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Spiegler J, El-Awad U, Baumann N, Lemola S, Wolke D. Participation in club sport in childhood is associated with mental health in preterm and term born adolescents. Eur Child Adolesc Psychiatry 2024; 33:2823-2830. [PMID: 38291168 PMCID: PMC11272685 DOI: 10.1007/s00787-023-02365-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024]
Abstract
Preterm born individuals have an increased risk for mental health problems. Participation in club sport is associated with better mental health but the causal direction is unclear. It is not known whether this association could also be found in preterm children. Data from term born (N = 10,368), late preterm (N = 630), and very to moderately preterm born (N = 243) children from the Millennium Cohort Study at the ages of 3, 5, 7, 11, and 14 years were used. Longitudinal associations between the parent-reported Strengths and Difficulties questionnaire (SDQ) and club sport participation (days per week) were analysed using multigroup structural equation modelling, adjusting for gender, maternal depression, parental education; motor problems and attrition were controlled for. Multi-group structural equation modelling showed that children with more peer relationship problems, emotional symptoms, conduct problems or hyperactivity-inattention were less likely to participate in club sport at subsequent assessment time points. More days with club sport participation was associated with lower levels of emotional symptoms and peer relationship problems but not conduct problems or hyperactivity-inattention at subsequent ages. Results were similar in all gestational age groups. Club sport participation predicts lower levels of peer relationship and emotional problems in subsequent waves while it is also predicted by lower levels of emotional problems, peer relationship problems, conduct problems and hyperactivity-inattention in preceding waves. Since no differences in the relationship between SDQ subscales and club sport participation were seen with regard to gestational age groups, club sport should be encouraged in all children.
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Affiliation(s)
- Juliane Spiegler
- Department of Paediatrics, University Hospital of Würzburg, Josef-Schneider-Strasse 2, 97080, Würzburg, Germany.
- Department of Psychology, University of Warwick, University Road, Coventry, CV4 7AL, UK.
| | - Usama El-Awad
- Faculty of Psychology and Sports Sciences, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany
| | - Nicole Baumann
- Department of Psychology, University of Warwick, University Road, Coventry, CV4 7AL, UK
- Department of Population Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Level 5, 18 Innovation Walk, Clayton Campus, Melbourne, VIC, 3800, Australia
| | - Sakari Lemola
- Department of Psychology, University of Warwick, University Road, Coventry, CV4 7AL, UK
- Faculty of Psychology and Sports Sciences, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, University Road, Coventry, CV4 7AL, UK
- Division of Mental Health & Wellbeing, University of Warwick, University Road, Coventry, CV4 7AL, UK
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2
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Borairi S, Deneault AA, Madigan S, Fearon P, Devereux C, Geer M, Jeyanayagam B, Martini J, Jenkins J. A meta-analytic examination of sensitive responsiveness as a mediator between depression in mothers and psychopathology in children. Attach Hum Dev 2024; 26:273-300. [PMID: 38860779 DOI: 10.1080/14616734.2024.2359689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/21/2024] [Indexed: 06/12/2024]
Abstract
The current meta-analysis examined the mediating role of sensitive-responsive parenting in the relationship between depression in mothers and internalizing and externalizing behavior in children. A systematic review of the path of maternal sensitive responsiveness to child psychopathology identified eligible studies. Meta-analytic structural equation modelling (MASEM) allowed for the systematic examination of the magnitude of the indirect effect across 68 studies (N = 15,579) for internalizing and 92 studies (N = 26,218) for externalizing psychopathology. The synthesized sample included predominantly White, English-speaking children (age range = 1 to 205 months; Mage = 66 months; 47% female) from Western, industrialized countries. The indirect pathway was small in magnitude and similar for externalizing (b = .02) and internalizing psychopathology (b = .01). Moderator analyses found that the indirect pathway for externalizing problems was stronger when mother-child interactions were observed during naturalistic and free-play tasks rather than structured tasks. Other tested moderators were not significant.
