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Yang F, Janszky I, Roos N, Li J, László KD. Prenatal Exposure to Severe Stress and the Risk of Heart Failure Up to Middle-Age. JACC. HEART FAILURE 2024; 12:1353-1362. [PMID: 38385940 DOI: 10.1016/j.jchf.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/12/2023] [Accepted: 01/10/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Prenatal stress is a potential risk factor for cardiovascular disease, but its association with heart failure (HF) is unknown. OBJECTIVES The purpose of this study was to investigate whether prenatal stress, defined as maternal bereavement, was associated with HF risk up to middle-age. METHODS This cohort study included 6,758,560 live singleton births from the Danish (1973-2016) and the Swedish (1973-2014) Medical Birth Registers. The authors retrieved information on death of the mothers' close family members (partner, older children, parents, and siblings) and offspring's HF (up to 2016 in Denmark and 2020 in Sweden) from nationwide registers. They estimated HRs and 95% CIs for HF in the offspring according to maternal bereavement. RESULTS During up to 48 years of follow-up, 4,812 offspring (0.07%) had a diagnosis of HF. Maternal loss of any close family member was not associated with HF in the offspring (adjusted HR: 1.04; 95% CI: 0.88-1.23). However, the most severe forms of bereavement, ie, death of a partner or an older child (adjusted HR: 1.47; 95% CI: 1.06-2.04) and unnatural death of a relative (adjusted HR: 2.77; 95% CI: 1.49-5.17), were associated with increased risks of HF. Congenital heart disease and preterm birth contributed substantially to the association of maternal loss of a partner or older child with HF risk in the offspring. CONCLUSIONS Maternal loss of a partner or older child and loss of a close relative caused by unnatural causes the year before or during pregnancy were associated with increased risk of HF in offspring.
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Affiliation(s)
- Fen Yang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Imre Janszky
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nathalie Roos
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Jiong Li
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Krisztina D László
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Penner F, Bunderson M, Bartz C, Brooker RJ, Rutherford HJV. Emotion regulation strategies and perceived stress during pregnancy in expectant mothers and fathers. J Reprod Infant Psychol 2024; 42:410-423. [PMID: 35949103 PMCID: PMC9911557 DOI: 10.1080/02646838.2022.2110224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Stress during pregnancy can increase physical and mental health risks in parents and offspring. Emotion regulation (ER) may protect against prenatal stress; however, ER is understudied in expectant parents, particularly expectant fathers. This study aimed to evaluate associations between ER strategies (reappraisal, suppression, ratio of suppression-to-reappraisal) and perceived stress among expectant parents, and also test whether expectant mothers and fathers differed in ER strategy use and perceived stress levels. METHODS N = 83 expectant parents (62.7% mothers) in the third trimester completed measures assessing perceived stress,reappraisal, and suppression. ANCOVA, hierarchical regression, and multilevel models were used to evaluate associations between ER strategies and perceived stress, and test for sex differences. RESULTS Controlling for age and education, lower reappraisal and higher suppression were associated with higher perceived stress; in addition, higher suppression-to-reappraisal ratios were associated with greater perceived stress. Mothers and fathers did not differ in perceived stress, reappraisal, or suppression; however, suppression-to-reappraisal ratios significantly differed. CONCLUSION Increasing ER skills such as reappraisal while reducing suppression may be beneficial for decreasing stress in expectant parents. Expectant fathers report similar levels of perceived stress to mothers and would benefit from prenatal mental health screening and intervention.
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Affiliation(s)
| | - Madison Bunderson
- Yale Child Study Center, Yale University School of Medicine
- Graduate School of Education, Stanford University
| | - Cody Bartz
- Yale Child Study Center, Yale University School of Medicine
- School of Public Affairs, American University
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University
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McKee KS, Tang X, Tung I, Wu G, Alshawabkeh AN, Arizaga JA, Bastain TM, Brennan PA, Breton CV, Camargo CA, Cioffi CC, Cordero JF, Dabelea D, Deutsch AR, Duarte CS, Dunlop AL, Elliott AJ, Ferrara A, Karagas MR, Lester B, McEvoy CT, Meeker J, Neiderhiser JM, Herbstman J, Trasande L, O’Connor TG, Hipwell AE, Comstock SS. Perinatal Outcomes during versus Prior to the COVID-19 Pandemic and the Role of Maternal Depression and Perceived Stress: A Report from the ECHO Program. Am J Perinatol 2024; 41:e1404-e1420. [PMID: 36781160 PMCID: PMC11195909 DOI: 10.1055/a-2033-5610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE We sought to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on perinatal outcomes while accounting for maternal depression or perceived stress and to describe COVID-specific stressors, including changes in prenatal care, across specific time periods of the pandemic. STUDY DESIGN Data of dyads from 41 cohorts from the National Institutes of Health Environmental influences on Child Health Outcomes Program (N = 2,983) were used to compare birth outcomes before and during the pandemic (n = 2,355), and a partially overlapping sample (n = 1,490) responded to a COVID-19 questionnaire. Psychosocial stress was defined using prenatal screening for depression and perceived stress. Propensity-score matching and general estimating equations with robust variance estimation were used to estimate the pandemic's effect on birth outcomes. RESULTS Symptoms of depression and perceived stress during pregnancy were similar prior to and during the pandemic, with nearly 40% of participants reporting mild to severe stress, and 24% reporting mild depression to severe depression. Gestations were shorter during the pandemic (B = - 0.33 weeks, p = 0.025), and depression was significantly associated with shortened gestation (B = - 0.02 weeks, p = 0.015) after adjustment. Birth weights were similar (B = - 28.14 g, p = 0.568), but infants born during the pandemic had slightly larger birth weights for gestational age at delivery than those born before the pandemic (B = 0.15 z-score units, p = 0.041). More women who gave birth early in the pandemic reported being moderately or extremely distressed about changes to their prenatal care and delivery (45%) compared with those who delivered later in the pandemic. A majority (72%) reported somewhat to extremely negative views of the impact of COVID-19 on their life. CONCLUSION In this national cohort, we detected no effect of COVID-19 on prenatal depression or perceived stress. However, experiencing the COVID-19 pandemic in pregnancy was associated with decreases in gestational age at birth, as well as distress about changes in prenatal care early in the pandemic. KEY POINTS · COVID-19 was associated with shortened gestations.. · Depression was associated with shortened gestations.. · However, stress during the pandemic remained unchanged.. · Most women reported negative impacts of the pandemic..
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Affiliation(s)
- Kimberly S. McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Xiaodan Tang
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Irene Tung
- Department of Psychology, California State University Dominguez Hills, Carson, California
| | - Guojing Wu
- Department of Epidemology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Akram N. Alshawabkeh
- Department of Civil and Environmental Engineering, College of Engineering, Northeastern University, Boston, Massachusetts
| | - Jessica A. Arizaga
- Department of Psychiatry and Behavioral Sciences, University of California-San Francisco, San Francisco, California
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Jose F. Cordero
- Department of Epidemiology and Biostatistics, College of Public Health, Athens, Georgia
| | - Dana Dabelea
- Department of Epidemiology, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Arielle R. Deutsch
- Department of Pediatrics, Avera Research Institute, University of South Dakota School of Medicine, Sioux Falls, South Dakota
| | | | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Amy J. Elliott
- Department of Pediatrics, Avera Research Institute, University of South Dakota School of Medicine, Sioux Falls, South Dakota
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Lebanon, New Hampshire
| | - Barry Lester
- Center for the Study of Children at Risk, Brown University, Providence, Rhode Island
| | - Cindy T. McEvoy
- Department of Pediatrics, MCR Oregon Health and Science University, Portland, Oregon
| | - John Meeker
- University of Michigan, Environmental Health Sciences, Global Public Health, Ann Arbor, Michigan
| | - Jenae M. Neiderhiser
- Department of Psychology, Pennsylvania State University, University Park, Pennsylvania
| | - Julie Herbstman
- Columbia Mailman School of Public Health, Environmental Health Sciences, New York, New York
| | - Leonardo Trasande
- Department of Pediatrics, New York University, New York
- Department of Environmental Medicine, and Population Health, New York University Grossman School of Medicine and New York University School of Global Public Health, New York University, New York
| | - Thomas G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, New York
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan
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Daalderop LA, Lagendijk J, Steegers EAP, El Marroun H, Posthumus AG. Psychological distress during pregnancy and adverse maternal and perinatal health outcomes: The role of socioeconomic status. Int J Gynaecol Obstet 2023; 163:920-930. [PMID: 37259252 DOI: 10.1002/ijgo.14891] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/13/2023] [Accepted: 05/09/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To study the contribution of socioeconomic status (SES) to the prevalence of psychological distress during pregnancy, and to investigate the association between psychological distress and maternal and perinatal health among different SES groups. METHODS This study was embedded in the Generation R study. Multiple self-reported questionnaires were used to measure psychological distress. Prevalence differences between SES groups were tested with the χ2 test. Linear and logistic regression analyses were used to examine the associations between psychological distress and maternal and perinatal health outcomes. RESULTS Women of low SES experience symptoms of psychopathology distress 4.5 times as often and symptoms of stress 2.5 times as often as women with of high SES. Women of low SES experiencing symptoms of psychopathology are at greater risk of delivering preterm. We also found associations between psychological distress and adverse perinatal health outcomes among women of middle and high SES. CONCLUSION The present study shows that the associations between SES, psychological distress, and maternal and perinatal health are complex, but do exist. To provide a better understanding of these associations, it is important to include mental health information in the standard national data collection on pregnant women, as this allows population-based studies.
