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Sebők-Welker T, Posta E, Ágrez K, Rádosi A, Zubovics EA, Réthelyi MJ, Ulbert I, Pászthy B, Bunford N. The Association Between Prenatal Maternal Stress and Adolescent Affective Outcomes is Mediated by Childhood Maltreatment and Adolescent Behavioral Inhibition System Sensitivity. Child Psychiatry Hum Dev 2024; 55:1-21. [PMID: 36738426 PMCID: PMC11362206 DOI: 10.1007/s10578-023-01499-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/05/2023]
Abstract
Prenatal maternal stress is linked to offspring outcomes; however, there is little research on adolescents, behavioral, transdiagnostic outcomes, or the mechanisms through which relations operate. We examined, in N = 268 adolescents (Mage = 15.31 years; SD = 1.063; 57.8% boys) whether prenatal maternal stress is associated with adolescent affective outcomes; whether this association is mediated, serially, by childhood home atmosphere and adolescent behavioral inhibition system (BIS) sensitivity; and whether mediational effects are moderated by adolescent attention-deficit/hyperactivity disorder or maternal internalizing symptomology. Prenatal maternal daily stress and major life events were associated with adolescent outcomes through childhood negative atmosphere/neglect and BIS sensitivity, with no evidence of moderation. Results have implications regarding the effect of prenatal maternal stress on offspring outcomes and regarding corresponding sensitive periods.
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Affiliation(s)
- T Sebők-Welker
- Developmental and Translational Neuroscience Research Group Developmental and Translational Neuroscience Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok Körútja 2, Budapest, 1117, Hungary
- Doctoral School of Mental Health Sciences, Semmelweis University, Balassa U. 6, Budapest, 1083, Hungary
| | - E Posta
- Developmental and Translational Neuroscience Research Group Developmental and Translational Neuroscience Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok Körútja 2, Budapest, 1117, Hungary
| | - K Ágrez
- Developmental and Translational Neuroscience Research Group Developmental and Translational Neuroscience Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok Körútja 2, Budapest, 1117, Hungary
| | - A Rádosi
- Developmental and Translational Neuroscience Research Group Developmental and Translational Neuroscience Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok Körútja 2, Budapest, 1117, Hungary
- Doctoral School of Mental Health Sciences, Semmelweis University, Balassa U. 6, Budapest, 1083, Hungary
| | - E A Zubovics
- Developmental and Translational Neuroscience Research Group Developmental and Translational Neuroscience Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok Körútja 2, Budapest, 1117, Hungary
| | - M J Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa U. 6, Budapest, 1083, Hungary
| | - I Ulbert
- Integrative Neuroscience Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok Körútja 2, Budapest, 1117, Hungary
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter Utca 50/A, Budapest, 1083, Hungary
| | - B Pászthy
- 1st Department of Paediatrics, Semmelweis University, Bókay János U. 53-54, Budapest, 1083, Hungary
| | - N Bunford
- Developmental and Translational Neuroscience Research Group Developmental and Translational Neuroscience Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok Körútja 2, Budapest, 1117, Hungary.
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Collins JM, Keane JM, Deady C, Khashan AS, McCarthy FP, O'Keeffe GW, Clarke G, Cryan JF, Caputi V, O'Mahony SM. Prenatal stress impacts foetal neurodevelopment: Temporal windows of gestational vulnerability. Neurosci Biobehav Rev 2024; 164:105793. [PMID: 38971516 DOI: 10.1016/j.neubiorev.2024.105793] [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: 04/09/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
Prenatal maternal stressors ranging in severity from everyday occurrences/hassles to the experience of traumatic events negatively impact neurodevelopment, increasing the risk for the onset of psychopathology in the offspring. Notably, the timing of prenatal stress exposure plays a critical role in determining the nature and severity of subsequent neurodevelopmental outcomes. In this review, we evaluate the empirical evidence regarding temporal windows of heightened vulnerability to prenatal stress with respect to motor, cognitive, language, and behavioural development in both human and animal studies. We also explore potential temporal windows whereby several mechanisms may mediate prenatal stress-induced neurodevelopmental effects, namely, excessive hypothalamic-pituitary-adrenal axis activity, altered serotonin signalling and sympathetic-adrenal-medullary system, changes in placental function, immune system dysregulation, and alterations of the gut microbiota. While broadly defined developmental windows are apparent for specific psychopathological outcomes, inconsistencies arise when more complex cognitive and behavioural outcomes are considered. Novel approaches to track molecular markers reflective of the underlying aetiologies throughout gestation to identify tractable biomolecular signatures corresponding to critical vulnerability periods are urgently required.
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Affiliation(s)
- James M Collins
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
| | - James M Keane
- APC Microbiome Ireland, University College Cork, Cork, Ireland.
| | - Clara Deady
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
| | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), Cork University Maternity Hospital, Cork, Ireland.
| | - Fergus P McCarthy
- The Irish Centre for Maternal and Child Health Research (INFANT), Cork University Maternity Hospital, Cork, Ireland; Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland.
| | - Gerard W O'Keeffe
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), Cork University Maternity Hospital, Cork, Ireland.
| | - Gerard Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), Cork University Maternity Hospital, Cork, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland.
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
| | - Valentina Caputi
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
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Yang Z, Shao C, Tang C. Risk Factors of Perinatal Negative Mood and Its Influence on Prognosis: A Retrospective Cohort Study. Psychol Res Behav Manag 2024; 17:853-865. [PMID: 38444720 PMCID: PMC10913804 DOI: 10.2147/prbm.s451843] [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] [Received: 11/26/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
Background Maternal anxiety or depression in the perinatal period has a high prevalence. The negative emotion during the puerpera is unfavorable to the process of childbirth and also affects the recovery and the quality of life in postpartum patients significantly. The present study aimed to elucidate the risk factors of negative emotion in perinatal women and its influence on prognosis to provide a reference for improving maternal prognosis. Methods Initially, 350 expectant mothers were randomly enrolled in the present study between August 2021 and August 2022. Among these, after applying the established inclusion and exclusion criteria, 314 patients were eventually selected. The independent risk factors of negative emotion and poor prognosis were analyzed through binary logistics regression and multiple linear regression. Follow-up was conducted via telephone, email, and a follow-up visit one month after discharge. Results Among the included patients, 18 (5.7%) had prenatal anxiety, 16 (5.1%) had prenatal depression, 31 (9.9%) had postnatal anxiety, and 28 (8.9%) had postnatal depression. Perinatal negative emotional risk factors include age, marital relationship, regular prenatal examination, E2 level, 5-HT level before and after delivery, family monthly income, neonatal health, breastfeeding time, intrapartum hemorrhage, constipation and other complications. The development of postpartum negative emotions is a risk factor for maternal prognosis. Conclusion The results showed that the risk factors of perinatal depression and anxiety were complex. In order to improve the quality of life of pregnant women, maintain their long-term emotional stability, and promote their postpartum recovery, it may be considered to promote the use of screening tools to identify women at risk of anxiety and depression before and after delivery, and timely psychological counseling for patients with high risk factors to promote their mental health.
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Affiliation(s)
- Zheng Yang
- Department of Obstetrics, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China
| | - Cuixiang Shao
- Department of Obstetrics, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China
| | - Chen Tang
- Department of Obstetrics, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China
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Xu Y, Zheng P, Feng W, Chen L, Sun S, Liu J, Tang W, Bao C, Xu L, Xu D, Zhao K. Patterns of attentional bias in antenatal depression: an eye-tracking study. Front Behav Neurosci 2023; 17:1288616. [PMID: 38192488 PMCID: PMC10773570 DOI: 10.3389/fnbeh.2023.1288616] [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: 09/04/2023] [Accepted: 11/07/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction One of the most common mental disorders in the perinatal period is depression, which is associated with impaired emotional functioning due to alterations in different cognitive aspects including thought and facial emotion recognition. These functional impairment may affect emerging maternal sensitivity and have lasting consequences for the dyadic relationship. The current study aimed to investigate the impact of depressive symptoms on the attention bias of infant stimuli during pregnancy. Methods Eighty-six pregnant women completed the Edinburgh Postnatal Depression Scale and an eye-tracking task comprising infant-related emotion images. All participants showed biased attention to infant-related images. Results First, compared to healthy pregnant women, pregnant women with depression symptoms initially directed their attention to infant-related stimuli more quickly (F (1, 84) = 6.175, p = 0.015, η2 = 0.068). Second, the two groups of pregnant women paid attention to the positive infant stimuli faster than the neutral infant stimuli, and the first fixation latency bias score was significantly smaller than that of the infant-related negative stimulus (p = 0.007). Third, compared with the neutral stimulus, the non-depression group showed a longer first gaze duration to the negative stimulus of infants (p = 0.019), while the depressive symptoms group did not show this difference. Conclusion We speculate that structural and functional changes in affective motivation and cognitive-attention brain areas may induce these attentional bias patterns. These results provide suggestions for the implementation of clinical intervention programs to correct the attention bias of antenatal depressed women.
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Affiliation(s)
- Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Peiwen Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wenqian Feng
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, Chengdu, China
| | - Lipeng Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Weina Tang
- Shaoxing 7th People’s Hospital, Shaoxing, China
| | - Ciqing Bao
- Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Ling Xu
- Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- Lishui Second People’s Hospital Affiliated to Wenzhou Medical University, Lishui, China
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, China
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Turk E, van den Heuvel MI, Sleurs C, Billiet T, Uyttebroeck A, Sunaert S, Mennes M, Van den Bergh BRH. Maternal anxiety during pregnancy is associated with weaker prefrontal functional connectivity in adult offspring. Brain Imaging Behav 2023; 17:595-607. [PMID: 37380807 PMCID: PMC10733226 DOI: 10.1007/s11682-023-00787-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND The connectome, constituting a unique fingerprint of a person's brain, may be influenced by its prenatal environment, potentially affecting later-life resilience and mental health. METHODS We conducted a prospective resting-state functional Magnetic Resonance Imaging study in 28-year-old offspring (N = 49) of mothers whose anxiety was monitored during pregnancy. Two offspring anxiety subgroups were defined: "High anxiety" (n = 13) group versus "low-to-medium anxiety" (n = 36) group, based on maternal self-reported state anxiety at 12-22 weeks of gestation. To predict resting-state functional connectivity of 32 by 32 ROIs, maternal state anxiety during pregnancy was included as a predictor in general linear models for both ROI-to-ROI and graph theoretical metrics. Sex, birth weight and postnatal anxiety were included as covariates. RESULTS Higher maternal anxiety was associated with weaker functional connectivity of medial prefrontal cortex with left inferior frontal gyrus (t = 3.45, pFDR < 0.05). Moreover, network-based statistics (NBS) confirmed our finding and revealed an additional association of weaker connectivity between left lateral prefontal cortex with left somatosensory motor gyrus in the offspring. While our results showed a general pattern of lower functional connectivity in adults prenatally exposed to maternal anxiety, we did not observe significant differences in global brain networks between groups. CONCLUSIONS Weaker (medial) prefrontal cortex functional connectivity in the high anxiety adult offspring group suggests a long-term negative impact of prenatal exposure to high maternal anxiety, extending into adulthood. To prevent mental health problems at population level, universal primary prevention strategies should aim at lowering maternal anxiety during pregnancy.
