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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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Tartour AI, Chivese T, Eltayeb S, Elamin FM, Fthenou E, Seed Ahmed M, Babu GR. Prenatal psychological distress and 11β-HSD2 gene expression in human placentas: Systematic review and meta-analysis. Psychoneuroendocrinology 2024; 166:107060. [PMID: 38677195 DOI: 10.1016/j.psyneuen.2024.107060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/10/2024] [Accepted: 04/18/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND The placenta acts as a buffer to regulate the degree of fetal exposure to maternal cortisol through the 11-Beta Hydroxysteroid Dehydrogenase isoenzyme type 2 (11-β HSD2) enzyme. We conducted a systematic review and meta-analysis to assess the effect of prenatal psychological distress (PPD) on placental 11-β HSD2 gene expression and explore the related mechanistic pathways involved in fetal neurodevelopment. METHODS We searched PubMed, Embase, Scopus, APA PsycInfo®, and ProQuest Dissertations for observational studies assessing the association between PPD and 11-β HSD2 expression in human placentas. Adjusted regression coefficients (β) and corresponding 95% confidence intervals (CIs) were pooled based on three contextual PPD exposure groups: prenatal depression, anxiety symptoms, and perceived stress. RESULTS Of 3159 retrieved records, sixteen longitudinal studies involving 1869 participants across seven countries were included. Overall, exposure to PPD disorders showed weak negative associations with the placental 11-β HSD2 gene expression as follows: prenatal depression (β -0.01, 95% CI 0.05-0.02, I2=0%), anxiety symptoms (β -0.02, 95% CI 0.06-0.01, I2=0%), and perceived stress (β -0.01 95% CI 0.06-0.04, I2=62.8%). Third-trimester PPD exposure was more frequently associated with lower placental 11-β HSD2 levels. PPD and placental 11-β HSD2 were associated with changes in cortisol reactivity and the development of adverse health outcomes in mothers and children. Female-offspring were more vulnerable to PPD exposures. CONCLUSION The study presents evidence of a modest role of prenatal psychological distress in regulating placental 11-β HSD2 gene expression. Future prospective cohorts utilizing larger sample sizes or advanced statistical methods to enhance the detection of small effect sizes should be planned. Additionally, controlling for key predictors such as the mother's ethnicity, trimester of PPD exposure, mode of delivery, and infant sex is crucial for valid exploration of PPD effects on fetal programming.
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Affiliation(s)
- Angham Ibrahim Tartour
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar.
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Safa Eltayeb
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Fatima M Elamin
- Office of Research Ethics and Integrity, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Eleni Fthenou
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Mohammed Seed Ahmed
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Giridhara Rathnaiah Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
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Schroeder M, Fuenzalida B, Yi N, Shahnawaz S, Gertsch J, Pellegata D, Ontsouka E, Leiva A, Gutiérrez J, Müller M, Brocco MA, Albrecht C. LAT1-dependent placental methionine uptake is a key player in fetal programming of metabolic disease. Metabolism 2024; 153:155793. [PMID: 38295946 DOI: 10.1016/j.metabol.2024.155793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/11/2023] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
The Developmental Origins of Health and Disease hypothesis sustains that exposure to different stressors during prenatal development prepares the offspring for the challenges to be encountered after birth. We studied the gestational period as a particularly vulnerable window where different stressors can have strong implications for fetal programming of the offspring's life-long metabolic status via alterations of specific placentally expressed nutrient transporters. To study this mechanism, we used a murine prenatal stress model, human preeclampsia, early miscarriage, and healthy placental tissue samples, in addition to in vitro models of placental cells. In stressed mice, placental overexpression of L-type amino acid transporter 1 (Lat1) and subsequent global placental DNA hypermethylation was accompanied by fetal and adult hypothalamic dysregulation in global DNA methylation and gene expression as well as long-term metabolic abnormalities exclusively in female offspring. In human preeclampsia, early miscarriage, and under hypoxic conditions, placental LAT1 was significantly upregulated, leading to increased methionine uptake and global DNA hypermethylation. Remarkably, subgroups of healthy term placentas with high expression of stress-related genes presented increased levels of placental LAT1 mRNA and protein, DNA and RNA hypermethylation, increased methionine uptake capacity, one-carbon metabolic pathway disruption, higher methionine concentration in the placenta and transport to the fetus specifically in females. Since LAT1 mediates the intracellular accumulation of methionine, global DNA methylation, and one-carbon metabolism in the placenta, our findings hint at a major sex-specific global response to a variety of prenatal stressors affecting placental function, epigenetic programming, and life-long metabolic disease and provide a much-needed insight into early-life factors predisposing females/women to metabolic disorders.
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Affiliation(s)
- Mariana Schroeder
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Switzerland; Swiss National Centre of Competence in Research, NCCR TransCure, University of Bern, Bern, Switzerland.
| | - Barbara Fuenzalida
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Switzerland
| | - Nan Yi
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Switzerland
| | - Saira Shahnawaz
- Department of Biochemistry, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan; Department of Allied Health Sciences, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Jürg Gertsch
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Switzerland; Swiss National Centre of Competence in Research, NCCR TransCure, University of Bern, Bern, Switzerland
| | - Daniele Pellegata
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Switzerland
| | - Edgar Ontsouka
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Switzerland
| | - Andrea Leiva
- Faculty of Medicine and Science, Universidad of San Sebastian, Santiago, Chile
| | - Jaime Gutiérrez
- Faculty of Medicine and Science, Universidad of San Sebastian, Santiago, Chile
| | - Martin Müller
- Division of Gynecology and Obstetrics, Lindenhofgruppe, Bern, Switzerland
| | - Marcela A Brocco
- Institute of Biotechnological Research, University of San Martín, Buenos Aires, Argentina
| | - Christiane Albrecht
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Switzerland; Swiss National Centre of Competence in Research, NCCR TransCure, University of Bern, Bern, Switzerland
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4
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Baker BH, Freije S, MacDonald JW, Bammler TK, Benson C, Carroll KN, Enquobahrie DA, Karr CJ, LeWinn KZ, Zhao Q, Bush NR, Sathyanarayana S, Paquette AG. Placental transcriptomic signatures of prenatal and preconceptional maternal stress. Mol Psychiatry 2024; 29:1179-1191. [PMID: 38212375 PMCID: PMC11176062 DOI: 10.1038/s41380-023-02403-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
Prenatal exposure to maternal psychological stress is associated with increased risk for adverse birth and child health outcomes. Accumulating evidence suggests that preconceptional maternal stress may also be transmitted intergenerationally to negatively impact offspring. However, understanding of mechanisms linking these exposures to offspring outcomes, particularly those related to placenta, is limited. Using RNA sequencing, we identified placental transcriptomic signatures associated with maternal prenatal stressful life events (SLEs) and childhood traumatic events (CTEs) in 1 029 mother-child pairs in two birth cohorts from Washington state and Memphis, Tennessee. We evaluated individual gene-SLE/CTE associations and performed an ensemble of gene set enrichment analyses combing across 11 popular enrichment methods. Higher number of prenatal SLEs was significantly (FDR < 0.05) associated with increased expression of ADGRG6, a placental tissue-specific gene critical in placental remodeling, and decreased expression of RAB11FIP3, an endocytosis and endocytic recycling gene, and SMYD5, a histone methyltransferase. Prenatal SLEs and maternal CTEs were associated with gene sets related to several biological pathways, including upregulation of protein processing in the endoplasmic reticulum, protein secretion, and ubiquitin mediated proteolysis, and down regulation of ribosome, epithelial mesenchymal transition, DNA repair, MYC targets, and amino acid-related pathways. The directional associations in these pathways corroborate prior non-transcriptomic mechanistic studies of psychological stress and mental health disorders, and have previously been implicated in pregnancy complications and adverse birth outcomes. Accordingly, our findings suggest that maternal exposure to psychosocial stressors during pregnancy as well as the mother's childhood may disrupt placental function, which may ultimately contribute to adverse pregnancy, birth, and child health outcomes.
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Affiliation(s)
- Brennan H Baker
- University of Washington, Seattle, WA, USA.
- Seattle Children's Research Institute, Seattle, WA, USA.
| | | | | | | | - Ciara Benson
- Global Alliance to Prevent Preterm Birth and Stillbirth (GAPPS), Lynnwood, WA, USA
| | | | | | | | - Kaja Z LeWinn
- University of California San Francisco, San Francisco, CA, USA
| | - Qi Zhao
- University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Nicole R Bush
- University of California San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Alison G Paquette
- University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
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5
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Hsiao CJ, Quinn EB, Maisha FM, Nevell LD, Mulligan CJ. Associations of maternal stress, gene expression, and newborn birthweight in the Democratic Republic of Congo. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 183:e24862. [PMID: 39101464 PMCID: PMC11292139 DOI: 10.1002/ajpa.24862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/02/2023] [Indexed: 08/06/2024]
Abstract
Objectives Maternal stress has long been associated with lower birthweight, which is associated with adverse health outcomes including many adult diseases. The underlying mechanisms remain elusive although changes in gene expression may play a role. Studies are only beginning to test how maternal stress impacts gene expression as reflected in the transcriptome. Materials and Methods In a cohort of mothers and newborns in the eastern Democratic Republic of Congo (n=93), we studied the effects of four maternal stress measures (chronic stress, war trauma, sexual trauma, and general trauma) on the transcriptomes of maternal venous blood, newborn venous blood, and placental tissues, and on newborn birthweight. Maternal stress was investigated as independent measures, principal components, and clusters identified through machine learning. The transcriptome was assayed using the ClariomD chip. Multiple regression models were used to test for associations between maternal stress measures, the transcriptome, and newborn birthweight. Results None of the maternal stress measures showed an association with expression of individual genes. In contrast, when testing global gene expression, war trauma was significantly associated with the placental transcriptome. War trauma was also significantly associated with birthweight in multiple models. Mediation analysis indicated that ~14% of the effect of war trauma on birthweight was mediated by a placental gene expression component. Discussion Our results suggest that gene expression in the placenta, which represents the interface between mother and developing fetus, may partially mediate the negative impact of maternal stress on newborn birthweight.
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Affiliation(s)
- Chu J. Hsiao
- Department of Anthropology, University of Florida, Gainesville, FL 32608
- Genetics Institute, University of Florida, Gainesville, FL 32608
- College of Medicine, University of Florida, Gainesville, FL 32608
| | - Edward B. Quinn
- Department of Anthropology, University of Florida, Gainesville, FL 32608
- Genetics Institute, University of Florida, Gainesville, FL 32608
| | - Felicien M. Maisha
- Department of Anthropology, University of Florida, Gainesville, FL 32608
- Genetics Institute, University of Florida, Gainesville, FL 32608
- HEAL Africa Hospital, Goma, Democratic Republic of Congo
- Maisha Institute, Goma, Democratic Republic of Congo
| | - Lisa D. Nevell
- Department of Anthropology, University of Florida, Gainesville, FL 32608
- Genetics Institute, University of Florida, Gainesville, FL 32608
| | - Connie J. Mulligan
- Department of Anthropology, University of Florida, Gainesville, FL 32608
- Genetics Institute, University of Florida, Gainesville, FL 32608
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6
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Stroud LR, Jao NC, Ward LG, Lee SY, Marsit CJ. Differential impact of prenatal PTSD symptoms and preconception trauma exposure on placental NR3C1 and FKBP5 methylation. Stress 2024; 27:2321595. [PMID: 38676353 PMCID: PMC11238900 DOI: 10.1080/10253890.2024.2321595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/16/2024] [Indexed: 04/28/2024] Open
Abstract
Perinatal stress is associated with altered placental methylation, which plays a critical role in fetal development and infant outcomes. This proof-of-concept pilot study investigated the impact of lifetime trauma exposure and perinatal PTSD symptoms on epigenetic regulation of placenta glucocorticoid signaling genes (NR3C1 and FKBP5). Lifetime trauma exposure and PTSD symptoms during pregnancy were assessed in a racially/ethnically diverse sample of pregnant women (N = 198). Participants were categorized into three groups: (1) No Trauma (-T); (2) Trauma, No Symptoms (T - S); and (3) Trauma and Symptoms (T + S). Placental tissue was analyzed via bisulfite pyrosequencing for degree of methylation at the NR3C1 promoter and FKBP5 regulatory regions. Analyses of covariance were used to test group differences in percentages of NR3C1 and FKBP5 methylation overall and at each CpG site. We found a significant impact of PTSD symptoms on placental NR3C1 methylation. Compared to the -T group, the T + S group had greater NR3C1 methylation overall and at CpG6, CpG8, CpG9, and CpG13, but lower methylation at CpG5. The T + S group had significantly higher NR3C1 methylation overall and at CpG8 compared to the T - S group. There were no differences between the T - S group and - T group. Additionally, no group differences emerged for FKBP5 methylation. Pregnant trauma survivors with PTSD symptoms exhibited differential patterns of placental NR3C1 methylation compared to trauma survivors without PTSD symptoms and pregnant women unexposed to trauma. Results highlight the critical importance of interventions to address the mental health of pregnant trauma survivors.