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Affiliation(s)
- Sahar Borairi
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Pasco Fearon
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Chloe Devereux
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Melissa Geer
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | | | - Julia Martini
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | - Jennifer Jenkins
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
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3
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Faa G, Fanos V, Manchia M, Van Eyken P, Suri JS, Saba L. The fascinating theory of fetal programming of adult diseases: A review of the fundamentals of the Barker hypothesis. J Public Health Res 2024; 13:22799036241226817. [PMID: 38434579 PMCID: PMC10908242 DOI: 10.1177/22799036241226817] [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: 11/24/2023] [Accepted: 12/27/2023] [Indexed: 03/05/2024] Open
Abstract
The theory of fetal programming of adult diseases was first proposed by David J.P. Barker in the eighties of the previous century, to explain the higher susceptibility of some people toward the development of ischemic heart disease. According to his hypothesis, poor maternal living conditions during gestation represent an important risk factor for the onset of atherosclerotic heart disease later in life. The analysis of the early phases of fetal development is a fundamental tool for the risk stratification of children and adults, allowing the identification of susceptible or resistant subjects to multiple diseases later in life. Here, we provide a narrative summary of the most relevant evidence supporting the Barker hypothesis in multiple fields of medicine, including neuropsychiatric disorders, such as Parkinson disease and Alzheimer disease, kidney failure, atherosclerosis, coronary heart disease, stroke, diabetes, cancer onset and progression, metabolic syndrome, and infectious diseases including COVID-19. Given the consensus on the role of body weight at birth as a practical indicator of the fetal nutritional status during gestation, every subject with a low birth weight should be considered an "at risk" subject for the development of multiple diseases later in life. The hypothesis of the "physiological regenerative medicine," able to improve fetal organs' development in the perinatal period is discussed, in the light of recent experimental data indicating Thymosin Beta-4 as a powerful growth promoter when administered to pregnant mothers before birth.
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Affiliation(s)
- Gavino Faa
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA
| | - Vassilios Fanos
- Unit of Neonatology and NICU Center, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Peter Van Eyken
- Department of Pathology, UZ Genk Regional Hospital, Genk, Belgium
| | - Jasjit S. Suri
- Stroke Diagnostic and Monitoring Division, Atheropoint, Roseville, CA, USA
| | - Luca Saba
- Unit of Radiology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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4
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Guille C, Henrich N, Brinson AK, Jahnke HR. Improving the Management of Maternal Mental Health with Digital Health Care. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2023; 6:23-32. [PMID: 38510485 PMCID: PMC10948940 DOI: 10.1176/appi.prcp.20230035] [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: 07/10/2023] [Revised: 08/28/2023] [Accepted: 09/27/2023] [Indexed: 03/22/2024] Open
Abstract
Objectives Digital health solutions have the potential to improve maternal mental health care. The objective of this study is to determine if utilization of a digital health platform, Maven, is associated with improved management of mental health among peripartum people with a history of mental health disorders and determine which components of utilization associate with maternal mental health outcomes. Methods Participants in this retrospective cohort analysis (n = 1561) accessed Maven as an employer-sponsored health benefit and enrolled during their pregnancy and delivered from January 2020 through September 2022. Participants completed health surveys at enrollment, including history of a mood disorder, and post-delivery. Maven includes online articles, asynchronous and synchronous virtual classes, app-based mental health screenings, access to allied health professional and maternity care providers via messaging and telehealth appointments. Quantile g-computation was used to estimate the effects of multi-utilization exposures on reports of postpartum depression (PPD) and management of mental health. Results Multi-utilization exposure mixture models demonstrated that increasing use of digital resources by one quartile is associated with an increased odds of reporting that Maven helped users manage their mental health (aOR: 12.58 [95% CI: 6.74, 23.48]) and was not associated with self-reported incidence of PPD (aOR: 1.30 [95% CI: 0.52, 3.27]). Care advocate appointments, provider messages, and article reads were positively associated with improved mental health management. Conclusions Digital health platforms, such as Maven, may play an important role in managing maternal mental health conditions among pregnant and postpartum people at high risk for PPD.
