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Weiner S, Wu Y, Kapse K, Vozar T, Cheng JJ, Murnick J, Henderson D, Teramoto H, Limperopoulos C, Andescavage N. Prenatal Maternal Psychological Distress During the COVID-19 Pandemic and Newborn Brain Development. JAMA Netw Open 2024; 7:e2417924. [PMID: 38900424 PMCID: PMC11190810 DOI: 10.1001/jamanetworkopen.2024.17924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/17/2024] [Indexed: 06/21/2024] Open
Abstract
Importance Elevated maternal psychological distress during pregnancy is associated with altered fetal brain development. During the COVID-19 pandemic, prenatal maternal psychological distress more than doubled. Objective To examine the association of the pandemic and rising maternal psychological distress with brain growth in newborns using quantitative 3-dimensional volumetric magnetic resonance imaging (MRI). Design, Setting, and Participants This prospective cross-sectional study recruited mother-infant dyads at Children's National Hospital, Washington, DC, during the COVID-19 pandemic (June 1, 2020, to June 30, 2022) into a longitudinal infant brain development study and compared them with an existing normative healthy cohort (recruited March 1, 2014, to December 31, 2019). Exclusion criteria included multiple gestation pregnancy, known or suspected congenital infection, documented chromosomal abnormalities, or any maternal contraindication to MRI, as well as prenatal COVID-19 exposure. Infants with structural brain abnormalities or a postnatal confirmation of a genetic syndrome were excluded. Exposure Psychological distress during COVID-19 pandemic. Main Outcomes and Measures Prenatal maternal mental health was evaluated using the Spielberger State-Trait Anxiety Inventory and the Perceived Stress Scale. Neonates underwent nonsedated brain MRI. An ordinary least squares linear regression model was used to measure the differences in regional brain volumes of neonates born before vs during the pandemic with and without exposure to elevated prenatal maternal psychological distress after adjustment for neonatal sex and gestational age at MRI and maternal age and educational level. Results A total of 159 mother-infant dyads were included in the analysis: 103 before and 56 during the pandemic (median gestational age of infants, 39.6 [IQR, 38.4-40.4] weeks; median maternal age, 34.5 [IQR, 31.0-37.0] years). Eighty-three infants (52.2%) were female. Among the mothers, 130 (81.8%) had a college degree and 87 (54.7%) had a graduate degree. Forty-four mothers (27.7%) identified as Asian, Hispanic, or multiracial; 27 (17.0%), as Black; and 88 (55.3%), as White. Scores on anxiety and stress measures were significantly increased in the pandemic cohort. Infants of mothers with elevated maternal distress showed median reductions in white matter (-0.36 [95% CI, -0.61 to -0.11] cm3; Q < .001), right hippocampal (-0.35 [95% CI, -0.65 to -0.06] cm3; Q = .04), and left amygdala (-0.49 [95% CI, -0.84 to -0.13] cm3; Q = .03) volumes compared with infants of mothers with low distress levels. After adjusting for the cohort effect of the pandemic, elevated trait anxiety remained significantly associated with decreased left amygdalar volumes (-0.71 [95% CI, -1.12 to -0.29]; Q < .001). Conclusions and Relevance In this cross-sectional study of maternal-infant dyads prior to and during the COVID-19 pandemic, regional neonatal brain volumes were associated with elevated maternal psychological distress.
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Affiliation(s)
- Susan Weiner
- Developing Brain Institute, Children’s National Hospital, Washington, DC
- The Institute for Biomedical Sciences, George Washington University, Washington, DC
| | - Yao Wu
- Developing Brain Institute, Children’s National Hospital, Washington, DC
| | - Kushal Kapse
- Developing Brain Institute, Children’s National Hospital, Washington, DC
| | - Tracy Vozar
- Department of Diagnostic Imaging and Radiology, Children’s National Hospital, Washington, DC
- Department of Psychology, Children’s National Hospital, Washington, DC
| | | | - Jonathan Murnick
- Department of Diagnostic Imaging and Radiology, Children’s National Hospital, Washington, DC
- Department of Radiology, George Washington University, Washington, DC
- Department of Neonatology, Children’s National Hospital, Washington, DC
| | - Diedtra Henderson
- Developing Brain Institute, Children’s National Hospital, Washington, DC
| | - Hironori Teramoto
- Developing Brain Institute, Children’s National Hospital, Washington, DC
| | - Catherine Limperopoulos
- Developing Brain Institute, Children’s National Hospital, Washington, DC
- Department of Diagnostic Imaging and Radiology, Children’s National Hospital, Washington, DC
- Department of Pediatrics, George Washington University, Washington, DC
- Department of Radiology, George Washington University, Washington, DC
| | - Nickie Andescavage
- Developing Brain Institute, Children’s National Hospital, Washington, DC
- Department of Pediatrics, George Washington University, Washington, DC
- Department of Neonatology, Children’s National Hospital, Washington, DC
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Nazzari S, Grumi S, Mambretti F, Villa M, Giorda R, Bordoni M, Pansarasa O, Borgatti R, Provenzi L. Sex-dimorphic pathways in the associations between maternal trait anxiety, infant BDNF methylation, and negative emotionality. Dev Psychopathol 2024; 36:908-918. [PMID: 36855816 DOI: 10.1017/s0954579423000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Maternal antenatal anxiety is an emerging risk factor for child emotional development. Both sex and epigenetic mechanisms, such as DNA methylation, may contribute to the embedding of maternal distress into emotional outcomes. Here, we investigated sex-dependent patterns in the association between antenatal maternal trait anxiety, methylation of the brain-derived neurotrophic factor gene (BDNF DNAm), and infant negative emotionality (NE). Mother-infant dyads (N = 276) were recruited at delivery. Maternal trait anxiety, as a marker of antenatal chronic stress exposure, was assessed soon after delivery using the Stait-Trait Anxiety Inventory (STAI-Y). Infants' BDNF DNAm at birth was assessed in 11 CpG sites in buccal cells whereas infants' NE was assessed at 3 (N = 225) and 6 months (N = 189) using the Infant Behavior Questionnaire-Revised (IBQ-R). Hierarchical linear analyses showed that higher maternal antenatal anxiety was associated with greater 6-month-olds' NE. Furthermore, maternal antenatal anxiety predicted greater infants' BDNF DNAm in five CpG sites in males but not in females. Higher methylation at these sites was associated with greater 3-to-6-month NE increase, independently of infants' sex. Maternal antenatal anxiety emerged as a risk factor for infant's NE. BDNF DNAm might mediate this effect in males. These results may inform the development of strategies to promote mothers and infants' emotional well-being.
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Affiliation(s)
- Sarah Nazzari
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Serena Grumi
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
| | - Fabiana Mambretti
- Molecular Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Marco Villa
- Molecular Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Roberto Giorda
- Molecular Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Matteo Bordoni
- Cellular Models and Neuroepigenetics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Orietta Pansarasa
- Cellular Models and Neuroepigenetics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
| | - Livio Provenzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
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3
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Nigam P, Gramszlo C, Srivastava S, Sood E. Experiences of fetal care, social support, and emotional functioning during the COVID-19 pandemic in women carrying a fetus with CHD. Cardiol Young 2023:1-7. [PMID: 38057139 PMCID: PMC11156789 DOI: 10.1017/s104795112300358x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
OBJECTIVE To explore how the COVID-19 pandemic affected fetal care, social support, and emotional functioning for women carrying a fetus with CHD. METHOD This was a single-centre qualitative study of 31 women who received a prenatal diagnosis of CHD during the pandemic. Patients completed semi-structured interviews about their experiences with fetal care, social support, and perceptions of risk to themselves and their fetus. Consistent themes regarding the impact of the pandemic were identified using an inductive thematic approach. Demographic data were collected via self-report and chart review. RESULTS Women generally reported consistent access to fetal care throughout the pandemic, with frequent use of telemedicine in addition to in-person care, but negative impacts resulting from restrictions on family support at appointments. Limited access to social support overall and a loss of pregnancy traditions were described. Many women reported feeling isolated and experiencing worries and fears about COVID-19 but also noted feeling supported by their healthcare team. Partner/family support during appointments and connection to peer-to-peer support were identified as recommendations to mitigate negative impacts. CONCLUSION Women carrying a fetus with CHD during the COVID-19 pandemic experienced unique stressors that may affect mental health. However, many also experienced unexpected supports that may mitigate effects of pandemic-related stressors. Results can inform efforts to promote positive family outcomes during and following the COVID-19 pandemic.
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Affiliation(s)
- Priya Nigam
- Nemours Cardiac Center, Nemours Children’s Health, Wilmington DE, USA
| | - Colette Gramszlo
- Nemours Cardiac Center, Nemours Children’s Health, Wilmington DE, USA
| | - Shubhika Srivastava
- Nemours Cardiac Center, Nemours Children’s Health, Wilmington DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
| | - Erica Sood
- Nemours Cardiac Center, Nemours Children’s Health, Wilmington DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
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Rogers AM, Youssef GJ, Teague S, Sunderland M, Le Bas G, Macdonald JA, Mattick RP, Allsop S, Elliott EJ, Olsson CA, Hutchinson D. Association of maternal and paternal perinatal depression and anxiety with infant development: A longitudinal study. J Affect Disord 2023; 338:278-288. [PMID: 37302506 DOI: 10.1016/j.jad.2023.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 05/31/2023] [Accepted: 06/04/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Maternal and paternal perinatal depression and anxiety are theorised to adversely impact infant development. Yet, few studies have assessed both mental health symptoms and clinical diagnoses within the one study. Moreover, research on fathers is limited. This study therefore aimed to examine the association between symptoms and diagnoses of maternal and paternal perinatal depression and anxiety with infant development. METHOD Data were from the Triple B Pregnancy Cohort Study. Participants included 1539 mothers and 793 partners. Depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale and Depression Anxiety Stress Scales. Major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, and agoraphobia were assessed using the Composite International Diagnostic Interview in trimester three. Infant development was assessed at 12-months using the Bayley Scales of Infant and Toddler Development. RESULTS Antepartum, maternal depressive and anxiety symptoms were associated with poorer infant social-emotional (d = -0.11, p = .025) and language development (d = -0.16, p = .001). At 8-weeks postpartum, maternal anxiety symptoms were associated with poorer overall development (d = -0.11, p = .030). No association was observed for clinical diagnoses in mothers, nor paternal depressive and anxiety symptoms or clinical diagnoses; albeit risk estimates were largely in the expected direction of adverse effects on infant development. CONCLUSIONS Evidence suggests that maternal perinatal depression and anxiety symptoms may adversely impact infant development. Effects were small but findings underscore the importance of prevention, early screening and intervention, alongside consideration of other risk factors during early critical periods.
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Affiliation(s)
- Alana M Rogers
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - Samantha Teague
- Department of Psychology, College of Healthcare Sciences, James Cook University, Queensland, Australia.
| | - Matthew Sunderland
- University of Sydney, Matilda Centre for Research in Mental Health and Substance Use, New South Wales, Australia.
| | - Genevieve Le Bas
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia.
