effects of prenatal psychological distress and positive mental health on offspring socioemotional development from infancy to adolescence: a meta-analysis. Front Pediatr 2023; 11:1221232. [PMID: 37780045 PMCID: PMC10536167 DOI: 10.3389/fped.2023.1221232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
The impact of prenatal maternal mental health on offspring socioemotional development is substantial and enduring. Existing literature primarily focuses on the effects of psychological distress during pregnancy, emphasizing adverse child outcomes. Recent studies, however, highlight the unique impact of positive maternal mental health on child outcomes. To elucidate the differential associations of maternal psychological distress and positive mental health during pregnancy with child outcomes, we conducted a systematic literature search and random-effects meta-analyses on studies investigating the associations of prenatal maternal mental health with child socioemotional development. Our analyses, comprising 74 studies with 321,966 mother-child dyads across 21 countries, revealed significant associations of prenatal psychological distress with both adverse and positive child socioemotional outcomes. Notably, the effect sizes for the association of psychological distress with positive child outcomes were smaller compared to adverse outcomes. Positive prenatal mental health, on the other hand, was significantly associated with positive socioemotional outcomes but not adverse outcomes. This meta-analysis highlights the independence of negative and positive prenatal mental health constructs and their distinct relationships with child socioemotional development. The findings underscore the importance of considering the positive spectrum of maternal mental health and developmental outcomes to enhance our understanding of prenatal influences on child development. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335227, identifier CRD42022335227.
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Affiliation(s)
- Desiree Y. Phua
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Chermaine S. M. Chew
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Yang Lik Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Benjamin J. K. Ng
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Florence K. L. Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
| | - Megan M. Y. Tham
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- School of Management and Communication, Republic Polytechnic, Singapore, Singapore
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Tung I, Keenan K, Hipwell AE. Adolescent Mothers' Psychological Wellbeing during Pregnancy and Infant Emotional Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:616-632. [PMID: 34605721 PMCID: PMC8977390 DOI: 10.1080/15374416.2021.1981339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Although many studies have identified risk factors for adolescent pregnancy, much less is known about factors that support pregnant adolescents' psychological wellbeing and offspring outcomes. This study drew on strength-based frameworks to investigate family and neighborhood factors linked to social connectedness that predict psychological wellbeing during adolescent pregnancy and offspring outcomes. METHOD Participants included 135 adolescent mothers (ages 14-21; 90% Black American) assessed annually since childhood as part of a longitudinal study. During preadolescence (ages 11-13), data on contextual stressors and neighborhood support were gathered from participants' caregivers; participants also rated their perceived trust/attachment with caregivers before and during pregnancy. To assess changes in psychological wellbeing, adolescents reported positive and depressed mood before and during pregnancy. A path analysis model tested the prospective associations between family and neighborhood factors, psychological wellbeing during pregnancy, and offspring outcomes (birth outcomes; observed infant positive/negative emotions at age 3-months). RESULTS Positive mood decreased from pre-pregnancy to pregnancy, whereas depressed mood remained stable. Adjusting for pre-pregnancy mood, perceived caregiver trust/attachment during pregnancy was associated with prenatal positive mood. Prenatal positive mood, in turn, reduced risk of preterm birth and indirectly predicted positive infant emotions via birth outcomes. Neighborhood support in preadolescence predicted lower prenatal depressed mood, but depressed mood did not predict infant outcomes beyond positive mood. Contextual life stress was not associated with prenatal mood after adjusting for family and neighborhood support. CONCLUSIONS Findings highlight changes in positive-valence emotions during adolescent pregnancy that may have unique associations with birth outcomes and offspring emotions.
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Affiliation(s)
- Irene Tung
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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Mefrouche ML, Siegmann EM, Böhme S, Berking M, Kornhuber J. The Effect of Digital Mindfulness Interventions on Depressive, Anxiety, and Stress Symptoms in Pregnant Women: A Systematic Review and Meta-Analysis. Eur J Investig Health Psychol Educ 2023; 13:1694-1706. [PMID: 37754461 PMCID: PMC10529137 DOI: 10.3390/ejihpe13090122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction. Pregnancy is a unique time in a woman's life that can be both exciting and challenging. It is also a period that can be associated with significant stress, anxiety, and depression, which can have negative consequences for both the mother and the baby. Mindfulness interventions are known to be a well-suited treatment and prevention method for psychiatric symptoms in pregnancy, and web-based applications have been explored. We here present an up-to-date systematic review and meta-analysis of randomized-controlled trials to investigate the effect of digital-based mindfulness interventions on depressive, anxiety, and stress symptoms during pregnancy. Methods. The systematic literature search and data extraction was performed by two independent raters. It resulted in 13 eligible studies overall comprising 1373 participants. We conducted random-effects meta-analyses for depressive, anxiety, and stress symptoms after completion of a digital mindfulness intervention (compared to a control group). Results. Digital mindfulness intervention methods were significantly able to reduce depression (g = -0.47, 95% CI [-0.9; -0.09]) and anxiety symptoms (g = -0.41, 95% CI [-0.77; -0.05]), but not stress symptoms. These effects were moderated by the attrition rate (βDepression = 0.025, pDepression < 0.01; βAnxiety = 0.022, pAnxiety < 0.01; βStress = 0.022, pStress < 0.01). Primiparity also had a significant influence on the intervention effect regarding depression symptoms (β = 0.033, p = 0.024). Conclusions. Digital mindfulness interventions are a promising method to reduce mental health symptoms in pregnant women. We identified certain parameters moderating this effect, for example, primiparity and the attrition rate.
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Affiliation(s)
- Monique L. Mefrouche
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.L.M.)
- Department of Clinical Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Eva-Maria Siegmann
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.L.M.)
| | - Stephanie Böhme
- Department of Clinical Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Matthias Berking
- Department of Clinical Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.L.M.)
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López-Morales H, Del-Valle MV, López MC, Andrés ML, García MJ, Canet-Juric L, Urquijo S. Maternal anxiety, exposure to the COVID-19 pandemic and socioemotional development of offspring. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023; 86:101517. [PMID: 36748034 PMCID: PMC9892320 DOI: 10.1016/j.appdev.2023.101517] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic context may predispose mothers to increased maternal psychopathology, which may be associated with offspring socioemotional development. The aim of this study is to analyze the relationships between prenatal anxiety and depression and exposure to the COVID-19 pandemic with offspring socioemotional development, controlling for postnatal anxiety and depression. A total of 105 mother-child dyads were assessed in pre- and postnatal periods. Questionnaires were used to assess the impact of the pandemic, indicators of psychopathology, and the socioemotional development of the offspring. Results suggest that negative pandemic experiences are indirectly associated with offspring socioemotional development via prenatal maternal anxiety symptomatology and after controlling for postnatal anxiety and depression. These indicators predispose to emotional deficits and increase the risks of psychopathological and neurodevelopmental disorders. It is important to adopt health policies that provide timely assessment of development in early childhood to reduce the risks associated with these deficits.
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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), Argentina
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, 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), Argentina
| | - Marcela Carolina López
- 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), 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), Argentina
| | - Matías Jonás García
- 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), 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), 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), Argentina
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Li P, Ru X, Teng Y, Han Y, Liu Z, Tao F, Huang K. Interaction between isolated maternal hypothyroxinemia and pregnancy-related anxiety on preschooler's internalizing and externalizing problems: A birth cohort study. Psychoneuroendocrinology 2023; 152:106102. [PMID: 37018881 DOI: 10.1016/j.psyneuen.2023.106102] [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: 10/29/2022] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Isolated maternal hypothyroxinemia (IMH) and pregnancy-related anxiety may increase the risk of offspring's emotional and behavioral problems, but little is known about their potential interactive effect on preschoolers' internalizing and externalizing problems. METHODS We conducted a large prospective cohort study in Ma'anshan Maternal and Child Health Hospital between May 2013 and September 2014. There were a total of 1372 mother-child pairs from the Ma'anshan birth cohort (MABC) included in this study. IMH was defined as the thyroid-stimulating hormone (TSH) level within the normal reference range (2.5-97.5th percentile) and the free thyroxine (FT4) level below the 2.5th percentile, and negative TPOAb. The pregnancy-related anxiety questionnaire (PRAQ) was used to assess women's pregnancy-related anxiety status in the first (1-13 weeks), second (14-27 weeks) and third (after 28 weeks) trimesters of pregnancy. The Achenbach Child Behavior Checklist (CBCL/1.5-5) was used to assess preschoolers' internalizing and externalizing problems. RESULTS Preschoolers born of mothers with IMH and anxiety had an increased risk of anxious/depressed (OR = 6.40, 95% CI 1.89-21.68), somatic complaints (OR = 2.69, 95% CI 1.01-7.20), attention problems (OR = 2.95, 95% CI 1.00-8.69) and total problems (OR = 3.40, 95% CI 1.60-7.21). Particularly, mothers with IMH and anxiety was associated with an increased risk of preschool girls' anxious/depressed (OR = 8.14, 95% CI 1.74-38.08), withdrawn (OR = 7.03, 95% CI 2.25-21.92), internalizing problems (OR = 2.66, 95% CI 1.00-7.08), and total problems (OR = 5.50, 95% CI 2.00-15.10). CONCLUSIONS IMH and pregnancy-related anxiety during pregnancy may synergistically increase the risk of internalizing and externalizing problems in preschooler children. This interaction is distinct in internalizing problems of preschool girls.