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Affiliation(s)
- Elise Turk
- Department of Cognitive Neuropsychology, Tilburg University, Warandelaan 2, 5037AB, Tilburg, The Netherlands.
| | - Marion I van den Heuvel
- Department of Cognitive Neuropsychology, Tilburg University, Warandelaan 2, 5037AB, Tilburg, The Netherlands
| | - Charlotte Sleurs
- Department of Cognitive Neuropsychology, Tilburg University, Warandelaan 2, 5037AB, Tilburg, The Netherlands
- Department of Oncology, Catholic University of Leuven, KU Leuven, Leuven, Belgium
| | | | - Anne Uyttebroeck
- Department of Oncology, Catholic University of Leuven, KU Leuven, Leuven, Belgium
| | | | - Maarten Mennes
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Bea R H Van den Bergh
- Health Psychology Research Group, Catholic University of Leuven, KU Leuven, Leuven, Belgium
- Department of Welfare, Public Health and Family, Flemish Government, Brussels, Belgium
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Kotsakis Ruehlmann A, Sammallahti S, Cortés Hidalgo AP, Bakulski KM, Binder EB, Campbell ML, Caramaschi D, Cecil CAM, Colicino E, Cruceanu C, Czamara D, Dieckmann L, Dou J, Felix JF, Frank J, Håberg SE, Herberth G, Hoang TT, Houtepen LC, Hüls A, Koen N, London SJ, Magnus MC, Mancano G, Mulder RH, Page CM, Räikkönen K, Röder S, Schmidt RJ, Send TS, Sharp G, Stein DJ, Streit F, Tuhkanen J, Witt SH, Zar HJ, Zenclussen AC, Zhang Y, Zillich L, Wright R, Lahti J, Brunst KJ. Epigenome-wide meta-analysis of prenatal maternal stressful life events and newborn DNA methylation. Mol Psychiatry 2023; 28:5090-5100. [PMID: 36899042 DOI: 10.1038/s41380-023-02010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/08/2023] [Accepted: 02/21/2023] [Indexed: 03/12/2023]
Abstract
Prenatal maternal stressful life events are associated with adverse neurodevelopmental outcomes in offspring. Biological mechanisms underlying these associations are largely unknown, but DNA methylation likely plays a role. This meta-analysis included twelve non-overlapping cohorts from ten independent longitudinal studies (N = 5,496) within the international Pregnancy and Childhood Epigenetics consortium to examine maternal stressful life events during pregnancy and DNA methylation in cord blood. Children whose mothers reported higher levels of cumulative maternal stressful life events during pregnancy exhibited differential methylation of cg26579032 in ALKBH3. Stressor-specific domains of conflict with family/friends, abuse (physical, sexual, and emotional), and death of a close friend/relative were also associated with differential methylation of CpGs in APTX, MyD88, and both UHRF1 and SDCCAG8, respectively; these genes are implicated in neurodegeneration, immune and cellular functions, regulation of global methylation levels, metabolism, and schizophrenia risk. Thus, differences in DNA methylation at these loci may provide novel insights into potential mechanisms of neurodevelopment in offspring.
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Affiliation(s)
- Anna Kotsakis Ruehlmann
- University of Cincinnati College of Medicine, Department of Environmental and Public Health Sciences, Cincinnati, OH, USA
| | - Sara Sammallahti
- Erasmus MC, University Medical Center Rotterdam, Department of Adolescent and Child Psychiatry and Psychology, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Andrea P Cortés Hidalgo
- Erasmus MC, University Medical Center Rotterdam, Department of Adolescent and Child Psychiatry and Psychology, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Kelly M Bakulski
- University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor, MI, USA
| | - Elisabeth B Binder
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Munich, Germany
| | - Megan Loraine Campbell
- University of Cape Town, Department of Psychiatry and Mental Health, Cape Town, South Africa
| | - Doretta Caramaschi
- School of Psychology, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Charlotte A M Cecil
- Erasmus MC, University Medical Center Rotterdam, Department of Adolescent and Child Psychiatry and Psychology, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cristiana Cruceanu
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Munich, Germany
| | - Darina Czamara
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Munich, Germany
| | - Linda Dieckmann
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - John Dou
- University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor, MI, USA
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunda Herberth
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany
| | - Thanh T Hoang
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, 27709, NC, USA
| | - Lotte C Houtepen
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and UCT Neuroscience Institute, Cape Town, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, 27709, NC, USA
| | - Maria C Magnus
- Norwegian Institute of Public Health, Centre for Fertility and Health, Oslo, Norway
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Rosa H Mulder
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Christian M Page
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Mathematics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Katri Räikkönen
- University of Helsinki, Faculty of Medicine, Department of Psychology and Logopedics, Helsinki, Finland
| | - Stefan Röder
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany
| | - Rebecca J Schmidt
- University of California-Davis, School of Medicine, Department of Public Health Sciences, Davis, CA, USA
| | - Tabea S Send
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gemma Sharp
- School of Psychology, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and UCT Neuroscience Institute, Cape Town, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johanna Tuhkanen
- University of Helsinki, Faculty of Medicine, Department of Psychology and Logopedics, Helsinki, Finland
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heather J Zar
- Department of Paediatrics & Child Health & SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Ana C Zenclussen
- Helmholtz Centre for Environmental Research - UFZ, Department of Environmental Immunology, Leipzig, Germany
| | - Yining Zhang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Rosalind Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jari Lahti
- University of Helsinki, Faculty of Medicine, Department of Psychology and Logopedics, Helsinki, Finland
| | - Kelly J Brunst
- University of Cincinnati College of Medicine, Department of Environmental and Public Health Sciences, Cincinnati, OH, USA.
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7
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Hardy KA, Hart DM, Rosen MJ. Early-life stress affects Mongolian gerbil interactions with conspecific vocalizations in a sex-specific manner. Front Behav Neurosci 2023; 17:1128586. [PMID: 37234406 PMCID: PMC10206074 DOI: 10.3389/fnbeh.2023.1128586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
During development, early-life stress (ELS) impairs cognition, learning, and emotional regulation, in part by disrupting neural circuitry in regions underlying these higher-order functions. In addition, our recent work indicates that ELS also alters simple sensory perception: ELS impaired auditory perception and neural encoding of short gaps in sounds, which are essential for vocal communication. The combination of higher-order and basic sensory disruption suggests that ELS is likely to affect both the perception and interpretation of communication signals. We tested this hypothesis by measuring behavioral responses to conspecific vocalizations (those emitted by other gerbils) in ELS and untreated Mongolian gerbils. Because stress effects often differ by sex, we separately examined females and males. To induce ELS, pups were intermittently maternally separated and restrained from post-natal days (P) 9-24, a time window when the auditory cortex is most sensitive to external disruption. We measured the approach responses of juvenile (P31-32) gerbils to two types of conspecific vocalizations: an alarm call, which is emitted to alert other gerbils of a potential threat, and the prosocial contact call, which is emitted near familiar gerbils, especially after separation. Control males, Control females, and ELS females approached a speaker emitting pre-recorded alarm calls, while ELS males avoided this source, suggesting that ELS affects the response to alarm calls in male gerbils. During playback of the pre-recorded contact call, Control females and ELS males avoided the sound source, while Control males neither approached nor avoided, and ELS females approached the sound. These differences cannot be accounted for by changes in locomotion or baseline arousal. However, ELS gerbils slept more during playback, suggesting that ELS may reduce arousal during vocalization playback. Further, male gerbils made more errors than females on a measure of working memory, but the sex difference of cognition in this context may stem from novelty aversion rather than impaired memory. These data indicate that ELS influences behavioral responses to ethologically relevant communication sounds in a sex-specific manner, and are among the first to demonstrate an altered response to auditory stimuli following ELS. Such changes may arise from differences in auditory perception, cognition, or a combination of factors, and suggest that ELS may affect auditory communication in human adolescents.
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Affiliation(s)
- Kate A. Hardy
- Department of Anatomy and Neurobiology, Hearing Research Group, Northeast Ohio Medical University, Rootstown, OH, United States
- Department of Biological Sciences, Brain Health Research Institute, Kent State University, Kent, OH, United States
| | - Denise M. Hart
- Department of Anatomy and Neurobiology, Hearing Research Group, Northeast Ohio Medical University, Rootstown, OH, United States
| | - Merri J. Rosen
- Department of Anatomy and Neurobiology, Hearing Research Group, Northeast Ohio Medical University, Rootstown, OH, United States
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8
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Gao Y, Tang X, Deng R, Liu J, Zhong X. Latent Trajectories and Risk Factors of Prenatal Stress, Anxiety, and Depression in Southwestern China-A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3818. [PMID: 36900833 PMCID: PMC10001100 DOI: 10.3390/ijerph20053818] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/11/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Few studies have explored the heterogeneity of trajectories of stress, anxiety, and depressive symptoms during pregnancy. This study aimed to explore the trajectory groups of stress, anxiety, and depressive symptoms in women during pregnancy and the risk factors associated with those groups. (2) Methods: Data came from pregnant women recruited from January to September 2018 in four hospitals in Chongqing Province, China. A structured questionnaire was given to pregnant women, which collected basic information, including personal, family, and social information. The growth mixture model was applied to identify potential trajectory groups, and multinomial logistic regression was applied to analyze factors of trajectory groups. (3) Results: We identified three stress trajectory groups, three anxiety trajectory groups, and four depression trajectory groups. Less developed regions, inadequate family care, and inadequate social support were associated with a high risk of stress; residence, use of potentially teratogenic drugs, owning pets, family care, and social support were strongly associated with the anxiety trajectory group; family care and social support were the most critical factors for the depression trajectory group. (4) Conclusions: The trajectories of prenatal stress, anxiety, and depressive symptoms are dynamic and heterogeneous. This study may provide some critical insights into the characteristics of women in the high-risk trajectory groups for early intervention to mitigate worsening symptoms.
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Affiliation(s)
- Yuwen Gao
- Department of Medical Record Management, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Xian Tang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
| | - Ruibin Deng
- Chongqing Shapingba District Center for Disease Control and Prevention, Chongqing 400030, China
| | - Jiaxiu Liu
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Xiaoni Zhong
- School of Public Health, Chongqing Medical University, Chongqing 400016, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China
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9
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Yang L, Sun J, Nan Y, Waqas A, Nisar A, Wang D, Rahman A, Li X. Prevalence of perinatal anxiety and its determinants in mainland China: A systematic review and meta-analysis. J Affect Disord 2023; 323:193-203. [PMID: 36442655 DOI: 10.1016/j.jad.2022.11.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/04/2022] [Accepted: 11/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Perinatal anxiety is among the most common mental health conditions that have a huge negative impact both on mothers and their children. This study aimed to establish summary estimates of the prevalence of perinatal anxiety and its influencing factors in Mainland China. METHODS A systematic search was carried out from nine major English and Chinese electronic databases to identify studies published up to August 20, 2022 with data on the prevalence of perinatal anxiety. Two reviewers conducted data extraction and quality assessment. Meta-analysis was performed using a random-effects model. Subgroup and meta-regression analyses were performed when possible. RESULTS 271 studies representing 369,477 women were included in the study. Pooled prevalence of perinatal anxiety was 17.4 % (95 % CI: 16.2 % to 18.7 %), with prenatal anxiety 17.4 % (95%CI: 16.1 % to 18.8 %) and postpartum anxiety 17.5 % (95%CI: 13.5 % to 22.4 %). However, the overall estimates presented substantial heterogeneity (I2 = 98.93 %). Qualitative summaries demonstrated some main potential risk factors of perinatal anxiety such as women with abnormal pregnancy-labor history, poor health status, pregnancy complications, and unplanned pregnancies, and some potential protective factors such as high family income, good social support, good interpersonal relationships, and history of multiple deliveries. LIMITATION Very large heterogeneity among studies was observed in meta-synthesis, and all included studies used self-report scales to identify anxiety rather than diagnostic interviews. CONCLUSION Varying degrees of perinatal anxiety is prevalent among Chinese women. Screening and evidence-based interventions are urgent and necessary to address this public concern and promote their health and well-being.
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Affiliation(s)
- Lei Yang
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China
| | - Jingwen Sun
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China
| | - Yiping Nan
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China
| | - Ahmed Waqas
- Human Development Research Foundation, Rawalpindi, Pakistan
| | - Anum Nisar
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, L3 5QA, United Kingdom
| | - Atif Rahman
- Department of Psychological Sciences, University of Liverpool, L69 3BX, United Kingdom.
| | - Xiaomei Li
- School of Nursing, Health Science Center, Xi'an Jiaotong University, 710061, China.