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
| | - Richard P Mattick
- The University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia.
| | - Steve Allsop
- Curtin University, National Drug Research Institute, Western Australia, Australia.
| | - Elizabeth J Elliott
- University of Sydney, Faculty of Medicine and Health, Discipline of Child and Adolescence, New South Wales, Australia; Sydney Children's Hospitals Network, Westmead, Sydney, Australia.
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia; The University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Australia.
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5
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Delagneau G, Twilhaar ES, Testa R, van Veen S, Anderson P. Association between prenatal maternal anxiety and/or stress and offspring's cognitive functioning: A meta-analysis. Child Dev 2023; 94:779-801. [PMID: 36582056 PMCID: PMC10952806 DOI: 10.1111/cdev.13885] [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: 12/31/2022]
Abstract
This meta-analysis examined the relationship between prenatal maternal stress and/or anxiety and the outcomes of children aged 3 months to 9 years. Of the 8754 studies published before June 2021 that were synthesized, 17 conducted in Western countries were included in the meta-analysis (Ntotal = 23,307; Mmales 54%; Methnicity White 77%, Pacific 15%, African American/Black 10%, Middle Eastern 7%, Eastern 8%). Effect sizes ranged from -0.41 to 0.15. A weak negative association was found between prenatal stress and/or anxiety exposure and children's general intellectual development. Associations varied based on the type of exposure. Findings are limited to developed counties and cannot be generalized to low- and middle-income countries. Directions for maternal prenatal intervention and future studies are discussed.
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Affiliation(s)
- Garance Delagneau
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
| | - E. Sabrina Twilhaar
- Obstetrical Perinatal and Pediatric Epidemiology Research TeamInstitute of Health and Medical ResearchCentre of Research in Epidemiology and StatisticsUniversité Paris CitéParisFrance
| | - Renee Testa
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
- Murdoch Children's Research InstituteRoyal Children's Hospital (Dept of Mental Health)ParkvilleVictoriaAustralia
| | - Sarit van Veen
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
| | - Peter Anderson
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityClaytonVictoriaAustralia
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Environmental Risk Factors and Cognitive Outcomes in Psychosis: Pre-, Perinatal, and Early Life Adversity. Curr Top Behav Neurosci 2023; 63:205-240. [PMID: 35915384 PMCID: PMC9892366 DOI: 10.1007/7854_2022_378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Risk for psychosis begins to accumulate as early as the fetal period through exposure to obstetric complications like fetal hypoxia, maternal stress, and prenatal infection. Stressors in the postnatal period, such as childhood trauma, peer victimization, and neighborhood-level adversity, further increase susceptibility for psychosis. Cognitive difficulties are among the first symptoms to emerge in individuals who go on to develop a psychotic disorder. We review the relationship between pre-, perinatal, and early childhood adversities and cognitive outcomes in individuals with psychosis. Current evidence shows that the aforementioned environmental risk factors may be linked to lower overall intelligence and executive dysfunction, beginning in the premorbid period and persisting into adulthood in individuals with psychosis. It is likely that early life stress contributes to cognitive difficulties in psychosis through dysregulation of the body's response to stress, causing changes such as increased cortisol levels and chronic immune activation, which can negatively impact neurodevelopment. Intersectional aspects of identity (e.g., sex/gender, race/ethnicity), as well as gene-environment interactions, likely inform the developmental cascade to cognitive difficulties throughout the course of psychotic disorders and are reviewed below. Prospective studies of birth cohorts will serve to further clarify the relationship between early-life environmental risk factors and cognitive outcomes in the developmental course of psychotic disorders. Specific methodological recommendations are provided for future research.
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Quagliato LA, de Matos UMA, Nardi AE. Lifetime psychopathology in the offspring of parents with anxiety disorders: A systematic review. J Affect Disord 2022; 319:618-626. [PMID: 36174782 DOI: 10.1016/j.jad.2022.09.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/25/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The offspring of parents with Anxiety Disorders (AD) are at high risk for different types of psychopathology, including AD. However, little is known about how parental anxiety during pregnancy and/or the postnatal period might result in alterations in behavior or neurodevelopmental changes in offspring. To examine the effect of parental AD on offspring behavior and neurodevelopment, we conducted a systematic review. METHODS Following PRISMA guidelines, we searched the Web of Science, PubMed, and PsycINFO databases. RESULTS Forty-seven articles met the inclusion criteria for the systematic review. Prenatal maternal anxiety is related to negative temperament, increased attention to fearful vocalizations, decreased alertness, and impaired psychomotor and cognitive development in early and middle childhood. AD during the postnatal period is associated with greater negative temperament, internalizing symptoms, and anxiety symptoms in early childhood, middle childhood, and adolescence. CONCLUSION Our review is the first to demonstrate that prenatal and postnatal AD symptoms impact offspring. Future research should explore the mediating and moderating factors leading to the development of psychopathology in the offspring of parents with AD.
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Affiliation(s)
- Laiana A Quagliato
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Voluntários da Pátria 190 s. 722, 22270-010, Brazil.
| | - Ursula M A de Matos
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Voluntários da Pátria 190 s. 722, 22270-010, Brazil
| | - Antonio E Nardi
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Voluntários da Pátria 190 s. 722, 22270-010, Brazil
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Jeličić L, Veselinović A, Ćirović M, Jakovljević V, Raičević S, Subotić M. Maternal Distress during Pregnancy and the Postpartum Period: Underlying Mechanisms and Child's Developmental Outcomes-A Narrative Review. Int J Mol Sci 2022; 23:ijms232213932. [PMID: 36430406 PMCID: PMC9692872 DOI: 10.3390/ijms232213932] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Maternal mental health may be considered a determining factor influencing fetal and child development. An essential factor with potentially negative consequences for a child's psychophysiological development is the presence of maternal distress during pregnancy and the postpartum period. The review is organized and presented to explore and describe the effects of anxiety, stress, and depression in pregnancy and the postpartum period on adverse child developmental outcomes. The neurobiology of maternal distress and the transmission mechanisms at the molecular level to the fetus and child are noted. In addition, the paper discusses the findings of longitudinal studies in which early child development is monitored concerning the presence of maternal distress in pregnancy and the postpartum period. This topic gained importance in the COVID-19 pandemic context, during which a higher frequency of maternal psychological disorders was observed. The need for further interdisciplinary research on the relationship between maternal mental health and fetal/child development was highlighted, especially on the biological mechanisms underlying the transmission of maternal distress to the (unborn) child, to achieve positive developmental outcomes and improve maternal and child well-being.
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Affiliation(s)
- Ljiljana Jeličić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-11-3208-519; Fax: +381-11-2624-168
| | - Aleksandra Veselinović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Milica Ćirović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Vladimir Jakovljević
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Saša Raičević
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
- Clinic of Gynecology and Obstetrics, Clinical Center of Montenegro, 81000 Podgorica, Montenegro
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia
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Amin K, Patel K. Role of Psychologists in Pediatric Congenital Heart Disease. Pediatr Clin North Am 2022; 69:865-878. [PMID: 36207098 DOI: 10.1016/j.pcl.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Congenital heart disease (CHD) is stressful to both pediatric patients and their caregivers. Maternal anxiety during pregnancy is associated with adverse perinatal outcomes. After birth, a prolonged hospital stay can be taxing on the infant and caregiver leading to long-term adverse effects. During adolescence, CHD continues to serve as a stressor for the child not only due to medical care but also due to social limitations and bullying. Many patients also struggle during the transition from adolescence to adult care. Psychologists may aid both the parents and child at all stages from pregnancy to the child's transition to adulthood.
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Affiliation(s)
- Kanhai Amin
- Yale University, 261 Park St, New Haven, CT 06511, USA
| | - Keshav Patel
- Department of Internal Medicine, University of Illinois at Chicago College of Medicine, University of Illinois at Chicago, 840 South Wood Street, Room 440, MC 718, Chicago, IL 60612-7323, USA.
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Lemus A, Vogel SC, Greaves AN, Brito NH. Maternal anxiety symptoms associated with increased behavioral synchrony in the early postnatal period. INFANCY 2022; 27:821-835. [PMID: 35524642 PMCID: PMC9887273 DOI: 10.1111/infa.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 03/29/2022] [Accepted: 04/11/2022] [Indexed: 02/02/2023]
Abstract
The presence of perinatal mood and anxiety disorders has typically been associated with decreases in the quality of mother-infant interactions. However, maternal anxiety symptoms during the postpartum period have been less studied than other mental health disorders like depression. In the current study, we examined associations among symptoms of maternal anxiety, maternal perceived stress, and mother-infant behavioral synchrony in the early postnatal period. Eighty-one mother-infant dyads participated in this study when the infants were 3 months old. Surveys were given to obtain demographic information and current maternal mental health symptoms, and dyads completed a 5-min free-play task to measure behavioral synchrony. Results indicated that maternal anxiety symptoms were positively associated with behavioral synchrony, but only for mothers reporting moderate levels of perceived stress. These findings highlight the differential impact of maternal postpartum mental health on behavioral synchrony and suggest that higher maternal anxiety symptoms during the postnatal period may play an adaptive role in fostering more dynamic mother-infant interactions.
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Affiliation(s)
- Alejandra Lemus
- Department of Applied Psychology New York University New York New York USA
| | - Sarah C. Vogel
- Department of Applied Psychology New York University New York New York USA
| | - Ashley N. Greaves
- Department of Applied Psychology New York University New York New York USA
| | - Natalie H. Brito
- Department of Applied Psychology New York University New York New York USA
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11
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Mudra S, Göbel A, Möhler E, Stuhrmann LY, Schulte-Markwort M, Arck P, Hecher K, Diemert A. Behavioral Inhibition in the Second Year of Life Is Predicted by Prenatal Maternal Anxiety, Overprotective Parenting and Infant Temperament in Early Infancy. Front Psychiatry 2022; 13:844291. [PMID: 35722567 PMCID: PMC9203734 DOI: 10.3389/fpsyt.2022.844291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background Behavioral inhibition, characterized by shyness, fear and avoidance of novel stimuli, has been linked with internalizing personality traits in childhood, adolescence and early adulthood, and particularly later social anxiety disorder. Little is known about the relevance of potential prenatal precursors and early predictors for the development of inhibited behavior, such as infant vulnerability and family risk factors like parental anxiety and overprotection. Pregnancy-related anxiety has been associated with both infant temperament and maternal overprotective parenting. Thus, the aim of this study was investigating the predictive relevance of prenatal pregnancy-related anxiety for behavioral inhibition in toddlerhood, by considering the mediating role of maternal overprotection and infant distress to novelty. Materials and Methods As part of a longitudinal pregnancy cohort, behavioral inhibition at 24 months postpartum was assessed in N = 170 mother-child pairs. Maternal pregnancy-related anxiety was examined in the third trimester of pregnancy, and maternal overprotection and infant distress to novelty at 12 months postpartum. Results Mediation analysis with two parallel mediators showed that the significant direct effect of pregnancy-related anxiety on child behavioral inhibition was fully mediated by infant distress to novelty p < 0.001 and maternal overprotection (p < 0.05). The included variables explained 26% of variance in behavioral inhibition. A subsequent explorative mediation analysis with serial mediators further showed a significant positive association between distress to novelty and maternal overprotective parenting (p < 0.05). Conclusion Results indicate a predictive relevance of both infant and maternal factors for the development of behavioral inhibition in toddlerhood. Mothers who perceived more pregnancy-related anxiety showed more overprotective parenting and had infants with more distress to novelty. Further, mothers being more overprotective reported their child to be more inhibited in toddlerhood. Our findings also indicate the stability of reported infant distress to novelty as one aspect of later behavioral inhibition. Addressing specific forms of parental anxiety from pregnancy on and in interaction with child-related variables seems to be a promising approach for future studies and clinical interventions.