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Affiliation(s)
- Peixuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xue Ru
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yuzhu Teng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yan Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Zijian Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China.
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15
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Dabb C, Dryer R, Brunton RJ, Yap K, Roach VJ. Paternal pregnancy-related anxiety: Systematic review of men's concerns and experiences during their partners' pregnancies. J Affect Disord 2023; 323:640-658. [PMID: 36481231 DOI: 10.1016/j.jad.2022.11.092] [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: 10/17/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Up to 25 % of expectant parents experience anxiety symptoms. Pregnancy-related anxiety is characterised by concerns and worries specific to pregnancy, childbirth, and the transition to parenthood. While pregnancy-related anxiety is well-researched in women, the exact nature of this construct in men is unclear. The purpose of the current review was to examine men's concerns, worries, and fears during pregnancy and gain an understanding of their experiences during pregnancy. METHODS An integrative review design was adopted, using thematic content analysis to synthesise findings from quantitative and qualitative studies. Quality appraisal of the quantitative studies used the AXIS appraisal tool. The Critical Appraisal Skills Program (CASP) checklist was used for the qualitative studies. RESULTS A comprehensive search of nine databases led to inclusion of 14 quantitative and 41 qualitative studies. Ten dimensions of paternal pregnancy-related anxiety were identified: childbirth concerns, attitudes towards childbirth, baby concerns, acceptance of pregnancy, partner concerns, relationship concerns, worry about self, transition to parenthood, attitudes towards health care professionals, and practical and financial concerns. The pregnancy transition was characterised by mixed emotions and conflicted experiences for fathers. LIMITATIONS Generalizability of review findings was limited by poor reporting of demographic information by many included studies, exclusion of studies not published in English, and focus on heterosexual relationships. CONCLUSIONS Expectant fathers may experience anxiety symptoms characterised by excessive worry across multiple domains of pregnancy-related concerns. Clinicians play an important role in identifying and supporting fathers with pregnancy-related anxiety and addressing the sense of exclusion often experienced by them.
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Affiliation(s)
- Carol Dabb
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield Campus, NSW 2135, Australia.
| | - Rachel Dryer
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield Campus, NSW 2135, Australia
| | - Robyn J Brunton
- School of Psychology, Charles Sturt University, Bathurst Campus, NSW 2795, Australia
| | - Keong Yap
- School of Behavioural and Health Sciences, Australian Catholic University, Strathfield Campus, NSW 2135, Australia
| | - Vijay J Roach
- Past President, Royal Australian and New Zealand College of Obstetricians and Gynaecologists
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16
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Kukafka R, Eysenbach G, Wang J, Mao F, Wu L, Huang Y, Sun J, Cao F. Effectiveness of Digital Guided Self-help Mindfulness Training During Pregnancy on Maternal Psychological Distress and Infant Neuropsychological Development: Randomized Controlled Trial. J Med Internet Res 2023; 25:e41298. [PMID: 36763452 PMCID: PMC9960047 DOI: 10.2196/41298] [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: 07/21/2022] [Revised: 12/17/2022] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Maternal psychological distress during pregnancy is associated with unfavorable outcomes in infants. Mindfulness-based interventions (MBIs) can effectively alleviate psychological distress, but there are often barriers to the access of face-to-face interventions. OBJECTIVE This study aimed to investigate the effectiveness of a digital guided self-help (GSH) MBI (GSH-MBI) in reducing maternal psychological distress and improving infant neuropsychological performance. METHODS This was a randomized controlled trial. We recruited 160 women who were 12 to 20 weeks pregnant and exhibited psychological distress. We randomized them into a digital GSH-MBI group and a control group (usual perinatal care). The digital GSH-MBI consisted of a 6-week intervention through a WeChat mini program, with a daily reminder sent to the participants by a research assistant via WeChat. The primary outcomes consisted of maternal psychological distress, including depression, anxiety, and pregnancy-related anxiety symptoms, which were assessed at 6 time points from baseline to 6 months post partum (only pregnancy-related anxiety symptoms were assessed 3 times during pregnancy). The secondary outcomes were infant neuropsychological outcomes, including temperament and developmental behaviors, which were assessed at 6 weeks and 6 months post partum. RESULTS Compared with the control group, the digital GSH-MBI group showed a significant reduction in depression, anxiety, and pregnancy-related anxiety symptoms. In addition, the scores of the digital GSH-MBI group were lower than those of the control group for the 3 types of infant temperament at 6 weeks post partum, including quality of mood, distractibility, and adaptability. CONCLUSIONS Digital GSH-MBIs are effective in alleviating psychological distress among pregnant women and protecting infant outcomes. TRIAL REGISTRATION Chinese Clinical Trial Register ChiCTR2000040717; https://www.chictr.org.cn/showproj.aspx?proj=65376.
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Affiliation(s)
| | | | - Juan Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Fangxiang Mao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Liuliu Wu
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yongqi Huang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Jiwei Sun
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
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Azar N, Booij L. DNA methylation as a mediator in the association between prenatal maternal stress and child mental health outcomes: Current state of knowledge. J Affect Disord 2022; 319:142-163. [PMID: 36113690 DOI: 10.1016/j.jad.2022.09.008] [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: 06/10/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Prenatal maternal stress is increasingly recognized as a risk factor for offspring mental health challenges. DNA methylation may be a mechanism, but few studies directly tested mediation. These few integrative studies are reviewed along with studies from three research areas: prenatal maternal stress and child mental health, prenatal maternal stress and child DNA methylation, and child mental health and DNA methylation. METHODS We conducted a narrative review of articles in each research area and the few published integrative studies to evaluate the state of knowledge. RESULTS Prenatal maternal stress was related to greater offspring internalizing and externalizing symptoms and to greater offspring peripheral DNA methylation of the NR3C1 gene. Youth mental health problems were also related to NR3C1 hypermethylation while epigenome-wide studies identified genes involved in nervous system development. Integrative studies focused on infant outcomes and did not detect significant mediation by DNA methylation though methodological considerations may partially explain these null results. LIMITATIONS Operationalization of prenatal maternal stress and child mental health varied greatly. The few published integrative studies did not report conclusive evidence of mediation by DNA methylation. CONCLUSIONS DNA methylation likely mediates the association between prenatal maternal stress and child mental health. This conclusion still needs to be tested in a larger number of integrative studies. Key empirical and statistical considerations for future research are discussed. Understanding the consequences of prenatal maternal stress and its pathways of influence will help prevention and intervention efforts and ultimately promote well-being for both mothers and children.
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Affiliation(s)
- Naomi Azar
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, Quebec H4B 1R6, Canada; Sainte-Justine University Hospital Research Center, 3175 chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Linda Booij
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, Quebec H4B 1R6, Canada; Sainte-Justine University Hospital Research Center, 3175 chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada; Department of Psychiatry and Addictology, Faculty of Medicine, Pavillon Roger-Gaudry, Université de Montréal, P.O. Box 6128, succursale Centre-ville, Montréal, Québec H3C 3J7, Canada.