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10
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Huang J, Xu L, Xu Z, Luo Y, Liao B, Li Y, Shi Y. The relationship among pregnancy-related anxiety, perceived social support, family function and resilience in Chinese pregnant women: a structural equation modeling analysis. BMC Womens Health 2022; 22:546. [PMID: 36572883 PMCID: PMC9791157 DOI: 10.1186/s12905-022-02145-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that pregnancy-related anxiety (PRA) has adverse impacts on maternity health and infant development. A substantial body of literature has documented the important influence of family function, perceived social support and resilience on PRA. However, research identifying the mediating mechanisms underlying this relationship in China are still lacking. Therefore, the current study aimed to investigate the prevalence of PRA under the three-child policy in China, and also explore the interrelationships among perceived social support, family function, resilience, and PRA. METHODS In this cross-sectional study, a convenient sampling method was used to select 579 pregnant women who underwent prenatal examination at the maternity outpatient departments of the First Affiliated Hospital of Chongqing Medical University in China from December 2021 to April 2022. Participants were required to complete the following questionnaires: the demographic form, the Chinese Pregnancy-related Anxiety scale, the 10-item Connor-Davidson Resilience Scale, the APGAR Family Care Index Scale, and Multidimensional Scale of Perceived Social Support. Pearson correlation analysis was utilized to examine the rudimentary relationship among the study variables. Bootstrapping analyses in the structural equation modeling were applied to identify the significance of indirect effects. RESULTS There were 41.4% of pregnant Chinese women indicating PRA. Correlational analyses indicated that perceived social support, family function and resilience were negatively associated with PRA (r = - 0.47, P < 0.01; r = - 0.43, P < 0.01; r = - 0.37, P < 0.01, respectively). The results of bootstrapping analyses demonstrated significant indirect effects of perceived social support (β = - 0.098, 95% CI [- 0.184, - 0.021]) and family function (β = - 0.049, 95% CI [- 0.103, - 0.011]) on PRA via resilience. CONCLUSIONS Chinese pregnant women are suffering from high levels of PRA. Better family function and perceived social support might reduce the occurrence of PRA, as well as by the mediating effects of resilience. Healthcare providers must be concerned about PRA and perform corresponding actions to reduce it. By strengthening social support and improving family function, antenatal care providers could effectively reduce or prevent PRA. And more importantly, implementing resilience-promoting measures are also essential to relieve anxiety and support mental health in pregnant women.
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Affiliation(s)
- Jingui Huang
- grid.190737.b0000 0001 0154 0904Department of Medical Oncology, Chongqing University Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Lingli Xu
- grid.190737.b0000 0001 0154 0904Department of Human Resources, Chongqing University Cancer Hospital, Chongqing, 400030 China
| | - Zhen Xu
- grid.190737.b0000 0001 0154 0904Department of Medical Oncology, Chongqing University Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Yexin Luo
- grid.190737.b0000 0001 0154 0904Department of Medical Oncology, Chongqing University Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Bizhen Liao
- grid.452206.70000 0004 1758 417XDepartment of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Yan Li
- grid.452206.70000 0004 1758 417XDepartment of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Yumei Shi
- grid.190737.b0000 0001 0154 0904Department of Medical Oncology, Chongqing University Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
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11
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Somers JA, Luecken LJ. Prenatal Programming of Behavior Problems via Second-by-Second Infant Emotion Dynamics. Psychol Sci 2022; 33:2027-2039. [PMID: 36206269 PMCID: PMC10068505 DOI: 10.1177/09567976221116816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/13/2022] [Indexed: 12/14/2022] Open
Abstract
Fetal adaptations to prenatal maternal stress may confer high risk for childhood behavior problems, potentially operating via dynamic fluctuations in infants' emotions during mother-infant interactions. These fluctuations over time may give rise to behavior problems. Among a sample of 210 low-income mothers of Mexican origin and their 24-week-old infants, dynamic structural equation modeling was used to examine whether within-infant second-by-second emotion processes were predicted by maternal prenatal stress and predicted behavior problems at 36 and 54 months. The mean level around which infant negative affect fluctuated was related to prenatal stress, but not to childhood behavior problems. The volatility in infant negative affect, reflecting greater ebb and flow in infant negative affect during playful interaction, was predicted by prenatal stress and predicted enduring behavior problems in childhood. Results highlight a potential child-driven pathway linking prenatal exposure with childhood behavior problems via infant negative emotional volatility.
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12
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Weinberg A. Pathways to depression: Dynamic associations between neural responses to appetitive cues in the environment, stress, and the development of illness. Psychophysiology 2022; 60:e14193. [PMID: 36256483 DOI: 10.1111/psyp.14193] [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: 05/12/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022]
Abstract
This review focuses on research my colleagues and I have conducted on etiological pathways to depression. Much of this work has focused on the measurement of neural responses to appetitive cues, using two event-related brain potential (ERP) components, the Late Positive Potential (LPP) and the Reward Positivity (RewP). Reductions in each of these components have been associated with current symptoms of depression, and in some cases have been shown to differentiate anxious from depressive phenotypes. In this review, I will describe three broad and related approaches we have taken in our research to address a series of interdependent issuess. The first attempts to understand different sources of variation in the LPP and RewP, and how these sources interact with one another. The second tries to identify whether variation in the processes measured by these ERP components might reflect a latent vulnerability to depression and its symptoms, that is evident prior to illness onset. And the third examines the possibility that the processes reflected in the LPP and RewP might play a mechanistic role in the development of depression.
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Affiliation(s)
- Anna Weinberg
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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13
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Kemppinen L, Mattila M, Ekholm E, Huolila L, Pelto J, Karlsson H, Mäkikallio K, Karlsson L. Gestational anemia and maternal antenatal and postpartum psychological distress in a prospective FinnBrain Birth Cohort Study. BMC Pregnancy Childbirth 2022; 22:704. [PMID: 36100878 PMCID: PMC9469542 DOI: 10.1186/s12884-022-05032-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gestational anemia, most commonly caused by iron deficiency, may increase the risk of maternal anxiety and depression and have a potentially far-reaching impact on mother's and newborn's health. Several mechanisms, such as effects of iron deficiency on cerebral neurotransmitter metabolism, have been suggested. None of the earlier studies have assessed the association between gestational anemia and depression, anxiety and pregnancy-related anxiety simultaneously. METHODS Women, participating in the FinnBrain Birth Cohort Study and attending maternity welfare clinics in Turku, whose hemoglobin (Hb) values during pregnancy were available were included in this study (n = 1273). The study group consisted of 301 women with Hb levels < 11.0 g/dL at any time during pregnancy, and 972 women with Hb ≥ 11.0 g/dL were included in the control group. Symptoms of depression, anxiety, and pregnancy-related anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS), Symptom Checklist-90 (SCL), and Pregnancy-Related Anxiety Questionnaire (PRAQ) questionnaires at 14, 24, and 34 gestational weeks, and EPDS and SCL were also performed 3 and 6 months postpartum. RESULTS Gestational anemia was not associated with an increased risk of depression either prenatally or postpartum when the analyses were adjusted for maternal age at birth, parity, smoking during pregnancy, maternal education, and gestational age. However, a weak connection was found between gestational anemia and prenatal anxiety in the early pregnancy. Furthermore, the analysis between women with Hb < 10.0 g/dL and those with Hb ≥ 10.0 g/dL showed an association between gestational anemia and anxiety in the late pregnancy, but otherwise no difference in psychological distress was found. CONCLUSIONS No evidence supporting the association between gestational anemia and antenatal or postpartum depression was found. However, a weak connection between gestational anemia and antenatal anxiety was observed. This finding needs further investigation to establish timing and investigate causality.
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Affiliation(s)
- Lotta Kemppinen
- Department of Obstetrics and Gynecology, Turku University Hospital, U-Hospital, Savitehtaankatu 5, 20520, Turku, Finland. .,University of Turku, Turku, Finland.
| | - Mirjami Mattila
- Department of Obstetrics and Gynecology, Turku University Hospital, U-Hospital, Savitehtaankatu 5, 20520, Turku, Finland.,University of Turku, Turku, Finland
| | - Eeva Ekholm
- Department of Obstetrics and Gynecology, Turku University Hospital, U-Hospital, Savitehtaankatu 5, 20520, Turku, Finland.,University of Turku, Turku, Finland
| | - Linda Huolila
- Department of Obstetrics and Gynecology, Turku University Hospital, U-Hospital, Savitehtaankatu 5, 20520, Turku, Finland.,University of Turku, Turku, Finland
| | - Juho Pelto
- Department of Clinical Medicine, University of Turku, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
| | - Hasse Karlsson
- Department of Clinical Medicine, University of Turku, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Kaarin Mäkikallio
- Department of Obstetrics and Gynecology, Turku University Hospital, U-Hospital, Savitehtaankatu 5, 20520, Turku, Finland.,University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Clinical Medicine, University of Turku, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland.,Department of Paediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
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14
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Barroca NCB, Della Santa G, Suchecki D, García-Cairasco N, Umeoka EHDL. Challenges in the use of animal models and perspectives for a translational view of stress and psychopathologies. Neurosci Biobehav Rev 2022; 140:104771. [PMID: 35817171 DOI: 10.1016/j.neubiorev.2022.104771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/15/2022] [Accepted: 07/05/2022] [Indexed: 12/25/2022]
Abstract
The neurobiology and development of treatments for stress-related neuropsychiatric disorders rely heavily on animal models. However, the complexity of these disorders makes it difficult to model them entirely, so only specific features of human psychopathology are emulated and these models should be used with great caution. Importantly, the effects of stress depend on multiple factors, like duration, context of exposure, and individual variability. Here we present a review on pre-clinical studies of stress-related disorders, especially those developed to model posttraumatic stress disorder, major depression, and anxiety. Animal models provide relevant evidence of the underpinnings of these disorders, as long as face, construct, and predictive validities are fulfilled. The translational challenges faced by scholars include reductionism and anthropomorphic/anthropocentric interpretation of the results instead of a more naturalistic and evolutionary understanding of animal behavior that must be overcome to offer a meaningful model. Other limitations are low statistical power of analysis, poor evaluation of individual variability, sex differences, and possible conflicting effects of stressors depending on specific windows in the lifespan.
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Affiliation(s)
- Nayara Cobra Barreiro Barroca
- Department of Neuroscience and Behavioral Science, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Giovanna Della Santa
- Department of Neuroscience and Behavioral Science, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Deborah Suchecki
- Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Norberto García-Cairasco
- Department of Neuroscience and Behavioral Science, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil; Department of Physiology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Eduardo Henrique de Lima Umeoka
- Department of Neuroscience and Behavioral Science, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil; School of Medicine, University Center UniCerrado, Goiatuba, GO, Brazil
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15
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Zietlow AL, Woll CFJ, Nonnenmacher N, Müller M, Labonte V, Ditzen B, Paulus M, Sodian B, Nater UM, Herpertz SC, Reck C. Study protocol of the COMPARE-Interaction study: the impact of maternal comorbid depression and anxiety disorders in the peripartum period on child development. BMJ Open 2022; 12:e050437. [PMID: 35058257 PMCID: PMC8783832 DOI: 10.1136/bmjopen-2021-050437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION To date, there are only few studies that compare the consequences of peripartum maternal depressive disorders (PD) versus depressive with comorbid anxiety disorders (PDCA) for infant and child development. As comorbidity is associated with greater impairment and symptom severity related to the primary diagnosis, comorbidity in mothers might raise their offspring's risk of developing internalising or externalising disorders even more than has been noted in conjunction with PD alone. METHODS AND ANALYSIS This study aims to analyse the impact of parental psychopathology, particularly peripartum depression in mothers with and without comorbid anxiety disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) on child cognitive and socioemotional development. Maternal/paternal psychopathology, mother-infant/father-infant interaction and child development are assessed at four measurement points over the first 2 years (T1: 3-4 months postpartum, T2: 12 months postpartum, T3: 18 months postpartum and T4: 24 months postpartum). The mediating role of mother-infant/father-infant interaction and infant stress reactivity in the relationship between PD/PDCA and infant cognitive and socioemotional development will be analysed. In the ongoing study, 174 families (n=58 mothers with PD, n=58 mothers with PDCA and n=58 healthy controls) will be recruited in inpatient and outpatient centres as well as maternity hospitals in Munich and Heidelberg. ETHICS AND DISSEMINATION This study is implemented in accordance with the current guidelines of the World Medical Association (revised Declaration of Helsinki) and the General Data Protection Regulation of the European Union. The study procedures were approved by the independent ethics committees of the Department of Psychology, Ludwig-Maximilians-University Munich (74_Reck_b) and of the Medical Faculty, University Heidelberg (S-446/2017). Participation is voluntary. A signed written informed consent form must be obtained from each study subject prior to any study-specific procedure. Participants can withdraw from the study at any point in time without giving a reason or being subjected to any future disadvantages. In case of withdrawal from the study, the subject's data and material will be kept unless the participant asks for data removal. Results will be published and disseminated to further the discussion on the effects of maternal PD and PDCA on parent-infant interaction, infant stress reactivity and child development. Furthermore, study results will be presented at international congresses and expert conferences.