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Affiliation(s)
- Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Saarland University Medical Center, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Schulte-Markwort
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra Arck
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kurt Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Diemert
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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12
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Child age dependent predictors of South Korean mothers’ psychological distress. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-01446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Sinesi A, Cheyne H, Maxwell M, O'Carroll R. THE STIRLING ANTENATAL ANXIETY SCALE (SAAS): DEVELOPMENT AND INITIAL PSYCHOMETRIC VALIDATION. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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14
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Dufford AJ, Salzwedel AP, Gilmore JH, Gao W, Kim P. Maternal trait anxiety symptoms, frontolimbic resting-state functional connectivity, and cognitive development in infancy. Dev Psychobiol 2021; 63:e22166. [PMID: 34292595 PMCID: PMC10775911 DOI: 10.1002/dev.22166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 06/13/2021] [Accepted: 06/22/2021] [Indexed: 11/07/2022]
Abstract
Exposure to maternal anxiety symptoms during infancy has been associated with difficulties in development and greater risk for developing anxiety later in life. Although previous studies have examined associations between prenatal maternal distress, infant brain development, and developmental outcomes, it is still largely unclear if there are associations between postnatal anxiety, infant brain development, and cognitive development in infancy. In this study, we used resting-state functional magnetic resonance imaging to examine the association between maternal anxiety symptoms and resting-state functional connectivity in the first year of life. We also examine the association between frontolimbic functional connectivity and infant cognitive development. The sample consisted of 21 infants (mean age = 24.15 months, SD = 4.17) that were scanned during their natural sleep using. We test the associations between maternal trait anxiety symptoms and amygdala-anterior cingulate cortex (ACC) functional connectivity, a neural circuit implicated in early life stress exposure. We also test the associations between amygdala-ACC connectivity and cognitive development. We found a significant negative association between maternal trait anxiety symptoms and left amygdala-right ACC functional connectivity (p < .05, false discovery rate corrected). We found a significant negative association between left amygdala-right ACC functional connectivity and infant cognitive development (p < .05). These findings have potential implications for understanding the role of postpartum maternal anxiety symptoms in functional brain and cognitive development in infancy.
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Affiliation(s)
| | - Andrew P. Salzwedel
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - John H. Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Wei Gao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, Colorado, USA
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15
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De Asis-Cruz J, Krishnamurthy D, Zhao L, Kapse K, Vezina G, Andescavage N, Quistorff J, Lopez C, Limperopoulos C. Association of Prenatal Maternal Anxiety With Fetal Regional Brain Connectivity. JAMA Netw Open 2020; 3:e2022349. [PMID: 33284334 DOI: 10.1001/jamanetworkopen.2020.22349] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Maternal psychological distress during pregnancy is associated with adverse obstetric outcomes and neuropsychiatric deficits in children. Currently unavailable in vivo interrogation of fetal brain function could provide critical insights into the onset and timing of altered neurodevelopmental trajectories. OBJECTIVE To investigate the association between prenatal maternal stress, anxiety, and depression and in vivo fetal brain resting state functional connectivity. DESIGN, SETTING, AND PARTICIPANTS This cohort study included pregnant women scanned between January 2016 and April 2019. A total of 50 pregnant women with healthy pregnancies were prospectively recruited from low-risk obstetric clinics in the Washington DC area and were scanned at Children's National in Washington DC. EXPOSURES Maternal stress, anxiety, and depression. MAIN OUTCOMES AND MEASURES The association of prenatal maternal stress, anxiety, and depression with whole-brain connectivity was analyzed using multivariate distance matrix regression. Prenatal maternal stress, anxiety, and depression were assessed using the Perceived Stress Scale, Spielberger State Anxiety Inventory and Spielberger Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale, respectively. Whole-brain connectivity was measured from 100 functionally defined regions of interest. RESULTS This study analyzed 59 resting-state functional connectivity magnetic resonance image data sets from the fetuses (mean [SD] gestational age, 33.52 [4 weeks]) of 50 healthy pregnant women (mean [SD] age, 33.77 [5.51]). Mean (SD) scores for the questionnaires were as follows: Spielberger State Anxiety Inventory, 26.66 (6.72) (range, 20-48); Spielberger Trait Anxiety Inventory, 28.09 (6.62) (range, 20-50); Perceived Stress Scale, 9.27 (5.13) (range, 1-25); and Edinburgh Postnatal Depression Scale 3.24 (2.84) (range, 0-14). Prenatal maternal anxiety scores measured using the Spielberger Trait and State Anxiety Inventories were associated with differences in fetal connectivity (Spielberger State Anxiety Inventory: pseudo-R2 = 0.019, P = .04; Spielberger Trait Anxiety Inventory: pseudo-R2 = 0.021, P = .007). Interhemispheric connections, such as those involving the parietofrontal and occipital association cortices, were associated with reduced maternal prenatal anxiety, and those between the brainstem and sensorimotor areas were associated with higher anxiety scores. CONCLUSIONS AND RELEVANCE In this cohort study, an association was found between prenatal maternal anxiety and disturbances in fetal brain functional connectivity, suggesting altered fetal programming. Early onset of functional deviations suggests the need for more widespread screening of pregnant women for symptoms of anxiety.
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Affiliation(s)
| | | | - Li Zhao
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | - Kushal Kapse
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | | | - Jessica Quistorff
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | - Catherine Lopez
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
| | - Catherine Limperopoulos
- Division of Diagnostic Imaging and Radiology, Children's National, Washington DC
- Department of Pediatrics, The George Washington University School of Medicine, Washington DC
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16
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Anderson CM, Brunton RJ, Dryer R. Pregnancy‐related anxiety: Re‐examining its distinctiveness†. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Carla M. Anderson
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Robyn J. Brunton
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Rachel Dryer
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
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17
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Maternal prenatal anxiety trajectories and infant developmental outcomes in one-year-old offspring. Infant Behav Dev 2020; 60:101468. [PMID: 32745812 DOI: 10.1016/j.infbeh.2020.101468] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/22/2020] [Accepted: 07/09/2020] [Indexed: 12/11/2022]
Abstract
A longitudinal study of a sample of women and their offspring from two urban areas (N = 233) was conducted to test whether maternal prenatal anxiety trajectories from early to late pregnancy are associated with 12-month infant developmental outcomes, independent of maternal postpartum anxiety symptoms, prenatal and postpartum depressive symptoms, parity, birth outcomes and maternal education. Three types of maternal anxiety trajectories over the course of pregnancy were identified and labeled increasing, decreasing, and stable-low. Only increasing maternal prenatal anxiety was associated with 12-month infant outcomes, specifically lower Bayley-III scores on receptive language and gross motor skills. Maternal anxiety measured at each individual timepoint in pregnancy was not associated with infant Bayley-III outcomes, highlighting the importance of examining trajectories of maternal affect.
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18
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Thomas S, Vigil E, Thomas T, Bellinger DC, Ramthal A, Kurpad AV, Duggan CP, Srinivasan K. Antenatal Depressive Symptoms and Neurodevelopment Outcomes in Children at 30 Months. A Study From South India. Front Psychiatry 2020; 11:486175. [PMID: 33192637 PMCID: PMC7541826 DOI: 10.3389/fpsyt.2020.486175] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Prevalence of antenatal depression in low and middle income countries is high. However studies examining the association between maternal antenatal depression and early childhood development from these countries are scarce. The objective of the study was to examine the association between antenatal depressive symptoms assessed serially during pregnancy and child neurodevelopment outcomes in mother-child dyads part of a randomized control trial of maternal B12 supplementation during pregnancy. METHOD Subjects were 203 women who had participated in the placebo-controlled, randomized trial of vitamin B12 supplementation during pregnancy and 6 weeks post-partum on whom serial assessments of depressive symptoms in each of the trimesters were available. Cognitive, receptive language, expressive language, fine motor skills and gross motor skills were assessed at 30 months using the Bayley's Scale of Infant Development-3rd edition (BSID-III). Antenatal depressive symptoms were assessed at three trimesters using the Kessler's 10 Psychological Distress Scale (K10). Women were classified into three categories: not depressed (K10 <6 in all trimesters), with intermittent depressive symptoms (K10 ≥6 in at least one trimester) and with persistent depressive symptoms (K10 score ≥6 in at least 2 trimesters). RESULTS 112 (55.2%) of the women did not have depressive symptoms, 58 (28.6%) had intermittent depressive symptoms and 33 (16.2%) had persistent depressive symptoms. The children of women with intermittent antenatal depressive symptoms scored lower on the receptive language domain on BSID-III compared to children of women who were not depressed on univariate analysis, but not on bivariate regression analysis. Women with persistent depressive symptoms had lower educational attainment (p = 0.004), lower social support (p = 0.006) and used more emotional coping strategies (p = 0.005) compared to the not depressed group. CONCLUSIONS A significant number of women in south India had antenatal depressive symptoms. Findings from this study suggest a possible association between antenatal depressive symptoms and receptive language in children. Larger studies including women with clinical depression are needed to confirm these findings.
