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Wang J, Alessie R, Angelini V. Exposure in utero to adverse events and health late-in-life: Evidence from China. HEALTH ECONOMICS 2023; 32:541-557. [PMID: 36377693 PMCID: PMC10098622 DOI: 10.1002/hec.4632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/29/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
This paper estimates the effect of in utero exposure to adverse events on late life diabetes, cardiovascular disease risks and cognition deficiency. We merge data on the regional violence during the Cultural Revolution and the excessive death rates during the Chinese Great Famine with data from the China Health and Retirement Longitudinal Study survey. Results show that female babies who were exposed in utero to the famine have higher diabetes risks, while male babies who were exposed to the Cultural Revolution are shown to have lower cognitive abilities.
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Affiliation(s)
- Jiyuan Wang
- School of InsuranceChina Institute for Actuarial ScienceCentral University of Finance and EconomicsBeijingChina
| | - Rob Alessie
- University of Groningen and NetsparGroningenThe Netherlands
| | - Viola Angelini
- University of Groningen and NetsparGroningenThe Netherlands
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2
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Near birth experience: An exploratory study on the communication experiences with a hypothetical prenatal consciousness. Explore (NY) 2022:S1550-8307(22)00207-5. [DOI: 10.1016/j.explore.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
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Vidal-Ribas P, Govender T, Yu J, Livinski AA, Haynie DL, Gilman SE. The developmental origins of suicide mortality: a systematic review of longitudinal studies. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-02092-6. [PMID: 36205791 PMCID: PMC10207387 DOI: 10.1007/s00787-022-02092-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022]
Abstract
Suicide prevention efforts generally target acute precipitants of suicide, though accumulating evidence suggests that vulnerability to suicide is partly established early in life before acute precipitants can be identified. The aim of this systematic review was to synthesize evidence on early life vulnerability to suicide beginning in the prenatal period and extending through age 12. We searched PubMed, Embase, PsycNet, Web of Science, Scopus, Social Services Abstracts, and Sociological Abstracts for prospective studies published through January 2021 that investigated early life risk factors for suicide mortality. The search yielded 13,237 studies; 54 of these studies met our inclusion criteria. Evidence consistently supported the link between sociodemographic (e.g., young maternal age at birth, low parental education, and higher birth order), obstetric (e.g., low birth weight), parental (e.g., exposure to parental death by external causes), and child developmental factors (e.g., exposure to emotional adversity) and higher risk of suicide death. Among studies that also examined suicide attempt, there was a similar profile of risk factors. We discuss a range of potential pathways implicated in these associations and suggest that additional research be conducted to better understand how early life factors could interact with acute precipitants and increase vulnerability to suicide.
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Affiliation(s)
- Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
| | - Theemeshni Govender
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Jing Yu
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Alicia A Livinski
- Office of Research Services, National Institutes of Health Library, OD, NIH, Bethesda, MD, USA
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Mandal PK, Gaur S, Roy RG, Samkaria A, Ingole R, Goel A. Schizophrenia, Bipolar and Major Depressive Disorders: Overview of Clinical Features, Neurotransmitter Alterations, Pharmacological Interventions, and Impact of Oxidative Stress in the Disease Process. ACS Chem Neurosci 2022; 13:2784-2802. [PMID: 36125113 DOI: 10.1021/acschemneuro.2c00420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Psychiatric disorders are one of the leading causes of disability worldwide and affect the quality of life of both individuals and the society. The current understanding of these disorders points toward receptor dysfunction and neurotransmitter imbalances in the brain. Treatment protocols are hence oriented toward normalizing these imbalances and ameliorating the symptoms. However, recent literature has indicated the possible role of depleted levels of antioxidants like glutathione (GSH) as well as an alteration in the levels of the pro-oxidant, iron in the pathogenesis of major psychiatric diseases, viz., schizophrenia (Sz), bipolar disorder (BD), and major depressive disorder (MDD). This review aims to highlight the involvement of oxidative stress (OS) in these psychiatric disorders. An overview of the clinical features, neurotransmitter abnormalities, and pharmacological treatments concerning these psychiatric disorders has also been presented. Furthermore, it attempts to synthesize literature from existing magnetic resonance spectroscopy (MRS) and quantitative susceptibility mapping (QSM) studies for these disorders, assessing GSH and iron, respectively. This manuscript is a sincere attempt to stimulate research discussion to advance the knowledge base for further understanding of the pathoetiology of Sz, BD, and MDD.