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Affiliation(s)
- Leonie A Daalderop
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jacqueline Lagendijk
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry, University Medical Centre Rotterdam, Erasmus MC, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Anke G Posthumus
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Bansal A, Cherbuin N, Leach L, Simmons RA, Nolan CJ. Wildfires and COVID-19: syndemic impact on maternal and child health. Trends Endocrinol Metab 2023; 34:779-782. [PMID: 37658035 DOI: 10.1016/j.tem.2023.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/03/2023]
Abstract
The prevailing COVID-19 pandemic and climate change-mediated wildfires can combine to impact maternal-child health, yet this connection remains understudied. To shape policies and design interventions to mitigate the combined effects of future global catastrophes, it is vital to holistically evaluate the impact of syndemics on maternal-child health.
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Affiliation(s)
- Amita Bansal
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia; John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia.
| | - Nicolas Cherbuin
- National Center for Epidemiology and Population Health, Australian National University, Acton, ACT 2601, Australia
| | - Liana Leach
- National Center for Epidemiology and Population Health, Australian National University, Acton, ACT 2601, Australia
| | - Rebecca A Simmons
- Center for Research on Reproduction and Women's Health, University of Pennsylvania, Philadelphia, PA 19104, USA; Center of Excellence in Environmental Toxicology, University of Pennsylvania, Philadelphia, PA 19104, USA; Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Christopher J Nolan
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia; John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia; Endocrinology and Diabetes, The Canberra Hospital, Canberra Health Services, ACT 2601, Australia
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Jones SL, Caccese C, Davis KP, Lew J, Elgbeili G, Herba CM, Barnwell J, Robert CH, Gavanski I, Horsley K, Fraser WD, Da Costa D, Séguin JR, Nguyen TV, Montreuil TC. Longitudinal associations between paternal mental health and child behavior and cognition in middle childhood. Front Psychol 2023; 14:1218384. [PMID: 38022974 PMCID: PMC10646505 DOI: 10.3389/fpsyg.2023.1218384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/13/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Paternal mental health has been associated with adverse consequences on offspring psychosocial development, and family environmental factors may partly explain those associations. To clarify this, we need comprehensive prospective studies, particularly in middle-childhood when the child enters school and is expected to make use of behavioral and cognitive skills as part of their interactions and learning. Method Using data from a sub-sample of the prospective 3D birth cohort study comprised of mother-father-child triads, and a follow-up of the parents and the children at 6-8 years of age (n = 61; 36 boys, 25 girls), we examined whether paternal anxious and depressive symptoms measured during the pregnancy period (i.e., prenatally) or concurrently when the child was assessed at 6-8 years old were associated with children's cognition/behavior. Results In contrast to our hypotheses, we found that greater prenatal paternal depressive symptoms predicted fewer child behavioral difficulties; and that greater concurrent childhood paternal depression or anxiety symptoms were associated with higher child full-scale IQ, controlling for the equivalent maternal mental health assessment and parental education. Father parenting perception did not mediate these associations, nor were they moderated by maternal mental health at the concurrent assessment, or paternal ratings of marital relationship quality. Discussion These findings suggest that higher symptoms of paternal mental health symptoms are associated with fewer child behavioral difficulties and higher cognitive performance in middle childhood. Potential clinical implications and future research directions are discussed.
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Affiliation(s)
- Sherri Lee Jones
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Douglas Research Center, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Christina Caccese
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Douglas Research Center, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Kelsey P. Davis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Jimin Lew
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Douglas Research Center, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Integrated Program in Neuroscience, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Guillaume Elgbeili
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Catherine M. Herba
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
- Research Center, CHU Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
| | - Julia Barnwell
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Department of Pediatrics, Human Genetics and Pharmacology & Therapeutics, McGill University, Montreal, QC, Canada
| | - Cindy Hénault Robert
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Douglas Research Center, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | | | - Kristin Horsley
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - William D. Fraser
- Research Center, CHU Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Obstetrics and Gynecology, Centre de Recherche du CHU de Sherbrooke, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Deborah Da Costa
- Department of Physical and Occupational Sciences, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Jean R. Séguin
- Research Center, CHU Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, QC, Canada
| | - Tuong-Vi Nguyen
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Reproductive Psychiatry Program, Department of Psychiatry and Obstetrics and Gynecology, McGill University Health Centre, Montreal, QC, Canada
| | - Tina C. Montreuil
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Psychiatry, Research Institute of the McGill University Health Center, McGill University, Montreal, QC, Canada
- Research Center, CHU Sainte-Justine Mother and Child University Hospital Center, Montreal, QC, Canada
- Department of Pediatrics, Human Genetics and Pharmacology & Therapeutics, McGill University, Montreal, QC, Canada
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada
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Bahrami‐Samani S, Omidvar S, Mohsenzadeh‐Ledari F, Azizi A, Ashrafpour M, Kordbagheri M. The relationship between perceived stress and pregnancy distress with self-care of pregnant women: The mediating role of social support-A cross-sectional study. Health Sci Rep 2023; 6:e1730. [PMID: 38028701 PMCID: PMC10663433 DOI: 10.1002/hsr2.1730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/19/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Pregnancy is a stressful experience, which can affect different aspects of a woman's life. Yet, women with a supportive network of friends and family may experience lower stress and improved self-care behavior. The study aimed to investigate the relationship between perceived stress and pregnancy distress with the self-care of pregnant women, as well as the mediating role of social support. Methods This cross-sectional study was conducted from February to May 2022 in Babol, Iran. A total of 157 pregnant women participated in the study. The participants completed five questionnaires, including a demographic and obstetric questionnaire, a Self-care questionnaire, Perceived Social support (PSS), Perceived Stress Inventory (PSI), and Pregnancy Specific Distress. Structural equation modeling was used to test the hypothesis relationships among the variables. Results We found that Perceived stress (β = -0.221, p = 0.012β) and pregnancy distress (β = -0.203, p = 0.002β) had a negative and significant effect on the self-care of pregnant women. Also, perceived stress (β = -0.429, p < 0.001β) and pregnancy distress (β = -0.381, p < 0.001β) had a negative and significant effect on the social support of pregnant women. The results exhibited a significant specific indirect effect between pregnancy distress, perceived stress, and pregnancy self-care, with social support as the mediator: standardized indirect effect = -0.068, -0.076, respectively. Conclusion According to the findings, social support plays a direct and mediating role in improving self-care behaviors among pregnant women. Therefore, providing strategies and measures to improve perceived social support by maternal health professionals may be expected to reduce the impact of stress on pregnant women's self-care. The implementation of policies and social interventions to improve the social support of pregnant women can be one of the applications of the findings.