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Affiliation(s)
- Laura R. Stroud
- COBRE Center for Stress, Trauma, and Resilience*, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Nancy C. Jao
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - L. G. Ward
- COBRE Center for Stress, Trauma, and Resilience*, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Sharon Y. Lee
- COBRE Center for Stress, Trauma, and Resilience*, Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Carmen J. Marsit
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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7
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Volqvartz T, Andersen HHB, Pedersen LH, Larsen A. Obesity in pregnancy-Long-term effects on offspring hypothalamic-pituitary-adrenal axis and associations with placental cortisol metabolism: A systematic review. Eur J Neurosci 2023; 58:4393-4422. [PMID: 37974556 DOI: 10.1111/ejn.16184] [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] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
Obesity, affecting one in three pregnant women worldwide, is not only a major obstetric risk factor. The resulting low-grade inflammation may have a long-term impact on the offspring's HPA axis through dysregulation of maternal, placental and fetal corticosteroid metabolism, and children born of obese mothers have increased risk of diabetes and cardiovascular disease. The long-term effects of maternal obesity on offspring neurodevelopment are, however, undetermined and could depend on the specific effects on placental and fetal cortisol metabolism. This systematic review evaluates how maternal obesity affects placental cortisol metabolism and the offspring's HPA axis. Pubmed, Embase and Scopus were searched for original studies on maternal BMI, obesity, and cortisol metabolism and transfer. Fifteen studies were included after the screening of 4556 identified records. Studies were small with heterogeneous exposures and outcomes. Two studies found that maternal obesity reduced placental HSD11β2 activity. In one study, umbilical cord blood cortisol levels were affected by maternal BMI. In three studies, an altered cortisol response was consistently seen among offspring in childhood (n = 2) or adulthood (n = 1). Maternal BMI was not associated with placental HSD11β1 or HSD11β2 mRNA expression, or placental HSD11β2 methylation. In conclusion, high maternal BMI is associated with reduced placental HSD11β2 activity and a dampened cortisol level among offspring, but the data is sparse. Further investigations are needed to clarify whether the HPA axis is affected by prenatal factors including maternal obesity and investigate if adverse effects can be ameliorated by optimising the intrauterine environment.
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Affiliation(s)
- Tabia Volqvartz
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Lars Henning Pedersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark
| | - Agnete Larsen
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark
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8
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Verney C, Vitalis T. [Stress during prenatal and early postnatal period when everything begins]. Med Sci (Paris) 2023; 39:744-753. [PMID: 37943135 DOI: 10.1051/medsci/2023124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Abstract
Early severe stresses are known to affect the biological and psychological development in childhood. Good and adaptable stress during prenatal and early postnatal period can switch to traumatic during these highly susceptible developmental stages. These different stresses modulate genetic/epigenetic processes and the setting up of connectome during these highly plastic and adaptable time periods. The polyvagal processes control the base of the security/well-being perception of the newborn by the onset of synchronized interactions between the mother/parent/nurse and the baby. These positive adjustments in mirror lead to attachment and social links and to implicit learning processes leading to a balanced emotional and cognitive development.
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Affiliation(s)
- Catherine Verney
- Université de Paris, NeuroDiderot, Paris, France - Association Ensemble pour l'éducation de la petite enfance, 37 allée du Forum, 92100 Boulogne-Billancourt, France
| | - Tania Vitalis
- Université de Paris, NeuroDiderot, Paris, France - Inserm, Paris, U1141, hôpital Robert-Debré, 48 boulevard Sérurier, 75019 Paris, France
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9
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Woo T, King C, Ahmed NI, Cordes M, Nistala S, Will MJ, Bloomer C, Kibiryeva N, Rivera RM, Talebizadeh Z, Beversdorf DQ. microRNA as a Maternal Marker for Prenatal Stress-Associated ASD, Evidence from a Murine Model. J Pers Med 2023; 13:1412. [PMID: 37763179 PMCID: PMC10533003 DOI: 10.3390/jpm13091412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Autism Spectrum Disorder (ASD) has been associated with a complex interplay between genetic and environmental factors. Prenatal stress exposure has been identified as a possible risk factor, although most stress-exposed pregnancies do not result in ASD. The serotonin transporter (SERT) gene has been linked to stress reactivity, and the presence of the SERT short (S)-allele has been shown to mediate the association between maternal stress exposure and ASD. In a mouse model, we investigated the effects of prenatal stress exposure and maternal SERT genotype on offspring behavior and explored its association with maternal microRNA (miRNA) expression during pregnancy. Pregnant female mice were divided into four groups based on genotype (wildtype or SERT heterozygous knockout (Sert-het)) and the presence or absence of chronic variable stress (CVS) during pregnancy. Offspring behavior was assessed at 60 days old (PD60) using the three-chamber test, open field test, elevated plus-maze test, and marble-burying test. We found that the social preference index (SPI) of SERT-het/stress offspring was significantly lower than that of wildtype control offspring, indicating a reduced preference for social interaction on social approach, specifically for males. SERT-het/stress offspring also showed significantly more frequent grooming behavior compared to wildtype controls, specifically for males, suggesting elevated repetitive behavior. We profiled miRNA expression in maternal blood samples collected at embryonic day 21 (E21) and identified three miRNAs (mmu-miR-7684-3p, mmu-miR-5622-3p, mmu-miR-6900-3p) that were differentially expressed in the SERT-het/stress group compared to all other groups. These findings suggest that maternal SERT genotype and prenatal stress exposure interact to influence offspring behavior, and that maternal miRNA expression late in pregnancy may serve as a potential marker of a particular subtype of ASD pathogenesis.
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Affiliation(s)
- Taeseon Woo
- Interdisciplinary Neuroscience Program, University of Missouri, Columbia, MO 65211, USA;
| | - Candice King
- Department of Biological Science, University of Missouri, Columbia, MO 65211, USA; (C.K.); (M.C.)
| | - Nick I. Ahmed
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA; (N.I.A.); (M.J.W.)
| | - Madison Cordes
- Department of Biological Science, University of Missouri, Columbia, MO 65211, USA; (C.K.); (M.C.)
| | | | - Matthew J. Will
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA; (N.I.A.); (M.J.W.)
| | - Clark Bloomer
- Genomics Core, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Nataliya Kibiryeva
- College of Bioscience, Kansas City University, Kansas City, MO 64106, USA;
| | - Rocio M. Rivera
- Division of Animal Sciences, University of Missouri, Columbia, MO 65211, USA;
| | - Zohreh Talebizadeh
- American College of Medical Genetics and Genomics, Bethesda, MD 20814, USA;
| | - David Q. Beversdorf
- Interdisciplinary Neuroscience Program, University of Missouri, Columbia, MO 65211, USA;
- Department of Radiology, Neurology, and Psychological Science, William and Nancy Thompson Endowed Chair in Radiology, University of Missouri, Columbia, MO 65211, USA
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10
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Wei L, Ying X, Zhai M, Li J, Liu D, Liu X, Yu B, Yan H. The association between peritraumatic distress, perceived stress, depression in pregnancy, and NR3C1 DNA methylation among Chinese pregnant women who experienced COVID-19 lockdown. Front Immunol 2022; 13:966522. [PMID: 36091061 PMCID: PMC9453447 DOI: 10.3389/fimmu.2022.966522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Prenatal stress can affect pregnant women in an epigenetic way during the critical period of conception of their offspring. The study aims to investigate the relationship between peritraumatic distress, prenatal perceived stress, depression, and glucocorticoid receptor (NR3C1) DNA methylation among pregnant women who experienced COVID-19 lockdown in China. Study data were collected from 30 pregnant women in Wuhan and Huanggang, China. The Peritraumatic Distress Inventory was used to measure peritraumatic distress, the Edinburgh Postnatal Depression Scale was used to measure depressive symptoms, and the Perceived Stress Scale was used to measure perceived stress. DNA methylation in the exon 1F promoter region of NR3C1 gene from the venous blood mononuclear cell genome was characterized by bisulfite sequencing. Correlation and linear regression were used for data analysis. The mean level of peritraumatic distress, perceived stress, and depression was 6.30 (SD = 5.09), 6.50 (SD = 5.41), and 6.60 (SD = 4.85), respectively, with 23.33% of pregnant women being depressed. The mean NR3C1 methylation was 0.65 (SD = 0.22). Prenatal depression was positively correlated with the degree of methylation in venous blood from the mother (r = 0.59, p = 0.001), and depression predicted methylation of NR3C1 gene at the CpG 8 site (β = 0.05, p = 0.03). No association was found between peritraumatic distress as well as perceived stress and methylation of NR3C1. NR3C1 gene was susceptible to epigenetic modification of DNA methylation in the context of prenatal stress, and maternal depression was associated with increased NR3C1 methylation among women who experienced COVID-19 lockdown.
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Affiliation(s)
- Liqing Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Xiaohong Ying
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Mengxi Zhai
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Jiayu Li
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Dan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Xin Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
| | - Bin Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
- Population and Health Research Center, Wuhan University, Wuhan, China
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, China
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11
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Öztürk KH, Ünal GÖ, Doğuç DK, Toğay VA, Koşar PA, Sezik M. Hypothalamic NR3C1 DNA methylation in rats exposed to prenatal stress. Mol Biol Rep 2022; 49:7921-7928. [PMID: 35661969 DOI: 10.1007/s11033-022-07626-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Human and animal studies have indicated that maternal prenatal stress (PS) has molecular and behavioral effects during pregnancy and early life. The present study aimed to evaluate the epigenetic changes of the NR3C1 gene involved in the HPA axis in the hypothalamic tissues of rats exposed to PS induced by chronic unpredictable mild stress (CUMS). Behavioral and molecular effects of these changes on the next generation were also assessed. METHODS AND RESULTS CUMS protocol was used to generate stress in pregnant Wistar rats. To determine the effects of stress on anhedonia and movement, sucrose preference test, forced swimming test, and open field test were performed. Following these behavioral experiments, bisulfite sequencing PCR for DNA methylation levels of the NR3C1 gene, RT-qPCR for mRNA levels, and Western blot techniques for protein analysis were used in the hypothalamic tissue of sacrificed rats. Depression-like behaviors were evident in the behavioral tests of stress-exposed mothers and pups. In PS-exposed pups, hypothalamic NR3C1 promoter methylation was higher, and NR3C1 mRNA levels and NR3C1 protein levels were lower compared with controls, regardless of sex. CONCLUSION Our results confirm the relationship between PS and epigenetic changes of HPA axis-related genes and show that NR3C1 gene methylation status in pups is sensitive to PS during pregnancy. Environmental maternal stress may have transgenerational effects that are potentially associated with adverse outcomes in the pups.