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Affiliation(s)
- Pravat K Mandal
- Neuroimaging and Neurospectroscopy (NINS) Laboratory, National Brain Research Centre, Manesar, Haryana 122050, India.,The Florey Institute of Neuroscience and Mental Health, Melbourne School of Medicine Campus, Melbourne 3052, Australia
| | - Shradha Gaur
- Neuroimaging and Neurospectroscopy (NINS) Laboratory, National Brain Research Centre, Manesar, Haryana 122050, India
| | - Rimil Guha Roy
- Neuroimaging and Neurospectroscopy (NINS) Laboratory, National Brain Research Centre, Manesar, Haryana 122050, India
| | - Avantika Samkaria
- Neuroimaging and Neurospectroscopy (NINS) Laboratory, National Brain Research Centre, Manesar, Haryana 122050, India
| | | | - Anshika Goel
- Neuroimaging and Neurospectroscopy (NINS) Laboratory, National Brain Research Centre, Manesar, Haryana 122050, India
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Vidal-Ribas P, Govender T, Sundaram R, Perlis RH, Gilman SE. Prenatal origins of suicide mortality: A prospective cohort study in the United States. Transl Psychiatry 2022; 12:14. [PMID: 35013255 PMCID: PMC8748551 DOI: 10.1038/s41398-021-01777-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 12/01/2022] Open
Abstract
Most suicide research focuses on acute precipitants and is conducted in high-risk populations. Yet, vulnerability to suicide is likely established years prior to its occurrence. In this study, we aimed to investigate the risk of suicide mortality conferred by prenatal sociodemographic and pregnancy-related factors. Offspring of participants (N = 49,853) of the Collaborative Perinatal Project, a U.S. population-based cohort of pregnancies enrolled between 1959 and 1966, were linked to the U.S. National Death Index to determine their vital status by the end 2016. We examined associations between sociodemographic factors during pregnancy, pregnancy complications, labor and delivery complications, and neonatal complications with suicide death coded according to ICD-9/10 criteria. By the end of 2016, 3,555 participants had died. Of these, 288 (214 males, 74 females) died by suicide (incidence rate = 15.6 per 100,000 person-years, 95% Confidence Interval [CI] = 13.9-17.5). In adjusted models, male sex (Hazard Ratio [HR] = 2.98, CI: 2.26-3.93), White race (HR = 2.14, CI = 1.63-2.83), low parental education (HR = 2.23, CI = 1.38-3.62), manual parental occupation (HR = 1.38, CI = 1.05-1.82), being a younger sibling (HR = 1.52, CI = 1.10-2.11), higher rates of pregnancy complications (HR = 2.36, CI = 1.08-5.16), and smoking during pregnancy (HR = 1,28, CI = 0.99-1.66) were independently associated with suicide risk, whereas birth and neonatal complications were not. Consistent with the developmental origins of psychiatric disorders, vulnerability to suicide mortality is established early in development. Both sociodemographic and pregnancy factors play a role in this risk, which underscores the importance of considering life course approaches to suicide prevention, possibly including provision of high-quality prenatal care, and alleviating the socioeconomic burdens of mothers and families.
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Affiliation(s)
- Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
| | - Theemeshni Govender
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Roy H Perlis
- Center for Quantitative Health, Center for Genomic Medicine and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Zhang X, Liu Y, Li J, Li B, Yang X, Sun Q, Yan J, Wang Z, Liu H. Prenatal Alcohol Exposure and the Risk of Depression in Offspring: a Meta-Analysis. Int J Clin Pract 2022; 2022:5458611. [PMID: 35685596 PMCID: PMC9159193 DOI: 10.1155/2022/5458611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/05/2022] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) has been related to poor consequences of mental health in offspring. However, it remains unknown whether maternal alcohol drinking during pregnancy is associated with depression in the offspring. METHODS A meta-analysis was performed accordingly. Relevant observational studies were identified from Medline, Embase, and Web of Science databases. A fixed-effect or a random-effect model was selected dependending on the between-study heterogeneity. RESULTS Eight cohort studies were included. The heterogeneity was not significant (I 2 = 14%). A meta-analysis with a fixed-effect model showed that PAE was associated with a higher risk of depression in offspring (odds ratio (OR): 2.28, 95% confidence interval (CI): 1.61 to 3.25, p < 0.001). Subgroup analysis showed that moderate (OR: 1.74, 95% CI: 1.22 to 2.49, p=0.002, I 2 = 0%) or heavy (OR: 2.41, 95% CI: 1.55 to 3.73, p < 0.001, I 2 = 0%) maternal alcohol drinking in pregnancy was associated with depression in offspring, but not for those with low maternal alcohol drinking (OR: 1.18, 95% CI: 0.97 to 1.44, p=0.10, I 2 = 0%). Further subgroup analyses according to study design, timing of PAE evaluation, age at depression diagnosis, and quality scores showed consistent results. Univariate metaregression showed a dose-response association between PAE and offspring depression (coefficient: 0.073, 95% CI: 0.019 to 0.127, p=0.014). CONCLUSIONS Current evidence suggests that PAE may be a risk factor of depression in offspring.