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Affiliation(s)
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
| | - Farideh Mohsenzadeh‐Ledari
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
| | - Alireza Azizi
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
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Jones-Mason K, Coccia M, Alkon A, Melanie Thomas KCP, Laraia B, Adler N, Epel ES, Bush NR. Parental sensitivity modifies the associations between maternal prenatal stress exposure, autonomic nervous system functioning and infant temperament in a diverse, low-income sample. Attach Hum Dev 2023; 25:487-523. [PMID: 37749913 DOI: 10.1080/14616734.2023.2257669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
Evidence suggests that adversity experienced during fetal development may shape infant physiologic functioning and temperament. Parental sensitivity is associated with child stress regulation and may act as a buffer against risk for intergenerational health effects of pre- or postnatal adversity. Building upon prior evidence in a racially and ethnically diverse sample of infants (M infant age = 6.5 months) and women of low socioeconomic status, this study examined whether coded parenting sensitivity moderated the association between an objective measure of prenatal stress exposures (Stressful Life Events (SLE)) and infant parasympathetic (respiratory sinus arrhythmia; RSA) or sympathetic (pre-ejection period; PEP) nervous system functioning assessed during administration of the Still-Face-Paradigm (SFP) (n = 66), as well as maternal report of temperament (n = 154). Results showed that parental sensitivity moderated the associations between prenatal stress exposures and infant RSA reactivity, RSA recovery, PEP recovery, and temperamental negativity. Findings indicate that greater parental sensitivity is associated with lower infant autonomic nervous system reactivity and greater recovery from challenge. Results support the hypothesis that parental sensitivity buffers infants from the risk of prenatal stress exposure associations with offspring cross-system physiologic reactivity and regulation, potentially shaping trajectories of health and development and promoting resilience.
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Affiliation(s)
- Karen Jones-Mason
- Department of Psychiatry, University of California, San Francisco, USA
| | - Michael Coccia
- Department of Psychiatry, University of California, San Francisco, USA
| | - Abbey Alkon
- School of Nursing, University of California, San Francisco, USA
| | | | - Barbara Laraia
- School of Public Health, University of California, Berkeley, USA
| | - Nancy Adler
- Department of Psychiatry, University of California, San Francisco, USA
| | - Elissa S Epel
- Department of Psychiatry, University of California, San Francisco, USA
| | - Nicole R Bush
- Department of Psychiatry, University of California, San Francisco, USA
- Department of Pediatrics, University of California, San Francisco, USA
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9
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Cuervo S, Creaghead N, Vannest J, Hunter L, Ionio C, Altaye M, Parikh NA. Language Outcomes of Children Born Very Preterm in Relation to Early Maternal Depression and Anxiety. Brain Sci 2023; 13:1355. [PMID: 37891724 PMCID: PMC10605035 DOI: 10.3390/brainsci13101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Unaddressed maternal psychological distress within the first year postpartum is known to have numerous negative consequences on the child's developmental outcomes, including language acquisition. This study examined the relationship between early maternal psychosocial factors and the language outcomes of children born very preterm (VPT; ≤32 weeks gestational age). It used data from the Cincinnati Infant Neurodevelopment Early Prediction Study, an ongoing National-Institutes-of-Health-funded prospective, multicenter cohort investigation of VPT infants. A total of 243 (125 boys; 118 girls) children born VPT (M = 29.03 weeks of gestation; SD = 2.47) and their corresponding 207 mothers (34 with multiple infants) were included in this study. We did not find an association between maternal depression or anxiety and Bayley-III (M = 92.3, SD = 18.9) language scores. Additionally, maternal grit and self-efficacy did not modify the relationship between depression and anxiety and language scores. A higher level of maternal education and infant female sex were significantly associated with higher language scores. While preterm birth typically results in higher rates of depression and anxiety for parents, the findings suggest that maternal depression, anxiety, and grit and the self-efficacy of the mothers in this sample did not relate to the language development of their children, independent of maternal education and infant female sex.
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Affiliation(s)
- Sisan Cuervo
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Nancy Creaghead
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
| | - Jennifer Vannest
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
| | - Lisa Hunter
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
| | - Chiara Ionio
- Department of Psychology, Catholic University of the Sacred Heart, 00168 Milano, Italy;
| | - Mekibib Altaye
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Nehal A. Parikh
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
- Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
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10
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Hawkins M, Mallapareddi A, Misra D. Social mobility and perinatal depression in Black women. FRONTIERS IN HEALTH SERVICES 2023; 3:1227874. [PMID: 37693235 PMCID: PMC10491480 DOI: 10.3389/frhs.2023.1227874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/31/2023] [Indexed: 09/12/2023]
Abstract
Background Higher socioeconomic position is associated with better birth outcomes and maternal mental health, although this relationship is less consistent for Black women. The literature is limited on the impact of social mobility across the life course on mental health of pregnant women. This study examines the impact of perceived financial status across the life-course on depressive symptoms during pregnancy among Black women. Methods Data were from the Life-course Influences of Fetal Environments (LIFE) retrospective cohort study among pregnant Black women in metropolitan Detroit, Michigan. Depressive symptoms in the two weeks prior to birth were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Social mobility was determined at three intervals over the life course using self-report of financial status during childhood, adolescence, and current age in pregnancy. Results 1,410 pregnant women participated, ranging in age from 18 to 45 years old. CES-D scores ranged from 0 to 53 (mean = 15.3) and 26% of the sample reported high depressive symptoms. In each age interval, higher financial status was associated with significant protective effect on depressive symptoms, and the magnitude of the effect increased across the life course. Trajectory analysis demonstrated that both the upward (4.51; 95% CI, 2.43-6.6) and downward (4.04; 95% CI, 2.62-5.46 and 3.09; 95% CI, 1.57-4.62) life-course social mobility groups had increased mean CES-D scores compared to the static social mobility group. Conclusion This study describes the importance of previous childhood and current financial status effects on mental health in Black pregnant women.
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Affiliation(s)
- Melissa Hawkins
- Department of Health Studies, College of Arts and Sciences, American University, Washington, DC, United States
| | - Arun Mallapareddi
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Dawn Misra
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI, United States
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11
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Demirel Bozkurt O, Yagcan H, Hazar S, Karaman T. The effect of spousal support on distress experienced during pregnancy in COVID-19 pandemic: Sample of Türkiye. Health Care Women Int 2023; 45:1003-1015. [PMID: 37477893 DOI: 10.1080/07399332.2023.2235312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
We conducted this study with 147 volunteer pregnant women to determine the effect of spousal support on the stress experienced during pregnancy during the COVID-19 pandemic period. We determined that the prenatal stress level of the pregnant women was low (15.34 ± 7.07), they were not at risk for distress, and the spousal support level was high (74.58 ± 8.78). We found that the rate of spousal support was 0.897 times higher for women who did not experience distress. Due to the stay-at-home rule during the pandemic, couples had to be together at home, which caused high spousal support, and we found that women's stress levels were lower.
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Affiliation(s)
- Ozlem Demirel Bozkurt
- Women's Health and Diseases Nursing Department, Faculty of Nursing, Ege University, Izmir, Turkey
| | - Hande Yagcan
- Obstetric, and Gynecologic Nursing Department, Faculty of Nursing, DEU University, Izmir, Turkey
| | - Seda Hazar
- Women's Health and Diseases Nursing Department, Faculty of Nursing, Inonu University, Malatya, Turkey
| | - Tugba Karaman
- Behcet Uz Pediatric Surgery Training and Research Hospital, Izmir, Turkey
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12
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The Relationship between Psychological Suffering, Value of Maternal Cortisol during Third Trimester of Pregnancy and Breastfeeding Initiation. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020339. [PMID: 36837540 PMCID: PMC9960982 DOI: 10.3390/medicina59020339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
Background and Objectives: Cortisol, the stress hormone, is an important factor in initiating and maintaining lactation. Maternal suffering during pregnancy is predictive for the initiation and shorter duration of breastfeeding and can also lead to its termination. The aim of this study is to evaluate the relationship between the level of salivary cortisol in the third trimester of pregnancy and the initiation of breastfeeding in the postpartum period in a cohort of young pregnant women who wanted to exclusively breastfeed their newborns during hospitalization. Materials and Methods: For the study, full-term pregnant women were recruited between January and May 2022 in the Obstetrics and Gynecology Clinic of the Mureș County Clinical Hospital. Socio-demographic, clinical obstetric and neonatal variables were collected. Breastfeeding efficiency was assessed using the LATCH Breastfeeding Assessment Tool at 24 and 48 h after birth. The mean value of the LATCH score assessed at 24 and 48 h of age was higher among mothers who had a higher mean value of salivary cortisol measured in the third trimester of pregnancy (p < 0.05). A multivariate logistic regression model was used to detect risk factors for the success of early breastfeeding initiation. Results: A quarter of pregnant women had a salivary cortisol level above normal limits during the third trimester of pregnancy. There is a statistically significant association between maternal smoking, alcohol consumption during pregnancy and the level of anxiety or depression. Conclusions: The most important finding of this study was that increased salivary cortisol in the last trimester of pregnancy was not associated with delayed initiation/absence of breastfeeding.