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Affiliation(s)
- Kuyaş Hekimler Öztürk
- Department of Medical Genetics, Faculty of Medicine, Süleyman Demirel University, 32260, Isparta, Turkey.
| | - Gülin Özdamar Ünal
- Department of Psychiatry, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Duygu Kumbul Doğuç
- Department of Biochemistry, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Vehbi Atahan Toğay
- Department of Medical Biology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Pınar Aslan Koşar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Mekin Sezik
- Department of Obstetrics and Gynecology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
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12
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The maternal-placental-fetal interface: Adaptations of the HPA axis and immune mediators following maternal stress and prenatal alcohol exposure. Exp Neurol 2022; 355:114121. [DOI: 10.1016/j.expneurol.2022.114121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/18/2022]
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13
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Folger AT, Nidey N, Ding L, Ji H, Yolton K, Ammerman RT, Bowers KA. Association Between Maternal Adverse Childhood Experiences and Neonatal SCG5 DNA Methylation-Effect Modification by Prenatal Home Visiting. Am J Epidemiol 2022; 191:636-645. [PMID: 34791022 DOI: 10.1093/aje/kwab270] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 09/21/2021] [Accepted: 11/08/2021] [Indexed: 12/27/2022] Open
Abstract
Maternal childhood adversity and trauma may elicit biological changes that impact the next generation through epigenetic responses measured in DNA methylation (DNAm). These epigenetic associations could be modified by the early postnatal environment through protective factors, such as early childhood home visiting (HV) programs that aim to mitigate deleterious intergenerational effects of adversity. In a cohort of 53 mother-child pairs recruited in 2015-2016 for the Pregnancy and Infant Development Study (Cincinnati, Ohio), we examined the association between maternal adverse childhood experiences (ACEs) and neonatal DNAm in the secretogranin V gene (SCG5), which is important in neuroendocrine function. We examined prenatal HV as an effect modifier. Mothers completed a questionnaire on ACEs during pregnancy, and infant buccal samples were collected 1 month postpartum. Multivariable linear regression was used to examine the association between maternal ACEs and neonatal DNAm expressed as M-values averaged across 4 cytosine-phosphate-guanine dinucleotide sites. A higher number of maternal ACEs (>3) was associated with a 5.79-percentage-point lower offspring DNAm (95% confidence interval: -10.44, -1.14), and the association was modified by the number of home visits received during pregnancy. In a population of at-risk mother-child dyads, preliminary evidence suggests that maternal ACEs have a relationship with offspring SCG5 DNAm that differs by the amount of prenatal HV.
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14
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Garay SM, Sumption LA, John RM. Prenatal health behaviours as predictors of human placental lactogen levels. Front Endocrinol (Lausanne) 2022; 13:946539. [PMID: 36157466 PMCID: PMC9500170 DOI: 10.3389/fendo.2022.946539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/24/2022] [Indexed: 11/26/2022] Open
Abstract
Placental lactogen (hPL) is a key hormone of pregnancy responsible for inducing maternal adaptations critical for a successful pregnancy. Low levels of placental lactogen have been associated with lower birth weight as well as symptoms of maternal depression and anxiety. Lower placental lactogen has been reported in women with higher body mass index (BMI) but it is unclear whether prenatal health behaviours predict hPL levels or if hPL is associated with infant weight outcomes. This study utilised data from the longitudinal Grown in Wales cohort, based in South Wales. Participants were recruited at the pre-surgical appointment for an elective caesarean section. This study incorporates data from recruitment, post-delivery and a 12 month follow-up. Measures of maternal serum hPL were available for 248 participants. Analysis included unadjusted and adjusted linear and binary regression. Unadjusted, prenatal smoking and a Health Conscious dietary pattern were associated with hPL levels, however this was lost on adjustment for BMI at booking, Welsh Index of Multiple Deprivation (WIMD) score and placental weight. When stratified by maternal BMI at booking, a Health Conscious dietary pattern remained associated with increased hPL levels in women with a healthy BMI (p=.024, B=.59. 95% CI=.08,1.11) following adjustment for WIMD score and placental weight. When adjusted for a wide range of confounders, maternal hPL was also associated with increased custom birthweight centiles (CBWC) (p=.014, B=1.64. 95% CI=.33,2.94) and increased odds of large for gestational age deliveries (p=<.001, Exp(B)=1.42. 95% CI=1.17,1.72). This study identified that consuming a Health Conscious dietary pattern in pregnancy was associated with increased hPL, within women of a healthy BMI. Moreover, higher hPL levels were associated with increased CBWC and increased odds of delivering a large for gestational age infant. This improves the current limited evidence surrounding the nature of hPL in these areas.
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15
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Kolk TA, Nath S, Howard LM, Pawlby S, Lockwood-Estrin G, Trevillion K. The association between maternal lifetime interpersonal trauma experience and perceived mother-infant bonding. J Affect Disord 2021; 294:117-127. [PMID: 34280788 PMCID: PMC8424749 DOI: 10.1016/j.jad.2021.06.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 06/19/2021] [Accepted: 06/27/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Interpersonal traumas are common among expectant and new mothers and are found to have considerable impacts on women's mental health. These experiences may disrupt maternal perceptions of the mother-infant relationship, which is essential for healthy infant development, but findings are inconsistent. This study aims to explore associations between lifetime interpersonal traumas and their impact on self-reported mother-infant bonding. METHODS Secondary data analysis of a representative cohort of 453 women attending at a South London maternity service. Lifetime interpersonal trauma experience and its association with self-reported mother-infant bonding (Postpartum Bonding Questionnaire) was assessed in uni- and multivariable linear regressions, the latter adjusted to account for antenatal depressive and posttraumatic symptoms, measured using the Edinburgh Postnatal Depression Scale and Posttraumatic Stress Disorder Scale, and key sociodemographic risk factors. RESULTS Maternal lifetime trauma was not associated with perceived difficulties in mother-infant bonding at three months postnatal; however antenatal depressive symptoms, both with continuous EPDS score (0.33, 95% CI 0.17-0.50, p<0.001) and clinical cut-off ≥13 (4.26, 95% CI 2.02-6.49, p<0.001) were associated with self-reported bonding difficulties. LIMITATIONS The composite trauma measurement did not allow for a comprehensive assessment of individual trauma types. CONCLUSIONS There was no evidence for a link between maternal lifetime trauma experiences and self-reported bonding difficulties. However, an association between antenatal depressive symptoms and perceived postpartum bonding impairment was found. This highlights the importance of identification and treatment of depressive symptoms during pregnancy and offering women support in facilitating a positive mother-infant relationship.
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Affiliation(s)
- Tessel Annejo Kolk
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK..
| | - Selina Nath
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Louise Michele Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Susan Pawlby
- Division of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Georgia Lockwood-Estrin
- Henry Wellcome Building, Centre for Brain and Cognitive Development, Birkbeck College, 32 Torrington Square, London WC1E 7JL, UK
| | - Kylee Trevillion
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
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16
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Nomura Y, Rompala G, Pritchett L, Aushev V, Chen J, Hurd YL. Natural disaster stress during pregnancy is linked to reprogramming of the placenta transcriptome in relation to anxiety and stress hormones in young offspring. Mol Psychiatry 2021; 26:6520-6530. [PMID: 33981007 PMCID: PMC8586067 DOI: 10.1038/s41380-021-01123-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/29/2021] [Accepted: 04/13/2021] [Indexed: 12/29/2022]
Abstract
Prenatal stress can lead to long-term adverse effects that increase the risk of anxiety and other emotional disorders in offspring. The in utero underpinnings contributing to such phenotypes remain unknown. We profiled the transcriptome of placental specimens from women who lived through Hurricane Sandy during pregnancy compared to those pregnant during non-Sandy conditions. Following birth, longitudinal assessments were conducted in their offspring during childhood (~3-4 years old) to measure steroid hormones (in hair) and behavioral and emotional problems. This revealed a significant link between prenatal Sandy stress (PNSS) and child HPA dysfunction, evident by altered cortisol, dehydroepiandrosterone (DHEA), and cortisol:DHEA levels. In addition, PNSS was associated with significantly increased anxiety and aggression. These findings coincided with significant reorganization of the placental transcriptome via vascular, immune, and endocrine gene pathways. Interestingly, many of the most prominently altered genes were known to be uniquely expressed in syncytiotrophoblast (STB)-subtype of placental cells and harbored glucocorticoid response elements in promoter regions. Finally, several vascular development- and immune-related placental gene sets were found to mediate the relationship between PNSS and childhood phenotypes. Overall, these findings suggest that natural disaster-related stress during pregnancy reprograms the placental molecular signature, potentially driving long-lasting changes in stress regulation and emotional health. Further examination of placental mechanisms may elucidate the environment's contribution to subsequent risk for anxiety disorders later in life.
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Affiliation(s)
- Yoko Nomura
- Queens College, CUNY, Psychology, New York, NY, United States,CUNY, The Graduate Center, Psychology, Graduate School of Public Health, New York, NY, United States,Icahn School of Medicine at Mount Sinai, Psychiatry and Neuroscience, Addiction Institute of Mount Sinai, New York, NY, United States
| | - Gregory Rompala
- Icahn School of Medicine at Mount Sinai, Psychiatry and Neuroscience, Addiction Institute of Mount Sinai, New York, NY, United States
| | - Lexi Pritchett
- Queens College, CUNY, Psychology, New York, NY, United States,CUNY, The Graduate Center, Psychology, Graduate School of Public Health, New York, NY, United States
| | - Vasily Aushev
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai
| | - Yasmin L. Hurd
- Icahn School of Medicine at Mount Sinai, Psychiatry and Neuroscience, Addiction Institute of Mount Sinai, New York, NY, United States
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17
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Liu H, Liu Y, Huang K, Yan S, Hao J, Zhu P, Tao F, Shao S. Gender-specific associations of pregnancy-related anxiety with placental epigenetic patterning of glucocorticoid response genes and preschooler's emotional symptoms and hyperactivity. BMC Pediatr 2021; 21:479. [PMID: 34715840 PMCID: PMC8555194 DOI: 10.1186/s12887-021-02938-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 10/08/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUD We have recently reported that maternal prenatal pregnancy-related anxiety predicts preschoolers' emotional and behavioral development in a gender-dependent manner. This study aims to test for this gender-specific effect in a different cohort and investigate whether the gender difference was specific to placental methylation of genes regulating glucocorticoids. METHODS A total of 2405 mother-child pairs from the Ma'anshan Birth Cohort Study were included in present study. The maternal pregnancy-related anxiety symptoms were evaluated with the Pregnancy-Related Anxiety Questionnaire in the third trimester of pregnancy. Child neurobehavior was assessed with the Strengths and Difficulties Questionnaire at 4 years old. Placental methylation of FKBP5, NR3C1 and HSD11B2 genes was quantified using the MethylTarget approach in 439 pregnant women. After exploratory factor analysis, the associations between methylation factor scores and pregnancy-related anxiety and child neurobehavior were examined using logistic regression analysis. RESULTS After controlling for confounding factors, pregnancy-related anxiety in the third trimester of pregnancy increased the risk of hyperactivity only in boys and emotional symptoms only in girls. Decreased scores of the factor characterized by FKBP5 methylation were associated with maternal pregnancy-related anxiety only in boys. Furthermore, increased scores of the factors characterized by NR3C1 and HSD11B2 methylation were associated with hyperactivity (NR3C1: adjusted OR = 1.80, 95%CI = 1.15-2.83) and emotional symptoms (HSD11B2: adjusted OR = 0.53, 95%CI = 0.29-0.97; NR3C1: adjusted OR = 1.64, 95%CI = 1.03-2.59) only in boys. However, the scores of the factor characterized by FKBP5, NR3C1 and HSD11B2 did not mediate the relationship between maternal pregnancy-related anxiety and preschoolers' emotional symptoms and hyperactivity. CONCLUSIONS Our results suggested that pregnancy-related anxiety in the third trimester of pregnancy predicted preschoolers' emotional symptoms and hyperactivity in a gender-dependent manner. Although we did not find the mediation role of the placental methylation of genes regulating glucocorticoids, we found it was associated with both maternal pregnancy-related anxiety and preschoolers' emotional symptoms and hyperactivity in a gender-dependent manner.
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Affiliation(s)
- Hui Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yuwei Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shuangqin Yan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Maternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan, 243011, Anhui, China
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Shanshan Shao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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18
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Czamara D, Dieckmann L, Röh S, Kraemer S, Rancourt RC, Sammallahti S, Kajantie E, Laivuori H, Eriksson JG, Räikkönen K, Henrich W, Plagemann A, Binder EB, Braun T, Entringer S. Betamethasone administration during pregnancy is associated with placental epigenetic changes with implications for inflammation. Clin Epigenetics 2021; 13:165. [PMID: 34446099 PMCID: PMC8393766 DOI: 10.1186/s13148-021-01153-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/12/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Glucocorticoids (GCs) play a pivotal role in fetal programming. Antenatal treatment with synthetic GCs (sGCs) in individuals in danger of preterm labor is common practice. Adverse short- and long-term effects of antenatal sGCs have been reported, but their effects on placental epigenetic characteristics have never been systematically studied in humans. RESULTS We tested the association between exposure to the sGC betamethasone (BET) and placental DNA methylation (DNAm) in 52 exposed cases and 84 gestational-age-matched controls. We fine-mapped associated loci using targeted bisulfite sequencing. The association of placental DNAm with gene expression and co-expression analysis on implicated genes was performed in an independent cohort including 494 placentas. Exposure to BET was significantly associated with lower placenta DNAm at an enhancer of FKBP5. FKBP5 (FK506-binding protein 51) is a co-chaperone that modulates glucocorticoid receptor activity. Lower DNAm at this enhancer site was associated with higher expression of FKBP5 and a co-expressed gene module. This module is enriched for genes associated with preeclampsia and involved in inflammation and immune response. CONCLUSIONS Our findings suggest that BET exposure during pregnancy associates with few but lasting changes in placental DNAm and may promote a gene expression profile associated with placental dysfunction and increased inflammation. This may represent a pathway mediating GC-associated negative long-term consequences and health outcomes in offspring.