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Affiliation(s)
- Xiaoming Zhang
- Department of Psychiatry, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Yanru Liu
- Department of Psychiatry, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Jing Li
- Department of Psychiatry, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Binbin Li
- Department of Psychiatry, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Xingjie Yang
- Department of Psychiatry, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Qi Sun
- Chengde Medical University, Chengde 067000, Hebei, China
| | - Jingyi Yan
- Chengde Medical University, Chengde 067000, Hebei, China
| | - Zhiren Wang
- Department of Psychiatry, Beijing Huilongguan Hospital, Beijing 100096, China
| | - Huaqing Liu
- Department of Psychiatry, Beijing Huilongguan Hospital, Beijing 100096, China
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Rajyaguru P, Kwong ASF, Braithwaite E, Pearson RM. Maternal and paternal depression and child mental health trajectories: evidence from the Avon Longitudinal Study of Parents and Children. BJPsych Open 2021; 7:e166. [PMID: 34556196 PMCID: PMC8485341 DOI: 10.1192/bjo.2021.959] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The relationships between offspring depression profiles across adolescence and different timings of parental depression during the perinatal period remain unknown. AIMS To explore different timings of maternal and paternal perinatal depression in relation to patterns of change in offspring depressive mood over a 14 year period. METHOD Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parental antenatal depression (ANTD) was assessed at 18 weeks gestation, and postnatal depression (PNTD) at 8 weeks postpartum. Population-averaged trajectories of offspring depressive symptoms were estimated using the Short Mood and Feelings Questionnaire (SMFQ) on nine occasions between 10 and 24 years of age. RESULTS Full data were available for 5029 individuals. Offspring exposed to both timings of maternal depression had higher depressive symptoms across adolescence compared with offspring not exposed to ANTD or PNTD, characterised by higher depressive symptoms at age 16 (7.07 SMFQ points (95% CI = 6.19, 7.95; P < 0.001)) and a greater rate of linear change (0.698 SMFQ points (95% CI = 0.47, 0.93; P = 0.002)). Isolated maternal ANTD and to a lesser extent PNTD were also both associated with higher depressive symptoms at age 16, yet isolated maternal PNTD showed greater evidence for an increased rate of linear change across adolescence. A similar pattern was observed for paternal ANTD and PNTD, although effect sizes were attenuated. CONCLUSIONS This study adds to the literature demonstrating that exposure to two timings of maternal depression (ANTD and PNTD) is strongly associated with greater offspring trajectories of depressive symptoms.
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Affiliation(s)
- Priya Rajyaguru
- Centre for Academic Mental Health, University of Bristol, Bristol, and Oxford Health NHS Foundation Trust, UK
| | - Alex S F Kwong
- Population Health Sciences, Bristol Medical School, and Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Elizabeth Braithwaite
- Department of Psychology, School of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Rebecca M Pearson
- Population Health Sciences, Bristol Medical School, and Medical Research Council Integrative Epidemiology Unit, University of Bristol, and National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK
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Abstract
Tracing the early paths leading to developmental disorders is critical for prevention. In previous work, we detected an interaction between genomic risk scores for schizophrenia (GRSs) and early-life complications (ELCs), so that the liability of the disorder explained by genomic risk was higher in the presence of a history of ELCs, compared with its absence. This interaction was specifically driven by loci harboring genes highly expressed in placentae from normal and complicated pregnancies [G. Ursini et al., Nat. Med. 24, 792-801 (2018)]. Here, we analyze whether fractionated genomic risk scores for schizophrenia and other developmental disorders and traits, based on placental gene-expression loci (PlacGRSs), are linked with early neurodevelopmental outcomes in individuals with a history of ELCs. We found that schizophrenia's PlacGRSs are negatively associated with neonatal brain volume in singletons and offspring of multiple pregnancies and, in singletons, with cognitive development at 1 y and, less strongly, at 2 y, when cognitive scores become more sensitive to other factors. These negative associations are stronger in males, found only with GRSs fractionated by placental gene expression, and not found in PlacGRSs for other developmental disorders and traits. The relationship of PlacGRSs with brain volume persists as an anlage of placenta biology in adults with schizophrenia, again selectively in males. Higher placental genomic risk for schizophrenia, in the presence of ELCs and particularly in males, alters early brain growth and function, defining a potentially reversible neurodevelopmental path of risk that may be unique to schizophrenia.