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13
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Dong W, Shi N, Wen C, Zhang Y. An investigation of maternal psychological status of children with congenital talipes equinovarus treated with the Ponseti method. J Child Orthop 2023; 17:184-190. [PMID: 37034198 PMCID: PMC10080240 DOI: 10.1177/18632521221145479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/23/2022] [Indexed: 01/07/2023] Open
Abstract
Objectives: To investigate maternal psychological status of children with congenital talipes equinovarus in different periods, and to clarify the influence on maternal psychological status of congenital talipes equinovarus treated with the Ponseti method. Methods: Sixty-seven mothers of children with congenital talipes equinovarus were investigated. Self-rating Depression Scale and Self-rating Anxiety Scale were used to evaluate the psychological stress of the mothers at different periods. Paired-samples t-test was used to analyze the results. Results: The mothers of 67 children with congenital talipes equinovarus ranged from 25 to 38 years old, with an average of 33.5 years old. Before prenatal diagnosis of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 42.537 ± 10.476, and the average score of Self-rating Depression Scale was 47.254 ± 12.846; after prenatal diagnosis of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 54.224 ± 13.050, and the average score of Self-rating Depression Scale was 57.403 ± 13.649 points. Before the postpartum treatment of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 53.388 ± 12.716, the average score of Self-rating Depression Scale was 56.284 ± 13.617; after the treatment of congenital talipes equinovarus with the Ponseti method, the average score of Self-rating Anxiety Scale was 47.731 ± 12.259, and the average score of Self-rating Depression Scale was 51.910 ± 13.878 points. The above differences were statistically significant (P < 0.001). Conclusion: The prenatal diagnosis of congenital talipes equinovarus will increase the maternal psychological stress, and the maternal psychological status will be significantly improved after the deformity of congenital talipes equinovarus is corrected effectively by the Ponseti method. Level of evidence: level III, retrospective study.
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Affiliation(s)
- Wentao Dong
- Department of Orthopaedics, Shenzhen
University General Hospital, Shenzhen, P.R. China
| | - Ningning Shi
- Department of Operating Room and
Anesthesia, Shenzhen University General Hospital, Shenzhen, P.R. China
| | - Chunyu Wen
- Department of Orthopaedics, Shenzhen
University General Hospital, Shenzhen, P.R. China
| | - Yong Zhang
- Department of Orthopaedics, Shenzhen
University General Hospital, Shenzhen, P.R. China
- Yong Zhang, Department of Orthopaedics,
Shenzhen University General Hospital, Shenzhen 518055, P.R. China.
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14
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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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15
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Cevik A, Onat Koroglu C, Karacam Z, Gokyildiz Surucu S, Alan S. Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis. Clin Nurs Res 2022; 31:1405-1421. [PMID: 35912813 DOI: 10.1177/10547738221112748] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This systematic review and meta-analysis study aims to determine the effects of the Covid-19 pandemic on the prevalence of insomnia, anxiety, and depression symptoms during pregnancy. Reviews were done through PubMed, EBSCO (Medline, CINAHL), Embase (OVID), Web of Science, PsycINFO, TR Index, Turkish Thesis Center databases using (pregnancy OR pregnant) and (sleep OR sleep disorders OR insomnia), and (anxiety OR depression) keywords between April and May 2021. The meta-analysis included 48 articles (sample: 77,299). It was found that the Covid-19 pandemic did not affect the prevalence of depression symptoms and anxiety during pregnancy, but it increased insomnia. While insomnia ratio was reported 39.6% (95% CI: 0.253-0.560) in the studies conducted before the pandemic, it was reported 88.8% (95% CI: 0.821-0.921) in the studies conducted during the pandemic. This study found that the Covid-19 pandemic did not have effects on depression symptoms and anxiety, but it increased insomnia complaints.
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16
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Murphy HR, Gu Y, Wu Q, Brunner J, Panisch LS, Best M, Arnold MS, Duberstein ZT, Putzig J, Carnahan J, Groth SW, Barrett ES, Qiu X, O'Connor TG. Prenatal diurnal cortisol: Normative patterns and associations with affective symptoms and stress. Psychoneuroendocrinology 2022; 143:105856. [PMID: 35797838 DOI: 10.1016/j.psyneuen.2022.105856] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Abstract
The hypothalamic-pituitary-adrenal (HPA) axis in pregnancy has attracted considerable research attention, in part, because it may be a mechanism by which diverse prenatal exposures alter perinatal and child health outcomes. Symptoms of affective disturbance and stress are among the most-studied prenatal factors associated with HPA axis alterations, but there remains uncertainty about the nature of the association because of the limitations to, and variability in, data collection and analytic approaches. The current study capitalized on a prospective, longitudinal pregnancy cohort that examined salivary diurnal cortisol, collected at 5 time points across the day, at each trimester in a diverse sample of women. Detailed data on affective symptoms and major life events were collected at each trimester, as were data on health behaviors, medication, and socio-demographics. Results indicated modest stability of individual differences in diurnal cortisol across pregnancy, which was evident for diurnal slope (ICC = .20) and measures of total output (area under the curve, ICC = .25); substantial gestation-related increases in total cortisol output across pregnancy was also observed (p < .001). Adjusting for health behaviors, medication, and socio-demographic covariates, elevated levels of depressive symptoms and major life events were significantly (p < .05) associated with a higher morning awakening value and flatter diurnal slope, which was evident across all trimesters. In addition to the normative gestation-related changes in cortisol production, our results demonstrate selective but robust associations between psychological symptoms, stressors, and the HPA axis across gestation, and suggest both methodological and mechanistic strategies for future study.
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Affiliation(s)
- Hannah R Murphy
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Yu Gu
- Biostatistics and Computational Biology, University of Rochester, 265 Crittenden Blvd., Box 630, Rochester, NY 14642, USA
| | - Qiuyi Wu
- Biostatistics and Computational Biology, University of Rochester, 265 Crittenden Blvd., Box 630, Rochester, NY 14642, USA
| | - Jessica Brunner
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Lisa S Panisch
- Wayne State University School of Social Work, 5447 Woodward Ave., Detroit, MI 48202, USA
| | - Meghan Best
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Molly S Arnold
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, NY 14627, USA
| | - Zoe T Duberstein
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, NY 14627, USA
| | - Jenelle Putzig
- Pediatrics Infectious Diseases, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Jennifer Carnahan
- Pediatrics Infectious Diseases, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Susan W Groth
- School of Nursing, University of Rochester, 255 Crittenden Blvd., Rochester, NY, USA
| | - Emily S Barrett
- Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd., Piscataway, NJ 08854, USA
| | - Xing Qiu
- Biostatistics and Computational Biology, University of Rochester, 265 Crittenden Blvd., Box 630, Rochester, NY 14642, USA
| | - Thomas G O'Connor
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, NY 14627, USA; Neuroscience, University of Rochester, 601 Elmwood Avenue, Box 603, KMRB G.9602, Rochester, NY 14642, USA; Psychiatry, University of Rochester, 300 Crittenden Blvd., Rochester, NY 14642, USA.
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17
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Nguyen LD, Nguyen LH, Ninh LT, Nguyen HTT, Nguyen AD, Vu LG, Nguyen HSA, Nguyen SH, Doan LP, Vu TMT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities. BMC Pregnancy Childbirth 2022; 22:631. [PMID: 35945522 PMCID: PMC9364562 DOI: 10.1186/s12884-022-04961-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 07/20/2022] [Indexed: 12/12/2022] Open
Abstract
Background Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. Methods A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. Findings Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians’ prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. Conclusion This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.