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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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19
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Baldoni F, Giannotti M, Casu G, Agostini F, Mandolesi R, Peverieri S, Ambrogetti N, Spelzini F, Caretti V, Terrone G. The Perinatal Assessment of Paternal Affectivity (PAPA): Italian validation of a new tool for the screening of perinatal depression and affective disorders in fathers. J Affect Disord 2022; 317:123-130. [PMID: 36028014 DOI: 10.1016/j.jad.2022.08.049] [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: 01/19/2022] [Revised: 08/05/2022] [Accepted: 08/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Questionnaires for the screening of paternal perinatal psychological distress are based on clinical manifestations expressed by women, showing limitations in capturing the wide array of signs and symptoms exhibited by men. The current study aimed to validate the Perinatal Assessment of Paternal Affectivity, a new self-report tool for the screening of paternal depressive and affective disorder. METHOD This study used a cross-sectional design with a 3-month test-retest, involving respectively 385 (T1) and a sub-sample of 111(T2) fathers. Confirmatory factor analysis (CFA) was performed to test structural validity and concurrent validity was assessed by Spearman correlations. We assessed reliability using McDonald's ω and ordinal alpha. Group differences in PAPA scores based on sociodemographic were also tested. RESULTS The CFA reported a one factor structure as the optimal solution. The PAPA also showed adequate reliability and internal consistency as well as acceptable test-retest indices. Concurrent validity was confirmed by significant correlations between PAPA total score and standardized test scores. Non-Italian fathers and fathers who experienced recent stressful life events reported higher PAPA scores. LIMITATIONS Our sample was not homogeneous in terms of nationality and most of the participants, were from Northern Italy. Some risk factors associated with paternal parental psychological distress (e.g., unplanned pregnancy) have not been considered. CONCLUSION This study provides initial evidence of validity and reliability of the PAPA as a brief and sensitive screening tool to detect signs and symptoms of paternal affective disorder during both prenatal and postnatal period.
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Affiliation(s)
- F Baldoni
- Department of Psychology, University of Bologna, Italy
| | - M Giannotti
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy.
| | - G Casu
- Department of Psychology, University of Bologna, Italy
| | - F Agostini
- Department of Psychology, University of Bologna, Italy
| | - R Mandolesi
- Department of Psychology, University of Bologna, Italy
| | - S Peverieri
- Department of Psychology, University of Bologna, Italy
| | - N Ambrogetti
- Department of Psychology, University of Bologna, Italy
| | - F Spelzini
- Operative Unit of Obstetrics and Gynecology, Rimini Hospital, AUSL Romagna, Rimini, Italy
| | | | - G Terrone
- University of Rome Tor Vergata, Rome, Italy
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20
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Jeličić L, Veselinović A, Ćirović M, Jakovljević V, Raičević S, Subotić M. Maternal Distress during Pregnancy and the Postpartum Period: Underlying Mechanisms and Child's Developmental Outcomes-A Narrative Review. Int J Mol Sci 2022; 23:ijms232213932. [PMID: 36430406 PMCID: PMC9692872 DOI: 10.3390/ijms232213932] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Maternal mental health may be considered a determining factor influencing fetal and child development. An essential factor with potentially negative consequences for a child's psychophysiological development is the presence of maternal distress during pregnancy and the postpartum period. The review is organized and presented to explore and describe the effects of anxiety, stress, and depression in pregnancy and the postpartum period on adverse child developmental outcomes. The neurobiology of maternal distress and the transmission mechanisms at the molecular level to the fetus and child are noted. In addition, the paper discusses the findings of longitudinal studies in which early child development is monitored concerning the presence of maternal distress in pregnancy and the postpartum period. This topic gained importance in the COVID-19 pandemic context, during which a higher frequency of maternal psychological disorders was observed. The need for further interdisciplinary research on the relationship between maternal mental health and fetal/child development was highlighted, especially on the biological mechanisms underlying the transmission of maternal distress to the (unborn) child, to achieve positive developmental outcomes and improve maternal and child well-being.
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Affiliation(s)
- Ljiljana Jeličić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-11-3208-519; Fax: +381-11-2624-168
| | - Aleksandra Veselinović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Milica Ćirović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Vladimir Jakovljević
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Saša Raičević
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
- Clinic of Gynecology and Obstetrics, Clinical Center of Montenegro, 81000 Podgorica, Montenegro
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
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21
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Changes in Stereotypies: Effects over Time and over Generations. Animals (Basel) 2022; 12:ani12192504. [PMID: 36230246 PMCID: PMC9559266 DOI: 10.3390/ani12192504] [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: 07/31/2022] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 11/20/2022] Open
Abstract
Simple Summary Herein, we propose that there should be discussion about the function and effects of stereotypies in relation to the time during which they are shown. In the first stages, stereotypies may help animals deal with challenges. However, behavior can potentially alter the brain, impairing its function due the absence of a diverse repertory, and change brain connections, neurophysiology and later neuroanatomy. The neuroanatomical changes in individuals showing stereotypies could be an effect rather than a cause of the stereotypy. As a consequence, studies showing different outcomes for animal welfare from stereotypy expression could be due to variation in a timeline of expression. Stereotypies are widely used as an animal welfare indicator, and their expression can tell us about psychological states. However, there are questions about the longer-term consequences if animals express stereotypies: do the stereotypies help in coping? During the prenatal period, stereotypic behavior expressed by the mother can change the phenotype of the offspring, especially regarding emotionality, one mechanism acting via methylation in the limbic system in the brain. Are individuals that show stereotypies for shorter or longer periods all better adjusted, and hence have better welfare, or is the later welfare of some worse than that of individuals that do not show the behavior? Abstract Stereotypies comprise a wide range of repeated and apparently functionless behaviors that develop in individuals whose neural condition or environment results in poor welfare. While stereotypies are an indicator of poor welfare at the time of occurrence, they may have various consequences. Environmental enrichment modifies causal factors and reduces the occurrence of stereotypies, providing evidence that stereotypies are an indicator of poor welfare. However, stereotypy occurrence and consequences change over time. Furthermore, there are complex direct and epigenetic effects when mother mammals that are kept in negative conditions do or do not show stereotypies. It is proposed that, when trying to deal with challenging situations, stereotypies might initially help animals to cope. After further time in the conditions, the performance of the stereotypy may impair brain function and change brain connections, neurophysiology and eventually neuroanatomy. It is possible that reported neuroanatomical changes are an effect of the stereotypy rather than a cause.
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22
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Reich SM, Tulagan N, Dahlin M, Labaff S, Dutt N, Rahmani A. Pregnant in a Pandemic: Connecting Perceptions of Uplifts and Hassles to Mental Health. J Health Psychol 2022:13591053221120115. [PMID: 36036227 DOI: 10.1177/13591053221120115] [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: 11/17/2022] Open
Abstract
How women experience pregnancy as uplifting or a hassle is related to their mental and physical health and birth outcomes. Pregnancy during a pandemic introduces new hassles, but may offer benefits that could affect how women perceive their pregnancy. Surveying 118 ethnically and racially diverse pregnant women, we explore (1) women's traditional and pandemic-related pregnancy uplifts and hassles and (2) how these experiences of pregnancy relate to their feelings of loneliness, positivity, depression, and anxiety. Regressions show that women who experience more intense feelings of uplifts than hassles also feel more positive, less lonely, and have better mental health. Findings suggest that focusing on positive aspects of being pregnant, in general and during a pandemic, might be beneficial for pregnant women's mental health.
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Affiliation(s)
| | | | | | | | - Nikil Dutt
- University of California, Irvine, CA, USA
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23
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Associations of maternal prenatal emotional symptoms with neurodevelopment of children and the neonatal meconium microbiota: A prospective cohort study. Psychoneuroendocrinology 2022; 142:105787. [PMID: 35512557 DOI: 10.1016/j.psyneuen.2022.105787] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Maternal emotional symptoms during pregnancy increase the risk of neurodevelopmental problems in offspring, and microbiota have been shown to be a potential mechanism underlying the link. However, the associations among maternal prenatal emotional symptoms, the meconium microbiota, and offspring neurodevelopment have yet to be fully elucidated. The aim of this prospective cohort study was to assess the relationship between maternal prenatal emotional symptoms and neurodevelopment of the child at 24 months of age, and to investigate the potential role of the neonatal meconium microbiota in the relationship. METHODS A total of 410 mother-child pairs (152 women in the Symptoms group vs. 258 women in the No-symptoms group) were recruited from the ongoing Shanghai Maternal-Child Pairs Cohort. This study included a subgroup of women who were assessed for maternal anxiety and depressive symptoms at 32-36 weeks of gestation. Neonatal meconium samples were collected after birth for 16 S sequencing. Children's neurodevelopment was measured using the Ages and Stages Questionnaire, Third Edition (ASQ-3) and Strengths and Difficulties Questionnaire (SDQ) at 24 months postnatally (n = 287). RESULTS Compared with the No-symptoms group, children in the Symptoms group had a higher degree of hyperactivity and total difficulties at 24 months of age. Increases in alpha diversity, distinct overall composition, enriched relative abundance of Proteobacteria, and different predicted microbial functions were observed in the meconium of neonates exposed to maternal prenatal emotional symptoms. The neonatal gut microbiota alpha diversity and relative abundance of genera from the Proteobacteria phylum and Lactobacillus were negatively correlated with children's degree of prosocial behavior, tendency toward hyperactivity, and poor fine motor development. In addition, mediating effects of neonatal meconium microbial richness and the relative abundance of Lactobacillus were observed between maternal emotional symptoms and children's prosocial behavior. CONCLUSIONS Maternal prenatal emotional symptoms are associated with alterations in the offspring meconium microbiota and children's neurodevelopment at 24 months of age, and the microbial richness indices and Lactobacillus may play a mediating role. Future research is needed to identify and understand the biological pathways and metabolisms linking the relationships among maternal emotional symptoms, meconium microbiota, and neurodevelopment of children.