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Affiliation(s)
- Constance Guille
- Department of Psychiatry and Behavioral SciencesMedical University of South CarolinaCharlestonSouth CarolinaUSA
- Department of Obstetrics and GynecologyMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | | | - Alison K. Brinson
- Maven ClinicNew YorkNew YorkUSA
- Department of AnthropologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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5
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Schneider I, Zietlow AL. [The parent-child relationship in the context of parental mental illness-Possibilities for intervention]. DER NERVENARZT 2023; 94:822-826. [PMID: 37171658 DOI: 10.1007/s00115-023-01491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/13/2023]
Abstract
The parent-child relationship is the earliest and one of the most important close social relationships in a person's life. It begins even during pregnancy, is expressed in interactions and is accompanied by many neurobiological processes. A sensitive interaction with the parent who is well-adapted to the needs of the child, is necessary for a healthy child development; however, parents with mental disorders often face more difficulties in parenting than healthy parents. They tend to exhibit more intrusive or withdrawn behavior and report experiencing increased stress in parenting, which in turn can be a risk factor for the mental disorder. At the same time, parenting can be a great resource. Early recognition of stress in parenting is central to healthy child development and also to the parent's mental health. In addition to disorder-specific treatment for parents, parent-child focused interventions can be used in relationship or interaction disorders. This article presents and discusses different prevention and intervention approaches.
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Affiliation(s)
- Isabella Schneider
- Klinik für Allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland.
| | - Anna-Lena Zietlow
- Klinische Kinder- und Jugendpsychologie, Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Chemnitzer Straße 46a, 01187, Dresden, Deutschland
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6
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Na X, Glasier CM, Andres A, Bellando J, Chen H, Gao W, Livingston LW, Badger TM, Ou X. Associations between mother's depressive symptoms during pregnancy and newborn's brain functional connectivity. Cereb Cortex 2023; 33:8980-8989. [PMID: 37218652 PMCID: PMC10350841 DOI: 10.1093/cercor/bhad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
Depression during pregnancy is common and the prevalence further increased during the COVID pandemic. Recent findings have shown potential impact of antenatal depression on children's neurodevelopment and behavior, but the underlying mechanisms are unclear. Nor is it clear whether mild depressive symptoms among pregnant women would impact the developing brain. In this study, 40 healthy pregnant women had their depressive symptoms evaluated by the Beck Depression Inventory-II at ~12, ~24, and ~36 weeks of pregnancy, and their healthy full-term newborns underwent a brain MRI without sedation including resting-state fMRI for evaluation of functional connectivity development. The relationships between functional connectivities and maternal Beck Depression Inventory-II scores were evaluated by Spearman's rank partial correlation tests using appropriate multiple comparison correction with newborn's gender and gestational age at birth controlled. Significant negative correlations were identified between neonatal brain functional connectivity and mother's Beck Depression Inventory-II scores in the third trimester, but not in the first or second trimester. Higher depressive symptoms during the third trimester of pregnancy were associated with lower neonatal brain functional connectivity in the frontal lobe and between frontal/temporal lobe and occipital lobe, indicating a potential impact of maternal depressive symptoms on offspring brain development, even in the absence of clinical depression.
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Affiliation(s)
- Xiaoxu Na
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Charles M Glasier
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Aline Andres
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
- Arkansas Children’s Nutrition Center, Little Rock 72202, AR, United States
- Arkansas Children’s Research Institute, Little Rock 72202, AR, United States
| | - Jayne Bellando
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Haitao Chen
- Department of Biomedical Sciences and Imaging, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
- Department of Bioengineering, University of California at Los Angeles, Los Angeles, CA 90095, United States
| | - Wei Gao
- Department of Biomedical Sciences and Imaging, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Luke W Livingston
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
| | - Thomas M Badger
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
- Arkansas Children’s Nutrition Center, Little Rock 72202, AR, United States
- Arkansas Children’s Research Institute, Little Rock 72202, AR, United States
| | - Xiawei Ou
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
- Arkansas Children’s Nutrition Center, Little Rock 72202, AR, United States
- Arkansas Children’s Research Institute, Little Rock 72202, AR, United States
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7
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Morales MF, Girard LC, Raouna A, MacBeth A. The association of different presentations of maternal depression with children's socio-emotional development: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001649. [PMID: 36963088 PMCID: PMC10021281 DOI: 10.1371/journal.pgph.0001649] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 02/03/2023] [Indexed: 03/01/2023]
Abstract
Maternal depression from the perinatal period onwards is a global health priority associated with an increased likelihood of suboptimal socio-developmental outcomes in offspring. An important aspect of this association is the extent to which sustained maternal depression impacts on these outcomes. The current review synthesised the evidence on maternal depression from the perinatal period onwards and offspring internalising, externalising, and social competence outcomes. We also identified sources of methodological bias. A systematic review following PRISMA guidelines was conducted. Longitudinal studies targeting biological mothers with depressive symptomology, detailing onset, using repeated validated measures, and assessing children's outcomes between three and 12 years were included. Twenty-four studies met inclusion criteria. Findings supported the validity of different presentations of maternal depression, including consistent identification of a group of chronically depressed mothers across countries. Mothers within this group reported poorer internalising, externalising, and social competence outcomes for their offspring, with the highest levels of child problems associated with greater maternal chronicity and symptom severity. Results differed by measurement type with mothers rating poorer outcomes in comparison to teachers reports. For timing of depression, evidence was inconsistent for independent effects of antenatal or postnatal depression on child outcomes. There was substantial variability in study quality assessment. Assessing different presentations of maternal depression is essential for capturing the longitudinal associations between maternal depression and offspring outcomes to inform targets of early intervention. Chronicity, severity, and concurrent maternal depression have important implications for children's development and should be targeted in future programme planning. Further research in low- and middle-income countries is warranted.