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9
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Delara M, McMillan DE, Nickel NC, Jong GW, Seitz DP, Mignone J. Early life exposure to antibiotics and the risk of mood and anxiety disorders in children and adolescents: A population-based cohort study. J Psychiatr Res 2021; 137:621-633. [PMID: 33168199 DOI: 10.1016/j.jpsychires.2020.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/19/2020] [Accepted: 11/02/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Mood and anxiety disorders (MADs) are common conditions with multiple aetiologies. Exposure to antibiotics has been proposed as a possible risk factor in animal studies. We aimed to assess maternal antibiotic use in pregnancy and child antibiotic use in the first three years of life, collectively called early life, as potential risk factors for subsequent development of MADs during childhood and adolescence. METHODS A population-based retrospective cohort study was conducted including 221,139 children born in Manitoba, Canada between 1996 and 2012. Exposure was defined as having filled one or more antibiotic prescriptions during early life. Children were followed until the earliest MADs diagnoses, 19th birthday, migration, death, or end of the study period. We computed crude and adjusted hazard ratios (aHRs) with corresponding 95% confidence intervals (CIs) using Cox proportional hazard regression. RESULTS Children born to mothers who received one or more antibiotic courses in pregnancy had significantly higher rates of MADs compared with non-exposed children (aHR 1.08, 95% CI 1.03,1.13). Overall antibiotic exposure during the first three years of life was not significantly associated with MADs (aHR 1.00, 95% CI 0.94,1.07). A significantly increased risk of MADs was observed after postnatal exposure to tetracyclines, aminoglycosides, quinolones (33%) or sulfonamides and trimethoprim (28%). Postnatal exposure to macrolides, lincosamides, and streptogramins significantly reduced the risk of MADs by 16%. CONCLUSION Early life exposure to antibiotics is associated with different risk effects on MADs in children. The apparent associations may have been confounded by indication and may not be clinically meaningful.
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Affiliation(s)
- Mahin Delara
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Diana E McMillan
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba & Health Sciences Centre, Winnipeg, MB, Canada
| | - Nathan C Nickel
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Geert W't Jong
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada
| | - Dallas P Seitz
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Canada
| | - Javier Mignone
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Hypertensive disorders of pregnancy and the risk of offspring depression in childhood: Findings from the Avon Longitudinal Study of Parents and Children. Dev Psychopathol 2020; 32:845-851. [PMID: 31345273 DOI: 10.1017/s0954579419000944] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Hypertensive disorders of pregnancy (HDP) may increase the risk of offspring depression in childhood. Low birth weight is also associated with increased risk of mental health problems, including depression. This study sought to investigate (a) whether there is an association between HDP and the risk of depression in childhood and (b) whether low birth weight mediates this association. The current study is based on the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, population-based study that has followed a cohort of offspring since their mothers were pregnant (n = 6,739). Depression at the age of 7 years was diagnosed using parent reports via the Development and Well-Being Assessment (DAWBA). Log-binomial regression and mediation analyses were used. Children exposed to HDP were 2.3 times more likely to have a depression diagnosis compared with nonexposed children, adjusted Risk Ratio [RR], 2.31; 95% CI, [1.20, 4.47]. Low birth weight was a weak mediator of this association. Results were adjusted for confounding variables including antenatal depression and anxiety during pregnancy.This study suggests that fetal exposure to maternal hypertensive disorders of pregnancy increased the risk of childhood depression. The study adds to the evidence suggesting that the uterine environment is a critical determinant of neurodevelopmental and psychiatric outcomes.