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Affiliation(s)
- Susan Thomas
- Division of Mental Health & Neurosciences, St John's Research Institute, Bengaluru, India
| | - Emelia Vigil
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Tinku Thomas
- Division of Epidemiology, Biostatistics and Population Health, St John's Research Institute, Bengaluru, India
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Asha Ramthal
- Division of Mental Health & Neurosciences, St John's Research Institute, Bengaluru, India
| | - Anura V Kurpad
- Division of Nutrition, St John's Research Institute, Bengaluru, India.,Department of Physiology, St Johns Medical College, Bengaluru, India
| | - Christopher P Duggan
- Division of Nutrition, St John's Research Institute, Bengaluru, India.,Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, United States
| | - Krishnamachari Srinivasan
- Division of Mental Health & Neurosciences, St John's Research Institute, Bengaluru, India.,Department of Psychiatry, St John's Medical College, Bengaluru, India
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19
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MacGinty RP, Kariuki SM, Barnett W, Wedderburn CJ, Hardy A, Hoffman N, Newton CR, Zar HJ, Donald KA, Stein DJ. Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort. Compr Psychiatry 2020; 96:152128. [PMID: 31715335 PMCID: PMC6945113 DOI: 10.1016/j.comppsych.2019.152128] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Antenatal maternal psychological distress is common in low and middle-income countries (LMIC), but there is a dearth of research on its effect on birth and developmental outcomes in these settings, particularly in Sub-Saharan Africa. This study set out to identify risk factors for antenatal maternal psychological distress and determine whether antenatal maternal psychological distress was associated with infant birth and developmental outcomes, using data from the Drakenstein Child Health Study (DCHS), a birth cohort study in South Africa. METHODS Pregnant women were enrolled in the DCHS from primary care antenatal clinics. Antenatal maternal psychological distress was measured using the Self-Reporting Questionnaire 20-item (SRQ-20). A range of psychosocial measures, including maternal childhood trauma, depression, and posttraumatic stress disorder (PTSD) were administered. Birth outcomes, including premature birth, weight-for-age z-score and head circumference-for-age z-score, were measured using revised Fenton growth charts. The Bayley III Scales of Infant and Toddler Development was administered at 6 months of age to assess infant development outcomes, including cognitive, language, and motor domains in a subset of n=231. Associations of maternal antenatal psychological distress with psychosocial measures, and with infant birth and developmental outcomes were examined using linear regression models. RESULTS 961 women were included in this analysis, with 197 (21%) reporting scores indicating the presence of psychological distress. Antenatal psychological distress was associated with maternal childhood trauma, antenatal depression, and PTSD, and inversely associated with partner support. No association was observed between antenatal maternal psychological distress and preterm birth or early developmental outcomes, but antenatal maternal psychological distress was associated with a smaller head circumference at birth (coefficient=-0.30, 95% CI: -0.49; -0.10). CONCLUSION Antenatal maternal psychological distress is common in LMIC settings and was found to be associated with key psychosocial measures during pregnancy, as well as with adverse birth outcomes, in our study population. These associations highlight the potential value of screening for antenatal maternal psychological distress as well as of developing targeted interventions.
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Affiliation(s)
- R P MacGinty
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa.
| | - S M Kariuki
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, UK
| | - W Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa
| | - C J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - A Hardy
- Statistical Consulting Service, Department of Statistical Science, University of Cape Town, South Africa
| | - N Hoffman
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
| | - C R Newton
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, UK
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa
| | - K A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - D J Stein
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk & Resilience in Mental Disorders, South Africa
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20
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Abstract
Early Life Stress Stress and daily hassles are a normal part of day-to day-life. The amount of control that is experienced strongly contributes to resilience and coping. Children very frequently do not experience control over the stressors within their lives. Starting from pregnancy, they are subjected - via the maternal endocrine system - to a variety of stressors ranging from normal stress regarding the transition to parenthood to maternal abuse or torture. This article collects research of the last two decades regarding the influence of stress on the developing brain. Both, animal and human studies will shed light on the effect of pre- and postnatal stress demonstrating an influence of early life stressors reaching far into adulthood. A direct influence of stress on multiple developmental characteristics has been postulated and shown. The results of this review will underline the necessity of early life programs focusing stress reduction and resilience in children and their parents. Also, a need for programs targeting stress reduction in pregnancy will be demonstrated and emphasized.
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21
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D'Souza S, Crawford CN, Buckley J, Underwood L, Peterson ER, Bird A, Morton SMB, Waldie KE. Antenatal determinants of early childhood talking delay and behavioural difficulties. Infant Behav Dev 2019; 57:101388. [PMID: 31634704 DOI: 10.1016/j.infbeh.2019.101388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022]
Abstract
The determinants of talking delay alone or its comorbidity with behavioural difficulties was examined in 5768 two-year-old members of the Growing Up in New Zealand longitudinal study. Using the MacArthur-Bates Communicative Development inventories and the total difficulties score from the preschool Strengths and Difficulties Questionnaire, a composite measure was created so that children were categorised as showing no language or behavioural concerns (72.5%), behavioural only difficulties (6.1%), language only difficulties (18.1%), and comorbid language and behavioural difficulties (3.3%). Analyses revealed that antenatal factors such as maternal perceived stress, inadequate folate intake, vitamin intake, alcohol consumption during the first trimester and maternal smoking all had a significant effect on child outcomes. In particular, low multivitamin intake and perceived stress during pregnancy were associated with coexisting language and behavioural difficulties. These findings support international research in showing that maternal factors during pregnancy are associated with developmental outcomes in the early childhood period, and demonstrate these associations within a NZ context. Interventions which address maternal stress management and health behaviours during pregnancy could be beneficial to offspring development.
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Affiliation(s)
- Stephanie D'Souza
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | | | - Jude Buckley
- School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Amy Bird
- School of Psychology, University of Wollongong, NSW, Australia
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.
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Grigoriadis S, Graves L, Peer M, Mamisashvili L, Tomlinson G, Vigod SN, Dennis CL, Steiner M, Brown C, Cheung A, Dawson H, Rector NA, Guenette M, Richter M. A systematic review and meta-analysis of the effects of antenatal anxiety on postpartum outcomes. Arch Womens Ment Health 2019; 22:543-556. [PMID: 30523416 DOI: 10.1007/s00737-018-0930-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/13/2018] [Indexed: 01/14/2023]
Abstract
To systematically review and meta-analyze research investigating the association between maternal anxiety during pregnancy and outcomes for mother and baby following the immediate delivery period. MEDLINE, Medline In-Process & Other Non-Indexed Citations, PsycINFO, Embase, CINAHL, and the Cochrane library were searched. English-language, prospective studies providing data on outcomes following delivery in women with and without antenatal anxiety (defined by clinical diagnosis or score on validated scale) were included. Three-hundred-fifty-eight articles were retrieved and 13 were included. Titles and abstracts were screened; two reviewers independently reviewed full text articles, conducted quality assessments, extracted, and checked the data. Where available for > 2 studies, random effect meta-analysis was conducted and heterogeneity was quantified. Subanalyses explored moderators, regardless of heterogeneity, including type of anxiety assessment and timing, among others. There were two outcomes that were amenable to meta-analysis. Antenatal anxiety was significantly associated with postpartum depression (PPD) measured within 6 months postpartum (pooled odds ratio [OR] = 2.64, 95% CI 2.02-3.46; 8 studies), regardless of restricting analyses to those studies controlling for prenatal depression (2.45, 1.77-3.39; 6 studies). Associations were also significant when PPD was measured at 1-3 months (2.57, 1.94-3.40; 7 studies) and 6-10 months (4.42, 1.45-13.49; 3 studies). Maternal anxiety was also associated with reduced odds of breastfeeding (0.63, 0.53-0.74; 5 studies). Antenatal anxiety is associated with PPD up to the first 10 months, independent of prenatal depression, and with lower odds of breastfeeding.
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Affiliation(s)
- Sophie Grigoriadis
- Department of Psychiatry, Sunnybrook Health Sciences Centre and the University of Toronto, FG29 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. .,Women's Mood and Anxiety Clinic: Reproductive Transitions, Department of Psychiatry, FG 29, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.
| | - Lisa Graves
- Department of Family and Community Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, 49008-8017, USA
| | - Miki Peer
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, F111 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Lana Mamisashvili
- Evaluative Clinical Sciences, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, F111 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - George Tomlinson
- Biostatistics and Department of Medicine, Toronto General Hospital and the University of Toronto, Eaton North 13th Fl., Rm. 238 - 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada
| | - Simone N Vigod
- Department of Psychiatry, Women's College Hospital and the University of Toronto, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
| | - Meir Steiner
- Departments of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton and McMaster University, West 5th Campus, 100 West 5th St., Level 1 - Room G112, Hamilton, ON, L8N 3K7, Canada
| | - Cara Brown
- Department of Psychiatry, University of Toronto, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
| | - Amy Cheung
- Department of Psychiatry, Sunnybrook Health Sciences Centre and the University of Toronto, FG29 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Hiltrud Dawson
- Health Promotion Consultant, Health Nexus, 180 Dundas Street West, Suite 301, Toronto, ON, M5G 1Z8, Canada
| | - Neil A Rector
- Department of Psychiatry, Sunnybrook Health Sciences Centre and the University of Toronto, FG29 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Melanie Guenette
- Division of Neurology, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Margaret Richter
- Department of Psychiatry, Sunnybrook Health Sciences Centre and the University of Toronto, FG29 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
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23
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Abazarnejad T, Ahmadi A, Nouhi E, Mirzaee M, Atghai M. Effectiveness of psycho-educational counseling on anxiety in preeclampsia. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 41:276-282. [PMID: 31390458 DOI: 10.1590/2237-6089-2017-0134] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 02/04/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Preeclampsia is a serious complication during pregnancy that not only influences maternal and fetal physical health, but also has maternal mental health outcomes such as anxiety. Prenatal anxiety has negative short- and long-term effects on pre- and postpartum maternal mental health, delivery, and mental health in subsequent pregnancies. OBJECTIVE To investigate the effectiveness of individual psycho-educational counseling on anxiety in pregnant women with preeclampsia. METHODS This was a randomized, intervention-controlled study involving two governmental hospitals in the municipality of Sirjan, Kerman, from January 30 2017 to March 31 2017. A total of 44 pregnant women with preeclampsia were assessed. The women were randomized into two groups: control (n=22) and intervention (n=22). The intervention consisted of two sessions of individual psycho-educational counseling. The level of anxiety was measured using the Spielberger State-Trait Anxiety Inventory (STAI) as pretest before the first session and as posttest after the second session during the hospitalization period. RESULTS There was a significant reduction in the anxiety level after the counselling sessions in the intervention group (p<0.005). In addition, there was a slight increase in the anxiety level in the control group after the study. CONCLUSION According to the results, psycho-educational counseling can significantly reduce the anxiety level in pregnant women with preeclampsia. Therefore, it is recommended that healthcare providers provide this type of therapeutic intervention for pregnant women after hospitalization, in order to reduce their anxiety level and its subsequent negative outcomes. Clinical trial registration: IRCT2017082029817N3.