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Affiliation(s)
- María Francisca Morales
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Lisa-Christine Girard
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Aigli Raouna
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Angus MacBeth
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
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8
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Association between maternal prenatal psychological distress and autism spectrum disorder among 3-year-old children: The Japan Environment and Children's Study. J Dev Orig Health Dis 2023; 14:70-76. [PMID: 35801288 DOI: 10.1017/s2040174422000411] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Maternal prenatal psychological distress, which includes depression and anxiety, affects the onset of autism spectrum disorder (ASD). However, there is no consistent knowledge regarding at which term during pregnancy psychological distress affects the risk of ASD among children. We used a dataset obtained from the Japan Environment and Children's Study, which is a nationwide prospective birth cohort study, to evaluate the association between the six-item Kessler Psychological Distress Scale (K6) and ASD among 3-year-old children. A total of 78,745 children were analyzed, and 355 of them were diagnosed with ASD (0.45%). The maternal K6 was administered twice during pregnancy: at a median of 15.1 weeks (M-T1) and at that of 27.4 weeks (M-T2) of gestation. Multivariate logistic regression analyses demonstrated that the group with a maternal K6 score of ≥5 at both M-T1 and M-T2 was significantly associated with ASD among the children (adjusted odds ratio, 1.440; 95% confidence interval, 1.104-1.877) compared to the group with a score of ≤4 at both M-T1 and M-T2. There was no significant difference between the group with a score of ≥5 only at M-T1 or M-T2 and that with a score of ≤4 at both M-T1 and M-T2. In conclusion, from the first to the second half of pregnancy, continuous maternal psychological distress was associated with ASD among 3-year-old children. Contrarily, in the group without persistent maternal psychological distress during pregnancy, there was no significant association.
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9
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Maternal prenatal psychological distress and motor/cognitive development in two-year-old offspring: The Japan Environment and Children's Study. J Dev Orig Health Dis 2023; 14:389-401. [PMID: 36650740 DOI: 10.1017/s2040174422000691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Maternal prenatal psychological distress, including depression and anxiety, may affect offspring's motor/cognitive development. However, research findings have been inconsistent. We used a dataset from the Japan Environment and Children's Study to evaluate associations between maternal six-item Kessler Psychological Distress Scale (K6) scores and motor/cognitive development among offspring at two years of age. Their offspring's motor/cognitive development was assessed using the Kyoto Scale of Psychological Development 2001. Records for 1859 male and 1817 female offspring were analyzed. The maternal K6 was administered twice during pregnancy: at a median of 14.6 weeks (M-T1) and 27.3 weeks (M-T2) of gestation. Multiple regression analysis was performed with the group with K6 scores ≤4 at both M-T1 and M-T2 as a reference. In the group with K6 scores ≥5 at both M-T1 and M-T2, male offspring had significantly lower developmental quotients (DQ) in the posture-motor area (partial regression coefficient [B]: -3.68, 95% confidence interval [CI]: -5.92 to -1.44) and language-social area (B: -1.93; 95%CI: -3.73 to -0.12), while female offspring had a lower DQ for the language-social area (B: -1.95; 95%CI: -3.73 to -0.17). In those with K6 scores ≥5 only at M-T1 or M-T2, male and female offspring did not differ significantly in DQ for any area. Continuous maternal psychological distress from the first to the second half of pregnancy was associated with lower motor and verbal cognitive development in male offspring and lower verbal cognitive development in female offspring at 2 years compared with the group without persistent maternal prenatal psychological distress.