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Affiliation(s)
- Anna-Lena Zietlow
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Christian Franz Josef Woll
- Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Nora Nonnenmacher
- Institute of Medical Psychology, Centre of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mitho Müller
- Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Verena Labonte
- Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Centre of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Markus Paulus
- Department of Psychology, Developmental and Educational Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Beate Sodian
- Department of Psychology, Developmental and Educational Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Urs M Nater
- Department of Psychology, University of Vienna, Vienna, Austria
| | - Sabine C Herpertz
- Department of General Psychiatry, Centre of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Corinna Reck
- Department of Psychology, Clinical Psychology of Children and Adolescents, Ludwig-Maximilians-University Munich, Munich, Germany
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16
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Tarafa H, Alemayehu Y, Nigussie M. Factors associated with pregnancy-related anxiety among pregnant women attending antenatal care follow-up at Bedelle general hospital and Metu Karl comprehensive specialized hospital, Southwest Ethiopia. Front Psychiatry 2022; 13:938277. [PMID: 36213901 PMCID: PMC9537765 DOI: 10.3389/fpsyt.2022.938277] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Pregnancy-related anxiety (PRA) is an anxiety related to the pregnancy, involving labor and delivery, the well-being of the fetus/infant and the mother, the availability of quality of healthcare resources, and the capacity to parent. There is scarcity of study conducted on magnitude of Pregnancy-related anxiety and its associated factors among pregnant women in Ethiopia. The main objective of this research was to assess factors associated with Pregnancy-related anxiety among pregnant women attending ANC follow-up at Bedelle general and Metu Karl comprehensive specialized hospitals, Southwest Ethiopia. A hospital-based cross-sectional study design was used among pregnant women attending ANC follow-up. Data were collected from 406 sampled pregnant women who were selected through a systematic random sampling technique. Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R2) was used to measure the outcome variable. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 26. Logistic regression analyses were done to identify factors associated with Pregnancy-related anxiety and significance level set at p < 0.05. The overall prevalence of PRA in this study was 32.7%. Unwanted pregnancy AOR = 2.77, 95% CI [1.71, 4.54], high perceived stress AOR = 2.39, 95% CI [1.54, 3.62], young age AOR = 2.14, 95% CI [1.49, 2.83], depression AOR = 2.09, 95% CI [1.39, 2.89], low income AOR = 2.01, 95% CI [1.29, 3.14], and poor social support AOR = 1.79, 95% CI [1.14, 3.37] were significantly associated with Pregnancy-related anxiety. The findings of this study showed that the prevalence of Pregnancy-related anxiety was high in the study area and positively associated with young age, low income, poor social support, high perceived stress, depression, and unwanted pregnancy. This finding suggests that clinicians should integrate screening for Pregnancy-related anxiety into clinical standards, more efforts should be made in the future to reduce the anxiety among pregnant women who had an unwanted pregnancy, young women, and poor social support. Also, it is good to encourage the pregnant mother to enhance their social connectedness by creating a self-help group, and increasing early identification of mental health problems throughout their daily ANC follow-up.
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Affiliation(s)
- Hunde Tarafa
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
| | - Yadeta Alemayehu
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
| | - Meskerem Nigussie
- Department of Psychiatry, College of Health Sciences, Metu University, Metu, Ethiopia
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17
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Lamichhane DK, Jung DY, Shin YJ, Lee KS, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Association between ambient air pollution and perceived stress in pregnant women. Sci Rep 2021; 11:23496. [PMID: 34873215 PMCID: PMC8648786 DOI: 10.1038/s41598-021-02845-4] [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] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Air pollution may influence prenatal maternal stress, but research evidence is scarce. Using data from a prospective cohort study conducted on pregnant women (n = 2153), we explored the association between air pollution and perceived stress, which was assessed using the 14-item Perceived Stress Scale (PSS), among pregnant women. Average exposures to particulate matter with an aerodynamic diameter of < 2.5 µm (PM2.5) or < 10 µm (PM10), nitrogen dioxide (NO2), and ozone (O3) for each trimester and the entire pregnancy were estimated at maternal residential addresses using land-use regression models. Linear regression models were applied to estimate associations between PSS scores and exposures to each air pollutant. After adjustment for potential confounders, interquartile-range (IQR) increases in whole pregnancy exposures to PM2.5, PM10, and O3 in the third trimester were associated with 0.37 (95% confidence interval [CI] 0.01, 0.74), 0.54 (95% CI 0.11, 0.97), and 0.30 (95% CI 0.07, 0.54) point increases in prenatal PSS scores, respectively. Furthermore, these associations were more evident in women with child-bearing age and a lower level of education. Also, the association between PSS scores and PM10 was stronger in the spring. Our findings support the relationship between air pollution and prenatal maternal stress.
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Affiliation(s)
- Dirga Kumar Lamichhane
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dal-Young Jung
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yee-Jin Shin
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sook Lee
- grid.444037.00000 0000 9208 7123Department of Rehabilitation, Hanshin University, Osan, Gyeonggi-do Republic of Korea
| | - So-Yeon Lee
- grid.413967.e0000 0001 0842 2126Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- grid.414964.a0000 0001 0640 5613Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ,grid.414964.a0000 0001 0640 5613Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- grid.15444.300000 0004 0470 5454Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- grid.413793.b0000 0004 0624 2588Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- grid.31501.360000 0004 0470 5905Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
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18
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Mennes M, Stiers P, Lagae L, Van den Bergh BRH. Antenatal maternal anxiety modulates the BOLD response in 20-year-old men during endogenous cognitive control. Brain Imaging Behav 2021; 14:830-846. [PMID: 30617784 DOI: 10.1007/s11682-018-0027-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Evidence is building for an association between the level of anxiety experienced by a mother during pregnancy and offspring cognition and structural and functional brain correlates. The current study uses fMRI to examine the association between prenatal exposure to maternal anxiety and brain activity associated with endogenous versus exogenous cognitive control in 20-year-old males. Endogenous cognitive control refers to the ability to generate control over decisions, strategies, conflicting information and so on, from within oneself without external signals, while exogenous control is triggered by external signals. In line with previous results of this long-term follow-up study we found that 20-year-olds of mothers reporting high levels of anxiety during weeks 12-22 of pregnancy exhibited a different pattern of decision making in a Gambling paradigm requiring endogenous cognitive control, compared to adults of mothers reporting low to average levels of anxiety. Moreover, the blood oxygenation level dependent (BOLD) response in a number of prefrontal cortical areas was modulated by the level of antenatal maternal anxiety. In particular, a number of right lateralized clusters including inferior frontal junction, that were modulated in the adults of mothers reporting low to average levels of anxiety during pregnancy by a task manipulation of cognitive control, were not modulated by this manipulation in the adults of mothers reporting high levels of anxiety during pregnancy. These differences in brain functional correlates provide a neurobiological underpinning for the hypothesis of an association between exposure to maternal anxiety in the prenatal life period and a deficit in endogenous cognitive control in early adulthood.
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Affiliation(s)
- Maarten Mennes
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Peter Stiers
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Lieven Lagae
- Section Paediatric Neurology, Department Development and Regeneration, University Hospitals KU Leuven, Leuven, Belgium
| | - Bea R H Van den Bergh
- Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven - KU Leuven, Tiensestraat 102 - bus 3726, 3000, Leuven, Belgium. .,Department of Welfare, Public Health and Family, Flemish Government, Brussels, Belgium.
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19
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Akinsulore A, Temidayo AM, Oloniniyi IO, Olalekan BO, Yetunde OB. Pregnancy-related anxiety symptoms and associated factors amongst pregnant women attending a tertiary hospital in south-west Nigeria. S Afr J Psychiatr 2021; 27:1616. [PMID: 33824759 PMCID: PMC8007988 DOI: 10.4102/sajpsychiatry.v27i0.1616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 11/21/2022] Open
Abstract
Background Pregnancy can be associated with anxiety symptoms because of anticipated uncertainty. Aim This study investigated pregnancy-related anxiety symptoms (PRASs) and their associated factors amongst pregnant women. Setting Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Methods This cross-sectional survey involved 230 pregnant women attending antenatal clinic at a tertiary teaching hospital in Nigeria. Pregnancy-related anxiety symptoms, maternal worries, personality traits and social support were measured by using Perinatal Anxiety Screening Scale (PASS), Cambridge Worry Scale (CWS), Big Five Personality Inventory (BFI-10) and Maternal Social Support Scale (MSSS) respectively. Socio-demographic and obstetric details were also obtained. The Chi-square, t-test and logistic regression were used. Results Respondents’ mean age was 28.2 ± 5.4 years, whilst 192 (83.5%) were of Yoruba ethnicity. Twenty-four respondents (10.4%) were in the first trimester, 85 (37.0%) in the second and 121 (52.6%) in the third trimester. Some 154 (67.0%) were parous. The prevalence of PRAS and major maternal worries were 43.5% and 55.7% respectively. The socio-demographic factors significantly associated with PRAS were age (p = 0.004), ethnicity (p = 0.001), educational level (p = 0.011) and living arrangement (p = 0.029). Associated obstetric factors include trimester (p = 0.01), hypertension (p = 0.006), past miscarriage(s) (p = 0.013) and past pregnancy complication (p = 0.030). Significant psychosocial factors were partner social support (p = 0.038), maternal worries (p < 0.001) and extraversion (p = 0.016). Factors that contributed significantly to regression models were older maternal age and socio-medical worries. Conclusion High level of PRAS and major maternal worries were common amongst antenatal clinic attendees of a tertiary teaching hospital in Nigeria. Older maternal age and socio-medical maternal worries are important predictors of PRAS.
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Affiliation(s)
- Adesanmi Akinsulore
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
| | - Akinfenwa M Temidayo
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
| | - Ibidunni O Oloniniyi
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
| | - Badejoko O Olalekan
- Department of Obstetrics, Gynaecology and Perimatology, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
| | - Oladimeji B Yetunde
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ife-Ife, Osun State, Nigeria
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20
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Taboada MJ. The first encounter with death: A physical experience. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2021. [DOI: 10.1016/j.ejtd.2020.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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Lisi G, Ribolsi M, Siracusano A, Niolu C. Maternal Vitamin D and its Role in Determining Fetal Origins of Mental Health. Curr Pharm Des 2020; 26:2497-2509. [PMID: 32370709 DOI: 10.2174/1381612826666200506093858] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/26/2020] [Indexed: 12/21/2022]
Abstract
There is evidence that mental health disorders may have roots in fetal life and are associated with deficiencies in various micronutrients, including vitamin D. During pregnancy, vitamin D balance is influenced by an increase in maternal calcitriol and a substantial increase in maternal Vitamin D Binding Protein concentrations. In the early stages of life, vitamin D is necessary to mediate numerous brain processes such as proliferation, apoptosis, and neurotransmission. Furthermore, Vitamin D has a recognized anti-inflammatory activity that normally suppresses inflammation. Increased activation of hypothalamo-pituitary-adrenal axis (HPA) and inflammation during gestation may influence maternal health and fetal neurodevelopment during and beyond pregnancy. A deficit of Vitamin D and maternal stressful events during gestation, such as perinatal depression, could influence the efficacy of the immune system altering its activity. Vitamin D deficiency during gestation associated with a reduction in fetal brain development has been widely described and correlated with alteration in the production of the brain-derived neurotrophic factor. To this regard, many studies highlights that low maternal vitamin D dosage during gestation has been related to a significantly greater risk to develop schizophrenia and other severe mental illnesses in later life. The objective of this paper is a comprehensive overview of maternal vitamin D balance in determining the fetal origins of mental health with some references to the link between vitamin D levels, inflammatory responses to stress and mental disorders in adult life.