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Affiliation(s)
- Tayebe Abazarnejad
- Student Research Committee, Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Atefeh Ahmadi
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Esmat Nouhi
- Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Moghaddameh Mirzaee
- Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Monavare Atghai
- Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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24
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Polte C, Junge C, von Soest T, Seidler A, Eberhard-Gran M, Garthus-Niegel S. Impact of Maternal Perinatal Anxiety on Social-Emotional Development of 2-Year-Olds, A Prospective Study of Norwegian Mothers and Their Offspring : The Impact of Perinatal Anxiety on Child Development. Matern Child Health J 2019; 23:386-396. [PMID: 30610530 DOI: 10.1007/s10995-018-2684-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Introduction Anxiety in women is highly prevalent during pregnancy and in the postnatal period. Anxiety disorders in mothers have been linked to adverse outcomes in their children's development. However, large-scale prospective studies on this issue, covering both the prenatal and postnatal period with follow-up periods beyond the first year of life are scarce. Method In this prospective cohort study, data gathered from 1336 Norwegian women and their children were used. Maternal anxiety symptoms were measured at gestation week 17-19 and 32, as well as 8 weeks postpartum using the Symptom Check List. Child development problems were assessed at 2 years postpartum using the Ages & Stages Questionnaire: Social-Emotional. Logistic regressions were conducted to examine the association between maternal prenatal, postnatal, and perinatal anxiety and the risk of social-emotional development problems in 2-year-old children. Results Of all women, 8.2% experienced prenatal anxiety, 4.0% had postnatal anxiety, and 4.4% reported perinatal anxiety (i.e., anxiety in both the prenatal and postnatal period). 5.6% of the 2-year-olds showed problems in their social-emotional behavior. Child development problems were associated with maternal prenatal anxiety (Odds Ratio [OR] = 2.48, 95% CI 1.55-4.92), postnatal anxiety (OR 3.32, 95% CI 1.43-7.74), and anxiety both in the prenatal and postnatal period (OR 3.98, 95% CI 1.85-8.56). Adjusted for confounders, maternal anxiety continued to be a significant predictor of adverse child social-emotional development (postnatal anxiety: OR 2.46, 95% CI 1.01-5.97; perinatal anxiety: OR 2.40, 95% CI 1.03-5.59). Discussion Maternal postnatal anxiety and anxiety both during and after pregnancy are unique substantial predictors for problems in a 2-year-old's social-emotional development, even when controlled for confounders.
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Affiliation(s)
- Carolin Polte
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Carolin Junge
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | | | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Malin Eberhard-Gran
- Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway.,Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Campus Ahus, Lørenskog, Norway.,Department for Infant Mental Health, Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Susan Garthus-Niegel
- Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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25
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Prenatal depression, fetal neurobehavior, and infant temperament: Novel insights on early neurodevelopment from a socioeconomically disadvantaged Indian cohort. Dev Psychopathol 2018; 30:725-742. [PMID: 30068420 DOI: 10.1017/s0954579418000615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This article extends the research focusing on the early origins of psychopathology into the prenatal period, by exploring the association between maternal prenatal depression and offspring (fetal and infant) neurobehavior. The sample is recruited from a rural population in South India where women in the third trimester of pregnancy were assessed for depression and the heart rate responses of their fetuses to extrinsically applied vibroacoustic stimuli were studied. At 2 months postbirth, infant temperament and cortisol responsivity to immunization were assessed. The association between maternal prenatal depression and fetal responsivity to vibroacoustic stimulation, and infant responsivity to immunization, was U shaped with higher levels of responsivity noted in the offspring of mothers with very high and very low depression scores, and lower levels noted in the offspring of mothers with moderate depression scores. Maternal prenatal depression was not associated with infant temperament. The findings highlight the importance of environmental influences in the developmental origins of neurobehavior, suggesting that such differences, not evident at baseline, may emerge upon exposure to stressors. The study also emphasizes the need for further investigation in low- and middle-income contexts by providing preliminary evidence of the differing patterns of association observed between high- and low-income populations.
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26
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Cortes Hidalgo AP, Neumann A, Bakermans-Kranenburg MJ, Jaddoe VWV, Rijlaarsdam J, Verhulst FC, White T, van IJzendoorn MH, Tiemeier H. Prenatal Maternal Stress and Child IQ. Child Dev 2018; 91:347-365. [PMID: 30376186 DOI: 10.1111/cdev.13177] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The evidence for negative influences of maternal stress during pregnancy on child cognition remains inconclusive. This study tested the association between maternal prenatal stress and child intelligence in 4,251 mother-child dyads from a multiethnic population-based cohort in the Netherlands. A latent factor of prenatal stress was constructed, and child IQ was tested at age 6 years. In Dutch and Caribbean participants, prenatal stress was not associated with child IQ after adjustment for maternal IQ and socioeconomic status. In other ethnicities no association was found; only in the Moroccan/Turkish group a small negative association between prenatal stress and child IQ was observed. These results suggest that prenatal stress does not predict child IQ, except in children from less acculturated minority groups.
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Affiliation(s)
| | | | | | | | | | | | - Tonya White
- Erasmus MC - University Medical Center Rotterdam
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27
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Madigan S, Oatley H, Racine N, Fearon RMP, Schumacher L, Akbari E, Cooke JE, Tarabulsy GM. A Meta-Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development. J Am Acad Child Adolesc Psychiatry 2018; 57:645-657.e8. [PMID: 30196868 DOI: 10.1016/j.jaac.2018.06.012] [Citation(s) in RCA: 247] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/23/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Observed associations between maternal prenatal stress and children's socioemotional development have varied widely in the literature. The objective of the current study was to provide a synthesis of studies examining maternal prenatal anxiety and depression and the socioemotional development of their children. METHOD Eligible studies through to February 2018 were identified using a comprehensive search strategy. Included studies examined the association between maternal prenatal depression or anxiety and the future development of their children's socioemotional development (eg, difficult temperament, behavioral dysregulation) up to 18 years later. Two independent coders extracted all relevant data. Random-effects meta-analyses were used to derive mean effect sizes and test for potential moderators. RESULTS A total of 71 studies met full inclusion criteria for data analysis. The weighted average effect size for the association between prenatal stress and child socioemotional problems was as follows: odds ratio (OR) = 1.66 (95% CI = 1.54-1.79). Effect sizes were stronger for depression (OR = 1.79; 95% CI = 1.61-1.99) compared to anxiety (OR = 1.50; 95% CI = 1.36-1.64). Moderator analyses indicated that effect sizes were stronger when depression was more severe and when socio-demographic risk was heightened. CONCLUSION Findings suggest that maternal prenatal stress is associated with offspring socioemotional development, with the effect size for prenatal depression being more robust than for anxiety. Mitigating stress and mental health difficulties in mothers during pregnancy may be an effective strategy for reducing offspring behavioral difficulties, especially in groups with social disadvantage and greater severity of mental health difficulties.
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Affiliation(s)
| | - Hannah Oatley
- Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | - Emis Akbari
- George Brown College, Toronto, Ontario, Canada
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28
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Haselbeck C, Niederberger U, Gubi-Kelm S, Jahn F, Dautwiz F, Siniatchkin M. Secure attachment style appears to compensate for the effect of prenatal maternal distress regarding difficult infant temperament development. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2018; 47:239-251. [PMID: 30080118 DOI: 10.1024/1422-4917/a000606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: Secure attachment style is a known protective factor regarding psychopathological development. The infant's attachment style, which is developed during the first two years of life, is therefore considered a moderating factor on the association between prenatal maternal distress and child temperament development which has repeatedly been reported in previous studies. Method: In this longitudinal study on a new sample of 51 mother-child-dyads, reported maternal distress and maternal empathy were assessed during pregnancy. Infant temperament and motor development were assessed at 12 months, while additionally controlling for the infant's attachment style as a postnatal factor. Results: Infants with secure attachment style whose mothers had experienced higher prenatal distress showed slightly better gross motor development at the age of 12 months. No association could be found between prenatal maternal distress and infant temperament. Conclusions: The results support the view that secure attachment style in children is a protective factor and softens the effects of prenatal maternal distress on difficult temperament development.
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Affiliation(s)
- Christin Haselbeck
- 1 Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus, Kiel, Germany
| | - Uwe Niederberger
- 1 Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus, Kiel, Germany
| | - Silvia Gubi-Kelm
- 2 Department of Psychology, Medical School Hamburg, Hamburg, Germany
| | - Franziska Jahn
- 1 Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus, Kiel, Germany
| | - Friederike Dautwiz
- 1 Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus, Kiel, Germany
| | - Michael Siniatchkin
- 1 Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus, Kiel, Germany
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29
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Soares-Cunha C, Coimbra B, Borges S, Domingues AV, Silva D, Sousa N, Rodrigues AJ. Mild Prenatal Stress Causes Emotional and Brain Structural Modifications in Rats of Both Sexes. Front Behav Neurosci 2018; 12:129. [PMID: 30034328 PMCID: PMC6043801 DOI: 10.3389/fnbeh.2018.00129] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/07/2018] [Indexed: 12/16/2022] Open
Abstract
Stress or high levels of glucocorticoids (GCs) during developmental periods is known to induce persistent effects in the neuroendocrine circuits that control stress response, which may underlie individuals’ increased risk for developing neuropsychiatric conditions later in life, such as anxiety or depression. We developed a rat model (Wistar han) of mild exposure to unpredictable prenatal stress (PS), which consists in a 4-h stressor administered three times per week on a random basis; stressors include strobe lights, noise and restrain. Pregnant dams subjected to this protocol present disrupted circadian corticosterone secretion and increased corticosterone secretion upon acute stress exposure. Regarding progeny, both young adult (2 months old) male and female rats present increased levels of circulating corticosterone and hyperactivity of the hypothalamus-pituitary-adrenal axis to acute stress exposure. Both sexes present anxious- and depressive-like behaviors, shown by the decreased time spent in the open arms of the elevated plus maze (EPM) and in the light side of the light-dark box (LDB), and by increased immobility time in the forced swim test, respectively. Interestingly, these results were accompanied by structural modifications of the bed nucleus of stria terminalis (BNST) and hippocampus, as well as decreased norepinephrine and dopamine levels in the BNST, and serotonin levels in the hippocampus. In summary, we characterize a new model of mild PS, and show that stressful events during pregnancy can lead to long-lasting structural and neurochemical effects in the offspring, which affect behavior in adulthood.
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Affiliation(s)
- Carina Soares-Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Bárbara Coimbra
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Sónia Borges
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ana Verónica Domingues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Deolinda Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
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30
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Chheang D, Connolly EJ. A Review of the Historical, Criminological, and Theoretical Understandings of the Cambodian American Population: A Call for More Comprehensive Research. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:2624-2649. [PMID: 28929837 DOI: 10.1177/0306624x17732579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The collective view of Asian Americans as model minorities is evident with the extensive amount of statistical data showing support for the academic and socioeconomic success of Asian Americans in the United States. This perception, however, often presents an inaccurate portrayal of Asian Americans, in general, as it overlooks many of the difficulties and hardships experienced by Asian American ethnic groups such as Southeast Asians. Within this group, Cambodian Americans are at the highest risk for experiencing socioeconomic hardships, behavioral health problems, substance use disorders, and contact with the criminal justice system, with deportation also being a prevailing issue. Unfortunately, research in this area is scant and contemporary research on Cambodian Americans has several limitations. To begin to address this issue, the present article merges information from existing research on this population from a sociohistorical, criminological, and theoretical standpoint to call for more comprehensive research on Cambodian Americans.