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10
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Naudé PJW, Pariante C, Hoffman N, Koopowitz SM, Donald KA, Zar HJ, Stein DJ. Antenatal maternal depression, early life inflammation and neurodevelopment in a South African birth cohort. Brain Behav Immun 2022; 105:160-168. [PMID: 35803482 DOI: 10.1016/j.bbi.2022.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/07/2022] [Accepted: 07/03/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Antenatal exposure to maternal psychological adversity, including depression, increases the risk of impaired neurodevelopment in children. The underlying biological mechanisms remain unclear, especially in early life during critical windows of development and maturation. This study investigated the association of antenatal maternal depression, maternal and early life inflammatory markers and neurodevelopmental outcomes in children at 2 years of age. METHODS A subgroup of mothers and their children (n = 255) that were enrolled in a South African birth cohort study, the Drakenstein Child Health Study, were followed from the antenatal period through to 2 years of child age. Maternal depressive symptoms were measured by the Beck Depression Inventory (BDI-II) at 26 weeks gestation. Serum inflammatory markers [granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ (IFN-γ), interleukin IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, tumour necrosis factor-α (TNF-α), neutrophil gelatinase-associated lipocalin (NGAL) and metalloproteinase-9 (MMP-9)] were measured in mothers at enrolment and in their children at 6-10 weeks and at 2 years. Neurodevelopment was assessed at 2 years using the Bayley Scales of Infant and Toddler Development III. RESULTS Antenatal depressive symptoms (present in 25% of the mothers) were significantly associated with higher levels of IL-7 (p = 0.008), IL-8 (p = 0.019) and TNF-α (p = 0.031) in the mothers after correcting for sociodemographic and lifestyle factors. Serum IL-1β and NGAL levels were significantly elevated over time in children born to mothers with depressive symptoms compared to those without depression, after controlling for maternal and child health and sociodemographic factors. Elevated infant IL-1β at 6-10 weeks of age partially mediated the association of maternal depressive symptoms with poorer language scores at 2 years. CONCLUSION Alterations in early life immunity, as reflected by elevated IL-1β, is a potential pathway through which antenatal maternal depressive symptoms may impact language development in young children.
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Affiliation(s)
- Petrus J W Naudé
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa.
| | - Carmine Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Nadia Hoffman
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | | | - Kirsten A Donald
- Neuroscience Institute, University of Cape Town, South Africa; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; SA-MRC Unit on Child and Adolescent Health, University of Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa; SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South Africa
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11
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Lähdepuro A, Lahti-Pulkkinen M, Pyhälä R, Tuovinen S, Lahti J, Heinonen K, Laivuori H, Villa PM, Reynolds RM, Kajantie E, Girchenko P, Räikkönen K. Positive maternal mental health during pregnancy and mental and behavioral disorders in children: A prospective pregnancy cohort study. J Child Psychol Psychiatry 2022; 64:807-816. [PMID: 35524467 DOI: 10.1111/jcpp.13625] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The role of positive maternal mental health during pregnancy in child mental health remains largely unknown. We investigated whether positive maternal mental health during pregnancy is associated with lower hazards of mental and behavioral disorders in children and mitigates the adverse effects of negative maternal mental health. METHODS Among 3,378 mother-child dyads of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study, mothers reported their positive mental health biweekly throughout pregnancy with the Positive and Negative Affect Schedule, the Spielberger State Anxiety Inventory Curiosity scale, and a visual analogue scale for social support, and negative mental health with the Center for Epidemiologic Studies Depression Scale. We extracted data on their mental and behavioral disorder diagnoses from a nationwide medical register. This register provided data on their children's mental and behavioral disorder diagnoses as well, from birth until 8.4-12.8 (Median = 10.2, Interquartile Range 9.7-10.8) years of age. RESULTS A positive maternal mental health composite score during pregnancy was associated with a lower hazard of any mental and behavioral disorder among all children [Hazard Ratio (HR) = 0.79, 95% Confidence Interval (CI) 0.71 - 0.87] and among children of mothers experiencing clinically relevant depressive symptoms during pregnancy [HR = 0.80, 95%CI 0.64 - 1.00] and/or mental and behavioral disorders before or during pregnancy [HR = 0.69, 95%CI 0.55-0.86]. These associations were independent of covariates. CONCLUSIONS Children whose mothers had more positive mental health during pregnancy were less likely to develop mental and behavioral disorders. Protective effects were seen also among children of mothers facing mental health adversities before or during pregnancy.