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24
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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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25
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Bagheri F, Goudarzi I, Lashkarbolouki T, Elahdadi Salmani M, Goudarzi A, Morley-Fletcher S. The Combined Effects of Perinatal Ethanol and Early-Life Stress on Cognition and Risk-Taking Behavior through Oxidative Stress in Rats. Neurotox Res 2022; 40:925-940. [PMID: 35507233 DOI: 10.1007/s12640-022-00506-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 04/07/2022] [Accepted: 04/09/2022] [Indexed: 11/29/2022]
Abstract
Both prenatal ethanol and early-life stress have been shown to induce reduced risk-taking and explorative behavior as well as cognitive dysfunction in the offspring. In this study, we examined the effect of combined exposure to ethanol and early stress on maternal care, exploratory behavior, memory performances, and oxidative stress in male offspring. Pregnant rats were exposed to ethanol (4 g/kg) from gestational day (GD) 6-to postnatal day (PND) 14 and limited nesting material (LNS) from PND0-PND14 individually or in combination. Maternal behavior was evaluated during diurnal cycle. The level of corticosterone hormone and markers of oxidative stress were evaluated in the pups. Risk-taking and explorative behavior were assessed with the elevated-plus maze (EPM) test and cognitive behavior with the Morris water maze (MWM), novel object recognition (NORT), and object location memory (OLM) tests. In the mothers, perinatal alcohol or LNS either alone or in combination decreased maternal behavior. In the offspring, the combination of the two factors significantly increased the pup's plasma corticosterone concentration in comparison with ethanol and LNS alone. Reduced risk-taking behavior was observed in the ethanol, LNS and ethanol + LNS groups compared with the control group, and this was amplified in the co-exposure of ethanol and LNS groups. The MWM, NORT, and OLM tests revealed spatial and recognition memory impairment in the ethanol and LNS groups. This impairment was more profound in the co-exposure of ethanol and LNS. Also, we observed a significant decrease in superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities and an increase in malondialdehyde (MDA) level in the hippocampus of ethanol and LNS co-exposed animals as compared with individual exposure of ethanol and LNS. While each factor independently produced similar outcomes, the results indicate that the dual exposure paradigm could significantly strengthen the outcomes.
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Affiliation(s)
| | - Iran Goudarzi
- School of Biology, Damghan University, Damghan, Iran.
| | | | | | - Afsaneh Goudarzi
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Morley-Fletcher
- UMR 8576, Univ. Lille, CNRS, UGSF - Unité de Glycobiologie Structurale Et Fonctionnelle, 59000, Lille, France
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Negative emotionality as a candidate mediating mechanism linking prenatal maternal mood problems and offspring internalizing behaviour. Dev Psychopathol 2022; 35:604-618. [PMID: 35440354 DOI: 10.1017/s0954579421001747] [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: 11/06/2022]
Abstract
Negative emotionality (NE) was evaluated as a candidate mechanism linking prenatal maternal affective symptoms and offspring internalizing problems during the preschool/early school age period. The participants were 335 mother-infant dyads from the Maternal Adversity, Vulnerability and Neurodevelopment project. A Confirmatory Bifactor Analysis (CFA) based on self-report measures of prenatal depression and pregnancy-specific anxiety generated a general factor representing overlapping symptoms of prenatal maternal psychopathology and four distinct symptom factors representing pregnancy-specific anxiety, negative affect, anhedonia and somatization. NE was rated by the mother at 18 and 36 months. CFA based on measures of father, mother, child-rated measures and a semistructured interview generated a general internalizing factor representing overlapping symptoms of child internalizing psychopathology accounting for the unique contribution of each informant. Path analyses revealed significant relationships among the general maternal affective psychopathology, the pregnancy- specific anxiety, and the child internalizing factors. Child NE mediated only the relationship between pregnancy-specific anxiety and the child internalizing factors. We highlighted the conditions in which prenatal maternal affective symptoms predicts child internalizing problems emerging early in development, including consideration of different mechanistic pathways for different maternal prenatal symptom presentations and child temperament.
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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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28
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Doba K, Pezard L, Nandrino JL. How do maternal emotional regulation difficulties modulate the mother-infant behavioral synchrony? INFANCY 2022; 27:582-608. [PMID: 35170196 DOI: 10.1111/infa.12461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/15/2021] [Accepted: 01/22/2022] [Indexed: 11/30/2022]
Abstract
Mother-infant synchrony is one of the most important processes in the development of socio-affective competencies in children. While maternal abilities and psychopathology are related to maladaptive mother-infant synchrony, it is as yet unclear how maternal emotion regulation difficulties contribute to it. Based on a panel of behavioral indicators (i.e., gaze, vocal, and motor), the present study examined mother-infant synchrony at 6 months of age in a modified version of Ainsworth's Strange Situation (n = 72 dyads). Mother-infant interaction sequences were characterized by indicators of complexity (LZ complexity of joint behavioral sequences) and of synchronization quality (cross-recurrence plot quantification). Results showed that mothers' touch was greater in the reunion condition than in the initial condition. Mothers' motor behaviors were associated with the global levels of infants' behavioral involvement in the reunion condition, unlike the symmetrical influence observed between mothers and infants in the initial condition. Results show that maternal anxiety mediates the relationships between mothers' emotion regulation difficulties and gaze, vocal, and motor synchrony between mothers and infants in the initial and reunion conditions. This study emphasizes the central role of maternal emotion regulation difficulties in the establishment of maladaptive synchrony and in the adjustments of maternal physical contacts with infants.
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Affiliation(s)
- Karyn Doba
- University of Lille, CNRS, UMR 9193 -SCALAb, Sciences Cognitives et Sciences Affectives, Lille, France
| | - Laurent Pezard
- Aix-Marseille Université, CNRS UMR 7291, LNC, Marseille, France
| | - Jean-Louis Nandrino
- University of Lille, CNRS, UMR 9193 -SCALAb, Sciences Cognitives et Sciences Affectives, Lille, France
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29
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Mahapatro M, Nayar P, Roy S, Jadhav A, Panchkaran S. Domestic Violence during pregnancy as risk factors for stress and depression: The experience of women attending ANC at atertiary care hospital in India. Women Health 2022; 62:124-134. [DOI: 10.1080/03630242.2022.2029670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Poonam Nayar
- National Institute of Health and Family Welfare, New Delhi, India
| | - Sudeshna Roy
- National Institute of Health and Family Welfare, New Delhi, India
| | - Ashwini Jadhav
- National Institute of Health and Family Welfare, New Delhi, India
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30
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Lehtola SJ, Tuulari JJ, Karlsson L, Lewis JD, Fonov VS, Collins DL, Parkkola R, Saunavaara J, Hashempour N, Pelto J, Lähdesmäki T, Scheinin NM, Karlsson H. Sex-specific associations between maternal pregnancy-specific anxiety and newborn amygdalar volumes - preliminary findings from the FinnBrain Birth Cohort Study. Stress 2022; 25:213-226. [PMID: 35435124 DOI: 10.1080/10253890.2022.2061347] [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] [Indexed: 10/18/2022] Open
Abstract
Previous literature links maternal pregnancy-specific anxiety (PSA) with later difficulties in child emotional and social cognition as well as memory, functions closely related to the amygdala and the hippocampus. Some evidence also suggests that PSA affects child amygdalar volumes in a sex-dependent way. However, no studies investigating the associations between PSA and newborn amygdalar and hippocampal volumes have been reported. We investigated the associations between PSA and newborn amygdalar and hippocampal volumes and whether associations are sex-specific in 122 healthy newborns (68 males/54 females) scanned at 2-5 weeks postpartum. PSA was measured at gestational week 24 with the Pregnancy-Related Anxiety Questionnaire Revised 2 (PRAQ-R2). The associations were analyzed with linear regression controlling for confounding variables. PSA was associated positively with left amygdalar volume in girls, but no significant main effect was found in the whole group or in boys. No significant main or sex-specific effect was found for hippocampal volumes. Although this was an exploratory study, the findings suggest a sexually dimorphic association of mid-pregnancy PSA with newborn amygdalar volumes.