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Abstract
OBJECTIVES Maternal malnutrition during pregnancy may have long-lasting effects on offspring's mental health. We investigate the effect of prenatal exposure to the Dutch famine (mid November 1944 to late April 1945) on mental health in later mid-life. METHODS Data are from the Netherlands Kinship Panel Study (n = 642). We use difference-in-difference analyses to compare mental health in later midlife (measured with the MHI-5 index) across three cohorts ('pre-famine cohort', 'famine cohort', 'post-famine cohort') and across two regions (famine affected cities vs. rest of the country). RESULTS In the affected cities, we find poorer mental health for the famine cohort than for the pre-famine and post-famine cohorts. In the non-affected rest of the country, no significant mental health differences between birth cohorts were found. The mental health differences between birth cohorts differ significantly between the affected cities and the rest of the Netherlands. CONCLUSION Our analyses link prenatal famine exposure to poorer mental health in later midlife. This suggests that in utero malnutrition has a long-lasting detrimental effect on mental health.
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Affiliation(s)
- Thijs van den Broek
- a Department of Social Policy , London School of Economics and Political Science , United Kingdom
| | - Maria Fleischmann
- b Department of Epidemiology and Public Health , University College London , United Kingdom
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Abstract
Stress is an adaptive response to environment aversive stimuli and a common life experience of one's daily life. Chronic or excessive stress especially that happened in early life is found to be deleterious to individual's physical and mental health, which is highly related to depressive disorders onset. Stressful life events are consistently considered to be the high-risk factors of environment for predisposing depressive disorders. In linking stressful life events with depressive disorder onset, dysregulated HPA axis activity is supposed to play an important role in mediating aversive impacts of life stress on brain structure and function. Increasing evidence have indicated the strong association of stress, especially the chronic stress and early life stress, with depressive disorders development, while the association of stress with depression is moderated by genetic risk factors, including polymorphism of SERT, BDNF, GR, FKBP5, MR, and CRHR1. Meanwhile, stressful life experience particularly early life stress will exert epigenetic modification in these risk genes via DNA methylation and miRNA regulation to generate long-lasting effects on these genes expression, which in turn cause brain structural and functional alteration, and finally increase the vulnerability to depressive disorders. Therefore, the interaction of environment with gene, in which stressful life exposure interplay with genetic risk factors and epigenetic modification, is essential in predicting depressive disorders development. As the mediator of environmental risk factors, stress will function together with genetic and epigenetic mechanism to influence brain structure and function, physiology and psychology, and finally the vulnerability to depressive disorders.
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Molenaar NM, Tiemeier H, van Rossum EFC, Hillegers MHJ, Bockting CLH, Hoogendijk WJG, van den Akker EL, Lambregtse-van den Berg MP, El Marroun H. Prenatal maternal psychopathology and stress and offspring HPA axis function at 6 years. Psychoneuroendocrinology 2019; 99:120-127. [PMID: 30223193 DOI: 10.1016/j.psyneuen.2018.09.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 08/30/2018] [Accepted: 09/03/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Intrauterine exposures such as maternal psychopathology and stress are known to influence the physical and mental health of the offspring. One of the proposed pathways underlying these associations is dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity in the offspring. This study examined the relation of perinatal maternal symptoms of psychopathology and stress with offspring HPA axis activity at 6 years as measured by hair cortisol and cortisone concentrations. METHODS The study was part of the population-based Generation R Study, a prospective population-based cohort from fetal life onwards. 2546 children and their mothers formed the study population. Perinatal maternal psychopathology and stress were assessed by questionnaires in the second and third trimester. Principal components for both psychopathology and stress were created to reduce the number of explanatory variables. Child hair samples for cortisol and cortisone measurements were collected at the age of 6. Linear regression analysis, adjusted for covariates, was used to examine associations between maternal psychopathology and stress and child hair cortisol and cortisone levels. RESULTS The maternal psychopathology principal component was associated with higher child hair cortisone (adjusted B = 0.24, 95%CI 0.08;0.40, p-value < 0.01). Effect estimates of the individual dimensions ranged from 0.97 (95%CI 0.21;1.73, p-value = 0.01) for interpersonal sensitivity to 1.67 (95%CI 0.86;2.47, p-value < 0.01) for paranoid ideation. In addition, children exposed to intrauterine stress, as measured by the principal component, had higher hair cortisone levels (adjusted B = 0.54, 95%CI 0.21;0.88, p-value < 0.01). Exposure to maternal psychopathology and stress was not associated with offspring hair cortisol. Stratification by child sex resulted in associations between maternal symptoms of psychopathology during pregnancy and child hair cortisone levels in boys and associations between maternal symptoms of stress during pregnancy and child hair cortisone levels in girls. CONCLUSION Our results suggest that maternal psychopathology and stress during pregnancy are associated with long-term HPA axis activity of the offspring. The association of maternal psychopathology and stress during pregnancy with offspring hair cortisone levels is a novel finding. Future studies should examine whether these psychophysiological differences between exposed and non-exposed children underlie offspring morbidity associated with maternal psychopathology and stress during pregnancy.