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Affiliation(s)
- Lam Duc Nguyen
- Department of Anaesthesiology, Hanoi Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ly Thi Ninh
- Social Affair Department, Ca Mau Obstetrics & Pediatrics Hospital, Ca Mau, Vietnam
| | | | - Anh Duy Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam
| | | | - Son Hoang Nguyen
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam. .,Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam.
| | | | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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18
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Nicolson S, Carron S, Paul C. Supporting early infant relationships and reducing maternal distress with the Newborn Behavioral Observations: A randomized controlled effectiveness trial. Infant Ment Health J 2022; 43:455-473. [PMID: 35531961 PMCID: PMC9324818 DOI: 10.1002/imhj.21987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/27/2022] [Indexed: 11/29/2022]
Abstract
Research points to the significant impact of maternal distress on the parent‐infant relationship and infant development. The Newborn Behavioral Observations (NBO) is a brief intervention supporting the infant, the parent and their relationship. This randomized controlled trial examined the effectiveness of the NBO in a population with antenatal distress and risk of postnatal depression (PND). Pregnant, first‐time mothers with current anxiety or depression symptoms or past mental illness were recruited from two Australian hospitals. Participants received three NBO sessions in the first month of life plus treatment as usual (TAU), or, TAU‐only. Outcomes assessed at infant age 4 months included mother‐infant interaction quality; maternal anxiety and depression symptoms; and depression diagnosis. Of 111 pregnant individuals randomized, 90 remained eligible and 74 completed the trial (82.2% retention). There were intervention effects on emotional availability F(6, 67) = 2.52, p = .049, Cohen's d = .90, with higher sensitivity and non‐intrusiveness in the intervention group (n = 40) than the comparison group (n = 34). There was an intervention effect approaching significance for anxiety symptoms at 4 months (p = .06), and a significant effect over time (p = .014), but not for depression symptoms. Anxiety and depression symptoms significantly reduced to sub‐clinical levels within the intervention group only. There were fewer depression diagnoses (n = 6) than expected across groups, with no observed intervention effect. No adverse intervention effects were seen. Exploratory analysis of sensory processing sensitivity suggested differential susceptibility to distress and intervention benefits. The NBO was accepted and exerted meaningful effects on relationship quality and distress; and may enhance the infant's interaction experience and maternal emotional adjustment in at‐risk populations.
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Affiliation(s)
- Susan Nicolson
- Department of Psychiatry University of Melbourne Parkville Victoria Australia
- Department of General Practice University of Melbourne Parkville Victoria Australia
- Women's Mental Health Service Royal Women's Hospital Melbourne Victoria Australia
| | | | - Campbell Paul
- Department of Psychiatry University of Melbourne Parkville Victoria Australia
- Women's Mental Health Service Royal Women's Hospital Melbourne Victoria Australia
- Royal Children's Hospital Melbourne Victoria Australia
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19
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Huffhines L, Coe JL, Busuito A, Seifer R, Parade SH. Understanding links between maternal perinatal posttraumatic stress symptoms and infant socioemotional and physical health. Infant Ment Health J 2022; 43:474-492. [PMID: 35513001 PMCID: PMC9177799 DOI: 10.1002/imhj.21985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022]
Abstract
Maternal posttraumatic stress symptoms (PTSS) are associated with adverse consequences for older children, but very few studies have examined links between perinatal maternal PTSS and infant outcomes. Trauma exposure and psychopathology, including PTSS, is often heightened for women during pregnancy through 1 year postpartum. Therefore, the perinatal period may be a critical time for understanding the risk maternal PTSS and other mental health factors pose to the socioemotional and physical health of infants. The present study explored the relation between maternal PTSS and infant socioemotional and physical health problems in a sample of racially and ethnically diverse mother-infant dyads (N = 295) assessed prenatally and at 12 months postpartum. This study also examined whether there are: (1) moderating effects of maternal depressive symptoms and parenting stress on these associations and (2) indirect effects of PTSS on infant outcomes through observed maternal sensitivity. Results indicated that postpartum depressive symptoms and parenting stress, rather than PTSS, were associated with greater infant socioemotional health problems. However, prenatal PTSS were associated with greater infant physical health problems when mothers also reported clinically significant levels of postpartum depressive symptoms. Maternal sensitivity was not associated with maternal PTSS, depressive symptoms, or parenting stress, nor was it related to infant socioemotional and physical health; thus, maternal sensitivity was not tested as an intermediary mechanism linking maternal mental health with infant outcomes. Implications for promoting maternal mental health in the perinatal period to bolster socioemotional and physical health of infants are discussed.
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Affiliation(s)
- Lindsay Huffhines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
| | - Jesse L Coe
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
| | - Alex Busuito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA.,Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Stephanie H Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
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20
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Zhang CXW, Okeke JC, Levitan RD, Murphy KE, Foshay K, Lye SJ, Knight JA, Matthews SG. Evaluating depression and anxiety throughout pregnancy and after birth: impact of the COVID-19 pandemic. Am J Obstet Gynecol MFM 2022; 4:100605. [PMID: 35257937 PMCID: PMC8895717 DOI: 10.1016/j.ajogmf.2022.100605] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/09/2022] [Accepted: 02/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic presents unique social, economic, and psychological challenges for individuals globally. Thus, women who are pregnant face unprecedented mental health challenges. OBJECTIVE We sought to determine the impact of the pandemic on perinatal depression and anxiety in a longitudinal pregnancy cohort. We hypothesized increased depression and anxiety scores in women during pregnancy and after birth in the pandemic at all time points. STUDY DESIGN Participants were enrolled in the Ontario Birth Study, a pregnancy cohort embedded in clinical care at Mount Sinai Hospital, Toronto, Canada. Perinatal depression and anxiety were assessed using the 2-Item Patient Health Questionnaire and 2-Item Generalized Anxiety Disorder Questionnaire in early pregnancy, whereas the Edinburgh Postnatal Depression Scale and 2-Item Generalized Anxiety Disorder Questionnaire were used in late pregnancy and after birth. Logistic regression models were created to examine the association of the pandemic with clinically elevated mental health scores in the prepandemic group vs pandemic group while adjusting for covariates. RESULTS A total of 1159 survey responses from 649 participants between March 1, 2019, and February 28, 2021, were used to conduct this study. Participants were assessed in early pregnancy (n=416), in late pregnancy (n=373), and after birth (n=370). Responses received on or before February 29, 2020, were considered the “prepandemic” responses, whereas responses after the aforementioned date were considered the “pandemic” responses. Mean rank scores of depression and anxiety were significantly higher in the pandemic group (P=.02 and P=.003, respectively) in the postpartum period. There was no significant association between pandemic time and antenatal scores. However, postnatally, mothers were 2.6 times more likely to score ≥13 on the Edinburgh Postnatal Depression Scale during the pandemic than before the pandemic (95% confidence interval, 1.2–5.7; P=.02). Adjustment for ethnicity and income strengthened this association as the odds ratio increased to 3.3 (95% confidence interval, 1.4–8.0; P=.007). CONCLUSION Pandemic-associated increases in depression and anxiety scores were confined to the postpartum period, highlighting a need for increased screening and interventions for perinatal mood and anxiety disorders postnatally as this pandemic continues.
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Affiliation(s)
- Cindy X W Zhang
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews).
| | - Justin C Okeke
- Department of Obstetrics and Gynecology, Sinai Health System, New York City, NY (Mr Okeke and Drs Murphy, Lye, and Matthews)
| | - Robert D Levitan
- Mood and Anxiety Disorders Program, Centre for Addiction and Mental Health, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr Levitan); Department of Psychiatry, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr Levitan)
| | - Kellie E Murphy
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews); Department of Obstetrics and Gynecology, Sinai Health System, New York City, NY (Mr Okeke and Drs Murphy, Lye, and Matthews)
| | - Kim Foshay
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews)
| | - Stephen J Lye
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews); Department of Obstetrics and Gynecology, Sinai Health System, New York City, NY (Mr Okeke and Drs Murphy, Lye, and Matthews); Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Mount Sinai Hospital, Ontario, Canada (Drs Lye, Knight, and Matthews); and Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Julia A Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Mount Sinai Hospital, Ontario, Canada (Drs Lye, Knight, and Matthews); Dalla Lana School of Public Health, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr Knight)
| | - Stephen G Matthews
- Department of Physiology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada (Ms Zhang, Dr Murphy, Ms Foshay, and Drs Lye and Matthews); Department of Obstetrics and Gynecology, Sinai Health System, New York City, NY (Mr Okeke and Drs Murphy, Lye, and Matthews); Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Mount Sinai Hospital, Ontario, Canada (Drs Lye, Knight, and Matthews); and Department of Obstetrics and Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada
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21
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Emotion regulation during pregnancy: a call to action for increased research, screening, and intervention. Arch Womens Ment Health 2022; 25:527-531. [PMID: 35015146 PMCID: PMC8748524 DOI: 10.1007/s00737-022-01204-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/05/2022] [Indexed: 12/31/2022]
Abstract
This paper serves as a call to action for increased focus on emotion regulation during pregnancy. We make this case by summarizing the limited research to date on this topic, which has demonstrated that emotion regulation in pregnant people has important mental health, caregiving, and developmental correlates throughout the perinatal period. Given its crosscutting and modifiable nature, bolstering emotion regulation during pregnancy has the potential for considerable intergenerational consequences, and it is critical to further investigate this construct.