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Affiliation(s)
- Satu J Lehtola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine University of Turku, Turku, 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
- Turku Collegium for Science and Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Hedonia Research Group, University of Oxford, Oxford, UK
| | - Linnea 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
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - John D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Vladimir S Fonov
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - D Louis Collins
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Riitta Parkkola
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jani Saunavaara
- Department of Medical Physics, University of Turku and Turku University Hospital, Turku, Finland
| | - Niloofar Hashempour
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine University of Turku, Turku, Finland
| | - Juho Pelto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine University of Turku, Turku, Finland
| | - Tuire Lähdesmäki
- Department of Pediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - 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
| | - 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
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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31
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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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32
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Liu H, Liu Y, Huang K, Yan S, Hao J, Zhu P, Tao F, Shao S. Gender-specific associations of pregnancy-related anxiety with placental epigenetic patterning of glucocorticoid response genes and preschooler's emotional symptoms and hyperactivity. BMC Pediatr 2021; 21:479. [PMID: 34715840 PMCID: PMC8555194 DOI: 10.1186/s12887-021-02938-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 10/08/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUD We have recently reported that maternal prenatal pregnancy-related anxiety predicts preschoolers' emotional and behavioral development in a gender-dependent manner. This study aims to test for this gender-specific effect in a different cohort and investigate whether the gender difference was specific to placental methylation of genes regulating glucocorticoids. METHODS A total of 2405 mother-child pairs from the Ma'anshan Birth Cohort Study were included in present study. The maternal pregnancy-related anxiety symptoms were evaluated with the Pregnancy-Related Anxiety Questionnaire in the third trimester of pregnancy. Child neurobehavior was assessed with the Strengths and Difficulties Questionnaire at 4 years old. Placental methylation of FKBP5, NR3C1 and HSD11B2 genes was quantified using the MethylTarget approach in 439 pregnant women. After exploratory factor analysis, the associations between methylation factor scores and pregnancy-related anxiety and child neurobehavior were examined using logistic regression analysis. RESULTS After controlling for confounding factors, pregnancy-related anxiety in the third trimester of pregnancy increased the risk of hyperactivity only in boys and emotional symptoms only in girls. Decreased scores of the factor characterized by FKBP5 methylation were associated with maternal pregnancy-related anxiety only in boys. Furthermore, increased scores of the factors characterized by NR3C1 and HSD11B2 methylation were associated with hyperactivity (NR3C1: adjusted OR = 1.80, 95%CI = 1.15-2.83) and emotional symptoms (HSD11B2: adjusted OR = 0.53, 95%CI = 0.29-0.97; NR3C1: adjusted OR = 1.64, 95%CI = 1.03-2.59) only in boys. However, the scores of the factor characterized by FKBP5, NR3C1 and HSD11B2 did not mediate the relationship between maternal pregnancy-related anxiety and preschoolers' emotional symptoms and hyperactivity. CONCLUSIONS Our results suggested that pregnancy-related anxiety in the third trimester of pregnancy predicted preschoolers' emotional symptoms and hyperactivity in a gender-dependent manner. Although we did not find the mediation role of the placental methylation of genes regulating glucocorticoids, we found it was associated with both maternal pregnancy-related anxiety and preschoolers' emotional symptoms and hyperactivity in a gender-dependent manner.
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Affiliation(s)
- Hui Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yuwei Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shuangqin Yan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Maternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan, 243011, Anhui, China
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Shanshan Shao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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33
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Stress in pregnancy: Clinical and adaptive behavior of offspring following Superstorm Sandy. Dev Psychopathol 2021; 34:1249-1259. [PMID: 34596500 DOI: 10.1017/s0954579421000304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The current study investigated 304 children from a longitudinal project (the Stress in Pregnancy (SIP) Study) who were exposed and unexposed to Superstorm Sandy ("Sandy") in utero. They were prospectively followed from 2 to 6 years of age and their clinical and adaptive behaviors were assessed annually. Using a hierarchical linear model, the study found that in utero Sandy exposure was associated with greater clinical (anxiety, depression, and somatization) and lower adaptive behaviors (social skills and functional communication) at age 2 years. However, the trajectories were notably different between the two groups. Anxiety increased more rapidly among the exposed than unexposed group at ages 2-4, and depression increased only among the exposed. In contrast, social skills and functional communication were lower in exposed compared to unexposed children at age 2, but quickly increased and exceeded the capacities of unexposed children by age 3. The findings confirm that prenatal Sandy exposure is not only associated with an increase in anxiety, depression, and somatization in offspring, but also with greater adaptive skills as the children got older. Our study demonstrates that while children who have experienced stress in utero demonstrate elevated suboptimal clinical behaviors related to affective disorders, they nevertheless have the potential to learn adaptive skills.
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Provenzi L, Mambretti F, Villa M, Grumi S, Citterio A, Bertazzoli E, Biasucci G, Decembrino L, Falcone R, Gardella B, Longo MR, Nacinovich R, Pisoni C, Prefumo F, Orcesi S, Scelsa B, Giorda R, Borgatti R. Hidden pandemic: COVID-19-related stress, SLC6A4 methylation, and infants' temperament at 3 months. Sci Rep 2021; 11:15658. [PMID: 34341434 PMCID: PMC8329206 DOI: 10.1038/s41598-021-95053-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/20/2021] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic represents a collective trauma that may have enduring stress effects during sensitive periods, such as pregnancy. Prenatal stress may result in epigenetic signatures of stress-related genes (e.g., the serotonin transporter gene, SLC6A4) that may in turn influence infants' behavioral development. In April 2020, we launched a longitudinal cohort study to assess the behavioral and epigenetic vestiges of COVID-19-related prenatal stress exposure in mothers and infants. COVID-19-related prenatal stress was retrospectively assessed at birth. SLC6A4 methylation was assessed in thirteen CpG sites in mothers and infants' buccal cells. Infants' temperament was assessed at 3-month-age. Complete data were available from 108 mother-infant dyads. Greater COVID-19-related prenatal stress was significantly associated with higher infants' SLC6A4 methylation in seven CpG sites. SLC6A4 methylation at these sites predicted infants' temperament at 3 months.
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Affiliation(s)
| | | | - Marco Villa
- Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | | | | | | | | | | | | | - Barbara Gardella
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,University of Pavia, Pavia, Italy
| | | | - Renata Nacinovich
- Università Bicocca, Milano, Italy.,San Gerardo Hospital, ASST Monza, Monza, Italy
| | | | - Federico Prefumo
- ASST Spedali Civili, Brescia, Italy.,University of Brescia, Brescia, Italy
| | - Simona Orcesi
- IRCCS Mondino Foundation, Pavia, Italy.,University of Pavia, Pavia, Italy
| | | | - Roberto Giorda
- Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Renato Borgatti
- IRCCS Mondino Foundation, Pavia, Italy.,University of Pavia, Pavia, Italy
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35
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Kataja EL, Rodrigues AJ, Scheinin NM, Nolvi S, Korja R, Häikiö T, Ekholm E, Sousa N, Karlsson L, Karlsson H. Prenatal Glucocorticoid-Exposed Infants Do Not Show an Age-Typical Fear Bias at 8 Months of Age - Preliminary Findings From the FinnBrain Birth Cohort Study. Front Psychol 2021; 12:655654. [PMID: 34393896 PMCID: PMC8356796 DOI: 10.3389/fpsyg.2021.655654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022] Open
Abstract
Synthetic glucocorticoids (sGC) are frequently administered to pregnant women at risk for preterm delivery to promote fetal lung maturation. Despite their undeniable beneficial effects in lung maturation, the impact of these hormones on developing brain is less clear. Recent human studies suggest that emotional and behavioral disorders are more common among sGC-exposed vs. non-exposed children, but the literature is sparse and controversial. We investigated if prenatal sGC exposure altered fear bias, a well-established infant attention phenotype, at 8-months. We used eye tracking and an overlap paradigm with control, neutral, happy, and fearful faces, and salient distractors, to evaluate infants’ attention disengagement from faces, and specifically from fearful vs. neutral and happy faces (i.e., a fear bias) in a sample (N = 363) of general population from the FinnBrain Birth Cohort Study. sGC exposed infants (N = 12) did not differ from non-exposed infants (N = 351) in their overall probability of disengagement in any single stimulus condition. However, in comparison with non-exposed infants, they did not show the age-typical fear bias and this association remained after controlling for confounding factors such as prematurity, gestational age at birth, birth weight, sex, and maternal postnatal depressive symptoms. Prenatal sGC exposure may alter emotional processing in infants. The atypical emotion processing in turn may be a predictor of emotional problems later in development. Future longitudinal studies are needed in order to evaluate the long-term consequences of sGC exposure for the developing brain.