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Affiliation(s)
- N M Molenaar
- The Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - H Tiemeier
- The Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands; The Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, USA
| | - E F C van Rossum
- The Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M H J Hillegers
- The Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C L H Bockting
- The Department of Psychiatry, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - W J G Hoogendijk
- The Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - E L van den Akker
- The Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M P Lambregtse-van den Berg
- The Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands; The Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - H El Marroun
- The Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands; The Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands; The Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Rotterdam, The Netherlands.
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Hannigan LJ, Eilertsen EM, Gjerde LC, Reichborn-Kjennerud T, Eley TC, Rijsdijk FV, Ystrom E, McAdams TA. Maternal prenatal depressive symptoms and risk for early-life psychopathology in offspring: genetic analyses in the Norwegian Mother and Child Birth Cohort Study. Lancet Psychiatry 2018; 5:808-815. [PMID: 30245187 DOI: 10.1016/s2215-0366(18)30225-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/01/2018] [Accepted: 06/04/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Maternal prenatal depression is a known risk factor for early-life psychopathology among offspring; however, potential risk transmission mechanisms need to be distinguished. We aimed to test the relative importance of passive genetic transmission, direct exposure, and indirect exposure in the association between maternal prenatal depressive symptoms and early-life internalising and externalising psychopathology in offspring. METHODS We used structural equation modelling of phenotypic data and genetically informative relationships from the families of participants in the Norwegian Mother and Child Birth Cohort Study (MoBa). The analytic subsample of MoBa used in the current study comprises 22 195 mothers and 35 299 children. We used mothers' self-reported depressive symptoms during pregnancy, as captured by the Symptom Checklist, and their reports of symptoms of psychopathology in their offspring during the first few years of life (measured at 18, 36, and 60 months using the Child Behavior Checklist). FINDINGS Maternal prenatal depressive symptoms were found to be associated with early-life psychopathology primarily via intergenerationally shared genetic factors, which explained 41% (95% CI 36-46) of variance in children's internalising problems and 37% (30-44) of variance in children's externalising problems. For internalising problems, phenotypic transmission also contributed significantly, accounting for 14% (95% CI 5-19) of the association, but this contribution was found to be explained by exposure to concurrent maternal depressive symptoms, rather than by direct exposure in utero. INTERPRETATION Associations between maternal prenatal depressive symptoms and offspring behavioural outcomes in early childhood are likely to be at least partially explained by shared genes. This genetic confounding should be considered when attempting to quantify risks posed by in-utero exposure to maternal depressive symptoms. FUNDING UK Economic and Social Research Council, Norwegian Research Council, Norwegian Ministries of Health and Care Services, and Education & Research, Wellcome Trust, Royal Society, and National Institute for Health Research.
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Affiliation(s)
- Laurie J Hannigan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Espen Moen Eilertsen
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Line C Gjerde
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thalia C Eley
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fruhling V Rijsdijk
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway; School of Pharmacy, University of Oslo, Oslo, Norway
| | - Tom A McAdams
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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15
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Maxwell SD, Fineberg AM, Drabick DA, Murphy SK, Ellman LM. Maternal Prenatal Stress and Other Developmental Risk Factors for Adolescent Depression: Spotlight on Sex Differences. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 46:381-397. [PMID: 28393324 PMCID: PMC5828524 DOI: 10.1007/s10802-017-0299-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Maternal stress during pregnancy has been linked to premorbid abnormalities associated with depression (e.g., difficult temperament, cognitive deficits) in offspring. However, few studies have looked across developmental periods to examine maternal stress during pregnancy and offspring depression during adolescence and whether these associations differ by sex. The current study used data from 1711 mother-offspring dyads (offspring sex: 49.8% male) in a longitudinal birth cohort study. Maternal narratives collected during pregnancy were qualitatively coded for stress-related themes by independent raters. Latent class analysis (LCA) identified distinct subgroups of offspring based on exposure to maternal prenatal stress and other developmental factors from the prenatal, childhood, and adolescent periods that have been associated with depression and/or maternal prenatal stress. LCA identified subgroups that were compared to determine whether and to what extent they differed on adolescent depressive symptoms. LCA revealed a subgroup of "high-risk" individuals, characterized by maternal factors during pregnancy (higher ambivalence/negativity and lower positivity towards the pregnancy, higher levels of hassles, lower maternal education and higher maternal age at birth, higher pre-pregnancy BMI) and offspring developmental factors (decreased cognitive functioning during childhood and adolescence, lower perceived parental support during adolescence, and higher levels of maternal depression during adolescence). High-risk females exhibited elevated conduct symptoms and higher birth order, while high-risk males exhibited decreased internalizing symptoms and lower birth order. Both high-risk males and females reported elevated depressive symptoms during adolescence relative to their "low-risk" counterparts.