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Affiliation(s)
- Anna Lähdepuro
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Riikka Pyhälä
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Soile Tuovinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Psychology/Welfare Sciences, Tampere University, Tampere, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Psychology/Welfare Sciences, Tampere University, Tampere, Finland
| | - Hannele Laivuori
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.,Psychology/Welfare Sciences, Tampere University, Tampere, Finland.,Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynaecology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Pia M Villa
- Department of Obstetrics and Gynaecology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.,Hyvinkää Hospital, Helsinki and Uusimaa Hospital District, Helsinki, Finland
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.,Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
| | - Polina Girchenko
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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12
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Levin LK, Fuller EB, Coffield E, Bendell D. It's not always binary: Connecting the continuum of caregiver depression with child adjustment in children who are high risk for maltreatment. J Affect Disord 2022; 304:142-149. [PMID: 35167927 DOI: 10.1016/j.jad.2022.01.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Young children living with a depressed parent are at risk for developing social, behavioral, and emotional problems. The purpose of this study was to evaluate whether an increase in subclinical caregiver depression scores was associated with increases in internalizing and externalizing behavior in children who are at high risk for maltreatment. METHODS The 1019 U.S.-based dyads consisted of predominantly single (45.53%) and Black/African American (53.29%) caregivers and high-risk 4-year-olds from the LONGSCAN study. Multivariate regression analyzes were used to evaluate the relationship between caregiver Center for Epidemiological Studies-Depression (CES-D) scores, above and below the at-risk for depression CES-D score, and preschooler internalizing, externalizing, and total problem behaviors, measured with the Child Behavior Checklist (CBCL). RESULTS Caregiver CES-D score increases, above and below the at-risk for depression score, were significantly associated (p < 0.05) with increased child internalizing, externalizing, and total problem behaviors. After adjusting for covariates, among dyads whose caregivers had subclinical (CES-D < 16) scores, a one-unit score increase was significantly associated with a 0.43 increase (p = 0.00) in children's CBCL internalizing score. LIMITATIONS These findings are restricted to preschool children who are at risk for maltreatment, limiting generalizability. CONCLUSIONS Low and moderate levels of caregiver depressive symptomatology were associated with a negative influence on preschoolers' adjustment. Practitioners should consider that the link between caregiver depression and child wellbeing may lie on a continuum. With consideration of the full continuum of symptoms, early intervention and anticipatory guidance may decrease the impact of depression on the caregiver, child, and system.
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Affiliation(s)
- Leanne Katz Levin
- Department of Medicine, Foundations of Clinical Medicine, New York Medical College, 7 Dana Road, Valhalla, New York 10595, USA; Department of Clinical Psychology, School of Psychology, Fielding Graduate University, 2020 De La Vina Street, Santa Barbara, CA 93105, USA.