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Affiliation(s)
- Eeva-Leena Kataja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Noora M Scheinin
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Saara Nolvi
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology and Speech-Language Pathology, Turku Institute for Advanced Studies, University of Turku, Turku, Finland.,Department of Medical Psychology, Corporate Member of Freie Universität Berlin, Berlin Institute of Health (BIH), Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Riikka Korja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Tuomo Häikiö
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Eeva Ekholm
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Turku, Finland
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Linnea Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland.,Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Hasse Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland.,Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
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36
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van Dijk W, Oosterman M, Jansen I, de Vente W, Huizink A. Stress- and smoke free pregnancy study protocol: a randomized controlled trial of a personalized eHealth intervention including heart rate variability-biofeedback to support pregnant women quit smoking via stress reduction. BMC Public Health 2021; 21:905. [PMID: 33980201 PMCID: PMC8115871 DOI: 10.1186/s12889-021-10910-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/26/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Maternal smoking and stress during pregnancy are associated with adverse health effects for women themselves and are risk factors for adverse developmental outcomes of the unborn child. Smoking and stress seem to be intertwined in various ways. First, the majority of smoking pregnant women is of lower socio-economic status, which is associated with higher levels of perceived stress. Second, smoking women often report to smoke because they feel stressed. Third, quitting smoking often increases perceived stress levels initially. Therefore, effective interventions are needed to support women with smoking cessation by reducing stress. The aim of this study is to test the effectiveness of an eHealth intervention on stress reduction and smoking cessation. METHODS/DESIGN The Stress- and Smoke Free Start of Life (SSFSL) study is a randomized controlled trial (RCT) comparing a personalized eHealth intervention with a control condition. Inclusion criteria for the women are: (1) > 18 years of age, (2) < 28 weeks pregnant at recruitment, (3) currently smoking. Consenting participants will be randomly assigned to the intervention or control group. Participants allocated to the intervention group will receive an 8-week intervention delivered on their smartphone. The application includes psycho-education on pregnancy, stress, and smoking (cessation); stress-management training consisting of Heart Rate Variability-biofeedback; and a personalized stop-smoking-plan. Participants in the control condition will be invited to visit a webpage with information on pregnancy, stress, and smoking (cessation). Study outcomes will be collected via online questionnaires, at four timepoints: pre-intervention (baseline; t0), post-intervention (8 weeks + 1 day after t0; t1), follow up at two weeks after birth (t2), and follow up at three months after birth (t3). The primary outcome measure is self-reported smoking cessation. Secondary outcomes include daily self-reported number of cigarettes smoked, perceived stress, pregnancy experience, birth outcomes, and negative affectivity scores of the baby. Moreover, the mediating effect of stress reduction on smoking cessation will be examined, and possible moderators will be tested. DISCUSSION If the eHealth intervention is effective in smoking cessation among pregnant smoking women, it can be implemented as a tool into the health care in the Netherlands. TRIAL REGISTRATION Netherlands Trial Register, ID: NL8156 . Registered on 11 November 2019.
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Affiliation(s)
- Willeke van Dijk
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands.
| | - Mirjam Oosterman
- Department of Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Imke Jansen
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Wieke de Vente
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Anja Huizink
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
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37
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Ceniceros LC, Capitanio JP, Kinnally EL. Prenatal Relocation Stress Enhances Resilience Under Challenge in Infant Rhesus Macaques. Front Behav Neurosci 2021; 15:641795. [PMID: 33854420 PMCID: PMC8039121 DOI: 10.3389/fnbeh.2021.641795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/04/2021] [Indexed: 11/13/2022] Open
Abstract
The prenatal period is a developmental stage of peak sensitivity, during which environmental exposures can program post-natal developmental outcomes. Prenatal stress, in particular, has often been associated with detrimental neurobehavioral outcomes like mood and anxiety disorders. In the present study, we examined the effects of a stressful prenatal maternal experience (maternal relocation during pregnancy) on the post-partum development of offspring in rhesus macaques. To help isolate the effects of prenatal stress from genetic predispositions and post-natal experience, we compared biologically reared infants (infants raised with their biological mothers) with cross-fostered infants (those raised by non-related females in new social groups). We examined the effects of prenatal relocation stress on measures collected at 3-4 months of age during a standardized biobehavioral assessment. Unexpectedly, we found that prenatal stress resulted in a behavioral pattern consistent with resilience rather than anxiety: prenatal stress was linked with greater activity, lower anxiety, and more interaction with novel objects, as well as higher ratings of temperamental confidence during assessment. These effects were observed in infants reared by biological mothers as well as cross-fostered infants, suggesting that the effects of prenatal stress were not attributable to maternal genetics or post-natal factors. Our surprising results suggest that prenatal relocation stress may confer resilience in infant rhesus monkeys.
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Affiliation(s)
- Lesly C Ceniceros
- California National Primate Research Center, University of California, Davis, Davis, CA, United States
| | - John P Capitanio
- California National Primate Research Center, University of California, Davis, Davis, CA, United States.,Department of Psychology, University of California, Davis, Davis, CA, United States
| | - Erin L Kinnally
- California National Primate Research Center, University of California, Davis, Davis, CA, United States.,Department of Psychology, University of California, Davis, Davis, CA, United States
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Prenatal exposure to maternal depression is related to the functional connectivity organization underlying emotion perception in 8-10-month-old infants - Preliminary findings. Infant Behav Dev 2021; 63:101545. [PMID: 33713910 DOI: 10.1016/j.infbeh.2021.101545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 11/22/2022]
Abstract
Emotion perception is critical for infant's social development. Mother's mood during pregnancy has been associated with infants' emotional developmental risks. Graphtheory analysis was applied on EEG data recorded from 35, 8-to-10-month-old-infants prenatally exposed to high or low depressed symptoms, while viewing happy and sad faces. We found an interaction between group and emotion such that infants exposed to high-depressed-symptoms showed higher modularity - reflecting reduced perceptual-dynamics - for viewing happy emotions compared to sad. The opposite was observed for infants exposed to low-depressive-symptoms. These preliminary findings suggest that prenatal depressive mood may shape early functional organization for viewing emotional faces.
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Vallorani A, Fu X, Morales S, LoBue V, Buss KA, Pérez-Edgar K. Variable- and person-centered approaches to affect-biased attention in infancy reveal unique relations with infant negative affect and maternal anxiety. Sci Rep 2021; 11:1719. [PMID: 33462275 PMCID: PMC7814017 DOI: 10.1038/s41598-021-81119-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/22/2020] [Indexed: 12/27/2022] Open
Abstract
Affect-biased attention is an automatic process that prioritizes emotionally or motivationally salient stimuli. Several models of affect-biased attention and its development suggest that it comprises an individual's ability to both engage with and disengage from emotional stimuli. Researchers typically rely on singular tasks to measure affect-biased attention, which may lead to inconsistent results across studies. Here we examined affect-biased attention across three tasks in a unique sample of 193 infants, using both variable-centered (factor analysis; FA) and person-centered (latent profile analysis; LPA) approaches. Using exploratory FA, we found evidence for two factors of affect-biased attention: an Engagement factor and a Disengagement factor, where greater maternal anxiety was related to less engagement with faces. Using LPA, we found two groups of infants with different patterns of affect-biased attention: a Vigilant group and an Avoidant group. A significant interaction noted that infants higher in negative affect who also had more anxious mothers were most likely to be in the Vigilant group. Overall, these results suggest that both FA and LPA are viable approaches for studying distinct questions related to the development of affect-biased attention, and set the stage for future longitudinal work examining the role of infant negative affect and maternal anxiety in the emergence of affect-biased attention.