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Affiliation(s)
- Giulia Lisi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Mental Health, ASL ROMA 1, Rome, Italy
| | - Michele Ribolsi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Policlinico Tor Vergata Foundation, Rome, Italy
| | - Alberto Siracusano
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Policlinico Tor Vergata Foundation, Rome, Italy
| | - Cinzia Niolu
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Policlinico Tor Vergata Foundation, Rome, Italy
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22
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Davis EP, Narayan AJ. Pregnancy as a period of risk, adaptation, and resilience for mothers and infants. Dev Psychopathol 2020; 32:1625-1639. [PMID: 33427164 PMCID: PMC7863987 DOI: 10.1017/s0954579420001121] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The pregnancy period represents a unique window of opportunity to identify risks to both the fetus and mother and to deter the intergenerational transmission of adversity and mental health problems. Although the maternal-fetal dyad is especially vulnerable to the effects of stress during pregnancy, less is known about how the dyad is also receptive to salutary, resilience-promoting influences. The present review adopts life span and intergenerational perspectives to review four key areas of research. The first part describes how pregnancy is a sensitive period for both the mother and fetus. In the second part, the focus is on antecedents of maternal prenatal risks pertaining to prenatal stress response systems and mental health. The third part then turns to elucidating how these alterations in prenatal stress physiology and mental health problems may affect infant and child outcomes. The fourth part underscores how pregnancy is also a time of heightened fetal receptivity to maternal and environmental signals, with profound implications for adaptation. This section also reviews empirical evidence of promotive and protective factors that buffer the mother and fetus from developmental and adaptational problems and covers a sample of rigorous evidence-based prenatal interventions that prevent maladaptation in the maternal-fetal dyad before babies are born. Finally, recommendations elaborate on how to further strengthen understanding of pregnancy as a period of multilevel risk and resilience, enhance comprehensive prenatal screening, and expand on prenatal interventions to promote maternal-fetal adaptation before birth.
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Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
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23
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Ross KM, Letourneau N, Climie E, Giesbrecht G, Dewey D. Perinatal Maternal Anxiety and Depressive Symptoms and Child Executive Function and Attention at Two-years of Age. Dev Neuropsychol 2020; 45:380-395. [PMID: 33081504 DOI: 10.1080/87565641.2020.1838525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective was to investigate whether perinatal maternal anxiety and depressive symptoms predicted child attention and executive function (EF). Mothers (N = 614) reported pregnancy and three-months postnatal anxiety and depressive symptoms. Attention and EF were measured at two-years-of-age. Covariates were demographics, alcohol use, mood disorder history, and pregnancy factors. Higher prenatal anxiety, b(SE) =.020(.005), p<.001, and postnatal depressive symptoms, b(SE) =.009(.004), p=.04, predicted poorer child attention. A prenatal-by-postnatal depressive symptom interaction emerged, b(SE) = -.005(.003), p=.04: When pregnancy depressive symptoms were low, higher postnatal symptoms predicted poorer attention. No distress variables predicted EF, p's>.22. Perinatal distress timing, kind, and change were important for child attention.
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Affiliation(s)
- Kharah M Ross
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Nicole Letourneau
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Emma Climie
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Gerald Giesbrecht
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
| | - Deborah Dewey
- Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Faculty of Nursing, Department of Paediatrics, and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute and Werklund School of Education, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics and Department of Community Health Sciences, University of Calgary , Calgary, Canada.,Owerko Centre, Alberta Children's Hospital Research Institute, Department of Paediatrics, Department of Community Health Sciences, And Hotchkiss Brain Institute, University of Calgary , Calgary, Canada
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24
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Nakamura Y, Okada T, Morikawa M, Yamauchi A, Sato M, Ando M, Ozaki N. Perinatal depression and anxiety of primipara is higher than that of multipara in Japanese women. Sci Rep 2020; 10:17060. [PMID: 33051530 PMCID: PMC7555526 DOI: 10.1038/s41598-020-74088-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/23/2020] [Indexed: 11/09/2022] Open
Abstract
The proportion of women who experience a depressive state after delivery differs between primiparas and multiparas, so it is important to clarify the different factors related to depression between the two groups. In this study, we confirmed the differences in depressive states, the perinatal period, and social support between primiparas and multiparas, and clarified their characteristics. Data were extracted from a prospective cohort questionnaire survey conducted on pregnant women in Japan that included sociodemographic questions, the Edinburgh Postnatal Depression Scale, and the Japanese version of the Social Support Questionnaire. We carried out the chi-square test, Student's t-test, and analysis of covariance to compare responses between primiparas and multiparas. A total of 1138 primiparas and 380 multiparas provided valid responses. We found that primiparas had higher rates of experiencing maternity blues and postpartum depression than multiparas. We also found that primiparas had higher anxiety scores than multiparas. Primiparas with postpartum depression perceived a lower number of persons available to provide social support than primiparas without postpartum depression. These findings suggest that it is important to provide pregnant women, especially for primiparas, with information that allows them to increase the number of people who can provide them with support.
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Affiliation(s)
- Yukako Nakamura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Takashi Okada
- Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Mako Morikawa
- Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Aya Yamauchi
- Psychiatry/Child and Adolescent Psychiatry, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Maya Sato
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Masahiko Ando
- Department of Advanced Medicine, Data Coordinating Center, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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25
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Braun K, Bock J, Wainstock T, Matas E, Gaisler-Salomon I, Fegert J, Ziegenhain U, Segal M. Experience-induced transgenerational (re-)programming of neuronal structure and functions: Impact of stress prior and during pregnancy. Neurosci Biobehav Rev 2020; 117:281-296. [DOI: 10.1016/j.neubiorev.2017.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 05/23/2017] [Accepted: 05/24/2017] [Indexed: 12/11/2022]
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26
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Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neurosci Biobehav Rev 2020; 117:26-64. [DOI: 10.1016/j.neubiorev.2017.07.003] [Citation(s) in RCA: 438] [Impact Index Per Article: 109.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 04/09/2017] [Accepted: 07/11/2017] [Indexed: 01/17/2023]
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27
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Cena L, Mirabella F, Palumbo G, Gigantesco A, Trainini A, Stefana A. Prevalence of maternal antenatal anxiety and its association with demographic and socioeconomic factors: A multicentre study in Italy. Eur Psychiatry 2020; 63:e84. [PMID: 32892763 PMCID: PMC7576533 DOI: 10.1192/j.eurpsy.2020.82] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/16/2020] [Accepted: 08/27/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Maternal antenatal anxiety is very common, and despite its short- and long-term effects on both mothers and fetus outcomes, it has received less attention than it deserves in scientific research and clinical practice. Therefore, we aimed to estimate the prevalence of state anxiety in the antenatal period, and to analyze its association with demographic and socioeconomic factors. METHODS A total of 1142 pregnant women from nine Italian healthcare centers were assessed through the state scale of the State-Trait Anxiety Inventory and a clinical interview. Demographic and socioeconomic factors were also measured. RESULTS The prevalence of anxiety was 24.3% among pregnant women. There was a significantly higher risk of anxiety in pregnant women with low level of education (p < 0.01), who are jobless (p < 0.01), and who have economic problems (p < 0.01). Furthermore, pregnant women experience higher level of anxiety when they have not planned the pregnancy (p < 0.01), have a history of abortion (p < 0.05), and have children living at the time of the current pregnancy (p < 0.05). CONCLUSION There exists a significant association between maternal antenatal anxiety and economic conditions. Early evaluation of socioeconomic status of pregnant women and their families in order to identify disadvantaged situations might reduce the prevalence of antenatal anxiety and its direct and indirect costs.
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Affiliation(s)
- L. Cena
- Department of Clinical and Experimental Sciences, Section of Neuroscience, Observatory of Perinatal Clinical Psychology, University of Brescia, viale Europa 11, Brescia25123, Italy
| | - F. Mirabella
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Viale Regina Elena 299, Rome00161, Italy
| | - G. Palumbo
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Viale Regina Elena 299, Rome00161, Italy
| | - A. Gigantesco
- Center for Behavioural Sciences and Mental Health, National Institute of Health, Viale Regina Elena 299, Rome00161, Italy
| | - A. Trainini
- Department of Clinical and Experimental Sciences, Section of Neuroscience, Observatory of Perinatal Clinical Psychology, University of Brescia, viale Europa 11, Brescia25123, Italy
| | - A. Stefana
- Department of Clinical and Experimental Sciences, Section of Neuroscience, Observatory of Perinatal Clinical Psychology, University of Brescia, viale Europa 11, Brescia25123, Italy
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28
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Yu Y, Wang T, Liang J, Yang C, Wang H, Zhao X, Zhang J, Liu W. Behavioural Problems Amongst Pre-School Children in Chongqing, China: Current Situation and Influencing Factors. Risk Manag Healthc Policy 2020; 13:1149-1160. [PMID: 32884376 PMCID: PMC7439761 DOI: 10.2147/rmhp.s263155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/28/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Behavioural problems in pre-school children are closely related to their mental health. Such problems include attention deficit, personality disorder, overdependency, poor adaptability and conduct problems. Methods From December 2018 to January 2019, we conducted a cross-sectional survey of parents of pre-schoolers. The survey covered sixteen kindergartens in six districts of Chongqing, China. A total of 2200 participants participated in the survey, and 1895 questionnaires were returned. After screening, 1496 valid questionnaires were compiled in the data analysis (n=1496). Results Analysis of the maximum likelihood estimation revealed that age, preterm birth, household income, amount of daily interaction with parents, and scolding frequency affected behavioural problems in the pre-schoolers. Behavioural problems tend to be attenuated as children grow. Preterm children had a higher probability of developing behavioural problems than did non-preterm children. Children from families with monthly household incomes between $1130-$1695 USD and $1696-$2260 USD were more prone to developing behavioural problems. Children whose parents spent less time interacting with them (39.26% of parents interacted with children less than 1 hour per day) and children who were scolded more often had greater behavioural problems (13.44% of parents often scolded their children). Discussion This study was conducted to evaluate the influence of parenting methods on pre-school children and the education provided by parents on their pre-school children's behavioural problems to provide insights for Chinese parents and mental health professionals to improve treatment of behavioural problems.
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Affiliation(s)
- Yao Yu
- Faculty of Education, Southwest University, Chongqing 400715, People's Republic of China.,Collaborative Innovation Platform of 0-6-Year-Old Children's Development and Education Network, Chongqing University of Education, Chongqing 400067, People's Republic of China
| | - Ting Wang
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Jiyu Liang
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Chenlu Yang
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Haozhuo Wang
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Xin Zhao
- Chongqing Collaborative Innovation Center for Functional Food, Chongqing Engineering Research Center of Functional Food, Chongqing Engineering Laboratory for Research and Development of Functional Food, Chongqing University of Education, Chongqing 400067, People's Republic of China
| | - Jiajun Zhang
- Faculty of Education, Southwest University, Chongqing 400715, People's Republic of China
| | - Weiwei Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, People's Republic of China
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29
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Lehtola SJ, Tuulari JJ, Scheinin NM, Karlsson L, Parkkola R, Merisaari H, Lewis JD, Fonov VS, Louis Collins D, Evans A, Saunavaara J, Hashempour N, Lähdesmäki T, Acosta H, Karlsson H. Newborn amygdalar volumes are associated with maternal prenatal psychological distress in a sex-dependent way. Neuroimage Clin 2020; 28:102380. [PMID: 32805677 PMCID: PMC7453059 DOI: 10.1016/j.nicl.2020.102380] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 12/20/2022]
Abstract
Maternal psychological distress during pregnancy (PPD)1 has been associated with changes in offspring amygdalar and hippocampal volumes. Studies on child amygdalae suggest that sex moderates the vulnerability of fetal brains to prenatal stress. However, this has not yet been observed in these structures in newborns. Newborn studies are crucial, as they minimize the confounding influence of postnatal life. We investigated the effects of maternal prenatal psychological symptoms on newborn amygdalar and hippocampal volumes and their interactions with newborn sex in 123 newborns aged 2-5 weeks (69 males, 54 females). Based on earlier studies, we anticipated small, but statistically significant effects of PPD on the volumes of these structures. Maternal psychological distress was measured at gestational weeks (GW)2 14, 24 and 34 using Symptom Checklist-90 (SCL-90, anxiety scale)3 and Edinburgh Postnatal Depression Scale (EPDS)4 questionnaires. Newborn sex was found to moderate the relationship between maternal distress symptoms at GW 24 and the volumes of left and right amygdala. This relationship was negative and significant only in males. No significant main effect or sex-based moderation was found for hippocampal volumes. This newborn study provides evidence for a sex-dependent influence of maternal psychiatric symptoms on amygdalar structural development. This association may be relevant to later psychopathology.