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Affiliation(s)
- Seth D Maxwell
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Anna M Fineberg
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Deborah A Drabick
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Shannon K Murphy
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA.
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Milaniak I, Cecil CAM, Barker ED, Relton CL, Gaunt TR, McArdle W, Jaffee SR. Variation in DNA methylation of the oxytocin receptor gene predicts children's resilience to prenatal stress. Dev Psychopathol 2017; 29:1663-1674. [PMID: 29162179 DOI: 10.1017/s0954579417001316] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Emerging research in epigenetics has shown that there is variability in how environmental exposures "get under the skin" through mechanisms like DNA methylation to influence gene expression that may lead to differential adaptations to stress. This is the first study to examine prospectively the relationship between DNA methylation at birth and resilience to prenatal environmental stressors in several domains (conduct, hyperactivity, emotional problems, and global symptomatology) in middle childhood. We focused on DNA methylation in the vicinity of the oxytocin receptor (OXTR) gene as it has been previously associated with impairments in social-cognitive processes that may underlie a wide range of childhood psychopathology. Participants were 91 youth exposed to pre- and postnatal adversity with established conduct problem trajectories drawn from the Avon Longitudinal Study of Parents and Children. Consistent with our hypothesis, OXTR DNA methylation was predictive of resilience in the conduct problems domain in middle childhood. DNA methylation profiles did not predict resilience in domains of emotional, hyperactivity, and global symptomatology, suggesting a potential role for OXTR in the development of conduct problems in particular. However, individuals who were resilient to conduct problems were also broadly resilient across multiple domains. Therefore, future research should elucidate the biological pathways between OXTR DNA methylation and gene expression and its relation to impairments in social behavior.
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17
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Braithwaite EC, Murphy SE, Ramchandani PG, Hill J. Associations between biological markers of prenatal stress and infant negative emotionality are specific to sex. Psychoneuroendocrinology 2017; 86:1-7. [PMID: 28888992 PMCID: PMC5667634 DOI: 10.1016/j.psyneuen.2017.09.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/29/2017] [Accepted: 09/03/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE Fetal programming is the idea that environmental stimuli can alter the development of the fetus, which may have a long-term effect on the child. We have recently reported that maternal prenatal cortisol predicts infant negative emotionality in a sex-dependent manner: high prenatal cortisol was associated with increased negative emotionality in females, and decreased negative emotionality in males. This study aims to test for this sex-specific effect in a different cohort, and investigate whether sex differences in fetal programming may be specific to glucocorticoid mechanisms by also examining a maternal salivary alpha-amylase (sAA) by sex interaction. METHODS 88 pregnant women (mean gestational age=27.4 weeks, SD=7.4) collected saliva samples at home over two working days to be assayed for the hormone cortisol (range=0.13-88.22nmol/l) and the enzyme alpha-amylase (range=4.57-554.8units/ml). Samples were collected at waking, 30-min post-waking and 12h post-waking. Two months after birth participants reported infant negative emotionality using the distress to limits subscale of the Infant Behavior Questionnaire. RESULTS The interaction between maternal prenatal cortisol and infant sex to predict distress to limits approached significance (p=0.067). In line with our previous finding there was a positive association between prenatal cortisol and negative emotionality in females, and a negative association in males. The interaction between sAA and sex to predict distress was significant (p=0.025), and the direction of effect was the same as for the cortisol data; high sAA associated with increased negative emotionality in females and reduced negative emotionality in males. CONCLUSIONS In line with our previous findings, this research adds to an emerging body of literature, which suggests that fetal programming mechanisms may be sex-dependent. This is the first study to demonstrate that maternal prenatal sAA may be an important biomarker for infant behavior, and the findings have implications for understanding sex differences in developmental psychopathology.