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Affiliation(s)
- Darina Czamara
- Department of Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, 80804 Munich, Germany
| | - Linda Dieckmann
- Department of Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, 80804 Munich, Germany
- International Max Planck Research School for Translational Psychiatry, München, Germany
| | - Simone Röh
- Department of Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, 80804 Munich, Germany
| | - Sarah Kraemer
- Institute of Medical Psychology, Charité − Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Luisenstr. 57, 10117 Berlin, Germany
| | - Rebecca C. Rancourt
- Department of Experimental Obstetrics, Charité − Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Augustenburger Platz 1, 13353 Berlin, Germany
| | - Sara Sammallahti
- Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hannele Laivuori
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Johan G. Eriksson
- Department of General Practice and Primary Care, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Wolfgang Henrich
- Department of Obstetrics, Charité − Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Augustenburger Platz 1, 13353 Berlin, Germany
| | - Andreas Plagemann
- Department of Experimental Obstetrics, Charité − Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Augustenburger Platz 1, 13353 Berlin, Germany
- Department of Obstetrics, Charité − Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Augustenburger Platz 1, 13353 Berlin, Germany
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, 80804 Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329 USA
| | - Thorsten Braun
- Department of Experimental Obstetrics, Charité − Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Augustenburger Platz 1, 13353 Berlin, Germany
- Department of Obstetrics, Charité − Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Augustenburger Platz 1, 13353 Berlin, Germany
| | - Sonja Entringer
- Institute of Medical Psychology, Charité − Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health (BIH), Luisenstr. 57, 10117 Berlin, Germany
- Development, Health, and Disease Research Program, University of California, Irvine, Orange, CA USA
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19
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Amgalan A, Andescavage N, Limperopoulos C. Prenatal origins of neuropsychiatric diseases. Acta Paediatr 2021; 110:1741-1749. [PMID: 33475192 DOI: 10.1111/apa.15766] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/28/2021] [Accepted: 01/18/2021] [Indexed: 12/18/2022]
Abstract
AIM The main objective is to review the available evidence in the literature for developmental origins of neuropsychiatric diseases and their underlying mechanisms. We also probe emerging cutting-edge prenatal MR imaging tools and their future role in advancing our understanding the prenatal footprints of neuropsychiatric disorders. OBSERVATIONS Both human and animal studies support early intrauterine origins of neuropsychiatric disease, particularly autism spectrum disorders (ASD), attention and hyperactivity disorders, schizophrenia, depression, anxiety and mood disorders. Specific mechanisms of intrauterine injury include infection, inflammation, hypoxia, hypoperfusion, ischaemia polysubstance use/abuse, maternal mental health and placental dysfunction. CONCLUSIONS AND RELEVANCE There is ample evidence to suggest developmental vulnerability of the foetal brain to intrauterine exposures that increases and individual's risk for neuropsychiatric disease, especially the risk of ASD, depression and anxiety. Elucidating the exact timing and mechanisms of injury can be difficult and require novel, non-invasive approaches to the study emerging structural and functional brain development of the foetus. Clinical care should both emphasise maternal health during pregnancy, as well as close, continued monitoring for at risk offspring throughout young adulthood for the early identification and treatment of neuropsychiatric diseases.
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Affiliation(s)
| | - Nickie Andescavage
- Division of Neonatology Children’s National Health System Washington DC USA
- Department of Pediatrics George Washington University School of Medicine Washington DC USA
| | - Catherine Limperopoulos
- Department of Pediatrics George Washington University School of Medicine Washington DC USA
- Division of Diagnostic Imaging & Radiology Children’s National Health System Washington DC USA
- Department of Radiology George Washington University School of Medicine Washington DC USA
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20
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Ding X, Liang M, Wu Y, Zhao T, Qu G, Zhang J, Zhang H, Han T, Ma S, Sun Y. The impact of prenatal stressful life events on adverse birth outcomes: A systematic review and meta-analysis. J Affect Disord 2021; 287:406-416. [PMID: 33838476 DOI: 10.1016/j.jad.2021.03.083] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Stressful life events as important stressors have gradually been recognized as the potential etiology that may lead to adverse birth outcomes such as preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). However, researches on this topic have shown relatively inconsistent results. This systematic review and meta-analysis was performed to synthesize available data on the association between prenatal stressful life events and increased risks of PTB, LBW, and SGA. METHODS Electronic databases were searched from their inception until September 2020. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to assess the association between prenatal stressful life events and PTB, LBW, and SGA using random effects models. In addition, subgroup analyses, cumulative meta-analyses, sensitivity analyses, and publication bias diagnosis were conducted. STATA 14.0 was applied for statistical analyses. RESULTS Totally 31 cohort studies involving 5,665,998 pregnant women were included. Prenatal stressful life events were associated with a 20% higher risk of PTB (RR = 1.20, 95%CI = 1.10-1.32), a 23% increased risk for LBW (RR = 1.23, 95%CI = 1.10-1.39), and a 14% higher risk of SGA (RR = 1.14, 95%CI = 1.08-1.20). Sensitivity analysis indicated the results were stable. CONCLUSIONS Findings indicated that pregnant women experiencing prenatal stressful life events were at increased risk of PTB, LBW, and SGA. This information provided additional supports that pregnant women experiencing prenatal stressful life events would benefit from receiving assessment and management in prenatal care services.
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Affiliation(s)
- Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yile Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Jian Zhang
- Department of Neonatology, Anhui Provincial Children's Hospital/Children's Hospital of Anhui Medical University, Hefei 230051, Anhui, China
| | - Huimei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Tiantian Han
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Centre for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
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21
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Ashrap P, Aker A, Watkins DJ, Mukherjee B, Rosario-Pabón Z, Vélez-Vega CM, Alshawabkeh A, Cordero JF, Meeker JD. Psychosocial status modifies the effect of maternal blood metal and metalloid concentrations on birth outcomes. ENVIRONMENT INTERNATIONAL 2021; 149:106418. [PMID: 33548848 PMCID: PMC7897320 DOI: 10.1016/j.envint.2021.106418] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Metal exposure and psychosocial stress in pregnancy have each been associated with adverse birth outcomes, including preterm birth and low birth weight, but no study has examined the potential interaction between them. OBJECTIVES We examined the modifying effect of psychosocial stress on the association between metals and birth outcomes among pregnant women in Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) birth cohort study. METHODS In our analysis of 682 women from the PROTECT study, we measured 16 essential and non-essential metals in blood samples at two time points. We administered questionnaires to collect information on depression, perceived stress, social support, and life experience during pregnancy. Using K-means clustering, we categorized pregnant women into one of two groups: "good" and "poor" psychosocial status. We then evaluated whether the effect of blood metals (geometric average) on adverse birth outcomes (gestational age, preterm birth [overall and spontaneous], birth weight z-score, small for gestation [SGA], large for gestation [LGA]) vary between two clusters of women, adjusting for maternal age, maternal education, pre-pregnancy body mass index (BMI), and second-hand smoke exposure. RESULTS Blood manganese (Mn) was associated with an increased odds ratio (OR) of overall preterm birth (OR/interquartile range [IQR] = 2.76, 95% confidence interval [CI] = 1.25, 6.12) and spontaneous preterm birth (OR/IQR: 3.68, 95% CI: 1.20, 6.57) only among women with "poor" psychosocial status. The association between copper (Cu) and SGA was also statistically significant only among women having "poor" psychosocial status (OR/IQR: 2.81, 95% CI: 1.20, 6.57). We also observed associations between nickel (Ni) and preterm birth and SGA that were modified by psychosocial status during pregnancy. CONCLUSIONS Presence of "poor" psychosocial status intensified the adverse associations between Mn and preterm birth, Cu and SGA, and protective effects of Ni on preterm. This provides evidence that prenatal psychosocial stress may modify vulnerability to metal exposure.
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Affiliation(s)
- Pahriya Ashrap
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Amira Aker
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Deborah J Watkins
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | - Zaira Rosario-Pabón
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, United States
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, United States
| | - Akram Alshawabkeh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - John D Meeker
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States.
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22
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Wang HQ, Wang ZZ, Chen NH. The receptor hypothesis and the pathogenesis of depression: Genetic bases and biological correlates. Pharmacol Res 2021; 167:105542. [PMID: 33711432 DOI: 10.1016/j.phrs.2021.105542] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/24/2021] [Accepted: 03/07/2021] [Indexed: 02/08/2023]
Abstract
Depression has become one of the most prevalent neuropsychiatric disorders characterized by anhedonia, anxiety, pessimism, or even suicidal thoughts. Receptor theory has been pointed out to explain the pathogenesis of depression, while it is still subject to debate. Additionally, gene abnormality accounts for nearly 40-50% of depression risk, which is a significant factor contributing to the onset of depression. Accordingly, studying on receptors and their gene abnormality are critical parts of the research on internal causes of depression. This review summarizes the pathogenesis of depression from six of the most related receptors and their associated genes, including N-methyl-D-aspartate receptor, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor, glucocorticoid receptor, 5-hydroxytryptamine receptor, GABAA receptor α2, and dopamine receptor; and several "non-classic" receptors, such as metabotropic glutamate receptor, opioid receptor, and insulin receptor. These receptors have received considerable critical attention and are highly implicated in the onset of depression. We begin by providing the biological mechanisms of action of these receptors on the pathogenesis of depression. Then we review the historical and social context about these receptors. Finally, we discuss the limitations of the current state of knowledge and outline insights on future research directions, aiming to provide more novel targets and theoretical basis for the early prevention, accurate diagnosis and prompt treatment of depression.
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Affiliation(s)
- Hui-Qin Wang
- Hunan University of Chinese Medicine & Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces, Changsha 410208, Hunan, China; State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China.
| | - Zhen-Zhen Wang
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China.
| | - Nai-Hong Chen
- Hunan University of Chinese Medicine & Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces, Changsha 410208, Hunan, China; State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China.
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Shimanoe C, Matsumoto A, Hara M, Akao C, Nishida Y, Horita M, Nanri H, Higaki Y, Tanaka K. Perceived stress, depressive symptoms, and cortisol-to-cortisone ratio in spot urine in 6878 older adults. Psychoneuroendocrinology 2021; 125:105125. [PMID: 33429220 DOI: 10.1016/j.psyneuen.2020.105125] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Late life depression and perceived stress could influence disease pathways via reduced 11β-HSD2 activity, particularly given suggestions that reduced 11β-HSD2 activity, which is reflected in the cortisol-to-cortisone ratio, is a risk factor of disease. To date, however, examination of the relationship between the cortisol-to-cortisone ratio and perceived stress or depressive symptoms is insufficient. METHODS We examined the cross-sectional association of the cortisol-to-cortisone ratio with perceived stress and depressive symptoms, and analyzed whether cortisol levels modify this association, in 6878 participants aged 45-74 years. Cortisol and cortisone in spot urine were measured using liquid chromatography-mass spectrometry. Perceived stress during the past year was measured using a self-reported questionnaire. Depressive symptoms were evaluated using the Zung Self-Rating Depression Scale. Analyses were performed with adjustment for age, sex, lifestyle factors (smoking habit, alcohol consumption, physical activity, and sleeping hours), and physical health factors (body mass index [kg/m2] and medical history [diabetes, hypertension, and medication for hyperlipidemia or corticosteroids]). RESULTS Cortisol-to-cortisone ratio and cortisol were positively associated with perceived stress (% change: 2.33, Ptrend = 0.003; and 4.74, Ptrend = 0.001, respectively), but were not significantly associated with depressive symptoms. Further, the relationship between cortisol-to-cortisone ratio and perceived stress was modified by cortisol level and sex: the positive association between perceived stress and the cortisol-to-cortisone ratio was more evident in subjects with lower cortisol levels (Pinteraction = 0.009) and in men (Pinteraction = 0.026). CONCLUSIONS These findings suggest that the cortisol-to-cortisone ratio in spot urine may be a useful marker for non-acute perceived stress in daily life against a possible background of reduced 11β-HSD2 in older adults.