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31
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Moss KM, Simcock G, Cobham VE, Kildea S, Laplante DP, King S. Continuous, emerging, and dissipating associations between prenatal maternal stress and child cognitive and motor development: The QF2011 Queensland Flood Study. Early Hum Dev 2018. [PMID: 29529544 DOI: 10.1016/j.earlhumdev.2018.02.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Katrina M Moss
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia; Mater Research, The University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia.
| | - Gabrielle Simcock
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia; Mater Research, The University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia.
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia; Mater Research, The University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia.
| | - Sue Kildea
- School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, QLD 4072, Australia.
| | - David P Laplante
- Douglas Hospital Research Centre, 6875 LaSalle Boulevard, Montreal, Quebec H4H 1R3, Canada.
| | - Suzanne King
- Douglas Hospital Research Centre, 6875 LaSalle Boulevard, Montreal, Quebec H4H 1R3, Canada; McGill University, Department of Psychiatry, Montreal, Quebec, Canada.
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32
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Evaluating Stress during Pregnancy: Do We Have the Right Conceptions and the Correct Tools to Assess It? J Pregnancy 2018; 2018:4857065. [PMID: 29484210 PMCID: PMC5816839 DOI: 10.1155/2018/4857065] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/19/2017] [Indexed: 01/08/2023] Open
Abstract
Gestational stress is believed to increase the risk of pregnancy failure and perinatal and adult morbidity and mortality in both the mother and her child or children. However, some contradictions might arise from methodological issues or even from differences in the philosophical grounds that guide the studies on gestational stress. Biased perspectives could lead us to use and/or design inadequate/incomplete panels of biochemical determinations and/or psychological instruments to diagnose it accurately during pregnancy, a psychoneuroimmune-endocrine state in which allostatic loads may be significant. Here, we review these notions and propose a model to evaluate and diagnose stress during pregnancy.
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33
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Greene MM, Rossman B, Meier P, Patra K. Elevated maternal anxiety in the NICU predicts worse fine motor outcome in VLBW infants. Early Hum Dev 2018; 116:33-39. [PMID: 29127891 PMCID: PMC8114942 DOI: 10.1016/j.earlhumdev.2017.10.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/15/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
Abstract
AIM The literature is sparse with respect to the impact of elevated maternal psychological distress in the neonatal intensive care unit (NICU) on later neurodevelopmental outcome in VLBW infants. The objective of this study is to examine the impact of elevated maternal distress, defined as elevated depression, anxiety and perinatal-specific post-traumatic stress, during the NICU hospitalization on VLBW infant ND outcome at 20months corrected age (CA). METHODS This was a prospective study of 69 mothers and their VLBW infants recruited in 2011-2012. Elevated maternal distress was collected by maternal questionnaire in the NICU. Elevated depression was quantified with the Center for Epidemiological Studies-Depression Scale, anxiety with the Spielberger State-Trait Anxiety Inventory and perinatal-specific post-traumatic stress with the Modified Perinatal Posttraumatic Stress Disorder Questionnaire. VLBW infant ND outcome was assessed using the Bayley Scales of Infant & Toddler Development-III at 20months CA. Regression analyses determined the impact of elevated distress on ND outcome after adjusting for infant medical and maternal sociodemographic variables. RESULTS After controlling for infant and maternal covariates, elevated maternal anxiety in the NICU predicted lower fine motor scores at 20months CA. CONCLUSION Elevated maternal anxiety in the NICU is associated with adverse ND outcome in VLBW infants in the 2nd year of life. NICU-based support services may help mothers' quality of life and VLBW infant outcome.
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Affiliation(s)
- Michelle M. Greene
- Department of Behavioral Sciences, Rush University Medical Center, 1653 W Congress Parkway, 1200 Kellogg Building, Chicago, IL 60612, United States,Department of Pediatrics, Rush University Medical Center, 1653 W Congress Parkway, 1200 Kellogg Building, Chicago, IL 60612, United States,Corresponding author at: Department of Pediatrics, Rush University Medical Center, 1653 W Congress Parkway, 1200 Kellogg Building, Chicago, IL 60612, United States. (M.M. Greene)
| | - Beverly Rossman
- College of Nursing, Rush University Medical Center, Chicago, IL, United States
| | - Paula Meier
- College of Nursing, Rush University Medical Center, Chicago, IL, United States
| | - Kousiki Patra
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
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34
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Reck C, Van Den Bergh B, Tietz A, Müller M, Ropeter A, Zipser B, Pauen S. Maternal avoidance, anxiety cognitions and interactive behaviour predicts infant development at 12 months in the context of anxiety disorders in the postpartum period. Infant Behav Dev 2017; 50:116-131. [PMID: 29272744 DOI: 10.1016/j.infbeh.2017.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/21/2017] [Accepted: 11/21/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Few studies have examined the relation between anxiety disorders in the postpartum period and cognitive as well as language development in infancy. AIMS This longitudinal study investigated whether anxiety disorder in the postpartum period is linked to infant development at twelve months. A closer look was also taken at a possible link between maternal interaction and infant development. STUDY DESIGN Subjects were videotaped during a Face-to-Face-Still-Face interaction with their infant (M = 4.0 months). Specific maternal anxiety symptoms were measured by self-report questionnaires (Anxiety Cognition Questionnaire (ACQ), Body Sensations Questionnaire (BSQ), Mobility Inventory (MI)) to check for a connection with infant development. The Bayley Scales of Infant and Toddler Development-III (Bayley-III) were used to assess infant language and cognitive development at one year of age. SUBJECTS n = 34 mothers with anxiety disorder (SCID-I; DSM-IV) and n = 47 healthy mothers with their infant. OUTCOME MEASURES Infant performance on Bayley-III language and cognitive scales. RESULTS Infants of mothers with anxiety disorder yielded significantly lower language scores than infants of controls. No significant group differences were found regarding infant cognitive development. Exploratory analyses revealed the vital role of "maternal avoidance accompanied" in infant language and cognitive development. Maternal neutral engagement, which lacks positive affect and vocalisations, turned out as the strongest negative predictor of cognitive development. Maternal anxiety cognitions and joint activity in mother-infant interaction were the strongest predictors of infant language performance. CONCLUSIONS Results underline the importance to also consider the interaction behaviour of women with anxiety disorders to prevent adverse infant development.
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Affiliation(s)
- C Reck
- Ludwig-Maximilians University, Department of Psychology, Munich, Germany.
| | - B Van Den Bergh
- Tilburg University, Department of Developmental Psychology, Netherlands
| | - A Tietz
- Heidelberg University Hospital, General Psychiatry, Heidelberg, Germany
| | - M Müller
- Ludwig-Maximilians University, Department of Psychology, Munich, Germany
| | - A Ropeter
- University of Heidelberg, Department of Psychology, Heidelberg, Germany
| | - B Zipser
- Heidelberg University Hospital, General Psychiatry, Heidelberg, Germany
| | - S Pauen
- University of Heidelberg, Department of Psychology, Heidelberg, Germany
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35
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Dennis CL, Brown HK. Psychosocial, psychological, and pharmacological interventions for treating antenatal anxiety. Hippokratia 2017. [DOI: 10.1002/14651858.cd012870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Cindy-Lee Dennis
- University of Toronto and St. Michael's Hospital; 155 College Street Toronto ON Canada M5T 1P8
| | - Hilary K. Brown
- Women's College Hospital; Psychiatry; 790 Bay Street 7th Floor Toronto ON Canada M5G 1N8
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36
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Leach DM, Terry P, Nikčević AV. The Pregnancy Related Beliefs Questionnaire (PRBQ): An examination of the psychometric properties in perinatal samples. Clin Psychol Psychother 2017; 25:152-162. [PMID: 29094777 DOI: 10.1002/cpp.2149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND Identifying vulnerability to perinatal depression is an important public health issue. Risk factors include general and maternal-specific dysfunctional attitudes. Scales of maternal attitudes have a number of shortcomings. Further, it is not known whether antenatal maternal attitudes predict post-natal depression, independently of general dysfunctional attitudes (GDA). The aim of the current study was to examine the psychometric properties of the Pregnancy Related Beliefs Questionnaire (PRBQ) and to establish, prospectively, the utility of the revised PRBQ in predicting the symptoms of post-natal depression. METHOD In Study 1, a cross-sectional sample of 344 participants, who were either pregnant or in the post-natal period, completed a battery of questionnaires assessing background factors, GDA, attitudes specific to motherhood (PRBQ), and depression. In Study 2, a sample of 210 women completed a battery of questionnaires, including a measure of GDA, the PRBQ-8, and depression, on two occasions: early in the second trimester of pregnancy and post-natally. RESULTS Exploratory and confirmatory factor analyses supported a one-factor, eight-item measure of maladaptive attitudes specific to motherhood (PRBQ-8). The PRBQ-8 was found to have good convergent, concurrent, and predictive validity and high internal and test-retest reliability. A hierarchical regression analysis revealed that antenatal PRBQ-8 scores predict the severity of post-natal depression symptoms, after controlling for background factors, antenatal depression, and GDA. CONCLUSIONS The PRBQ-8 is a psychometrically sound measure of maternal attitudes that can be used antenatally to identify women at risk of post-natal depression.
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Affiliation(s)
- Dawn M Leach
- Department of Psychology, Kingston University, Kingston upon Thames, UK
| | - Philip Terry
- Department of Psychology, Kingston University, Kingston upon Thames, UK
| | - Ana V Nikčević
- Department of Psychology, Kingston University, Kingston upon Thames, UK
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37
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Vujović M, Sovilj M, Jeličić L, Stokić M, Plećaš D, Plešinac S, Nedeljković N. Correlation between maternal anxiety, reactivity of fetal cerebral circulation to auditory stimulation, and birth outcome in normotensive and gestational hypertensive women. Dev Psychobiol 2017; 60:15-29. [PMID: 29091282 DOI: 10.1002/dev.21589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 09/10/2017] [Indexed: 12/17/2022]
Abstract
This study investigated the correlation between maternal anxiety and blood flow changes through the fetal middle cerebral artery (MCA) after defined acoustic stimulation in 43 normotensive (C) and 40 gestational hypertensive (GH) subjects. Neonatal outcomes (gestational age at birth, Apgar score, birth weight) in the C and GH groups were analyzed. State (STAI-S) and trait (STAI-T) anxiety was assessed using Spielberger's questionnaire. The MCA blood flow was assessed once between 28 and 41 weeks of gestation using color Doppler ultrasound before and after application of defined acoustic stimulus. Relative size of the Pulsatility index (Pi) change (RePi) was calculated. The general hypotheses were: (1) women in GH group would have higher anxiety; (2) higher anxiety correlates with higher RePi change and poorer neonatal outcome; (3) fetuses from the GH group would have poorer neonatal outcome. Subjects from the GH group had higher STAI-T and RePi compared to the C group. A positive correlation between RePi and STAI-S, STAI-T, and systolic/diastolic blood pressure was found in both groups. There were more preterm deliveries in the GH group compared to the C group. A significant effect of STAI-T on body weight was observed in the C and GH group. There was a predictive effect of STAI-T and RePi on the C group, and STAI-S, STAI-T, diastolic blood pressure, and RePi on the GH group in terms of neonatal body weight. This study demonstrates an association between antenatal anxiety in GH women and increased fetal cerebral circulation in response to defined auditory stimulation.