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Affiliation(s)
- Elizabeth C Braithwaite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK; Department of Experimental Psychology, University of Oxford, 9 South Parks Road, Oxford, UK.
| | - Susannah E Murphy
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
| | - Paul G Ramchandani
- The Centre for Psychiatry, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 ONN, UK.
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
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Braithwaite EC, Kundakovic M, Ramchandani PG, Murphy SE, Champagne FA. Maternal prenatal depressive symptoms predict infant NR3C1 1F and BDNF IV DNA methylation. Epigenetics 2016; 10:408-17. [PMID: 25875334 DOI: 10.1080/15592294.2015.1039221] [Citation(s) in RCA: 167] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Prenatal maternal psychological distress increases risk for adverse infant outcomes. However, the biological mechanisms underlying this association remain unclear. Prenatal stress can impact fetal epigenetic regulation that could underlie changes in infant stress responses. It has been suggested that maternal glucocorticoids may mediate this epigenetic effect. We examined this hypothesis by determining the impact of maternal cortisol and depressive symptoms during pregnancy on infant NR3C1 and BDNF DNA methylation. Fifty-seven pregnant women were recruited during the second or third trimester. Participants self-reported depressive symptoms and salivary cortisol samples were collected diurnally and in response to a stressor. Buccal swabs for DNA extraction and DNA methylation analysis were collected from each infant at 2 months of age, and mothers were assessed for postnatal depressive symptoms. Prenatal depressive symptoms significantly predicted increased NR3C1 1F DNA methylation in male infants (β = 2.147, P = 0.044). Prenatal depressive symptoms also significantly predicted decreased BDNF IV DNA methylation in both male and female infants (β = -3.244, P = 0.013). No measure of maternal cortisol during pregnancy predicted infant NR3C1 1F or BDNF promoter IV DNA methylation. Our findings highlight the susceptibility of males to changes in NR3C1 DNA methylation and present novel evidence for altered BDNF IV DNA methylation in response to maternal depression during pregnancy. The lack of association between maternal cortisol and infant DNA methylation suggests that effects of maternal depression may not be mediated directly by glucocorticoids. Future studies should consider other potential mediating mechanisms in the link between maternal mood and infant outcomes.
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Affiliation(s)
- E C Braithwaite
- a Department of Psychiatry; University of Oxford; Warneford Hospital ; Oxford , UK
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Braithwaite EC, Murphy SE, Ramchandani PG. Effects of prenatal depressive symptoms on maternal and infant cortisol reactivity. Arch Womens Ment Health 2016; 19:581-90. [PMID: 26940835 PMCID: PMC4963445 DOI: 10.1007/s00737-016-0611-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 02/15/2016] [Indexed: 12/11/2022]
Abstract
Prenatal depression is associated with adverse offspring outcomes, and the prevailing mechanistic theory to account for mood-associated effects implicates alterations of the maternal and foetal hypothalamic-pituitary adrenal (HPA) axes. Recent research suggests that depression may be associated with a failure to attenuate cortisol reactivity during early pregnancy. The aim of the current study is to investigate whether this effect continues into mid and late gestation. A further aim is to test whether maternal prenatal cortisol reactivity directly predicts infant cortisol reactivity. One hundred three pregnant women were recruited during either the second or third trimester. Depressive symptoms were assessed by self-report, and maternal salivary cortisol responses to a stressor (infant distress film) were measured. Approximately 2 months after birth, mothers (n = 88) reported postnatal depression and infant salivary cortisol responses to inoculation were measured. Prenatal depression was not associated with cortisol reactivity to acute stress in mid and late pregnancy. Similarly, neither prenatal depression nor maternal prenatal cortisol reactivity predicted infant cortisol reactivity to inoculation at 2 months. If the effects of prenatal depression on foetal and infant development are mediated by alterations of the maternal and foetal HPA axes, then early pregnancy may be a particularly vulnerable period. Alternatively, changes to HPA reactivity may not be as central to this association as previously thought.
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Affiliation(s)
- Elizabeth C. Braithwaite
- Department of Experimental Psychology, University of Oxford, 9 South Parks Road, Oxford, OX1 3UD UK
| | - Susannah E. Murphy
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Paul G. Ramchandani
- Centre for Mental Health, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN UK
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