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Affiliation(s)
- Chisato Shimanoe
- Department of Pharmacy, Saga University Hospital, Saga, Japan; Department of Social Medicine, Faculty of Medicine, Saga University, Saga, Japan.
| | - Akiko Matsumoto
- Department of Social Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Megumi Hara
- Department of Social Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Chiho Akao
- Department of Social Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yuichiro Nishida
- Department of Social Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Mikako Horita
- Department of Social Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hinako Nanri
- Section of Behavioral Physiology, Department of Physical Activity Research, National Institutes of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yasuki Higaki
- Laboratory of Exercise Physiology, Faculty of Sports and Health Science, Fukuoka University, Fukuoka, Japan
| | - Keitaro Tanaka
- Department of Social Medicine, Faculty of Medicine, Saga University, Saga, Japan
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Morgan JE, Channon S, Penny H, Waters CS. Longitudinal studies examining the impact of prenatal and subsequent episodes of maternal depression on offspring antisocial behaviour. Eur Child Adolesc Psychiatry 2021; 30:5-40. [PMID: 31792693 PMCID: PMC7864821 DOI: 10.1007/s00787-019-01447-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 11/20/2019] [Indexed: 12/16/2022]
Abstract
Maternal depression is associated with adverse child outcomes including antisocial behaviour (ASB). Prospective longitudinal studies have focused on the timing and cumulative exposure to maternal depression to further delineate the association and mechanisms of effect. The objective of this systematic review was to synthesise and evaluate the findings of longitudinal studies of maternal depression and offspring antisocial behaviour. Three databases were searched (Psychinfo, Web of Science, and Medline). Twenty of 5936 studies met inclusion criteria. Study quality was assessed using the Critical Appraisal Skills Programme criteria [Critical Appraisal Skills Programme (2017) CASP (cohort observation checklist). https://casp-uk.net/wpcontent/uploads/2018/01/CASP-Cohort-Study-Checklist.pdf ]. Results of individual studies were highly varied, using diverse analytical approaches and not all studies explored the independent effects of different episodes. Only three studies examined hypothesised mechanisms. Prenatal, postnatal, and later episodes of depression were all predictive of antisocial outcomes. One particular time period of depression exposure did not emerge as more predictive of offspring ASB than another. However, measures of maternal depression after the perinatal period were limited and typically included a one-off assessment of mothers' depressive symptoms that was concurrent to the assessment of offspring ASB. When cumulative exposure to maternal depression and specific timing effects were measured within the same study it was cumulative exposure that conferred the greatest risk for offspring ASB-particularly when this exposure began during the perinatal period. Findings are discussed in terms of limitations in the literature and highlight the need for future research to examine the biological and environmental mechanisms that underpin associations between maternal depression and offspring antisocial behaviour during different stages of development.
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Affiliation(s)
- Joanne E Morgan
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Sue Channon
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Helen Penny
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Cerith S Waters
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK.
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Jahnke JR, Terán E, Murgueitio F, Cabrera H, Thompson AL. Maternal stress, placental 11β-hydroxysteroid dehydrogenase type 2, and infant HPA axis development in humans: Psychosocial and physiological pathways. Placenta 2020; 104:179-187. [PMID: 33360746 DOI: 10.1016/j.placenta.2020.12.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Prenatal stress is known to influence fetal hypothalamic-pituitary-adrenal axis (HPA axis) development. Placental 11β-hydroxysteroid dehydrogenase type 2 (HSD11B2) is a central gene in this pathway, but little is known about what influences its functioning. We assess how maternal distress influences HSD11B2 functioning, and how HSD11B2 in turn, is associated with infant HPA axis development. METHODS Data come from 24 mother-infant dyads on the Galápagos Islands. Using adjusted linear regression models, we assess the effects of maternal psychosocial (stress and depressive symptoms, measured by the Perceived Stress Scale and the Patient Health Questionnaire-8, respectively) and physiological (HPA axis dysregulation) distress during pregnancy on HSD11B2 methylation and expression and then test how these HSD11B2 measures influence infant HPA axis development. RESULTS Maternal HPA axis dysregulation during pregnancy is associated with lower placental HSD11B2 expression, which is associated with an exaggerated cortisol reactivity in infants. Sex-specific analyses revealed that maternal depressive symptoms may influence the functioning of placental HSD11B2 differently in girls (n = 11, 46%) than in boys (n = 13, 54%), though the sample size was small. DISCUSSION These results support a disrupted adaptive framework, in which the ability to upregulate HSD11B2 expression in response to acute stress diminishes as maternal stress becomes chronic. In this model, chronic stress may exhaust the protective mechanism of HSD11B2, leaving the infant vulnerable to high levels of maternal cortisol, which could injure the fetal HPA axis and disrupt long-term neurobehavioral and metabolic development. While larger studies will be needed to confirm these findings, this study offers exploratory results on the effects of maternal distress on both HSD11B2 methylation and expression and the effect of HSD11B2 on offspring HPA axis development.
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Affiliation(s)
- Johanna R Jahnke
- Department of Anthropology, 301 Alumni Building CB #3115, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Carolina Population Center, 123 West Franklin Street, Chapel Hill, NC, 27516, USA.
| | - Enrique Terán
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito. Hospital de los Valles, Ed. Especialidades Médicas, PB, Av. Interoceánica Km. 12 ½; y Av. Florencia, Casilla Postal 17-1200-841, Quito, Ecuador; Galapagos Science Center. Avenida Alsacio Northia, Puerto Baquerizo Moreno, Ecuador San Cristobal, Galapagos Archipelago, Ecuador.
| | - Francisca Murgueitio
- Hospital Oskar Jandl, Ministerio de Salud Publica. San Cristóbal, Galápagos Archipiélago, Ecuador.
| | - Holger Cabrera
- Hospital Oskar Jandl, Ministerio de Salud Publica. San Cristóbal, Galápagos Archipiélago, Ecuador.
| | - Amanda L Thompson
- Department of Anthropology, 301 Alumni Building CB #3115, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Carolina Population Center, 123 West Franklin Street, Chapel Hill, NC, 27516, USA; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill 170 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599, USA.
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26
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Steine IM, LeWinn KZ, Lisha N, Tylavsky F, Smith R, Bowman M, Sathyanarayana S, Karr CJ, Smith AK, Kobor M, Bush NR. Maternal exposure to childhood traumatic events, but not multi-domain psychosocial stressors, predict placental corticotrophin releasing hormone across pregnancy. Soc Sci Med 2020; 266:113461. [PMID: 33126094 PMCID: PMC9380779 DOI: 10.1016/j.socscimed.2020.113461] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/19/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022]
Abstract
Maternal psychosocial stress increases the risk of adverse birth and postnatal outcomes for the mother and child, but the role of maternal exposure to childhood traumatic events (CTE) and multi-domain psychosocial stressors for the level and rise of placental Corticotrophin-Releasing Hormone (pCRH) across pregnancy has been understudied. In a sociodemographically and racially diverse sample of 1303 women (64% Black, 36% White/others) with low-medical risk pregnancies at enrollment from Shelby County, Tennessee, USA, blood samples were drawn twice, corresponding roughly to second and third trimester, and extracted prior to conducting radioimmune assays for pCRH. Mothers reported CTE (physical abuse, sexual abuse, or family violence, in childhood), adulthood traumatic events, and interpersonal violence during pregnancy. Neighborhood crime/deprivation was derived using geospatially-linked objective databases. General linear and mixed models tested associations between stress exposure variables and pCRH levels and rate of rise, adjusting for obstetric/clinical/health related factors. Maternal CTE did not predict pCRH levels at time 1, but positively predicted levels at time 2, and the rate of rise in pCRH across pregnancy. Race did not moderate this association. No additional maternal stress exposures across adulthood or during pregnancy predicted pCRH outcomes. Findings indicate that childhood violence or abuse exposure can become biologically embedded in a manner predicting later prenatal physiology relevant for maternal and offspring health, and that such embedding may be specific to childhood, but not adulthood, stress. Findings also highlight the placental-fetal unit as a mechanistic pathway through which intergenerational transmission of the adverse effects of childhood adversities may occur.
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Affiliation(s)
- Iris M Steine
- Visiting Scholar, UC Berkeley, Department of Psychology, 2121 Berkeley Way, Berkeley, CA, 94704, USA; Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
| | - Kaja Z LeWinn
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, USA
| | - Nadra Lisha
- Department of General Internal Medicine, University of California San Francisco, USA
| | - Frances Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Roger Smith
- Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Maria Bowman
- Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Sheela Sathyanarayana
- University of Washington Department of Pediatrics, Seattle, USA; Seattle Children's Research Institute, Seattle, USA; University of Washington Department of Environmental and Occupational Health Sciences, Seattle, USA
| | - Catherine J Karr
- University of Washington Department of Environmental and Occupational Health Sciences, Seattle, USA; University of Washington Departments of Pediatrics, Seattle, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA
| | - Michael Kobor
- Department of Medical Genetics, University of British Columbia, Canada
| | - Nicole R Bush
- Departments of Psychiatry and Pediatrics, University of California San Francisco, USA
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27
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Dereix AE, Ledyard R, Redhunt AM, Bloomquist TR, Brennan KJM, Baccarelli AA, Hacker MR, Burris HH. Maternal anxiety and depression in pregnancy and DNA methylation of the NR3C1 glucocorticoid receptor gene. Epigenomics 2020; 13:1701-1709. [DOI: 10.2217/epi-2020-0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: To quantify associations of anxiety and depression during pregnancy with differential cord blood DNA methylation of the glucorticoid receptor ( NR3C1). Materials & methods: Pregnancy anxiety, trait anxiety and depressive symptoms were collected using the Pregnancy Related Anxiety Scale, State-Trait Anxiety Index and Edinburgh Postnatal Depression Scale, respectively. NR3C1 methylation was determined at four methylation sites. Results: DNA methylation of CpG 1 in the NR3C1 CpG island shore was higher in infants born to women with high pregnancy anxiety (β 2.54, 95% CI: 0.49–4.58) and trait anxiety (β 1.68, 95% CI: 0.14–3.22). No significant association was found between depressive symptoms and NR3C1 methylation. Conclusion: We found that maternal anxiety was associated with increased NR3C1 CpG island shore methylation.
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Affiliation(s)
- Alexandra E Dereix
- Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USA
| | - Rachel Ledyard
- Division of Neonatology, Children’s Hospital of Pennsylvania, Philadelphia, PA 19104, USA
| | - Allyson M Redhunt
- Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Tessa R Bloomquist
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health Environmental Health Sciences, New York, NY 10032, USA
| | - Kasey JM Brennan
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health Environmental Health Sciences, New York, NY 10032, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health Environmental Health Sciences, New York, NY 10032, USA
| | - Michele R Hacker
- Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Department of Obstetrics, Gynecology & Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Heather H Burris
- Division of Neonatology, Children’s Hospital of Pennsylvania, Philadelphia, PA 19104, USA
- Division of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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28
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Kazantseva A, Davydova Y, Enikeeva R, Lobaskova M, Mustafin R, Malykh S, Takhirova Z, Khusnutdinova E. AVPR1A main effect and OXTR-by-environment interplay in individual differences in depression level. Heliyon 2020; 6:e05240. [PMID: 33088973 PMCID: PMC7567928 DOI: 10.1016/j.heliyon.2020.e05240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/10/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022] Open
Abstract
Background Multiple studies of depression indicated a significant role of gene-by-environment interactions; however, they are mainly limited to the examination of modulating effect of recent stressful life events. Other environmental factors occurring at different stages of ante- and postnatal development may affect the association between multiple genes and depression. The study aimed to analyze the main and haplotype-based effect of serotonergic system and HPA-axis gene polymorphisms on depression and to detect gene-by-environment interaction models explaining individual variance in depression in mentally healthy young adults from Russia. Methods Depression score was assessed using Beck Depression Inventory (BDI) in 623 healthy individuals (81% women; 17-25 years) of Caucasian origin (Russians, Tatars, Udmurts) from Russia. The main- and gene-based effects of 12 SNPs in SLC6A4 (5-HTTLPR, rs1042173), HTR2A (rs7322347), OXTR (rs7632287, rs2254298, rs13316193, rs53576, rs2228485, rs237911), AVPR1A (rs3803107, rs1042615), and AVPR1B (rs33911258) genes, and gene-by-environment interactions were tested with linear regression models (PLINK v.1.9) adjusted for multiple comparisons. Results We observed ethnicity-specific main effect of the AVPR1A rs3803107 (P = 0.003; PFDR = 0.047) and gene-based effect of the OXTR gene (Р = 0.005; Pperm = 0.034) on BDI-measured depression, and modifying effect of paternal care on OXTR rs53576 (P = 0.004; PFDR = 0.012) and birth order on OXTR rs237911 (P = 0.006; PFDR = 0.018) association with depression level. Limitations A hypothesis driven candidate gene approach, which examined a limited number of genetic variants in a moderately large sample, was used. Conclusions Our preliminary findings indicate that familial environment may play a permissive role modulating the manifestation of OXTR-based depression variance in mentally healthy subjects.