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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, University of Oxford, Oxford, United Kingdom
| | - 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
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine University of Turku, Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Riitta Parkkola
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Harri Merisaari
- Department of Future Technologies, University of Turku, 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
| | - Alan Evans
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Jani Saunavaara
- Department of Medical Physics, 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
| | - Tuire Lähdesmäki
- Department of Pediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - Henriette Acosta
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine University of Turku, Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Finland
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Maternal prenatal anxiety trajectories and infant developmental outcomes in one-year-old offspring. Infant Behav Dev 2020; 60:101468. [PMID: 32745812 DOI: 10.1016/j.infbeh.2020.101468] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/22/2020] [Accepted: 07/09/2020] [Indexed: 12/11/2022]
Abstract
A longitudinal study of a sample of women and their offspring from two urban areas (N = 233) was conducted to test whether maternal prenatal anxiety trajectories from early to late pregnancy are associated with 12-month infant developmental outcomes, independent of maternal postpartum anxiety symptoms, prenatal and postpartum depressive symptoms, parity, birth outcomes and maternal education. Three types of maternal anxiety trajectories over the course of pregnancy were identified and labeled increasing, decreasing, and stable-low. Only increasing maternal prenatal anxiety was associated with 12-month infant outcomes, specifically lower Bayley-III scores on receptive language and gross motor skills. Maternal anxiety measured at each individual timepoint in pregnancy was not associated with infant Bayley-III outcomes, highlighting the importance of examining trajectories of maternal affect.
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Zarrabi Jourshari F, Zargham Hajebi M, Saravani S, Eghbali Z. The Effect of Antenatal Physiological Classes on Depression, Anxiety and Social Support in the Last Month of Pregnancy. ACTA ACUST UNITED AC 2020. [DOI: 10.29252/jhc.22.1.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Bleker LS, Milgrom J, Sexton-Oates A, Parker D, Roseboom TJ, Gemmill AW, Holt CJ, Saffery R, Connelly A, Burger H, de Rooij SR. Cognitive Behavioral Therapy for Antenatal Depression in a Pilot Randomized Controlled Trial and Effects on Neurobiological, Behavioral and Cognitive Outcomes in Offspring 3-7 Years Postpartum: A Perspective Article on Study Findings, Limitations and Future Aims. Front Psychiatry 2020; 11:34. [PMID: 32116849 PMCID: PMC7031203 DOI: 10.3389/fpsyt.2020.00034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/13/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE OF ARTICLE In a previous pilot randomized controlled trial including 54 pregnant women with depression, maternal mood improved after Cognitive Behavioural Therapy (CBT) compared to treatment as usual (TAU), showing medium to large effect sizes. The effect persisted up to 9 months postpartum, with infant outcomes also showing medium to large effects favoring CBT in various child domains. This perspective article summarizes the results of a follow-up that was performed approximately 5 years later in the same cohort, assessing the effects of antenatal Cognitive Behavioural Therapy for depression and anxiety on child buccal cell DNA-methylation, brain morphology, behavior and cognition. FINDINGS Children from the CBT group had overall lower DNA-methylation compared to children from the TAU group. Mean DNA-methylation of all NR3C1 promoter-associated probes did not differ significantly between the CBT and TAU groups. Children from the CBT group had a thicker right lateral occipital cortex and lingual gyrus. In the CBT group, Voxel-Based-Morphometry analysis identified one cluster showing increased gray matter concentration in the right medial temporal lobe, and fixel-based analysis revealed reduced fiber-bundle-cross-section in the Fornix, the Optical Tract, and the Stria Terminalis. No differences were observed in full-scale IQ or Total Problems Score. When the total of hypotheses tests in this study was considered, differences in DNA-methylation and brain measurements were no longer significant. SUMMARY Our explorative findings suggest that antenatal depression treatment decreases overall child DNA-methylation, increases cortical thickness, and decreases white matter fiber-bundle cross-section in regions involved in cognitive function and the stress response. Nevertheless, larger studies are warranted to confirm our preliminary conclusion that CBT in pregnancy alters neurobiological outcomes in children. Clinical relevance remains unclear as we found no effects of antenatal CBT on child behavior or cognition (yet).
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Affiliation(s)
- Laura S. Bleker
- Academic Medical Centre, Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, Netherlands
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Alexandra Sexton-Oates
- Murdoch Children’s Research Institute—Cancer and Disease Epigenetics, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Donna Parker
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Tessa J. Roseboom
- Academic Medical Centre, Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, Netherlands
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
| | - Alan W. Gemmill
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
| | | | - Richard Saffery
- Murdoch Children’s Research Institute—Cancer and Disease Epigenetics, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Alan Connelly
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Huibert Burger
- University Medical Center Groningen, Department of General Practice, University of Groningen, Groningen, Netherlands
- Academic Medical Centre, Department of Psychiatry, Amsterdam UMC, Amsterdam, Netherlands
| | - Susanne R. de Rooij
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
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Tan HK, Goh SKY, Tsotsi S, Bruntraeger M, Chen HY, Broekman B, Tan KH, Chong YS, Meaney MJ, Qiu A, Rifkin-Graboi A. Maternal antenatal anxiety and electrophysiological functioning amongst a sub-set of preschoolers participating in the GUSTO cohort. BMC Psychiatry 2020; 20:62. [PMID: 32050929 PMCID: PMC7017524 DOI: 10.1186/s12888-020-2454-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 01/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antenatal maternal anxiety is a risk for offspring psychological and cognitive difficulties. The preschool years represent an important time for brain development, and so may be a window for intervention. However, electrophysiological investigations of maternal anxiety and preschoolers' brain functioning are lacking. We ask whether anxiety symptoms predict neurophysiology, and consider timing specificity (26-weeks antenatal or 24-months postnatal), form of insult (anxiety symptoms, per se, or also depression symptoms), and offspring gender. METHODS The sample consisted of a subset of 71 mothers and their 3 year old children taking part in the prospective birth cohort, GUSTO. Mothers provided antenatal (26 weeks) and postnatal (2 years) anxiety and depressive symptomatology data, respectively via the "State Trait Anxiety Questionnaire" and the "Edinburgh Postpartum Depression Scale." Offspring provided electrophysiological data, obtained while they indicated the emotional expression of actors whose facial expressions remained consistent throughout a pre-switch block, but were reversed at "post-switch." RESULTS Three electrophysiological components linked to different information processing stages were identified. The two earliest occurring components (i.e., the N1 and P2) differed across blocks. During post-switch, both were significantly predicted by maternal anxiety, after controlling for pre-switch neurophysiology. Similar results were observed with depression. Antenatal mental health remained a significant predictor after controlling for postnatal mental health. CONCLUSION In combination with past work, these findings suggest the importance of reducing symptoms in women prior to and during pregnancy, and offering support to offspring early in development.
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Affiliation(s)
- Hong Kuang Tan
- grid.452264.30000 0004 0530 269XIntegrative Neurosciences, Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609 Singapore ,grid.428397.30000 0004 0385 0924Duke-National University of Singapore, 8 College Road, Singapore, 169857 Singapore
| | - Shaun K. Y. Goh
- grid.4280.e0000 0001 2180 6431Department of Biomedical Engineering, National University Singapore, 4 Engineering Drive 3, Singapore, 117583 Singapore ,grid.59025.3b0000 0001 2224 0361Present Address: Centre for Research in Child Development, National Institute of Education, 1 Nanyang Walk, Singapore, S637616 Singapore
| | - Stella Tsotsi
- grid.452264.30000 0004 0530 269XIntegrative Neurosciences, Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609 Singapore ,grid.59025.3b0000 0001 2224 0361Present Address: Centre for Research in Child Development, National Institute of Education, 1 Nanyang Walk, Singapore, S637616 Singapore
| | - Michaela Bruntraeger
- grid.452264.30000 0004 0530 269XIntegrative Neurosciences, Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609 Singapore ,grid.10306.340000 0004 0606 5382Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SA UK
| | - Helen Yu Chen
- grid.428397.30000 0004 0385 0924Duke-National University of Singapore, 8 College Road, Singapore, 169857 Singapore ,Department of Psychological Medicine, KK Women and Children’s Hospital, 100 Bukit Timah Road, Singapore, 229899 Singapore
| | - Birit Broekman
- grid.452264.30000 0004 0530 269XIntegrative Neurosciences, Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609 Singapore ,Department of Psychiatry, OLVG and Amsterdam UMC, Amsterdam, Netherlands
| | - Kok Hian Tan
- Division of Obstetrics and Gynaecology, KK Women and Children’s Hospital, 100 Bukit Timah Road, Singapore, 229899 Singapore
| | - Yap Seng Chong
- grid.452264.30000 0004 0530 269XIntegrative Neurosciences, Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609 Singapore ,grid.412106.00000 0004 0621 9599Department of Gynaecology and Obstetrics, National University Hospital Singapore, 1E, Kent Ridge Road, Singapore, 119228 Singapore
| | - Michael J. Meaney
- grid.452264.30000 0004 0530 269XIntegrative Neurosciences, Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609 Singapore ,grid.14709.3b0000 0004 1936 8649McGill University, 6875 Boulevard Lasalle, Montréal, QC H4H 1R3 Canada ,Ludmer Centre for Neuroinformatics and Mental Health, 6875 Boulevard Lasalle, Montréal, QC H4H 1R3 Canada
| | - Anqi Qiu
- grid.452264.30000 0004 0530 269XIntegrative Neurosciences, Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609 Singapore ,grid.4280.e0000 0001 2180 6431Department of Biomedical Engineering, National University Singapore, 4 Engineering Drive 3, Singapore, 117583 Singapore
| | - Anne Rifkin-Graboi
- Integrative Neurosciences, Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore, 117609, Singapore. .,Present Address: Centre for Research in Child Development, National Institute of Education, 1 Nanyang Walk, Singapore, S637616, Singapore.
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Maria A, Nissilä I, Shekhar S, Kotilahti K, Tuulari JJ, Hirvi P, Huotilainen M, Heiskala J, Karlsson L, Karlsson H. Relationship between maternal pregnancy-related anxiety and infant brain responses to emotional speech - a pilot study. J Affect Disord 2020; 262:62-70. [PMID: 31710930 DOI: 10.1016/j.jad.2019.10.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/09/2019] [Accepted: 10/28/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Maternal pregnancy-related anxiety (PRA) is reportedly related to neurodevelopmental outcomes of infants. However, the relationship between maternal PRA and the processing of emotions in the infant brain has not been extensively studied with neuroimaging. The objective of the present pilot study is to investigate the relationship between maternal PRA and infant hemodynamic responses to emotional speech at two months of age. METHODS The study sample included 19 mother-infant dyads from a general sample of a population of Caucasian mothers. Self-reported Pregnancy-Related Anxiety Questionnaire (PRAQ-R2) data was collected from mothers during pregnancy at gestational weeks (gwks) 24 (N = 19) and 34 (N = 18). When their infants were two months old, the infants' brains functional responses to emotional speech in the left fronto-temporoparietal cortex were recorded using diffuse optical tomography (DOT). RESULTS Maternal PRAQ-R2 scores at gwk 24 correlated negatively with the total hemoglobin (HbT) responses to sad speech on both sides of the temporoparietal junction (Spearman's rank correlation coefficient ρ = -0.87). The correlation was significantly greater at gwk 24 than gwk 34 (ρ = -0.42). LIMITATIONS The field of view of the measurement did not include the right hemisphere or parts of the frontal cortex. The sample size is moderate and the mothers were relatively highly educated, thus there may be some differences between the study sample and the general population. CONCLUSIONS Maternal pregnancy-related anxiety may affect child brain emotion processing development. Further research is needed to understand the functional and developmental significance of the findings.