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Affiliation(s)
- Marina Vujović
- Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Mirjana Sovilj
- Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia.,Life Activities Advancement Center, Belgrade, Serbia
| | - Ljiljana Jeličić
- Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia.,Life Activities Advancement Center, Belgrade, Serbia
| | - Miodrag Stokić
- Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia.,Life Activities Advancement Center, Belgrade, Serbia
| | - Darko Plećaš
- Clinical Center of Serbia, Medical Faculty, University Clinic for Obstetrics and Gynecology, University of Belgrade, Belgrade, Serbia
| | - Snežana Plešinac
- Clinical Center of Serbia, Medical Faculty, University Clinic for Obstetrics and Gynecology, University of Belgrade, Belgrade, Serbia
| | - Nadežda Nedeljković
- Faculty of Biology, Department for General Physiology and Biophysics, University of Belgrade, Belgrade, Serbia
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38
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Moderating effects of maternal emotional availability on language and cognitive development in toddlers of mothers exposed to a natural disaster in pregnancy: The QF2011 Queensland Flood Study. Infant Behav Dev 2017; 49:296-309. [DOI: 10.1016/j.infbeh.2017.10.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 07/17/2017] [Accepted: 10/20/2017] [Indexed: 12/15/2022]
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Murphy SK, Fineberg AM, Maxwell SD, Alloy LB, Zimmermann L, Krigbaum NY, Cohn BA, Drabick DAG, Ellman LM. Maternal infection and stress during pregnancy and depressive symptoms in adolescent offspring. Psychiatry Res 2017; 257:102-110. [PMID: 28750213 PMCID: PMC5823248 DOI: 10.1016/j.psychres.2017.07.025] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/26/2017] [Accepted: 07/12/2017] [Indexed: 12/21/2022]
Abstract
Maternal infection during pregnancy has been linked to increased risk of offspring depression. Additionally, maternal stress during pregnancy has been consistently linked with adverse offspring outcomes associated with depression. Relatedly, stress has been associated with increased risk of infection; however no study has investigated stress-infection interactions during pregnancy and risk for offspring depression. Participants were drawn from the Child Health and Development Studies (CHDS), a prospective, longitudinal study that enrolled pregnant women from 1959 to 1966. Maternal health and birth outcome information were collected, as well as open-ended interviews about worrisome events during pregnancy. The present study included participants from a subsample of women whose offspring (n = 1711) completed self-reports of depressive symptoms during adolescence. Results indicated that maternal infection during only the second trimester was associated with higher scores on adolescent offspring depressive symptoms, while controlling for maternal education at birth, adolescent age, and maternal depressive symptoms at adolescence. Maternal experiences of daily stress during pregnancy moderated this association, such that mothers diagnosed with second trimester infection and who experienced daily stress had offspring with significantly higher depression scores than mothers of adolescents diagnosed with an infection alone. Findings have potential implications for prevention and intervention strategies.
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Affiliation(s)
| | - Anna M. Fineberg
- Temple University, Department of Psychology, Philadelphia, PA, USA
| | - Seth D. Maxwell
- Temple University, Department of Psychology, Philadelphia, PA, USA
| | - Lauren B. Alloy
- Temple University, Department of Psychology, Philadelphia, PA, USA
| | - Lauren Zimmermann
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA
| | - Nickilou Y. Krigbaum
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA
| | - Barbara A. Cohn
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA
| | | | - Lauren M. Ellman
- Temple University, Department of Psychology, Philadelphia, PA, USA,Corresponding author. Lauren M. Ellman, Ph.D., Temple University, Department of Psychology, Weiss Hall, 1701 North 13 Street, Philadelphia, PA, 19122,
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40
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Effects of combined IUGR and prenatal stress on the development of the hippocampus in a fetal guinea pig model. J Dev Orig Health Dis 2017; 8:584-596. [PMID: 28502262 DOI: 10.1017/s2040174417000307] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Intrauterine growth restriction (IUGR) and maternal stress during pregnancy are two compromises that negatively impact neurodevelopment and increase the risk of developing later life neuropsychiatric disorders such as schizophrenia, depression and behavioural disorders. Neurosteroids, particularly allopregnanolone, are important in protecting the developing brain and promoting many essential neurodevelopmental processes. Individually, IUGR and prenatal stress (PS) reduce myelination and neurogenesis within affected fetal brains, however less information is available on the combined effects of these two disorders on the term fetal brain. This study aimed to investigate how IUGR and PS impairs the neurosteroid pathway when combined using a guinea pig model, and how these then disrupt the neurodevelopment of the fetus. Uterine artery blood flow restriction was performed at GA30-35 to induce growth restriction, whilst PS was induced by exposure of the dam to a strobe light during gestation commencing GA40 and repeated every 5 days. Exposure in this model caused reductions in hippocampal CA1 MBP immunostaining of male fetuses in both IUGR alone and IUGR+PS paradigms but only by IUGR in the subcortical white mater, compared with control males. Plasma allopregnanolone was reduced by both stressors irrespective of sex, whereas GFAP or MAP2 expression were not affected by either stressor. Female neurodevelopment, as assessed by these markers, was unimpeded by these compromises. The addition of prenatal stress did not further compound these deficits.
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41
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Newman L, Judd F, Komiti A. Developmental implications of maternal antenatal anxiety mechanisms and approaches to intervention. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/20017022.2017.1309879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Louise Newman
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Fiona Judd
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Angela Komiti
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
- Centre for Women’s Mental Health, The Royal Women’s Hospital, Parkville, VIC, Australia
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42
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Haselbeck C, Niederberger U, Kulle A, Wache K, Brauner E, Gutermuth M, Holterhus PM, Gerber WD, Siniatchkin M. Prenatal maternal distress seems to be associated with the infant's temperament and motor development: an explorative study. J Neural Transm (Vienna) 2017; 124:881-890. [PMID: 28361282 DOI: 10.1007/s00702-017-1712-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 03/15/2017] [Indexed: 12/31/2022]
Abstract
According to the concept of fetal programming, prenatal distress has long-lasting consequences on the offspring's health later in life. The hypothalamic-pituitary-adrenal axis is considered a mediating system by which maternal distress is transferred to the fetus in intrauterine environment. In this longitudinal explorative study on 30 mother-child-dyads, reported maternal distress and salivary cortisol were collected during pregnancy. Infant temperament, motor and cognitive development were assessed at 16 months. Additionally, infant cortisol levels throughout the day and in reaction to a psycho-social stressor where measured. As expected, infants whose mothers had experienced higher prenatal distress expressed a more difficult temperament and lower fine motor development at 16 months. No association could be shown between prenatal maternal distress and infant salivary cortisol.
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Affiliation(s)
- Christin Haselbeck
- Institute of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein, Campus Kiel, Preußerstraße 1-9, 24105, Kiel, Germany.
| | - Uwe Niederberger
- Institute of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein, Campus Kiel, Preußerstraße 1-9, 24105, Kiel, Germany
| | - Alexandra Kulle
- Department of General Paediatrics, University Hospital of Schleswig-Holstein, Campus Kiel, Schwanenweg 20, 24105, Kiel, Germany
| | - Katharina Wache
- Institute of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein, Campus Kiel, Preußerstraße 1-9, 24105, Kiel, Germany
| | - Ellen Brauner
- Institute of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein, Campus Kiel, Preußerstraße 1-9, 24105, Kiel, Germany
| | - Merlin Gutermuth
- Institute of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein, Campus Kiel, Preußerstraße 1-9, 24105, Kiel, Germany
| | - Paul-Martin Holterhus
- Department of General Paediatrics, University Hospital of Schleswig-Holstein, Campus Kiel, Schwanenweg 20, 24105, Kiel, Germany
| | - Wolf-Dieter Gerber
- Institute of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein, Campus Kiel, Preußerstraße 1-9, 24105, Kiel, Germany
| | - Michael Siniatchkin
- Institute of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein, Campus Kiel, Preußerstraße 1-9, 24105, Kiel, Germany
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43
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Levine TA, Alderdice FA, Grunau RE, McAuliffe FM. Prenatal stress and hemodynamics in pregnancy: a systematic review. Arch Womens Ment Health 2016; 19:721-39. [PMID: 27329120 DOI: 10.1007/s00737-016-0645-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on hemodynamics during pregnancy remains unclear. This systematic review was conducted in order to assess the quality of the evidence available to date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. The PubMed/Medline, EMBASE, PsycINFO, Maternity and Infant Care, Trip, Cochrane Library, and CINAHL databases were searched using the search terms pregnancy; stress; fetus; blood; Doppler; ultrasound. Studies were eligible for inclusion if prenatal stress was assessed with standardized measures, hemodynamics was measured with Doppler ultrasound, and methods were adequately described. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-accepted quality appraisal guidelines. Of 2532 studies reviewed, 12 met the criteria for inclusion. Six reported that prenatal stress significantly affects maternal or fetal hemodynamics; six found no significant association between maternal stress and circulation. Significant relationships between prenatal stress and uterine artery resistance (RI) and pulsatility (PI) indices, umbilical artery RI, PI, and systolic/diastolic ratio, fetal middle cerebral artery PI, cerebroplacental ratio, and umbilical vein volume blood flow were found. To date, there is limited evidence that prenatal stress is associated with changes in circulation. More carefully designed studies with larger sample sizes, repeated assessments across gestation, tighter control for confounding factors, and measures of pregnancy-specific stress will clarify this relationship.
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Affiliation(s)
- Terri A Levine
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Fiona A Alderdice
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Ruth E Grunau
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Child and Family Research Institute, Vancouver, Canada
| | - Fionnuala M McAuliffe
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Northern Ireland.