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Affiliation(s)
- A Kazantseva
- Institute of Biochemistry and Genetics, Subdivision of the Ufa Federal Research Centre of the Russian Academy of Sciences, 71, Prospekt Oktyabrya, Ufa, 450054, Russia
| | - Yu Davydova
- Institute of Biochemistry and Genetics, Subdivision of the Ufa Federal Research Centre of the Russian Academy of Sciences, 71, Prospekt Oktyabrya, Ufa, 450054, Russia
| | - R Enikeeva
- Institute of Biochemistry and Genetics, Subdivision of the Ufa Federal Research Centre of the Russian Academy of Sciences, 71, Prospekt Oktyabrya, Ufa, 450054, Russia
| | - M Lobaskova
- Psychological Institute, Russian Academy of Education, 9/4, Mohovaya Street, Moscow, 125009, Russia
| | - R Mustafin
- Bashkir State Medical University, 3, Lenin Street, Ufa, 450008, Russia
| | - S Malykh
- Psychological Institute, Russian Academy of Education, 9/4, Mohovaya Street, Moscow, 125009, Russia
| | - Z Takhirova
- Russian Academy of Education, 8, Pogodinskaya Street, Moscow, 119121, Russia
| | - E Khusnutdinova
- Institute of Biochemistry and Genetics, Subdivision of the Ufa Federal Research Centre of the Russian Academy of Sciences, 71, Prospekt Oktyabrya, Ufa, 450054, Russia
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RNASeq analysis reveals upregulation of complement C3 in the offspring gut following prenatal stress in mice. Immunobiology 2020; 225:151983. [PMID: 32747015 DOI: 10.1016/j.imbio.2020.151983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/12/2020] [Accepted: 07/04/2020] [Indexed: 12/19/2022]
Abstract
Dysregulated activation of inflammatory signaling by the immature neonatal immune system could lead to the development of many pediatric diseases including necrotizing enterocolitis (NEC). While the mechanism(s) of pathogenesis is unknown, NEC is believed to have multifactorial causes. Microbial dysbiosis and intestinal immaturity have been implicated as potential triggers for this disease. We hypothesized that psychological stress during pregnancy negatively impacts the development of intestinal tissues in offspring and contributes to development of NEC. Consistent with this hypothesis, we previously observed shorter villi and a decrease in total surface area in the small intestine of pups derived from mice that were chronically stressed during gestation. In this study, we performed RNASeq analysis to determine the gene expression changes in the offspring gut following prenatal stress in pregnant mice and identified several differentially expressed genes (DEGs) and biological pathways. Notably, C3 was upregulated in the small intestine and contributed to a higher tissue injury score in a mesenteric ischemia model compared to unstressed controls. We discuss the potential implications of these stress-induced genes expression changes and their contribution to development of intestinal inflammation.
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Sumption LA, Garay SM, John RM. Low serum placental lactogen at term is associated with postnatal symptoms of depression and anxiety in women delivering female infants. Psychoneuroendocrinology 2020; 116:104655. [PMID: 32247203 DOI: 10.1016/j.psyneuen.2020.104655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/07/2020] [Accepted: 03/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Placental endocrine insufficiency may increase the risk of depression and anxiety during pregnancy and/or after birth. This study investigated the association between serum human placental lactogen (hPL) and measures of perinatal mental health, accounting for selective serotonin-reuptake inhibitor (SSRI) usage. METHOD Caucasian women with singleton, term pregnancies recruited at their pre-surgical appointment prior to an elective caesarean section (ELCS) were studied. Serum hPL levels were measured by ELISA in maternal blood collected at the pre-surgical appointment. Depression and anxiety scores were derived from Edinburgh Postnatal Depression Scale (EPDS) and the trait subscale of the State-Trait Anxiety Inventory (STAI) questionnaires completed at recruitment and three postnatal time points. Data was analysed by unadjusted and adjusted multiple linear regression. RESULTS In adjusted linear regressions, term maternal serum hPL levels were negatively associated with postnatal EPDS and STAI score ten weeks postnatal for mothers who had girls (B= -.367, p = .022, 95% CI -.679, -.056; and B= -.776, p = .030, 95% CI -1.475, -.077 respectively). Excluding women prescribed SSRIs strengthened the relationship at 10 weeks and uncovered an earlier association between hPL and mood scores within one week of delivery (EPDS B= -.357, p = .041, 95 % CI -.698, -.015; and STAI B= -.737, p = .027, 95 % CI -1.387, -.086). In mothers who had boys, there were no associations between hPL and mood scores at any time point. CONCLUSION Low hPL at term associated with postnatal depression and anxiety symptoms exclusively in mothers of girls. Insufficiency in hPL may contribute to maternal mood symptoms.
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Affiliation(s)
- Lorna A Sumption
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom
| | - Samantha M Garay
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom
| | - Rosalind M John
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom.
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Maternal stress in relation to sex-specific expression of placental genes involved in nutrient transport, oxygen tension, immune response, and the glucocorticoid barrier. Placenta 2020; 96:19-26. [PMID: 32421529 DOI: 10.1016/j.placenta.2020.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/20/2020] [Accepted: 05/07/2020] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Murine models provide evidence that maternal stress during pregnancy can influence placenta morphology and function, including altered expression of genes involved in the maintenance and progression of pregnancy and fetal development. Corresponding research evaluating the impact of maternal stress on placental gene expression in humans is limited. We examined maternal stress in relation to placental expression of 17 candidate genes in a community-based sample. METHODS Participants included 60 mother-newborn pairs enrolled in the PRogramming of Intergenerational Stress Mechanisms pregnancy cohort based at the Mount Sinai Hospital in New York City. Placentas were collected immediately following delivery and gene expression was measured using a qPCR-based platform. Maternal experiences of traumatic and non-traumatic stress were measured using the Life Stressor Checklist-Revised (LSC-R) administered during a mid-pregnancy interview. We used multivariable linear regression to examine associations between LSC-R scores and expression of each gene in separate models in the sample overall and stratified by fetal sex. RESULTS Higher maternal stress was associated with significantly increased placental expression of the nutrient sensor gene OGT, the glucose transporter gene GLUT1, and the hypoxia sensor gene HIF3A. In models stratified by fetal sex, significant associations remained only among males. DISCUSSION This study represents one of the most comprehensive examinations of maternal lifetime traumatic and non-traumatic stress in relation to placental gene expression in human tissue. Our findings support that maternal stress may alter sex-specific placental expression of genes involved in critical developmental processes.
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Toso K, de Cock P, Leavey G. Maternal exposure to violence and offspring neurodevelopment: A systematic review. Paediatr Perinat Epidemiol 2020; 34:190-203. [PMID: 32026500 DOI: 10.1111/ppe.12651] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/19/2019] [Accepted: 12/25/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Stress during pregnancy is known to affect fetal neurodevelopment. It seems likely therefore that intimate partner violence (IPV) and domestic violence (DV) as extreme stressors will have a similarly adverse effect. OBJECTIVES A systematic review was conducted to assess the association between prenatal exposure to violence for mothers and developmental difficulties in their children. DATA SOURCES PubMed, PsycInfo, CINAHL, ERIC, Science Direct, SCOPUS, PsyARTICLES, Networked Digital Library of Theses and Dissertations, Women's Studies International and Gender Studies Database were all searched using the agreed search terms. STUDY SELECTION AND DATA EXTRACTION We include studies of women who have experienced any violence, fear of violence or aggression while pregnant, including emotional, psychological, physical or sexual violence in the context of IPV or DV. Studies were excluded if the neurodevelopmental outcomes of the offspring were not assessed. Studies from all countries were included, in English or translated to English, and search dates were not restricted. We included all years from inception of the database until the search date. SYNTHESIS Study design and biases, assessment tools, management of confounding, results and overall quality were assessed. RESULTS We identified 11 papers reporting on observational studies. Almost three quarters of the studies found a relationship between prenatal exposure to violence and developmental difficulties in the offspring. Differing assessment tools were used with a range of data collected and not all adjusted their findings for the same confounders. CONCLUSIONS Current evidence on the relationship between prenatal violence exposure, as IPV or DV, and consequent child developmental disorders remains limited. Future research using comprehensive study designs, larger samples and longitudinal follow-up of the offspring could clarify this association. While maternal trauma resulting from exposure to violence may play an important role in childhood development disorders, additional intervening factors on the pathway need further explored.
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Affiliation(s)
- Kristin Toso
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Paul de Cock
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
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Fassaie S, McAloon J. Maternal distress, HPA activity, and antenatal interventions: A systematic review. Psychoneuroendocrinology 2020; 112:104477. [PMID: 31753328 DOI: 10.1016/j.psyneuen.2019.104477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/05/2019] [Accepted: 10/11/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Elevated antenatal distress has been associated with negative outcomes for both mothers and, as a result, their infants. One mechanism hypothesised to underlie these associations is the maternal hypothalamic pituitary adrenal (HPA) axis. Though research has examined whether biopsychosocial antenatal interventions can reduce maternal HPA activity, only one review has summarized the nature of findings to date. The present study examined randomised control trials (RCTs) specifically; our primary aim was to assess the effectiveness of antenatal interventions in reducing HPA activity in pregnant women, our secondary aim was to examine whether antenatal interventions reduced maternal self-report of depression and/or anxiety. METHODS This study systematically reviewed RCTs that evaluated biopsychosocial interventions that reported subjective and objective markers of maternal distress in pregnant women within the clinical population. RESULTS Eight studies met inclusion criteria and women were in their second or third trimester. HPA-activity was primarily assessed through salivary cortisol (n = 7) and self-reported maternal distress was assessed using a variety of validated screening measures. Included trials demonstrated significant methodological heterogeneity and small sample sizes, poor treatment adherence, and poor reliability in cortisol measurement indicated low methodological quality. CONCLUSIONS Due to the high heterogeneity across studies, small sample sizes, and unreliable sampling methods, firm conclusions about the efficacy and effectiveness of antenatal interventions cannot be drawn. Despite this, interventions which targeted pregnancy-specific influencers of maternal mood were more likely to result in reduced depression and anxiety symptomatology as reported by mothers.
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Affiliation(s)
- Soha Fassaie
- Graduate School of Health, University of Technology Sydney, PO Box 123, Broadway NSW 2007, Australia
| | - John McAloon
- Graduate School of Health, University of Technology Sydney, PO Box 123, Broadway NSW 2007, Australia.
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Edvinsson Å, Hoyer A, Hansson M, Kallak TK, Sundström-Poromaa I, Skalkidou A, Lager S. Placental glucocorticoid receptors are not affected by maternal depression or SSRI treatment. Ups J Med Sci 2020; 125:30-36. [PMID: 31960733 PMCID: PMC7054983 DOI: 10.1080/03009734.2019.1702126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Prenatal depression is common, with an estimate that up to one in five pregnant women suffers from depressive symptoms. Maternal depression is associated with poor pregnancy outcomes such as preterm birth and low birth-weight. Such outcomes possibly affect offspring development. Previous studies suggest placental RNA levels of the glucocorticoid receptor are altered by maternal depression or anxiety; this stress may affect the placenta of male and female foetuses differently. However, it is unknown if the protein levels and activity of this receptor are additionally affected in women with depressive symptoms or being pharmacologically treated for depression.Methods: In this study, we investigated whether the glucocorticoid receptor (NR3C1) in the placenta is affected by maternal depression and/or selective serotonin reuptake inhibitor (SSRIs) treatment. Placentas from 45 women with singleton, term pregnancies were analysed by Western blot to determine glucocorticoid receptor levels, and by DNA-binding capacity to measure glucocorticoid receptor activation.Results: There were no differences in levels of the glucocorticoid receptor or activity between groups (control, depressive symptoms, and SSRI treatment; n = 45). Similarly, there was no difference in placental glucocorticoid receptor levels or activity dependent upon foetal sex.Conclusion: Maternal depression and SSRI treatment do not affect the glucocorticoid receptors in the placenta.