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Affiliation(s)
- Alicia Vallorani
- Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Xiaoxue Fu
- University of South Carolina, Columbia, SC, USA
| | | | | | - Kristin A Buss
- Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Koraly Pérez-Edgar
- Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA
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Wang X, Xie J, Wu Y, Wu X, Yan S, Xu Y, Zhu P, Hao J, Tao F, Huang K. Gender-specific effect of pregnancy-related anxiety on preschooler's emotional and behavioral development: A population-based cohort study. J Affect Disord 2021; 279:368-376. [PMID: 33099051 DOI: 10.1016/j.jad.2020.10.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Pregnancy-related anxiety plays a major role in shaping offspring's neural development. However, its gender-specific effect on children's emotional and behavioral development is controversial and the knowledge of critical period is limited. This study aims to examine gender-specific effect of pregnancy-related anxiety on preschooler's emotional and behavioral development. METHODS This study was based on the China-Anhui Birth Cohort Study (C-ABCS). A total of 3443 mother-child pairs were included in final data analysis. Pregnancy-related anxiety was assessed by Pregnancy-Related Anxiety Questionnaire respectively in the 1st and 3rd trimester of pregnancy. Strengths and Difficulties Questionnaires (SDQ) were completed by parents to assess preschool emotional and behavioral development in boys and girls. Logistic regression models were used to examine the association between pregnancy-related anxiety and preschoolers' emotional and behavioral problems. RESULTS The overall prevalence of pregnancy-related anxiety was 31.6%. Compared with those whose mothers without pregnancy-related anxiety in either 1st or 3rd trimester, preschool boys born of mothers with pregnancy-related anxiety in the 1st trimester and in the 3rd trimester had an increased risk of conduct problems. Pregnancy-related anxiety in the 1st, 3rd trimester and in both trimesters all related with preschool boys' hyperactivity and total difficult problems. Pregnancy-related anxiety in the 1st trimester and in both 1st and 3rd trimester increased the risk of preschool girls' emotional problems and total difficult problems. CONCLUSION Pregnancy-related anxiety may relate with preschool boys' externalizing problems in early and late of pregnancy and increase the risk of internalizing problems in girls in early pregnancy. LIMITATIONS There was no data on pregnancy-related anxiety in the second trimester.
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Affiliation(s)
- Xiaoxu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Province, China; Key Laboratory of study on abnormal gametes and reproductive tract, National Health and Health Commission of the People's Republic of China, Anhui Province, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Province, China
| | - Jingjing Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Province, China; Key Laboratory of study on abnormal gametes and reproductive tract, National Health and Health Commission of the People's Republic of China, Anhui Province, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Province, China
| | - Ya Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Province, China; Key Laboratory of study on abnormal gametes and reproductive tract, National Health and Health Commission of the People's Republic of China, Anhui Province, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Province, China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Province, China; Key Laboratory of study on abnormal gametes and reproductive tract, National Health and Health Commission of the People's Republic of China, Anhui Province, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Province, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Center, No 72 Jiashan Road, Ma'anshan, Anhui Province, China
| | - Yeqing Xu
- Ma'anshan Maternal and Child Health Center, No 72 Jiashan Road, Ma'anshan, Anhui Province, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Province, China; Key Laboratory of study on abnormal gametes and reproductive tract, National Health and Health Commission of the People's Republic of China, Anhui Province, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Province, China
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Province, China; Key Laboratory of study on abnormal gametes and reproductive tract, National Health and Health Commission of the People's Republic of China, Anhui Province, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Province, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Province, China; Key Laboratory of study on abnormal gametes and reproductive tract, National Health and Health Commission of the People's Republic of China, Anhui Province, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Province, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Province, China; Key Laboratory of study on abnormal gametes and reproductive tract, National Health and Health Commission of the People's Republic of China, Anhui Province, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Province, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Anhui Province, China.
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A Primer on DNA Methylation and Its Potential to Impact Maternal Depression Risk and Assessment During Pregnancy and the Postpartum. J Perinat Neonatal Nurs 2021; 35:4-7. [PMID: 33528179 DOI: 10.1097/jpn.0000000000000528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Depression onset during and after pregnancy is prevalent and associated with significant implications for maternal, child, and family health. Although environmental risk factors important to the expression of pregnancy-related depression are well known, knowledge of the genetic underpinning is limited. Given the joint contribution of environmental and genetic factors to depression risk liability, DNA methylation presents itself as an ideal biomarker to investigate basic mechanisms and opportunities for translational research to care for pregnancy-related depression health outcomes. This article is an introduction to DNA methylation and its potential to serve as a marker of depression risk during pregnancy and the postpartum. This commentary discusses current clinical uses of DNA methylation-based testing and how it may be applied to perinatal depression clinical care and management.
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Takegata M, Matsunaga A, Ohashi Y, Toizumi M, Yoshida LM, Kitamura T. Prenatal and Intrapartum Factors Associated With Infant Temperament: A Systematic Review. Front Psychiatry 2021; 12:609020. [PMID: 33897486 PMCID: PMC8060501 DOI: 10.3389/fpsyt.2021.609020] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Temperament involves individual variations in behavioural tendencies of emotional responses and reactions to stimuli after birth. Because 'foetal programming' is a strong hypothesis in developing temperament, prenatal and intrapartum factors may be significant determinants of infant temperament. This systematic literature review aims to elucidate the evidence of prenatal and intrapartum predictors, including genetic, biological, environmental, socio-demographic, psychological, and obstetric factors of parents and their child. Methods: Relevant articles were searched using MEDLINE, PubMed, and SCOPUS. The inclusion criteria were (a) original research article, (b) written in English, (c) assessed the temperament of infants 12 months old or younger as an outcome variable, and (d) investigated prenatal and intrapartum factorial variables of infant temperament. Following the PRISMA guideline, the articles found in the three databases were screened and selected according to the inclusion and exclusion criteria before the final review. Results: Finally, 35 articles were reviewed. This systematic review identified a variety of prenatal and intrapartum factors that were significantly associated with infant temperament: (1) genetic and biological factors: certain genotypes, maternal cortisol and ACTH, and CRHs, (2) environmental factors: substance use such as tobacco, alcohol, and illegal drugs, (3) socio-demographic factor: lower-income, (4) psychological factors: depression or anxiety, eating disorders, personality types of mothers, and domestic violence, and (5) obstetric factors: foetal growth (birth weight), hypertension in mothers, nausea (emesis), and preterm birth. Conclusion: The findings support gene-environment interaction and biological mechanisms for developing infant temperament, suggesting the importance of ensuring a safe and comfortable environment for pregnant mothers, unborn infants, and families during pregnancy and delivery.
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Affiliation(s)
- Mizuki Takegata
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.,Kitamura Institute of Mental Health Tokyo, Tokyo, Japan
| | - Asami Matsunaga
- Kitamura Institute of Mental Health Tokyo, Tokyo, Japan.,Kitamura KOKORO Clinic Mental Health, Tokyo, Japan.,Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yukiko Ohashi
- Faculty of Nursing, Josai International University, Togane, Japan
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Lay Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Toshinori Kitamura
- Kitamura Institute of Mental Health Tokyo, Tokyo, Japan.,Kitamura KOKORO Clinic Mental Health, Tokyo, Japan.,T. and F. Kitamura Foundation for Studies and Skill Advancement in Mental Health, Tokyo, Japan.,Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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43
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Spry EA, Aarsman SR, Youssef GJ, Patton GC, Macdonald JA, Sanson A, Thomson K, Hutchinson DM, Letcher P, Olsson CA. Maternal and paternal depression and anxiety and offspring infant negative affectivity: A systematic review and meta-analysis. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2020.100934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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44
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Pregnant women misusing opioids: Depression, anxiety, stress, and neonatal opioid withdrawal syndrome. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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45
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Chandra PS, Nanjundaswamy MH. Pregnancy specific anxiety: an under-recognized problem. World Psychiatry 2020; 19:336-337. [PMID: 32931120 PMCID: PMC7491640 DOI: 10.1002/wps.20781] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Madhuri H Nanjundaswamy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
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46
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Aatsinki AK, Keskitalo A, Laitinen V, Munukka E, Uusitupa HM, Lahti L, Kortesluoma S, Mustonen P, Rodrigues AJ, Coimbra B, Huovinen P, Karlsson H, Karlsson L. Maternal prenatal psychological distress and hair cortisol levels associate with infant fecal microbiota composition at 2.5 months of age. Psychoneuroendocrinology 2020; 119:104754. [PMID: 32531627 DOI: 10.1016/j.psyneuen.2020.104754] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 05/06/2020] [Accepted: 05/29/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Maternal prenatal stress associates with infant developmental outcomes, but the mechanisms underlying this association are not fully understood. Alterations in the composition and function of infant intestinal microbiota may mediate some of the observed health effects, a viewpoint that is supported by animal studies along with a small human study showing that exposure to prenatal stress modifies the offspring's intestinal microbiota. In the current study, we aim to investigate the associations between maternal prenatal psychological distress (PPD) and hair cortisol concentration (HCC) with infant fecal microbiota composition in a large prospective human cohort. METHODS The study population was drawn from FinnBrain Birth Cohort Study. Maternal PPD was measured with standardized questionnaires (EPDS, SCL, PRAQ-R2, Daily Hassles) three times during pregnancy (n = 398). A measure addressing the chronicity of PPD was composed separately for each questionnaire. HCC was measured from a five cm segment at gestational week 24 (n = 115), thus covering the early and mid-pregnancy. Infant fecal samples were collected at the age of 2.5 months and analyzed with 16S rRNA amplicon sequencing. RESULTS Maternal chronic PPD (all symptom measures) showed positive associations (FDR < 0.01) with bacterial genera from phylum Proteobacteria, with potential pathogens, in infants. Further, chronic PPD (SCL, PRAQ-R2, and Daily Hassles negative scale) associated negatively with Akkermansia. HCC associated negatively with Lactobacillus. Neither maternal chronic PPD nor HCC associated with infant fecal microbiota diversity. CONCLUSION Chronic maternal PPD symptoms and elevated HCC associate with alterations in infant intestinal microbiota composition. In keeping with the earlier literature, maternal PPD symptoms were associated with increases in genera fromProteobacteria phylum. Further research is needed to understand how these microbiota changes are linked with later child health outcomes.