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22
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Mei X, Mei R, Liu Y, Wang X, Chen Q, Lei Y, Ye Z. Associations among fear of childbirth, resilience and psychological distress in pregnant women: A response surface analysis and moderated mediation model. Front Psychiatry 2022; 13:1091042. [PMID: 36590638 PMCID: PMC9797834 DOI: 10.3389/fpsyt.2022.1091042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Prenatal psychological distress is prevalent during pregnancy. This study aimed to estimate the associations among fear of childbirth, resilience and psychological distress. METHODS A total of 1,060 Chinese pregnant women were enrolled from Be Resilient to Postpartum Depression (ChiCTR2100048465) and the following instruments were administered to them: Childbirth Attitudes Questionnaire, Connor-Davidson Resilience Scale, Perceived Social Support Scale, General Self-Efficacy Scale, Adverse Childhood Experience scale and Hospital Anxiety and Depression Scale. A dominance, a response surface analysis and a moderated mediation analysis were performed. RESULTS In terms of psychological distress, resilience and fear of childbirth could explain 41.6% (0.148/0.356) and 33.1% (0.118/0.356), respectively. Pregnant women with high resilience-low fear of childbirth had significantly lower levels of psychological distress than those with low resilience-high fear of childbirth. The indirect effects of fear of childbirth on psychological distress through resilience was significantly (B = 0.054, 95% CI 0.038 to 0.070). The interactions between fear of childbirth and adverse childhood experiences (β = 0.114, 95% CI -0.002 to 0.231, p = 0.054) and between resilience and adverse childhood experiences (β = -0.118, 95% CI -0.222 to -0.012, p < 0.05) were significant. CONCLUSION Resilience, fear of childbirth and adverse childhood experiences may be three important factors to psychological distress in Chinese pregnant women.
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Affiliation(s)
- Xiaoxiao Mei
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ranran Mei
- Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuling Liu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qianwen Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Youjin Lei
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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23
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Gootjes DV, Posthumus AG, Jaddoe VWV, Steegers EAP. Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study. BMJ Open 2021; 11:e049075. [PMID: 34785546 PMCID: PMC8596053 DOI: 10.1136/bmjopen-2021-049075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes. DESIGN Prospective cohort study. SETTING The Netherlands, Rotterdam. PARTICIPANTS 8617 live singleton births from the Generation R cohort study. EXPOSITION Living in a deprived neighbourhood. MAIN OUTCOME MEASURES Fetal growth trajectories of head circumference, weight and length. SECONDARY OUTCOMES MEASURES Small-for-gestational age (SGA) and preterm birth (PTB). RESULTS Neighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01). CONCLUSIONS We found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.
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Affiliation(s)
- Dionne V Gootjes
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Anke G Posthumus
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, Rotterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
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24
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Maternal caregiving ameliorates the consequences of prenatal maternal psychological distress on child development. Dev Psychopathol 2021; 34:1376-1385. [PMID: 34311804 DOI: 10.1017/s0954579421000286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Children exposed to prenatal maternal psychological distress are at elevated risk for a range of adverse outcomes; however, it remains poorly understood whether postnatal influences can ameliorate impairments related to prenatal distress. The current study evaluated if sensitivematernal care during the first postnatal year could mitigate child cognitive and emotional impairments associated with prenatal psychological distress. Prenatal maternal psychological distress was assessed via self-reports of anxiety, depression, and perceived stress for 136 mothers at five prenatal and four postpartum time points. Quality of maternal care (sensitivity to nondistress, positive regard, and intrusiveness reverse-scored) were assessed during a mother-child play interaction at 6 and 12 months. Child cognitive function and negative emotionality were assessed at 2 years, using The Bayley Scales and the Early Childhood Behavior Questionnaire. Elevated prenatal distress was associated with poorer child cognitive function and elevated negative emotionality. Children exposed to elevated prenatal maternal distress did not, however, display these outcomes if they received high-quality caregiving. Specifically, maternal care moderated the relation between prenatal psychological distress and child cognitive function and negative emotionality. This association remained after consideration of postnatal maternal psychological distress and relevant covariates. Sensitive maternal care was associated with altered offspring developmental trajectories, supporting child resilience following prenatal distress exposure.
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25
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Riggs E, Yelland J, Mensah FK, Gold L, Szwarc J, Kaplan I, Small R, Middleton P, Krastev A, McDonald E, East C, Homer C, Nesvadba N, Biggs L, Braithwaite J, Brown SJ. Group Pregnancy Care for refugee background women: a codesigned, multimethod evaluation protocol applying a community engagement framework and an interrupted time series design. BMJ Open 2021; 11:e048271. [PMID: 34281928 PMCID: PMC8291298 DOI: 10.1136/bmjopen-2020-048271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Pregnancy and early parenthood are key opportunities for interaction with health services and connecting to other families at the same life stage. Public antenatal care should be accessible to all, however barriers persist for families from refugee communities to access, navigate and optimise healthcare during pregnancy. Group Pregnancy Care is an innovative model of care codesigned with a community from a refugee background and other key stakeholders in Melbourne, Australia. Group Pregnancy Care aims to provide a culturally safe and supportive environment for women to participate in antenatal care in a language they understand, to improve health literacy and promote social connections and inclusion. This paper outlines Froup Pregnancy Care and provides details of the evaluation framework. METHODS AND ANALYSIS The evaluation uses community-based participatory research methods to engage stakeholders in codesign of evaluation methods. The study is being conducted across multiple sites and involves multiple phases, use of quantitative and qualitative methods, and an interrupted time series design. Process and cost-effectiveness measures will be incorporated into quality improvement cycles. Evaluation measures will be developed using codesign and participatory principles informed by community and stakeholder engagement and will be piloted prior to implementation. ETHICS AND DISSEMINATION Ethics approvals have been provided by all six relevant authorities. Study findings will be shared with communities and stakeholders via agreed pathways including community forums, partnership meetings, conferences, policy and practice briefs and journal articles. Dissemination activities will be developed using codesign and participatory principles.
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Affiliation(s)
- Elisha Riggs
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Yelland
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Fiona K Mensah
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
- Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Josef Szwarc
- Victorian Foundation for Survivors of Torture, Melbourne, Victoria, Australia
| | - Ida Kaplan
- Victorian Foundation for Survivors of Torture, Melbourne, Victoria, Australia
| | - Rhonda Small
- Judith Lumely Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute, Stockholm, Sweden
| | - Philippa Middleton
- Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Faculty of Medical and Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ann Krastev
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ellie McDonald
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Christine East
- School of Nursing and Midwifery/Mercy Hospital for Women, La Trobe University, Melbourne, Victoria, Australia
| | - Caroline Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Natalija Nesvadba
- Multicultural Services, Mercy Hospitals Victoria Ltd, Melbourne, Victoria, Australia
| | - Laura Biggs
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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26
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Stanhope KK, Picon M, Schlusser C, Haddad LB, Jamieson DJ, Comeau DL, Suglia SF, Leon JS, Hogue CJR, Green VL, Kramer MR. Chronic Stress and Preconception Health Among Latina Women in Metro Atlanta. Matern Child Health J 2021; 25:1147-1155. [PMID: 33909207 DOI: 10.1007/s10995-021-03164-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Underserved subgroups are less likely to have optimal health prior to pregnancy. We describe preconception health indicators (behavior, pregnancy intention, and obesity) among pregnant Latina women with and without chronic stress in metro Atlanta. DESIGN We surveyed 110 pregnant Latina women enrolled in prenatal care at three clinics in Atlanta. The survey assessed chronic stress, pregnancy intention, preconception behavior changes (taking folic acid or prenatal vitamins, seeking healthcare advice, any reduction in smoking or drinking), and previous trauma. RESULTS Specific behaviors to improve health prior to pregnancy were uncommon (e.g., taking vitamins (25.5%) or improving nutrition (20.9%)). Just under half of women were experiencing a chronic stressor at the time of conception (49.5%). Chronically stressed women were more likely to be obese (aOR: 3.0 (1.2, 7.4)), less likely to intend their pregnancy (aOR: 0.3 (0.1, 0.7)), and possibly less likely to report any PHB (45.5% vs. 57.4%; aOR: 0.5 (0.2-1.1)). CONCLUSIONS Chronically stress women were less likely to enter prenatal care with optimal health. However, preconception behaviors were uncommon overall.