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44
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Fontein-Kuipers YJ, Ausems M, de Vries R, Nieuwenhuijze MJ. The effect of Wazzup Mama?! An antenatal intervention to prevent or reduce maternal distress in pregnancy. Arch Womens Ment Health 2016; 19:779-88. [PMID: 26965708 DOI: 10.1007/s00737-016-0614-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
Abstract
We evaluated the effect of the intervention WazzUp Mama?! on antenatal maternal distress in a non-randomized pre-post study including healthy women in 17 Dutch midwifery practices. The control group (n = 215) received antenatal care-as-usual. The experimental group (n = 218) received the intervention. Data were collected at the first and third trimester of pregnancy. Maternal distress (MD) was measured with the Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI), and Pregnancy-Related Anxiety Questionnaire (PRAQ). We used multivariate repeated-measure analysis to examine the across time changes and ANCOVA was used to examine the differences between the two groups. In the control group, mean EDS, STAI, and MD scores significantly increased from first to third trimester of pregnancy, mean PRAQ scores increased, but not significantly, the proportion of scores above cut-off level of EDS, STAI, and PRAQ significantly increased from first to third trimester, and the proportion of MD scores above cut-off level increased, but not significantly. Within the experimental group, the mean STAI, PRAQ, and MD scores significantly decreased from first to third trimester, the EDS mean scores decreased but not significantly, proportions of scores above cut-off level for PRAQ and MD significantly decreased from first to third trimester of pregnancy, the proportions of EDS and STAI scores above cut-off level decreased but not significantly. There was a moderate significant positive effect of WazzUP Mama?! on the MD scores (F(1.43) = 27.05, p < 0.001, d = 0.5). The results provide support for the effectiveness of the intervention WazzUp Mama?!
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Affiliation(s)
- Yvonne J Fontein-Kuipers
- Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery Science, PO Box 1256, 6201, Maastricht, The Netherlands.
| | - Marlein Ausems
- Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery Science, PO Box 1256, 6201, Maastricht, The Netherlands
| | - Raymond de Vries
- Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery Science, PO Box 1256, 6201, Maastricht, The Netherlands.,Maastricht University Medical Centre/CAPHRI, PO Box 6202, AZ, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 300 North Ingalis Street, Rm 7C27, Ann Arbor, MI, 48109-5429, USA
| | - Marianne J Nieuwenhuijze
- Midwifery Education & Studies Maastricht-ZUYD, Research Centre for Midwifery Science, PO Box 1256, 6201, Maastricht, The Netherlands
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45
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Le HN, Muñoz RF, Soto JA, Delucchi KL, Ippen CG. Identifying Risk for Onset of Major Depressive Episodes in Low-Income Latinas During Pregnancy and Postpartum. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2016. [DOI: 10.1177/0739986304269165] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to identify subgroups of pregnant women at imminent (1 year) risk for major depressive episodes. Participants were 84 low-income, predominantly Mexican women using public sector obstetrics services who participated in monthly interviews during pregnancy and up to 6 months postpartum. Participants were designated a priori as “more vulnerable” or “less vulnerable” to future perinatal depression based on evidence of mood regulation problems defined as (a) a self-reported history of major depressive episodes, (MDE) and/or (b) high current depressive symptom scores on a continuous depression scale. Two definitions of a major depressive episode based on meeting 2 or 3 DSM-IV MDE criteria, were used to measure the incidence of a new major depressive episode. Results suggest that more vulnerable groups (i.e., with the greatest mood regulation problems) had a higher incidence of major depressive episodes than less vulnerable groups. Implications for screening and developing preventive interventions for postpartum depression are discussed.
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46
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Lebowitz ER, Leckman JF, Silverman WK, Feldman R. Cross-generational influences on childhood anxiety disorders: pathways and mechanisms. J Neural Transm (Vienna) 2016; 123:1053-67. [PMID: 27145763 DOI: 10.1007/s00702-016-1565-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/29/2016] [Indexed: 12/14/2022]
Abstract
Anxiety disorders are common across the lifespan, cause severe distress and impairment, and usually have their onset in childhood. Substantial clinical and epidemiological research has demonstrated the existence of links between anxiety and its disorders in children and parents. Research on the pathways and mechanisms underlying these links has pointed to both behavioral and biological systems. This review synthesizes and summarizes several major aspects of this research. Behavioral systems include vicarious learning, social referencing, and modeling of parental anxiety; overly protective or critical parenting styles; and aspects of parental responses to child anxiety including family accommodation of the child's symptoms. Biological systems include aspects of the prenatal environment affected by maternal anxiety, development and functioning of the oxytocinergic system, and genetic and epigenetic transmission. Implications for the prevention and treatment of child anxiety disorders are discussed, including the potential to enhance child anxiety treatment outcomes through biologically informed parent-based interventions.
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Affiliation(s)
- Eli R Lebowitz
- Yale Child Study Center, 230 S. Frontage Rd., New Haven, CT, 06515, USA.
| | - James F Leckman
- Yale Child Study Center, 230 S. Frontage Rd., New Haven, CT, 06515, USA
| | - Wendy K Silverman
- Yale Child Study Center, 230 S. Frontage Rd., New Haven, CT, 06515, USA
| | - Ruth Feldman
- Gonda Brain Research, Bar Ilan University, Ramat Gan, Israel
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47
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Fallon V, Bennett KM, Harrold JA. Prenatal Anxiety and Infant Feeding Outcomes: A Systematic Review. J Hum Lact 2016; 32:53-66. [PMID: 26342007 DOI: 10.1177/0890334415604129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 08/11/2015] [Indexed: 11/15/2022]
Abstract
Prenatal anxiety may negatively affect infant health in multiple domains, including infant feeding. However, the relationship between prenatal anxiety and infant feeding is not well understood. Given the benefits of recommended infant feeding practices, clarifying this relationship is important. This review was conducted to examine the relationship between prenatal anxiety and infant feeding outcomes. Electronic searches were performed in relevant databases. A hand search of selected journals and reference lists of included articles was then conducted. All studies were considered that provided information related to infant feeding outcomes and anxiety during pregnancy. Quality assessment and data extraction were conducted by 2 reviewers; 99 studies were identified, of which 6 were eligible. No associations were found between prenatal anxiety and breastfeeding initiation or breastfeeding in any quantity. However, relationships between high levels of prenatal anxiety and a reduction in both breastfeeding intention and breastfeeding exclusivity were identified. The review was limited by the small number of studies included. Sample sizes lacking power and heterogeneous measures and definitions all significantly affected the comparability of findings. It is concluded that there is insufficient evidence to clarify the relationship between prenatal anxiety and infant feeding outcomes.
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48
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Müller M, Tronick E, Zietlow AL, Nonnenmacher N, Verschoor S, Träuble B. Effects of Maternal Anxiety Disorders on Infant Self-Comforting Behaviors: The Role of Maternal Bonding, Infant Gender and Age. Psychopathology 2016; 49:295-304. [PMID: 27576511 DOI: 10.1159/000448404] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/13/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS We investigated the links between maternal bonding, maternal anxiety disorders, and infant self-comforting behaviors. Furthermore, we looked at the moderating roles of infant gender and age. METHODS Our sample (n = 69) comprised 28 mothers with an anxiety disorder (according to DSM-IV criteria) and 41 controls, each with their 2.5- to 8-month-old infant (41 females and 28 males). Infant behaviors were recorded during the Face-to-Face Still-Face paradigm. Maternal bonding was assessed by the Postpartum Bonding Questionnaire. RESULTS Conditional process analyses revealed that lower maternal bonding partially mediated between maternal anxiety disorders and increased self-comforting behaviors but only in older female infants (over 5.5 months of age). However, considering maternal anxiety disorders without the influence of bonding, older female infants (over 5.5 months of age) showed decreased rates of self-comforting behaviors, while younger male infants (under 3 months of age) showed increased rates in the case of maternal anxiety disorder. CONCLUSIONS The results suggest that older female infants (over 5.5 months of age) are more sensitive to lower maternal bonding in the context of maternal anxiety disorders. Furthermore, results suggest a different use of self-directed regulation strategies for male and female infants of mothers with anxiety disorders and low bonding, depending on infant age. The results are discussed in the light of gender-specific developmental trajectories.
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Affiliation(s)
- Mitho Müller
- Department of Psychology, Ludwig Maximilian University Munich, Munich, Germany
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49
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Fontein-Kuipers Y, Ausems M, Budé L, Van Limbeek E, De Vries R, Nieuwenhuijze M. Factors influencing maternal distress among Dutch women with a healthy pregnancy. Women Birth 2015; 28:e36-43. [DOI: 10.1016/j.wombi.2015.02.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 02/05/2015] [Accepted: 02/11/2015] [Indexed: 01/19/2023]
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50
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Dettmer AM, Rosenberg KL, Suomi SJ, Meyer JS, Novak MA. Associations between Parity, Hair Hormone Profiles during Pregnancy and Lactation, and Infant Development in Rhesus Monkeys (Macaca mulatta). PLoS One 2015; 10:e0131692. [PMID: 26172048 PMCID: PMC4501543 DOI: 10.1371/journal.pone.0131692] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 06/05/2015] [Indexed: 11/18/2022] Open
Abstract
Studies examining hormones throughout pregnancy and lactation in women have been limited to single, or a few repeated, short-term measures of endocrine activity. Furthermore, potential differences in chronic hormonal changes across pregnancy/lactation between first-time and experienced mothers are not well understood, especially as they relate to infant development. Hormone concentrations in hair provide long-term assessments of hormone production, and studying these measures in non-human primates allows for repeated sampling under controlled conditions that are difficult to achieve in humans. We studied hormonal profiles in the hair of 26 female rhesus monkeys (Macaca mulatta, n=12 primiparous), to determine the influences of parity on chronic levels of cortisol (hair cortisol concentration, HCC) and progesterone (hair progesterone concentration, HPC) during early- to mid-pregnancy (PREG1), in late pregnancy/early lactation (PREG2/LACT1), and in peak lactation (LACT2). We also assessed infants' neurobehavioral development across the first month of life. After controlling for age and stage of pregnancy at the first hair sampling period, we found that HCCs overall peaked in PREG2/LACT1 (p=0.02), but only in primiparous monkeys (p<0.001). HPCs declined across pregnancy and lactation for all monkeys (p<0.01), and primiparous monkeys had higher HPCs overall than multiparous monkeys (p=0.02). Infants of primiparous mothers had lower sensorimotor reflex scores (p=0.02) and tended to be more irritable (p=0.05) and less consolable (p=0.08) in the first month of life. Moreover, across all subjects, HCCs in PREG2/LACT1 were positively correlated with irritability (r(s)=0.43, p=0.03) and negatively correlated with sensorimotor scores (r(s)=-0.41, p=0.04). Together, the present results indicate that primiparity influences both chronic maternal hormonal profiles and infant development. These effects may, in part, reflect differential reproductive and maternal effort in mothers with varied caretaking experience. In addition, infant exposure to relatively higher levels of maternal cortisol during the late fetal and early postnatal periods is predictive of poorer developmental outcomes.
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Affiliation(s)
- Amanda M. Dettmer
- Laboratory of Comparative Ethology, Eunice Kennedy Shriver National Institute of Child Health & Human Development, NIH, Poolesville, Maryland, United States of America
| | - Kendra L. Rosenberg
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
| | - Stephen J. Suomi
- Laboratory of Comparative Ethology, Eunice Kennedy Shriver National Institute of Child Health & Human Development, NIH, Poolesville, Maryland, United States of America
| | - Jerrold S. Meyer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
| | - Melinda A. Novak
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
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