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Affiliation(s)
- Åsa Edvinsson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Angela Hoyer
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Malin Hansson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | | | | | - Alkistis Skalkidou
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Susanne Lager
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- CONTACT Susanne Lager Department of Women’s and Children’s Health, Uppsala University, Uppsala, 751 85, Sweden
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Zhang W, Ham J, Li Q, Deyssenroth MA, Lambertini L, Huang Y, Tsuchiya KJ, Chen J, Nomura Y. Moderate prenatal stress may buffer the impact of Superstorm Sandy on placental genes: Stress in Pregnancy (SIP) Study. PLoS One 2020; 15:e0226605. [PMID: 31995614 PMCID: PMC6988921 DOI: 10.1371/journal.pone.0226605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 11/29/2019] [Indexed: 12/26/2022] Open
Abstract
The placenta plays a central role in the epigenetic programming of neurodevelopment by prenatal stress (PS), but this pathway is not fully understood. It difficult to study in humans because the conditions for intense, traumatic PS are almost impossible to create ethically. This study was able to capitalize on a 2012 disaster that hit New York, Superstorm Sandy, to examine the impact of traumatic stress on placental gene expression while also examining normative PS, and compare the two. Of the 303 expectant mothers participating in the Stress in Pregnancy Study, 95 women were pregnant when Superstorm Sandy struck. During their pregnancy, participants completed self-report measures of PS and distress that were combined, using latent profile analysis, into one global indicator of normative PS. Placental tissue was collected at delivery and frozen for storage. RNA expression was assessed for 40 placental genes known to associate with the stress response system and neurodevelopment in offspring. Results showed that normative PS increased expression of just MECP2, HSD11B2, and ZNF507, whereas Superstorm Sandy PS decreased expression of CDKL5, CFL1, DYRK1A, HSD11B2, MAOA, MAOB, NCOR1, and ZNF507. Interaction analyses indicated that Superstorm Sandy PS was associated with decreased gene expression for the low and high PS group for CFL1, DYRK1A, HSD11B2, MAOA, and NCOR1 and increased expression for the moderate PS group for FOXP1, NR3C1, and NR3C2. This study supports the idea that a moderate amount of normative PS may buffer the impact of traumatic PS, in this case caused by Superstorm Sandy, on placental gene expression, which suggests that the placenta itself mirrors the organism's ability to develop an epigenetic resilience to, and inoculation from, stress.
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Affiliation(s)
- Wei Zhang
- Department of Psychology, Queens College, CUNY, New York, NY, United States of America
- Department of Psychology, New Jersey City University, Jersey City, NJ, United States of America
| | - Jacob Ham
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Qian Li
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Maya A. Deyssenroth
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Luca Lambertini
- Department of Medicine, Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Yonglin Huang
- Department of Psychology, Queens College, CUNY, New York, NY, United States of America
- Department of Psychology, The Graduate Center, CUNY, New York, NY, United States of America
| | - Kenji J. Tsuchiya
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Yoko Nomura
- Department of Psychology, Queens College, CUNY, New York, NY, United States of America
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Psychology, The Graduate Center, CUNY, New York, NY, United States of America
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Shizuoka, Japan
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Duman EA, Atesyakar N, Ecevitoglu A. Multilevel Impact of Prenatal Risk and Protective Factors on Stress Biology and Infant Development: Study protocol of BABIP prospective birth cohort from Turkey. Brain Behav Immun Health 2020; 1:100005. [PMID: 38377425 PMCID: PMC8474236 DOI: 10.1016/j.bbih.2019.100005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 11/19/2022] Open
Abstract
Prenatal environment has long-lasting effects on offspring development and health. Research on prenatal stress identified various mechanisms of these effects, from changes in epigenetic and gene expression profiles to Maternal-Placental-Fetal (MPF) stress biology. There is also evidence for the role of additional risk and protective factors influencing the impact of prenatal stress on maternal and infant outcomes. Considering these findings, we present the study protocol of BABIP, a prospective birth cohort from Turkey. The aim of the project is to investigate the effect of prenatal stress on MPF stress biology (i.e. neuroendocrine, immune and metabolic systems), differential DNA methylation and gene expression patterns, and infant birth and developmental outcomes. We are recruiting 150 pregnant women and their babies for a longitudinal project with 4 time points: 20-24 (T1) and 30-34 (T2) weeks of pregnancy, and 1-month (T3) and 4-months (T4) after giving birth. Maternal early and prenatal environment (prenatal stress, early life stress, psychosocial resources, and health-related behaviors) are assessed during pregnancy with MPF stress biology, DNA methylation and gene expression measures. Infant birth outcomes, DNA methylation and development are assessed postpartum. BABIP is the first prospective birth cohort from Turkey with extensive measures on prenatal environment and health. Through investigating the multilevel impact of prenatal stress and related risk and protective factors during and after pregnancy, BABIP will contribute to our understanding of the mechanisms by which prenatal environment influences infant development and health. Being the first such cohort from Turkey, it may also allow identification of prenatal risk and protective factors specific to the context and population in Turkey.
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Affiliation(s)
- Elif Aysimi Duman
- Department of Psychology, Bogazici University, Istanbul, Turkey
- Center for Life Sciences and Technologies, Bogazici University, Istanbul, Turkey
| | - Nilay Atesyakar
- Department of Psychology, Bogazici University, Istanbul, Turkey
| | - Alev Ecevitoglu
- Department of Psychology, Bogazici University, Istanbul, Turkey
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Gottschalk MG, Domschke K, Schiele MA. Epigenetics Underlying Susceptibility and Resilience Relating to Daily Life Stress, Work Stress, and Socioeconomic Status. Front Psychiatry 2020; 11:163. [PMID: 32265751 PMCID: PMC7099635 DOI: 10.3389/fpsyt.2020.00163] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/20/2020] [Indexed: 02/05/2023] Open
Abstract
Susceptibility and resilience to mental disorders result from a complex choreography of gene-environment interactions with epigenetics at the intersection of external psychological stressors and internal biological systems. Increasing awareness of the growing disease burden influenced by daily life stress ("daily hassles"), work-related stress, and low socioeconomic status (SES) has resulted in a novel interest into their underlying molecular signatures. This review offers a brief outline of psychiatric epigenetics and a comprehensive overview of recent findings exploring the relationship of various occupational stressors and DNA methylation in epigenome-wide association studies (EWAS) and in candidate gene studies including the serotonin transporter (SLC6A4; 5-HTTLPR), melatonin receptor 1A (MTNR1A), brain-derived neurotrophic factor (BDNF), tyrosine hydroxylase (TH), and the protein family of DNA methyltransferases (DNMTs). Conceptual and methodological challenges of epigenetic investigations with a special focus on gene-environment interactions are highlighted and discussed. The findings are integrated into a pathophysiological framework featuring epigenetic plasticity factors and work-related stress as a possible central detrimental component targetable by workplace interventions. Finally, the potential of dynamic epigenetic biomarkers of treatment response to pharmacotherapy or psychotherapy is expanded upon.
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Affiliation(s)
- Michael G Gottschalk
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Edvinsson Å, Hellgren C, Kunovac Kallak T, Åkerud H, Skalkidou A, Stener-Victorin E, Fornes R, Spigset O, Lager S, Olivier J, Sundström-Poromaa I. The effect of antenatal depression and antidepressant treatment on placental tissue: a protein-validated gene expression study. BMC Pregnancy Childbirth 2019; 19:479. [PMID: 31805950 PMCID: PMC6896358 DOI: 10.1186/s12884-019-2586-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 11/07/2019] [Indexed: 12/22/2022] Open
Abstract
Background Antenatal depression affects 10–20% of pregnant women. Around 2–4% of European pregnant women use antidepressant treatment, most commonly selective serotonin reuptake inhibitors (SSRIs). Poor pregnancy outcomes, such as preterm birth and low birth weight, have been described in women with antenatal depression and in pregnant women on SSRI treatment. However, the effects of antenatal depression and antidepressant treatment on the placenta are largely unknown. The aim of this work was to compare placental gene and protein expression in healthy women, women with untreated antenatal depression and women on antidepressant treatment during pregnancy. Methods Placental samples from 47 controls, 25 depressed and 45 SSRI-treated women were analysed by means of qPCR using custom-designed TaqMan low-density arrays (TLDAs) for 44 genes previously known to be involved in the pathophysiology of depression, and expressed in the placenta. Moreover, placental protein expression was determined by means of immunohistochemistry in 37 healthy controls, 13 women with untreated depression and 21 women on antidepressant treatment. Statistical comparisons between groups were performed by one-way ANOVA or the Kruskal–Wallis test. Results Nominally significant findings were noted for HTR1A and NPY2R, where women with untreated depression displayed higher gene expression than healthy controls (p < 0.05), whereas women on antidepressant treatment had similar expression as healthy controls. The protein expression analyses revealed higher expression of HTR1A in placentas from women on antidepressant treatment, than in placentas from healthy controls (p < 0.05). Conclusion The differentially expressed HTR1A, both at the gene and the protein level that was revealed in this study, suggests the involvement of HTR1A in the effect of antenatal depression on biological mechanisms in the placenta. More research is needed to elucidate the role of depression and antidepressant treatment on the placenta, and, further, the effect on the fetus.
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Affiliation(s)
- Åsa Edvinsson
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden.
| | - Charlotte Hellgren
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | | | - Helena Åkerud
- Department of Immunology, Genetics and Pathology, Uppsala University, 751 85, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | | | - Romina Fornes
- Department of Physiology and Pharmacology, Karolinska Institute, 171 77, Stockholm, Sweden
| | - Olav Spigset
- Department of Clinical Pharmacology, St. Olav University Hospital, 7006, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Susanne Lager
- Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Jocelien Olivier
- Neurobiology, Unit Behavioral Neuroscience, Groningen Institute for Evolutionary Life Sciences, University of Groningen, 9747, AG, Groningen, The Netherlands
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Placental programming of neuropsychiatric disease. Pediatr Res 2019; 86:157-164. [PMID: 31003234 DOI: 10.1038/s41390-019-0405-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/05/2019] [Accepted: 04/11/2019] [Indexed: 12/24/2022]
Abstract
The placenta is vital for fetal growth, and compromised function is associated with abnormal development, especially of the brain. Linking placental function to brain development is a new field we have dubbed neuroplacentology. Approximately 380,000 infants in the United States each year abruptly lose placental support upon premature birth, and more than 10% of pregnancies are affected by more insidious placental dysfunction such as preeclampsia or infection. Abnormal fetal brain development or injury can lead to life-long neurological impairments, including psychiatric disorders. The majority of research connecting placental compromise to fetal brain injury has focused on gas exchange or nutritional programming, neglecting the placenta's essential neuroendocrine role. We will review the current evidence that placental dysfunction, particularly endocrine dysfunction, secretion of pro-inflammatory cytokines, or barrier breakdown may place many thousands of fetuses at risk for life-long neurodevelopmental impairments each year. Understanding how specific placental factors shape brain development and increase the risk for later psychiatric disorders, including autism, attention deficit disorder, and schizophrenia, paves the way for novel treatment strategies to maintain the normal developmental milieu and protect from further injury.
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40
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Gluck O, Grin L, Mizrachi Y, Leytes S, Namazov A, Anteby E, Bar J, Kovo M. Impact on pregnancy outcomes of exposure to military stress during the first or second trimester as compared with the third trimester. Int J Gynaecol Obstet 2019; 146:315-320. [PMID: 31197830 DOI: 10.1002/ijgo.12885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 11/27/2018] [Accepted: 06/03/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To compare pregnancy outcomes after exposure to military stress in different trimesters of pregnancy. METHODS A retrospective study of medical records of deliveries in the Wolfson (WMC) and Barzilai (BMC) medical centers in Israel between July 2014 and April 2015. All parturients were exposed to military stress for 51 days during pregnancy. Pregnancy outcomes were compared between those exposed to military stress in the first or second trimester, and those exposed in the third trimester. Outcomes were also compared between WMC (a new-onset military stress exposure area) and BMC (a chronic military stress exposure area). RESULTS At WMC, women exposed in the first or second trimester (n=2657) had a higher rate of preterm delivery (<37 weeks) as compared with those exposed in the third trimester (n=2037; 214 [8.1%] vs 121 [5.9%]; P=0.005). At BMC, women exposed in the first or second trimester (n=2208) had a tendency toward lower rates of diabetes mellitus (P=0.055) and macrosomia [103 (4.7%) vs 84 (6.3%); P=0.037], as compared with those exposed in the third trimester (n=1337). CONCLUSION Exposure to military stress during pregnancy had different impacts on pregnancy outcomes, depending on the time of exposure and whether continuous exposure to stress occurred.