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Affiliation(s)
- Kaitlyn K Stanhope
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA. .,Department of Gynecology and Obstetrics, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA. .,Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA.
| | - Michelle Picon
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA
| | - Courtney Schlusser
- Department of Behavioral Science and Health Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Lisa B Haddad
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA
| | - Denise J Jamieson
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA
| | - Dawn L Comeau
- Department of Behavioral Science and Health Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Shakira F Suglia
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Juan S Leon
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Carol J R Hogue
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Victoria L Green
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA
| | - Michael R Kramer
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
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27
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Hawkins M, Misra D, Zhang L, Price M, Dailey R, Giurgescu C. Family involvement in pregnancy and psychological health among pregnant Black women. Arch Psychiatr Nurs 2021; 35:42-48. [PMID: 33593514 PMCID: PMC7890047 DOI: 10.1016/j.apnu.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/29/2020] [Accepted: 09/07/2020] [Indexed: 12/14/2022]
Abstract
Social determinants of health influence psychological health in pregnancy and contribute to health inequities in birth outcomes. This study examines the association between family involvement during pregnancy and psychological health among Black women. Pregnant women in Detroit, MI and Columbus, OH were recruited between 8 and 29 weeks' gestation (n = 203). Higher family involvement was associated with lower depressive symptoms (CES-D; β = -1.3, p < 0.001), perceived stress (β = -0.8, p < 0.001), and anxiety (β = -0.39, p < 0.01), and higher levels of psychological well-being (β = 2.2, p < 0.001). Family involvement may be a protective factor for pregnant Black women.
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Affiliation(s)
- Melissa Hawkins
- Department of Health Studies, College of Arts & Sciences, American University, 4400 Massachusetts Avenue NW, Washington, DC 20016, United States of America.
| | - Dawn Misra
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Wilson Road Room B601, East Lansing, MI 48824, United States of America.
| | - Liying Zhang
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, 6135 Woodward Avenue, Detroit, MI 48202, United States of America.
| | - Mercedes Price
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, 6135 Woodward Avenue, Detroit, MI 48202, United States of America.
| | - Rhonda Dailey
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, 6135 Woodward Avenue, Detroit, MI 48202, United States of America.
| | - Carmen Giurgescu
- College of Nursing, University of Central Florida, 12201 Research Parkway, Suite 300, Orlando, FL 32826, United States of America.
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28
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Selman SB, Dilworth-Bart J, Selman HS, Cook JG, Duncan LG. Skin-to-skin contact and infant emotional and cognitive development in chronic perinatal distress. Early Hum Dev 2020; 151:105182. [PMID: 32977205 PMCID: PMC8536803 DOI: 10.1016/j.earlhumdev.2020.105182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We examined whether the timing of maternal-neonate skin-to-skin contact (SSC) predicts infant emotional and cognitive development in the context of chronic maternal perinatal stress and depressive symptoms. STUDY DESIGN This secondary analysis included data from a group-based prenatal care clinical trial for 37 pregnant women with low household income. Mothers completed the Perceived Stress Scale (PSS), and the Center for Epidemiologic Studies Depression Scale (CES-D) during the third trimester and postpartum. After birth, they reported timing of SSC, and completed the Infant Behavior Questionnaire-Revised Very Short Form (IBQ-R VSF) (M = 51.7 weeks, SD = 4.2). Increased PSS or CES-D score from the third trimester to post-birth indicates chronic maternal perinatal stress or depressive symptoms compared to a decrease or no change. Using hierarchical regression models, we examined if the timing of SSC makes a unique contribution in predicting infant outcomes in the context of chronic maternal perinatal stress and depressive symptoms. RESULTS Stress-exposed infants had less negative emotionality if SSC is provided immediately after delivery, less than 10 min after birth. The effect of SSC on effortful control in relation to chronic perinatal stress was not statistically significant. The impact of timing of SSC on negative emotionality or effortful control in relation to chronic perinatal depressive symptoms was not statistically significant. CONCLUSION This work implies that very early SSC may play a role in later infant emotion regulation process and could act as a protective factor in chronically stressed pregnant women.
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Affiliation(s)
- Saliha B. Selman
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Janean Dilworth-Bart
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - H. Sule Selman
- Department of Midwifery, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Joseph G. Cook
- Osher Center for Integrative Medicine, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Larissa G. Duncan
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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29
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Merced-Nieves FM, Dzwilewski KLC, Aguiar A, Lin J, Schantz SL. Associations of prenatal maternal stress with measures of cognition in 7.5-month-old infants. Dev Psychobiol 2020; 63:960-972. [PMID: 33169388 DOI: 10.1002/dev.22059] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/22/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022]
Abstract
Studies have shown that prenatal stress can negatively impact neurodevelopment, but little is known about its effect on early cognitive development. We assessed the impact of prenatal stress on cognition in 152 7.5-month-old infants using Cohen's Perceived Stress Scale (PSS), maternal telomere length (MTL), and a Stressful Life Events (SLE) Scale. A visual recognition memory task consisting of nine blocks, each with one familiarization trial (two identical stimuli) followed by two test trials (one familiar stimulus, one novel), was administered. Outcomes assessed included: average time looking at stimuli (measure: processing speed), time to reach looking time criterion (measure: attention), and the proportion of time looking at the novel stimulus (measure: recognition memory). We examined the association of each stress measure with each outcome adjusted for infant age and sex, which of the two stimuli in each set was novel, household income, and maternal age, education, and IQ. Higher prenatal stress was associated with shorter looking durations [PSS (β = -1.6, 95% CI: -2.5, -0.58); SLE (β = 0.58, 95% CI: -0.08, 1.24); MTL (β = 1.81, 95% CI: 0.18, 3.44)] and longer time to reach criterion [PSS (β = 9.1, 95% CI: 1.6, 16.6); SLE (β = 12.2, 95% CI: 1.9, 24.1); MTL (β = -23.1, 95% CI: -45.3, -0.9)], suggesting that higher prenatal stress is associated with decreased visual attention in infancy.
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Affiliation(s)
- Francheska M Merced-Nieves
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Beckman Institute for Advance Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kelsey L C Dzwilewski
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Beckman Institute for Advance Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Andrea Aguiar
- Beckman Institute for Advance Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Comparative Biosciences, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Susan L Schantz
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Beckman Institute for Advance Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Comparative Biosciences, University of Illinois Urbana-Champaign, Urbana, IL, USA
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Hanswijk SI, Spoelder M, Shan L, Verheij MMM, Muilwijk OG, Li W, Liu C, Kolk SM, Homberg JR. Gestational Factors throughout Fetal Neurodevelopment: The Serotonin Link. Int J Mol Sci 2020; 21:E5850. [PMID: 32824000 PMCID: PMC7461571 DOI: 10.3390/ijms21165850] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/24/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
Serotonin (5-HT) is a critical player in brain development and neuropsychiatric disorders. Fetal 5-HT levels can be influenced by several gestational factors, such as maternal genotype, diet, stress, medication, and immune activation. In this review, addressing both human and animal studies, we discuss how these gestational factors affect placental and fetal brain 5-HT levels, leading to changes in brain structure and function and behavior. We conclude that gestational factors are able to interact and thereby amplify or counteract each other's impact on the fetal 5-HT-ergic system. We, therefore, argue that beyond the understanding of how single gestational factors affect 5-HT-ergic brain development and behavior in offspring, it is critical to elucidate the consequences of interacting factors. Moreover, we describe how each gestational factor is able to alter the 5-HT-ergic influence on the thalamocortical- and prefrontal-limbic circuitry and the hypothalamo-pituitary-adrenocortical-axis. These alterations have been associated with risks to develop attention deficit hyperactivity disorder, autism spectrum disorders, depression, and/or anxiety. Consequently, the manipulation of gestational factors may be used to combat pregnancy-related risks for neuropsychiatric disorders.