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Affiliation(s)
- Ambika Maria
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland
| | - Ilkka Nissilä
- Aalto University, Department of Neuroscience and Biomedical Engineering, Finland.
| | - Shashank Shekhar
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Mississippi Medical Center, Department of Neurology, MS, USA
| | - Kalle Kotilahti
- Aalto University, Department of Neuroscience and Biomedical Engineering, Finland
| | - Jetro J Tuulari
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; The Turku Collegium for Science and Medicine (TCSM); University of Oxford, Department of Psychiatry, Oxford, United Kingdom; University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
| | - Pauliina Hirvi
- Aalto University, Department of Neuroscience and Biomedical Engineering, Finland; Aalto University, Department of Mathematics and Systems Analysis, Finland
| | - Minna Huotilainen
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Helsinki, Faculty of Educational Sciences, CICERO Learning, Finland
| | - Juha Heiskala
- Helsinki University Central Hospital, Department of Clinical Neurophysiology, Finland
| | - Linnea Karlsson
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Department of Child Psychiatry, Turku, Finland
| | - Hasse Karlsson
- University of Turku, Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort Study, Turku, Finland; University of Turku and Turku University Hospital, Department of Psychiatry, Turku, Finland
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Rabiepoor S, Abedi M, Saboory E, Khalkhali HR. Stress during pregnancy affected neonatal outcomes and changed cortisol and leptin levels both in mothers and newborns. J Neonatal Perinatal Med 2020; 12:209-219. [PMID: 30741697 DOI: 10.3233/npm-1818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The present study aimed to determine the effect of perceived stress during pregnancy on neonatal outcomes and cortisol and leptin levels in mothers and their newborns. METHODS This longitudinal study was carried out on 110 pregnant women in Miandoab city, Iran. Mothers, who had singleton pregnancies and gestational age of 24 to 28 weeks, were included in the study. The participants were asked to fill out Cohen's Perceived Stress Scale (PSS). The mothers were then tracked in gestational ages of 28-32 weeks, 32-36 weeks, and the time of delivery. The maternal and umbilical cord blood samples were obtained during labor in order to measure leptin and cortisol levels. RESULTS Umbilical cortisol level was significantly higher in newborns who had meconium stained amniotic fluid than those who did not. Maternal blood leptin levels at delivery were significantly higher in the mothers whose neonates had respiratory distress, low birth weight, low head circumference, low Apgar score, and were premature than those whose neonates did not have such problems. The level of leptin in umbilical cord blood was significantly higher in neonates who had respiratory distress than those who did not. The results also showed a significant correlation between maternal cortisol levels and PSS during weeks 24-28 and the entire pregnancy. A significant relationship was observed between umbilical leptin and maternal leptin levels. CONCLUSIONS It can be concluded that stress during pregnancy is accompanied by fetal distress. The probable reason for newborns distress may be related to increased maternal leptin levels.
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Affiliation(s)
- S Rabiepoor
- Department of Midwifery & Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - M Abedi
- Urmia University of Medical Sciences, Urmia, Iran
| | - E Saboory
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - H R Khalkhali
- Department of Biostatistics & Inpatient's Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
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McQuaid GA, Darcey VL, Avalos MF, Fishbein DH, VanMeter JW. Altered cortical structure and psychiatric symptom risk in adolescents exposed to maternal stress in utero: A retrospective investigation. Behav Brain Res 2019; 375:112145. [PMID: 31400378 PMCID: PMC10561894 DOI: 10.1016/j.bbr.2019.112145] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/22/2019] [Accepted: 08/06/2019] [Indexed: 02/06/2023]
Abstract
Maternal exposure to stress during pregnancy is associated with increased risk for cognitive and behavioral sequelae in offspring. Animal research demonstrates exposure to stress during gestation has effects on brain structure. In humans, however, little is known about the enduring effects of in utero exposure to maternal stress on brain morphology. We examine whether maternal report of stressful events during pregnancy is associated with brain structure and behavior in adolescents. We compare gray matter morphometry of typically-developing early adolescents (11-14 years of age, mean 12.7) at a single timepoint, based on presence/absence of retrospectively-assessed maternal report of negative major life event stress (MLES) during pregnancy: prenatal stress (PS; n = 28), comparison group (CG; n = 55). The Drug Use Screening Inventory Revised (DUSI-R) assessed adolescent risk for problematic behaviors. Exclusionary criteria included pre-term birth, low birth weight, and maternal substance use during pregnancy. Groups were equivalent for demographic (age, sex, IQ, SES, race/ethnicity), and birth measures (weight, length). Compared to CG peers, adolescents in the PS group exhibited increased gray matter density in bilateral posterior parietal cortex (PPC): bilateral intraparietal sulcus, left superior parietal lobule and inferior parietal lobule. Additionally, the PS group displayed greater risk for psychiatric symptoms and family system dysfunction, as assessed via DUSI-R subscales. These preliminary findings suggest that prenatal exposure to maternal MLES may exact enduring associations on offspring brain morphology and psychiatric risk, highlighting the importance of capturing these data in prospective longitudinal research studies (beginning at birth) to elucidate these associations.
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Affiliation(s)
- Goldie A McQuaid
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, 3900 Reservoir Road NW, Washington, DC, 20057, USA.
| | - Valerie L Darcey
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, 3900 Reservoir Road NW, Washington, DC, 20057, USA; Interdisciplinary Program in Neuroscience, Georgetown University, 3900 Reservoir Road NW, Washington, DC, 20057, USA
| | - Melissa F Avalos
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, 3900 Reservoir Road NW, Washington, DC, 20057, USA
| | - Diana H Fishbein
- Department of Human Development and Family Studies, Pennsylvania State University, 218 HHD Building, University Park, PA, 16802, USA
| | - John W VanMeter
- Center for Functional and Molecular Imaging, Georgetown University Medical Center, 3900 Reservoir Road NW, Washington, DC, 20057, USA
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Kasparian NA. Heart care before birth: A psychobiological perspective on fetal cardiac diagnosis. PROGRESS IN PEDIATRIC CARDIOLOGY 2019. [DOI: 10.1016/j.ppedcard.2019.101142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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O'Connor TG, Miller RK, Salafia C. Placental Studies for Child Development. CHILD DEVELOPMENT PERSPECTIVES 2019; 13:193-198. [PMID: 31413725 DOI: 10.1111/cdep.12338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Research on children's psychological and behavioral development readily incorporates changing biological models and techniques. In this article, we suggest that, in response to increasing evidence of robust influences of prenatal exposures on children's neurodevelopment and mental and physical health, developmental science also needs to consider the placenta's role in development. We argue why placental mechanisms are plausible targets in developmental science, and suggest initial and practical steps toward integrating placenta markers and mechanisms into research on child development.
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Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal Stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord 2019; 253:292-302. [PMID: 31077972 DOI: 10.1016/j.jad.2019.05.003] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/29/2019] [Accepted: 05/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prenatal mental disorders are associated with maternal and fetal adverse outcomes, while few studies have been performed in mainland China. This study aimed to investigate the prevalence and influencing factors of maternal stress, anxiety and depression in early pregnancy and provide scientific basis for reducing prenatal mental disorders. METHODS Data were obtained from 1220 women with < 15 weeks gestation in a cohort study conducted in Chongqing, China. Prenatal stress, anxiety and depression were assessed using the pregnancy pressure scale, the Hamilton anxiety scale, and the self-rating depression scale, respectively. RESULTS The prevalence of prenatal stress, anxiety and depression in early pregnancy was 91.86%, 15.04% and 5.19%, respectively. Logistic regression analysis revealed that the risk factors for prenatal stress include housewife/unemployment, presence of anxiety and low- and moderate-level social support, besides, the protective factors were exercise, active smoking and no suggestion from parents. Housewife/unemployment, primiparity, presence of stress and depression and low-level social support were found to be associated with the development of anxiety symptoms, whereas exercise had a protective effect on it. Group-oriented personality, presence of anxiety, no suggestion from husband, low- and moderate-level family care, and low-level social support were risk factors for prenatal depression. LIMITATIONS All participants were recruited from one region of China, and none of them have a history of cesarean section. CONCLUSION Early screening and intervention may have great significance for reducing mental disorders of pregnant women, and the family and society support should be brought into the intervention as well.
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Affiliation(s)
- Xian Tang
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Zhuo Lu
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Dihui Hu
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University, 1# yixue Rd., Chongqing 400016, China.
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Tambelli R, Trentini C, Trovato A, Volpi B. Role of psychosocial risk factors in predicting maternal and paternal depressive symptomatology during pregnancy. Infant Ment Health J 2019; 40:541-556. [PMID: 31062378 DOI: 10.1002/imhj.21791] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The aim of the present study was to investigate the role of several psychosocial risk factors in predicting depressive symptomatology during pregnancy in mothers and fathers, respectively. A total of 146 primiparous mothers and 105 primiparous fathers reporting a psychosocial risk condition were recruited independently from maternity and child health services, during the second trimester of pregnancy. All parents were evaluated for depressive symptomatology, anxiety, and perceived social support. Two hierarchical multiple regression analyses were performed to determine the role of psychosocial factors in predicting depressive symptomatology during pregnancy, in mothers and fathers. Marital dissatisfaction, personal history of depression, and personal trait anxiety were identified as significant predictors of depressive symptomatology during pregnancy, both in mothers and in fathers. Family history of substance abuse, conflictual relationship with the parents in the past year, and bereavement in the past year were identified as significant factors contributing to elevated depressive symptoms during pregnancy in mothers, but not fathers. In this study, several psychosocial risk factors were consistently related to an increase in maternal and paternal depressive symptoms during pregnancy; some of these factors seem to be specifically related to maternal depressive mood.
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Affiliation(s)
- Renata Tambelli
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Cristina Trentini
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Annamaria Trovato
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Barbara Volpi
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
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Cauli G, Iapichino E, Rucci P, Quartieri Bollani M, Marconi AM, Bassi M, Gala C. Promoting the well-being of mothers with multidisciplinary psychosocial interventions in the perinatal period. J Affect Disord 2019; 246:148-156. [PMID: 30580200 DOI: 10.1016/j.jad.2018.12.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 11/05/2018] [Accepted: 12/16/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Antenatal depressive and anxiety symptoms are common and may persist over time after delivery, with negative consequences on the mothers and their children. Evidence on the efficacy of psychological and pharmacological interventions during pregnancy aimed at preventing post-partum depression is controversial. METHODS A consecutive sample of 318 women presenting for scheduled obstetric visits during pregnancy was screened for risk factors and anxiety or depressive symptoms. Based on the screening results, women were classified into three groups at increasing risk of post-partum depression (PPD) and were offered different interventions. RESULTS Depressive or anxiety symptoms were found in 91 (28.6%) women, 89 (28.0%) had low risk of PPD and 138 (43.4%) had no risk of PPD. The multidisciplinary psychosocial interventions offered to women with clinical symptoms were well accepted, with an uptake of 76/91 (83.5%). Thirty-three women who did not improve with psychotherapy were offered sertraline or paroxetine as a second-line treatment: 7 accepted and 26 (78.8%) refused. Eleven women already on medication at baseline continued their treatment along with the MPI. The MPI interventions had some positive effects in terms of post-partum recovery, symptom reduction, and in preventing a new onset of depression. Among the 227 non-symptomatic during pregnancy, only 5 (2.2%) developed symptoms in the post-partum period. At 12 months post-partum, 84.6% of women who were symptomatic at 2 months post-partum recovered. LIMITATIONS Our results should be interpreted in light of important limitations, including the lack of a control group that was not offered the MPI, the lack of information on the reasons for refusal and discontinuation and on the number of psychotherapy sessions attended. CONCLUSIONS Our findings underscore the potential usefulness of MPI in recognizing early signs or symptoms during pregnancy and the advantage of building specific interventions for preventing post-natal depression. The MPI has positive effects on women with depressive or anxiety symptoms during pregnancy, that however did not exceed significantly those observed in women who refused the intervention. Thus, in the absence of a control group, our results are preliminary and warrant confirmation and testing in future randomized clinical trials.
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Affiliation(s)
- G Cauli
- Division of Psychiatry, San Paolo Hospital, 51, ASST Santi Paolo e Carlo, Milan, Italy
| | - E Iapichino
- Division of Psychiatry, San Paolo Hospital, 51, ASST Santi Paolo e Carlo, Milan, Italy
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy.
| | - M Quartieri Bollani
- Division of Psychiatry, San Paolo Hospital, 51, ASST Santi Paolo e Carlo, Milan, Italy
| | - A M Marconi
- Department of Obstetrics and Gynecology, San Paolo Hospital Medical School, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy
| | - M Bassi
- Division of Psychiatry, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - C Gala
- Division of Psychiatry, San Paolo Hospital, 51, ASST Santi Paolo e Carlo, Milan, Italy
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Comment on 'Prenatal maternal anxiety and children's brain structure and function: A systematic review of neuroimaging studies' (Adamson et al., J Affect Disord 2018, 241, 117-126). J Affect Disord 2019; 245:1187-1188. [PMID: 30579581 DOI: 10.1016/j.jad.2018.11.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 11/30/2018] [Indexed: 11/22/2022]
Abstract
In the review article by Adamson, Letourneau and Lebel (J Affect Disord 2018, 241, 117-126) the article of Mennes, Van den Bergh, Lagae & Stiers (Clin Neurophysiolol 2009, 120, 116-1122) was rated as "weak, due to lack of information provided regarding the sample population of mothers". However, Mennes et al. (2009) had referred to previous articles describing data and results of earlier waves. Unfortunately, this went unnoticed, most probably because of the use of an automatic extraction method and/or inaccurate verification of the data extraction tool. Moreover, Adamson et al. (2018) omit in Table 1 and in several sections of the text, crucial information that was provided in Mennes et al. (2009), pertaining to measurement of maternal state and trait anxiety, measurement of maternal anxiety at three times during pregnancy and the use of postnatal maternal trait anxiety as a control variable. In this letter we have clarified why the manuscript of Mennes et al. (2009) was not fully appreciated and kindly ask the authors of the review paper to add a corrigendum in which the remarks are considered.