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Affiliation(s)
- Ohad Gluck
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Leonti Grin
- Department of Obstetrics and Gynecology, Barzilai Medical Center, Ashkelon, affiliated to Ben-Gurion University, Ashkelon, Israel
| | - Yossi Mizrachi
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sophia Leytes
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ahmed Namazov
- Department of Obstetrics and Gynecology, Barzilai Medical Center, Ashkelon, affiliated to Ben-Gurion University, Ashkelon, Israel
| | - Eyal Anteby
- Department of Obstetrics and Gynecology, Barzilai Medical Center, Ashkelon, affiliated to Ben-Gurion University, Ashkelon, Israel
| | - Jacob Bar
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Kovo
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hamada H, Matthews SG. Prenatal programming of stress responsiveness and behaviours: Progress and perspectives. J Neuroendocrinol 2019; 31:e12674. [PMID: 30582647 DOI: 10.1111/jne.12674] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/07/2018] [Accepted: 12/15/2018] [Indexed: 12/12/2022]
Abstract
Parental exposure to stress or glucocorticoids either before or during pregnancy can have profound influences on neurodevelopment, neuroendocrine function and behaviours in offspring. Specific outcomes are dependent on the nature, intensity and timing of the exposure, as well as species, sex and age of the subject. Most recently, it has become evident that outcomes are not confined to first-generation offspring and that there may be intergenerational and transgenerational transmission of effects. There has been intense focus on the mechanisms by which such early exposure leads to long-term and potential transgenerational outcomes, and there is strong emerging evidence that epigenetic processes (histone modifications, DNA methylation, and small non-coding RNAs) are involved. New knowledge in this area may allow the development of interventions that can prevent, ameliorate or reverse the long-term negative outcomes associated with exposure to early adversity. This review will focus on the latest research, bridging human and pre-clinical studies, and will highlight some of the limitations, challenges and gaps that exist in the field.
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Affiliation(s)
- Hirotaka Hamada
- Departments of Physiology, Obstetrics and Gynaecology and Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephen G Matthews
- Departments of Physiology, Obstetrics and Gynaecology and Medicine, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health Systems, Toronto, Ontario, Canada
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Melby MK, Yamada G, Schwartz DA, Surkan PJ. One size does not fit all: Examining ethnicity in gestational weight gain guidelines. Health Care Women Int 2019; 40:365-385. [PMID: 30742558 DOI: 10.1080/07399332.2018.1531864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Pregnancy-related metrics vary by race/ethnicity, yet most gestational weight gain (GWG) guidelines are ethnicity-blind. We estimated small-for-gestational age (SGA) risk in a Japanese population, examining GWG adequacy categorized by Institute of Medicine (IOM) and Japanese guidelines in male (N = 192) and female (N = 191) full-term singleton infants. For predicting SGA, IOM guidelines had high sensitivity ( ≥ 0.75), but low specificity ( ≤ 0.25); Japanese guidelines had high specificity ( ≥ 0.80) but low sensitivity ( ≤ 0.50). GWG guidelines' implicit notions of Caucasian-Americans as optimal may lead to 'One Size Fits All' recommendations that can obscure important biocultural factors contributing to maternal child health outcomes.
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Affiliation(s)
- Melissa K Melby
- a Department of Anthropology and College of Health Sciences , University of Delaware , Newark , Delaware , USA
| | - Goro Yamada
- b Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
| | - David A Schwartz
- c Department of Pathology , Medical College of Georgia, Augusta University , Augusta , Georgia , USA
| | - Pamela J Surkan
- d Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA
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The Effect of Prenatal Stress, Proxied by Marital and Paternity Status, on the Risk of Preterm Birth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020273. [PMID: 30669349 PMCID: PMC6352213 DOI: 10.3390/ijerph16020273] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 01/09/2023]
Abstract
Uncertainty and insecurity in the relationship between the mother and father of a child are responsible for heightened maternal stress, which can lead to preterm birth (PTB). Different intensities of prenatal stress (proxied by four levels of marital status linked with the presence or absence of paternal data on birth records) were defined as the Marital-Father Data index. We assessed the impact of those varying intensities of prenatal stress on PTB with respect to parity among a group of Polish mothers residing in Krakow (N = 87,916). We found a pattern across the adjusted risk ratios (RR) of preterm birth that ordered these estimates in an increasing trend towards higher risk, beginning with the group of married mothers with father data present (baseline), through the groups of legitimizing marriages—married after conception with father data present (RR = 1.1; 95% Confidence Intervals (CI) 1.0–1.2) and unmarried mothers with father data present (RR = 1.3; 95% CI 1.2–1.5) to the group of unmarried mothers with father data absent (RR = 1.9; 95% CI 1.7–2.2). The adjusted p for the linear trend between Marital-Father Data index and PTB was less than 0.001. The adjusted effect of perceived prenatal stress differed with respect to parity (confirmed by statistically significant interactions between Marital-Father Data index levels and parity), with a higher magnitude of this effect noted among multiparous versus primiparous women. Low paternal involvement and support during pregnancy may negatively affect PTB risk and this effect may differ in relation to parity status. More attention should be paid to maternal pregnancy stress, especially of multiparous mothers, to decrease the risk of unfavorable birth outcomes.
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Gillespie SL, Anderson CM. Racial discrimination and leukocyte glucocorticoid sensitivity: Implications for birth timing. Soc Sci Med 2018; 216:114-123. [PMID: 30309686 PMCID: PMC6188674 DOI: 10.1016/j.socscimed.2018.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/07/2018] [Accepted: 08/16/2018] [Indexed: 12/18/2022]
Abstract
RATIONALE Psychological stress-induced cortisol elevations appear to contribute to preterm birth. Yet, some studies suggest that the biological ramifications of racial discrimination-associated stress are unique and may involve development of decreased glucocorticoid sensitivity despite normalized cortisol levels. OBJECTIVE In this study, we examined the effects of racial discrimination on maternal cortisol output, leukocyte glucocorticoid sensitivity, and the degree of correspondence between cortisol levels and birth timing in an African American cohort. METHOD A generally healthy prospective cohort was enrolled at 28-32 weeks gestation (n = 91). The Experiences of Discrimination scale was administered, whole blood collected, and plasma cortisol levels, cytokine levels, and leukocyte counts quantified for examination of patterns of endogenous feedback. RESULTS Racial discrimination in the mid-tertile was associated with greater maternal cortisol levels than the bottom tertile among women reporting internalizing responses (b* = 0.68, p = 0.001). Decreased leukocyte glucocorticoid sensitivity was witnessed at greater frequencies of experiences of racial discrimination, as evidenced by decreased correspondence between maternal cortisol levels and plasma IL-8 levels, monocyte counts, and lymphocyte counts (p values ≤ 0.043). The association between maternal cortisol levels and birth timing differed by discrimination tertile (p values ≤ 0.005), with greater cortisol levels predictive of earlier birth among women without (b* = -0.59, p < 0.001) but not with racial discrimination (ps ≥ 0.497). CONCLUSION We provide novel evidence of decreased glucocorticoid sensitivity at increasing frequency of exposure to racial discrimination. Our findings suggest that the biology of preterm birth may depend upon racial discriminatory exposures, favoring pathways dependent upon glucocorticoid-induced increases in leukocyte tissue surveillance versus glucocorticoid resistance-associated inflammatory aberrations at increasing levels of exposure. Precision approaches to prenatal care are sorely needed to combat preterm birth, particularly among African American women, with efforts dependent upon further research examining the pathways contributing to the syndrome dependent upon the totality of an individual's exposures.
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Affiliation(s)
- Shannon L Gillespie
- Martha S. Pitzer Center for Women, Children, and Youth, College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH, USA.
| | - Cindy M Anderson
- Martha S. Pitzer Center for Women, Children, and Youth, College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH, USA
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Prenatal maternal stress, fetal programming, and mechanisms underlying later psychopathology-A global perspective. Dev Psychopathol 2018; 30:843-854. [PMID: 30068411 DOI: 10.1017/s095457941800038x] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
There is clear evidence that the mother's stress, anxiety, or depression during pregnancy can alter the development of her fetus and her child, with an increased risk for later psychopathology. We are starting to understand some of the underlying mechanisms including the role of the placenta, gene-environment interactions, epigenetics, and specific systems including the hypothalamic-pituitary-adrenal axis and cytokines. In this review we also consider how these effects may be different, and potentially exacerbated, in different parts of the world. There can be many reasons for elevated prenatal stress, as in communities at war. There may be raised pregnancy-specific anxiety with high levels of maternal and infant death. There can be raised interpersonal violence (in Afghanistan 90.2% of women thought that "wife beating" was justified compared with 2.0% in Argentina). There may be interactions with nutritional deficiencies or with extremes of temperature. Prenatal stress alters the microbiome, and this can differ in different countries. Genetic differences in different ethnic groups may make some more vulnerable or more resilient to the effects of prenatal stress on child neurodevelopment. Most research on these questions has been in predominantly Caucasian samples from high-income countries. It is now time to understand more about prenatal stress and psychopathology, and the role of both social and biological differences, in the rest of the world.
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Janssen AB, Savory KA, Garay SM, Sumption L, Watkins W, Garcia-Martin I, Savory NA, Ridgway A, Isles AR, Penketh R, Jones IR, John RM. Persistence of anxiety symptoms after elective caesarean delivery. BJPsych Open 2018; 4:354-360. [PMID: 30202597 PMCID: PMC6127961 DOI: 10.1192/bjo.2018.48] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/05/2018] [Accepted: 07/16/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In the UK, 11.8% of expectant mothers undergo an elective caesarean section (ELCS) representing 92 000 births per annum. It is not known to what extent this procedure has an impact on mental well-being in the longer term. AIMS To determine the prevalence and postpartum progression of anxiety and depression symptoms in women undergoing ELCS in Wales. METHOD Prevalence of depression and anxiety were determined in women at University Hospital Wales (2015-16; n = 308) through completion of the Edinburgh Postnatal Depression Scale (EPDS; ≥13) and State-Trait Anxiety Inventory (STAI; ≥40) questionnaires 1 day prior to ELCS, and three postpartum time points for 1 year. Maternal characteristics were determined from questionnaires and, where possible, confirmed from National Health Service maternity records. RESULTS Using these criteria the prevalence of reported depression symptoms was 14.3% (95% CI 10.9-18.3) 1 day prior to ELCS, 8.0% (95% CI 4.2-12.5) within 1 week, 8.7% (95% CI 4.2-13.8) at 10 weeks and 12.4% (95% CI 6.4-18.4) 1 year postpartum. Prevalence of reported anxiety symptoms was 27.3% (95% CI 22.5-32.4), 21.7% (95% CI 15.8-28.0), 25.3% (95% CI 18.5-32.7) and 35.1% (95% CI 26.3-44.2) at these same stages. Prenatal anxiety was not resolved after ELCS more than 1 year after delivery. CONCLUSIONS Women undergoing ELCS experience prolonged anxiety postpartum that merits focused clinical attention. DECLARATION OF INTEREST None.
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Affiliation(s)
- Anna B Janssen
- Research Associate, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - Katrina A Savory
- Research Assistant, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - Samantha M Garay
- PhD student, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - Lorna Sumption
- PhD student, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - William Watkins
- Statistician, Infection and Immunity Team Bioinformatics and Statistics, College of Biomedical & Life Sciences, Cardiff University, UK
| | - Isabel Garcia-Martin
- PhD student, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - Nicola A Savory
- Research Midwife, Department of Obstetrics and Gynaecology, University Hospital Wales, UK
| | - Anouk Ridgway
- Research Midwife, Department of Obstetrics and Gynaecology, University Hospital Wales, UK
| | - Anthony R Isles
- Professor, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK
| | - Richard Penketh
- Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, University Hospital Wales, UK
| | - Ian R Jones
- Professor, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK
| | - Rosalind M John
- Professor, Biomedicine Division, School of Biosciences, Cardiff University, UK
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