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Affiliation(s)
- Sabrina I. Hanswijk
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, 6525 EN Nijmegen, The Netherlands; (S.I.H.); (M.S.); (M.M.M.V.); (O.G.M.)
| | - Marcia Spoelder
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, 6525 EN Nijmegen, The Netherlands; (S.I.H.); (M.S.); (M.M.M.V.); (O.G.M.)
| | - Ling Shan
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA Amsterdam, The Netherlands;
| | - Michel M. M. Verheij
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, 6525 EN Nijmegen, The Netherlands; (S.I.H.); (M.S.); (M.M.M.V.); (O.G.M.)
| | - Otto G. Muilwijk
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, 6525 EN Nijmegen, The Netherlands; (S.I.H.); (M.S.); (M.M.M.V.); (O.G.M.)
| | - Weizhuo Li
- College of Medical Laboratory, Dalian Medical University, Dalian 116044, China; (W.L.); (C.L.)
| | - Chunqing Liu
- College of Medical Laboratory, Dalian Medical University, Dalian 116044, China; (W.L.); (C.L.)
| | - Sharon M. Kolk
- Department of Molecular Neurobiology, Donders Institute for Brain, Cognition and Behavior, Radboud University, 6525 AJ Nijmegen, The Netherlands;
| | - Judith R. Homberg
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Centre, 6525 EN Nijmegen, The Netherlands; (S.I.H.); (M.S.); (M.M.M.V.); (O.G.M.)
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31
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The effects of a music and singing intervention during pregnancy on maternal well-being and mother-infant bonding: a randomised, controlled study. Arch Gynecol Obstet 2020; 303:69-83. [PMID: 32776296 PMCID: PMC7854426 DOI: 10.1007/s00404-020-05727-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022]
Abstract
Purpose Stress and impaired mother–infant bonding during pregnancy can lead to adverse effects for the expectant mother and the unborn child. The present study investigates whether a prenatal music and singing intervention can improve maternal well-being as well as mother–infant bonding. Methods A total of 172 pregnant women took part in this prospective, randomised, three-armed (music, singing or control group) study. Depressive symptoms, self-efficacy, maternal well-being and mother–infant bonding were assessed with visual analogue scales and questionnaires before the intervention phase (30th week of gestation) and afterwards (36th week of gestation). Additionally, immediate changes regarding experienced stress and mood from before until after the music and singing interventions were explored with questionnaires as well as saliva samples (for cortisol, alpha-amylase and oxytocin determination). Results Regarding immediate effects, both interventions showed positive effects on the emotional state, stress (cortisol) and bonding (oxytocin). Additionally, the singing group showed a larger reduction in cortisol and a larger improvement in valence than the music group. Looking at more prolonged effects, significant effects on general self-efficacy and perceived closeness to the unborn child (measured with a visual analogue scale) were found. No significant effects were revealed for the mother–infant bonding questionnaire and for depressive symptoms. Conclusion In the present study, promising effects of music and in particular singing on maternal well-being and perceived closeness during pregnancy appeared. Prenatal music and singing interventions could be an easy to implement and effective addition to improve mood and well-being of the expectant mother and support mother-infant bonding. Trial registration number DRKS00012822, date of registration: 17.10.2017 Electronic supplementary material The online version of this article (10.1007/s00404-020-05727-8) contains supplementary material, which is available to authorized users.
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Merced-Nieves FM, Aguiar A, Dzwilewski KLC, Musaad S, Korrick SA, Schantz SL. Association of prenatal maternal perceived stress with a sexually dimorphic measure of cognition in 4.5-month-old infants. Neurotoxicol Teratol 2020; 77:106850. [PMID: 31812786 PMCID: PMC6980724 DOI: 10.1016/j.ntt.2019.106850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/21/2019] [Accepted: 12/04/2019] [Indexed: 01/02/2023]
Abstract
Maternal prenatal stress can adversely impact subsequent child neurodevelopment, but little is known about its effect on cognitive development in infancy. This analysis of 107 infants from a prospective birth cohort assessed whether prenatal stress disrupts sexually dimorphic performance typically observed on a physical reasoning task. Maternal stress was assessed at 8-14 and 33-37 gestational weeks using the Perceived Stress Scale. Stress was defined as: low (scores below the median at both times), medium (scores above the median at one of the two times), and high (scores above the median at both times). At 4.5 months infants saw videos of two events: one impossible and the other possible. In the impossible event a box was placed against a wall without support underneath. In the possible event the box was placed against the wall, supported by the floor. Looking time at each event was recorded via infrared eye-tracking. Previous literature has shown that, at 4.5 months of age, girls typically look significantly longer at the impossible than at the possible event, suggesting that they expect the unsupported box to fall and are surprised when it does not. Boys tend to look equally at the two events suggesting that they do not share this expectation. This sex difference was replicated in the current study. General linear models stratified by sex and adjusted for household income, maternal education, mother's age at birth, infant's age at exam, and order of event presentation revealed that girls whose mothers reported high perceived stress during pregnancy had shorter looking time differences between the impossible and possible events than girls whose mothers reported low perceived stress (β = -7.1; 95% CI: -12.0, -2.2 s; p = 0.006). Similar to boys, girls in the highest stress category spent about the same amount of time looking at each event. For boys, there were no significant looking time differences by maternal stress level. This finding suggests prenatal stress is associated with a delay in the development of physical reasoning in girls.
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Affiliation(s)
- F M Merced-Nieves
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America.
| | - A Aguiar
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
| | - K L C Dzwilewski
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
| | - S Musaad
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States of America
| | - S A Korrick
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - S L Schantz
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
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Silva CCV, Vehmeijer FOL, El Marroun H, Felix JF, Jaddoe VWV, Santos S. Maternal psychological distress during pregnancy and childhood cardio-metabolic risk factors. Nutr Metab Cardiovasc Dis 2019; 29:572-579. [PMID: 30956027 DOI: 10.1016/j.numecd.2019.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/13/2019] [Accepted: 02/26/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Previous studies suggest that psychological distress during pregnancy may lead to fetal developmental adaptations, which programme cardio-metabolic disease of the offspring. We examined the associations of maternal overall psychological distress, depression and anxiety during pregnancy with cardio-metabolic risk factors in 10-year-old children and explore potential sex-specific differences. METHODS AND RESULTS In a population-based prospective cohort study among 4,088 mothers and their children, information about overall psychological distress, including depression and anxiety was obtained through the Brief Symptom Inventory during pregnancy. We measured child blood pressure and heart rate and insulin, glucose, serum lipids and C-reactive protein blood concentrations at 10 years. Analyses were performed in the total group and in boys and girls separately. Psychological distress during pregnancy was associated with higher childhood heart rate among boys only (differences 0.34 (95% Confidence Interval (CI) 0.18, 0.50) standard deviation scores (SDS), 0.22 (95% CI 0.06, 0.38) SDS, 0.33 (95% CI 0.19, 0.48) SDS, for overall psychological distress, depression and anxiety, respectively). Maternal anxiety during pregnancy was associated with higher childhood triglycerides among girls (difference 0.35 (95% CI 0.17, 0.53) SDS). Maternal psychological distress was not associated with childhood blood pressure, cholesterol, insulin, glucose and C-reactive protein concentrations. CONCLUSIONS Maternal psychological distress may influence their offspring heart rate and triglycerides concentrations. Further studies are needed to replicate these findings and assess the long-term cardio-metabolic consequences of maternal psychological distress.
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Affiliation(s)
- C C V Silva
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands
| | - F O L Vehmeijer
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, the Netherlands
| | - H El Marroun
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, the Netherlands; Erasmus University Rotterdam, Department of Psychology, Education and Child Studies, Rotterdam, the Netherlands
| | - J F Felix
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, the Netherlands
| | - V W V Jaddoe
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, the Netherlands.
| | - S Santos
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands
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