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Affiliation(s)
- Anna-Katariina Aatsinki
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland.
| | - Anniina Keskitalo
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Clinical Microbiology, Turku University Hospital, Turku, Finland
| | - Ville Laitinen
- Department of Future Technologies, University of Turku, Turku, Finland
| | - Eveliina Munukka
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland; Microbiome Biobank, Faculty of Medicine, University of Turku, Finland
| | - Henna-Maria Uusitupa
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Leo Lahti
- Department of Future Technologies, University of Turku, Turku, Finland
| | - Susanna Kortesluoma
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Paula Mustonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Bárbara Coimbra
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Pentti Huovinen
- Department of Clinical Microbiology, Turku University Hospital, Turku, Finland; Institute of Biomedicine, University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Erickson NL, Neumann AA, Hancock GR, Gartstein MA. Baby preparation and worry scale (Baby-PAWS): Instrument development and psychometric evaluation. Early Hum Dev 2020; 147:105080. [PMID: 32485400 DOI: 10.1016/j.earlhumdev.2020.105080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/02/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The Baby Preparation and Worry Scale (Baby-PAWS) addresses expectant mothers' anticipatory worries regarding the transition to parenthood, focusing on practical concerns (i.e., ability to care for the infant, securing childcare, personal wellbeing, and partner involvement). AIMS The present study describes measurement development, psychometric evaluation, and predictive and concurrent validity of Baby-PAWS, administered during pregnancy. STUDY DESIGN We used a repeated-measures design, with anonymous self-report obtained during the 3rd trimester of pregnancy and at 2 months postpartum. SUBJECTS Healthy pregnant women (N = 276) completed Baby-PAWS and measures of depression, general anxiety, and pregnancy-specific anxiety. Demographic, pregnancy, and birth-related information (e.g., complications, gestational age) was also obtained. At postpartum follow-up, the majority (n = 154) met inclusion criteria and provided data on themselves and their infants. OUTCOME MEASURES Prenatally, we examined correlations between Baby-PAWS and established measures of general anxiety, pregnancy-specific anxiety, and depression. Postnatally, Baby-PAWS scores were used to predict maternal depression, anxiety, and infant temperament. RESULTS AND CONCLUSIONS Two factor-analytic techniques indicated a three-factor structure, with internal consistency for all three components and the overall scale. We labeled the three factors: Self and Partner Worry, Non-parental Childcare Worry, and Baby Caregiving Worry, based on item content. Higher Baby-PAWS scores were associated with greater anxiety and depression in the third trimester. Predictive links with postpartum anxiety/depression symptoms and infant temperament were observed for the overall Baby-PAWS score and Self and Partner Worry factor. Although this instrument requires further evaluation, it offers promising utility in research and clinical settings.
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Affiliation(s)
- Nora L Erickson
- Hennepin Healthcare Research Institute, 701 Park Ave, Suite PP7.700, Minneapolis, MN 55415, United States of America.
| | - Alyssa A Neumann
- Washington State University, P.O. Box 644820, Pullman, WA 99164-4820, United States of America.
| | - Gregory R Hancock
- University of Maryland, 1230 Benjamin Building, 3942 Campus Drive, College Park, MD 20742-1115, United States of America.
| | - Maria A Gartstein
- Washington State University, P.O. Box 644820, Pullman, WA 99164-4820, United States of America.
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Reymond C, Derguy C, Wendland J, Loyal D. Validation française d’une échelle d’anxiété spécifique à la grossesse (PRAQ-R2). PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2018.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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49
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Schramm K, Nees J, Hoffmann J, Bruckner T, Haun MW, Maatouk I, Stepan H, Schott S. Emergency consultations in obstetrics: identification of decisive, contributing and associated factors. Arch Gynecol Obstet 2020; 302:821-828. [PMID: 32607806 DOI: 10.1007/s00404-020-05662-8] [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: 04/22/2020] [Accepted: 06/18/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Psychosocial and biological factors influence the perception of physical changes during pregnancy. Some pregnant women present to the obstetric emergency department (ED) with diverse symptoms not requiring urgent medical action. These visits result in over-consultation, tying up resources and inflating health care expenses. This study outlines factors associated with multiple ED visits during pregnancy, measures the prevalence of anxiety and depression, and explores the choice of maternity clinic for delivery aiming to elucidate options for care strategies. METHODS This prospective, cross-sectional, questionnaire-based bicentric study was performed in the obstetric outpatient departments of two university hospitals in Germany and recruited pregnant women between 12/2016 and 11/2017. The questionnaire included socio-demographics, obstetric history, anxiety (GAD-7), depression (PHQ-9), and health status (WHO-5, SF-12). RESULTS This analysis included 496 women and showed that women with numerous ED visits were significantly younger (p < 0.0001), less educated (p = 0.0002), and more likely to be unemployed and single. Different prevalences for anxiety and depression were detected correlating with the number of ED visits although each showing only low effect sizes (0.024 resp. 0.015). CONCLUSIONS Pregnant women attending the ED more often might benefit from health education, psychosomatic interventions, and social support to overcome their depression and anxiety to avoid non-urgent ED consultations. Further prospective studies are needed to support these findings.
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Affiliation(s)
- Katharina Schramm
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.,Children's Hospital Heilbronn, SLK-Klinikum am Gesundbrunnen, Heilbronn, Germany
| | - Juliane Nees
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - Janine Hoffmann
- Department of Obstetrics, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Thomas Bruckner
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Markus W Haun
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Holger Stepan
- Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany
| | - Sarah Schott
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
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50
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Hentges RF, Graham SA, Plamondon A, Tough S, Madigan S. A Developmental Cascade from Prenatal Stress to Child Internalizing and Externalizing Problems. J Pediatr Psychol 2020; 44:1057-1067. [PMID: 31166597 DOI: 10.1093/jpepsy/jsz044] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/07/2019] [Accepted: 05/10/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study utilized a developmental cascade approach to test alternative theories about the underlying mechanisms behind the association of maternal prenatal stress and child psychopathology. The fetal programming hypothesis suggests that prenatal stress affects fetal structural and physiological systems responsible for individual differences in child temperament, which further increases risk for internalizing and externalizing problems. Interpersonal models of stress transmission suggest that maternal stress influences child mental health via early parenting behaviors. We also examined a continuation of stress hypothesis, in which prenatal stress predicts child mental health via the continuation of maternal stress in the postpartum period. METHODS Participants were 1,992 mother-child pairs drawn from a prospective pregnancy cohort. Mothers reported on their perceived stress, anxiety, and depression during pregnancy and at 4-month postpartum. Birthweight was assessed via medical records of birthweight. At 4-month postpartum, hostile-reactive parenting behaviors were assessed. Child temperamental negative affect was measured at age 3. Child internalizing and externalizing problems were assessed at age 5. RESULTS Prenatal stress was associated with both internalizing and externalizing problems via postnatal stress and child temperament. Prenatal stress was also associated with externalizing behaviors via increased hostile-reactive parenting. After accounting for postnatal factors, prenatal stress continued to have a direct effect on child internalizing, but not externalizing, symptoms. CONCLUSION Results provide support for the fetal programming, interpersonal stress transmission, and continuation of stress models. Findings highlight the need for prenatal preventative programs that continue into the early postnatal period, targeting maternal stress and parenting behaviors.
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Affiliation(s)
- Rochelle F Hentges
- Department of Psychology, University of Calgary.,Owerko Centre, Alberta Children's Hospital Research Institute
| | - Susan A Graham
- Department of Psychology, University of Calgary.,Owerko Centre, Alberta Children's Hospital Research Institute
| | - Andre Plamondon
- Department des fondements et pratiques en éducation, Université Laval.,Applied Psychology and Human Development, University of Toronto
| | - Suzanne Tough
- Owerko Centre, Alberta Children's Hospital Research Institute.,Department of Community Health Sciences, University of Calgary.,Department of Pediatrics, University of Calgary
| | - Sheri Madigan
- Department of Psychology, University of Calgary.,Owerko Centre, Alberta Children's Hospital Research Institute
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