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Psychometric Properties of the Spanish Version of the Pregnancy Related Anxiety Questionnaire (PRAQ). SPANISH JOURNAL OF PSYCHOLOGY 2018; 21:E64. [PMID: 30501656 DOI: 10.1017/sjp.2018.67] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although pregnancy increases the vulnerability to anxiety, no specific assessment instruments are usually used to detect it. The objective of this study was to adapt the Pregnancy Related Anxiety Questionnaire (PRAQ) to Spanish population, as well as analyze its validity and reliability. A sample of 367 nulliparous pregnant women with a normal risk status filled in a socio-demographic and obstetric-gynaecological questionnaire, the PRAQ, the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). After performing a factorial analysis, a five-factor model that explains 53.1% of the variance was obtained. Estimates of internal consistency reliability were adequate (range = .78 to .93) for the five factors included in the final confirmatory factor analysis, and for the total scale (.97). Significant correlation among PRAQ, EPDS, and STAI was found (p < .001). The 85th percentile (score 234 or more) was used as a cut-off point to identify those women with high pregnancy-specific anxiety. In accordance with the results obtained, the PRAQ can be considered a useful screening tool to evaluate pregnancy-related anxiety among the Spanish population.
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Children's stress regulation mediates the association between prenatal maternal mood and child executive functions for boys, but not girls. Dev Psychopathol 2018; 30:953-969. [PMID: 30068413 DOI: 10.1017/s095457941800041x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Prenatal exposure to maternal mood disturbances shapes children's cognitive development reflected in the critical construct of executive functions (EFs). Little is known, however, about underlying mechanisms. By examining cortisol responses in both everyday and lab challenge settings, we tested whether the child/offspring hypothalamic-pituitary-adrenal axis mediates effects of prenatal maternal mood on child EFs at age 6. In 107 Canadian children born to women with a wide range of anxious and depressive symptoms during pregnancy, we found that in boys but not girls, depressed and/or anxious prenatal maternal mood is associated with heightened diurnal cortisol levels in everyday settings, as well as heightened cortisol reactivity to a lab challenge and that this heightened reactivity was associated with poorer EFs. Among boys we also observed that cortisol reactivity but not diurnal cortisol mediated the association between depressed and/or anxious prenatal maternal mood and EFs. Depressed and/or anxious prenatal maternal mood was related to child EFs for both girls and boys. To our knowledge, this is the first study to demonstrate a mediating role for child stress regulation in the association between prenatal maternal stress-related mood disturbances and child EFs, providing evidence of a mechanism contributing to fetal programming of cognition.
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Abstract
The prenatal period is increasingly considered as a crucial target for the primary prevention of neurodevelopmental and psychiatric disorders. Understanding their pathophysiological mechanisms remains a great challenge. Our review reveals new insights from prenatal brain development research, involving (epi)genetic research, neuroscience, recent imaging techniques, physical modeling, and computational simulation studies. Studies examining the effect of prenatal exposure to maternal distress on offspring brain development, using brain imaging techniques, reveal effects at birth and up into adulthood. Structural and functional changes are observed in several brain regions including the prefrontal, parietal, and temporal lobes, as well as the cerebellum, hippocampus, and amygdala. Furthermore, alterations are seen in functional connectivity of amygdalar-thalamus networks and in intrinsic brain networks, including default mode and attentional networks. The observed changes underlie offspring behavioral, cognitive, emotional development, and susceptibility to neurodevelopmental and psychiatric disorders. It is concluded that used brain measures have not yet been validated with regard to sensitivity, specificity, accuracy, or robustness in predicting neurodevelopmental and psychiatric disorders. Therefore, more prospective long-term longitudinal follow-up studies starting early in pregnancy should be carried out, in order to examine brain developmental measures as mediators in mediating the link between prenatal stress and offspring behavioral, cognitive, and emotional problems and susceptibility for disorders.
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Cortes Hidalgo AP, Neumann A, Bakermans-Kranenburg MJ, Jaddoe VWV, Rijlaarsdam J, Verhulst FC, White T, van IJzendoorn MH, Tiemeier H. Prenatal Maternal Stress and Child IQ. Child Dev 2018; 91:347-365. [PMID: 30376186 DOI: 10.1111/cdev.13177] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The evidence for negative influences of maternal stress during pregnancy on child cognition remains inconclusive. This study tested the association between maternal prenatal stress and child intelligence in 4,251 mother-child dyads from a multiethnic population-based cohort in the Netherlands. A latent factor of prenatal stress was constructed, and child IQ was tested at age 6 years. In Dutch and Caribbean participants, prenatal stress was not associated with child IQ after adjustment for maternal IQ and socioeconomic status. In other ethnicities no association was found; only in the Moroccan/Turkish group a small negative association between prenatal stress and child IQ was observed. These results suggest that prenatal stress does not predict child IQ, except in children from less acculturated minority groups.
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Affiliation(s)
| | | | | | | | | | | | - Tonya White
- Erasmus MC - University Medical Center Rotterdam
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Young-Wolff KC, Alabaster A, McCaw B, Stoller N, Watson C, Sterling S, Ridout KK, Flanagan T. Adverse Childhood Experiences and Mental and Behavioral Health Conditions During Pregnancy: The Role of Resilience. J Womens Health (Larchmt) 2018; 28:452-461. [PMID: 30183473 DOI: 10.1089/jwh.2018.7108] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Little is known about how exposure to adverse childhood experiences (ACEs) and protective factors, such as resilience, influence prenatal mental and behavioral health. This study examined associations between exposure to ACEs and mental and behavioral health during pregnancy overall and among women with high versus low levels of resilience. MATERIALS AND METHODS Women in two Kaiser Permanente Northern California medical centers were screened for ACEs and resilience during prenatal care (∼14-23 weeks of gestation; N = 355). Multivariable logistic regression analyses examined associations between ACEs and prenatal mental and behavioral health conditions overall and for women with low (≤32) versus high (>32) resilience on the 10-item Connor-Davidson Resilience Scale. RESULTS Overall, 54% of women reported 0 ACEs, 28% 1-2 ACEs, and 18% 3+ ACEs. Relative to women with 0 ACEs, those with 1-2 ACEs had higher odds of an anxiety or depressive disorder and intimate partner violence (IPV) (odds ratios [ORs] 2.42-3.12, p < 0.05), and those with 3+ ACEs had higher odds of an anxiety or depressive disorder, depression symptoms, and IPV (ORs 3.08-4.71, p < 0.05). In stratified analyses by high (56%) and low (44%) resilience, having one or more ACEs (vs. 0 ACEs) was only associated with worse mental and behavioral health in women with low resilience. CONCLUSIONS ACEs predicted mental and behavioral health conditions among pregnant women, and associations were the strongest among women with low levels of current resilience. Longitudinal research is needed to understand the causal mechanisms underlying these associations.
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Affiliation(s)
- Kelly C Young-Wolff
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Amy Alabaster
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Brigid McCaw
- 2 Family Violence Prevention Program, Kaiser Permanente Northern California, Oakland, California
| | - Nicole Stoller
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Carey Watson
- 3 Obstetrics and Gynecology, Kaiser Antioch Medical Center, Antioch, California
| | - Stacy Sterling
- 1 Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Kathryn K Ridout
- 4 Department of Psychiatry, Kaiser Permanente San Jose, San Jose, California
| | - Tracy Flanagan
- 5 The Permanente Medical Group, Regional Offices, Kaiser Permanente Northern California, Oakland, California
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Do mothers who are anxious during pregnancy have inattentive children? J Affect Disord 2018; 236:120-126. [PMID: 29730511 DOI: 10.1016/j.jad.2018.04.118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/03/2018] [Accepted: 04/08/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Maternal somatic anxiety during pregnancy may affect neural foetal development via corticoid pathways. Using a large epidemiological cohort, this study explores the relationship between maternal somatic anxiety in pregnancy and child scores on the Test of Everyday Attention in Children (TEA-Ch). METHODS Linear regression was used to analyse the association of maternal somatic anxiety during pregnancy and performance of children on three subtests of the TEA-Ch at age 8.5 years that assess selective attention (Sky Search), sustained attention (Sky Search Dual Test) and attentional control (Opposite Worlds). RESULTS Children with complete data on each subtest were included in the analysis, comprising 4,198 children for the Sky Search subtest, 3,845 for the Sky Search Dual Test and 4,202 for the Opposite Worlds subtest. No association was found between exposure to maternal somatic anxiety and child's performance in any of the TEA-Ch subtests either before or after adjusting for confounders. The results did not change when stratifying by gender. LIMITATIONS Selective attrition, lack of sensitivity of tests and lack of adjustment for the postnatal environment are possible limitations to this study. CONCLUSIONS We found no evidence of an association between exposure to maternal somatic anxiety in pregnancy and TEA-Ch scores. These results suggest that anxiety during pregnancy does not affect the development of children's attentional skills measured by TEA-Ch.
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Davis EP, Hankin BL, Swales DA, Hoffman MC. An experimental test of the fetal programming hypothesis: Can we reduce child ontogenetic vulnerability to psychopathology by decreasing maternal depression? Dev Psychopathol 2018; 30:787-806. [PMID: 30068416 PMCID: PMC7040571 DOI: 10.1017/s0954579418000470] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Maternal depression is one of the most common prenatal complications, and prenatal maternal depression predicts many child psychopathologies. Here, we apply the fetal programming hypothesis as an organizational framework to address the possibility that fetal exposure to maternal depressive symptoms during pregnancy affects fetal development of vulnerabilities and risk mechanisms, which enhance risk for subsequent psychopathology. We consider four candidate pathways through which maternal prenatal depression may affect the propensity of offspring to develop later psychopathology across the life span: brain development, physiological stress regulation (hypothalamic-pituitary-adrenocortical axis), negative emotionality, and cognitive (effortful) control. The majority of past research has been correlational, so potential causal conclusions have been limited. We describe an ongoing experimental test of the fetal programming influence of prenatal maternal depressive symptoms using a randomized controlled trial design. In this randomized controlled trial, interpersonal psychotherapy is compared to enhanced usual care among distressed pregnant women to evaluate whether reducing prenatal maternal depressive symptoms has a salutary impact on child ontogenetic vulnerabilities and thereby reduces offspring's risk for emergence of later psychopathology.
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Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, Colorado
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine California
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois, Urbana Champaign, Illinois
| | | | - M. Camille Hoffman
- University of Colorado School of Medicine, Departments of Obstetrics and Gynecology and Psychiatry, Aurora, CO
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Rifkin-Graboi A, Quan J, Richmond J, Goh SKY, Sim LW, Chong YS, Bureau JF, Chen H, Qiu A. Greater caregiving risk, better infant memory performance? Hippocampus 2018; 28:497-511. [DOI: 10.1002/hipo.22949] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 06/09/2017] [Accepted: 04/08/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Anne Rifkin-Graboi
- Singapore Institute for Clinical Sciences, A*STAR; Singapore 117609 Singapore
| | - Jeffry Quan
- Singapore Institute for Clinical Sciences, A*STAR; Singapore 117609 Singapore
- School of Psychology; University of Ottawa; Ottawa ON Canada
| | - Jenny Richmond
- Department of Psychology; University of New South Wales; Kensington NSW Australia
| | - Shaun Kok Yew Goh
- Department of Biomedical Engineering; National University Singapore; Singapore Singapore
| | - Lit Wee Sim
- Singapore Institute for Clinical Sciences, A*STAR; Singapore 117609 Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR; Singapore 117609 Singapore
- National University Hospital Singapore; Singapore Singapore
| | | | - Helen Chen
- Department of Psychological Medicine; KK Women and Children's Hospital; Singapore Singapore
- Duke-National University of Singapore; Singapore Singapore
| | - Anqi Qiu
- Singapore Institute for Clinical Sciences, A*STAR; Singapore 117609 Singapore
- Department of Biomedical Engineering; National University Singapore; Singapore Singapore
- Clinical Imaging Research Centre; National University of Singapore; Singapore Singapore
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