| | | | - Edward Coffield
- Department of Population Health, Hofstra University, New York, USA
| | - Debra Bendell
- Department of Clinical Psychology, School of Psychology, Fielding Graduate University, 2020 De La Vina Street, Santa Barbara, CA 93105, USA
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13
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Hendrix CL, Brown AL, McKenna BG, Dunlop AL, Corwin EJ, Brennan PA. Prenatal distress links maternal early life adversity to infant stress functioning in the next generation. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:117-129. [PMID: 35230857 PMCID: PMC9031909 DOI: 10.1037/abn0000688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Maternal stress in pregnancy exerts powerful programming effects into the next generation. Yet it remains unclear whether and how adversity from other times in the woman's life influences her prenatal stress and her offspring's stress functioning. In a sample of 217 Black American mother-infant dyads, we examined whether different types of maternal stress were differentially related to her infant's stress functioning within the first few months after birth. We prospectively assessed maternal distress (perceived stress, depression, and anxiety) early and late in pregnancy, infant behavioral adaption in the context of a mild stressor at 2 weeks of age, and infant diurnal cortisol at 3-6 months of age. We additionally collected retrospective reports of maternal experiences of lifetime discrimination and childhood adversity. Maternal distress experienced late, but not early, in pregnancy predicted lower infant attention in the context of a stressor. Moreover, lifetime experiences of discrimination indirectly impacted infant attention by increasing maternal distress late in pregnancy. These effects were specific to infant behavioral adaptation and were not related to infant diurnal cortisol levels. However, infant diurnal cortisol levels were associated with maternal experiences of discrimination from prior to pregnancy and adversity from the mother's childhood even after controlling for prenatal distress. Our results underscore the cascading nature of stress across the mother's life span and across generations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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14
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Kvist T, Sammallahti S, Lahti-Pulkkinen M, Cruceanu C, Czamara D, Dieckmann L, Tontsch A, Röh S, Rex-Haffner M, Wolford E, Reynolds R, Eriksson J, Suomalainen-König S, Laivuori H, Kajantie E, Lahdensuo E, Binder E, Räikkönen K. Cohort profile: InTraUterine sampling in early pregnancy (ITU), a prospective pregnancy cohort study in Finland: study design and baseline characteristics. BMJ Open 2022; 12:e049231. [PMID: 35105615 PMCID: PMC8804635 DOI: 10.1136/bmjopen-2021-049231] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The InTraUterine sampling in early pregnancy (ITU) is a prospective pregnancy cohort study. The overarching aim of ITU is to unravel genomic, epigenomic, transcriptomic, endocrine, inflammatory and metabolic maternal-placental-fetal mechanisms involved in the programming of health and disease after exposure to prenatal environmental adversity, such as maternal malnutrition, cardiometabolic disorders, infections, medical interventions, mental disorders and psychosocial stress. This paper describes the study protocol, design and baseline characteristics of the cohort. PARTICIPANTS We included 944 pregnant Finnish women, their partners and children born alive between April 2012 and December 2017. The women were recruited through the national, voluntary trisomy 21 screening between 9+0 and 21+6 gestational weeks. Of the participating women, 543 were screen positive and underwent fetal chromosomal testing. Test result of these women suggested no fetal chromosomal abnormality. Further, we recruited 401 women who were screen negative and who did not undergo fetal chromosomal testing. FINDINGS TO DATE We have collected chorionic villi and amniotic fluid from the screen-positive women; blood, urine, buccal swabs and diurnal salivary samples from all women; blood and buccal swabs from all partners; and placenta, cord blood and buccal swabs from all newborns for analyses of the genome, epigenome, transcriptome, and endocrine, inflammatory and metabolic markers. These data are coupled with comprehensive phenotypes, including questions on demographic characteristics, health and well-being of the women and their partners during pregnancy and of the women and their children at the child's age of 1.7 and 3 years. Data also come from patient records and nationwide registers covering health, lifestyle and medication data. FUTURE PLANS Multiple layers of ITU data allow integrative data analyses, which translate to biomarker identification and allow risk stratification and understanding of the biological mechanisms involved in prenatal programming of health and disease.
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Affiliation(s)
- Tuomas Kvist
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Sara Sammallahti
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Cristiana Cruceanu
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Linda Dieckmann
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Alina Tontsch
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Simone Röh
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Monika Rex-Haffner
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Eiina Wolford
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Rebecca Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Johan Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Obstetrics and Gynaecology, National University of Singapore Yong Loo Lin School of Medicine, Singapore
| | - Sanna Suomalainen-König
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Laivuori
- Medical and Clinical Genetics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Helsinki Institute of Life Science, Institute of Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Eija Lahdensuo
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Elisabeth Binder
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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15
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Li Q, Cai D, Huang H, Zhang H, Bai R, Zhao X, Sun H, Qin P. Phosphoproteomic profiling of the hippocampus of offspring rats exposed to prenatal stress. Brain Behav 2021; 11:e2233. [PMID: 34520625 PMCID: PMC8553319 DOI: 10.1002/brb3.2233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/10/2021] [Accepted: 05/21/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Prenatal stress (PS) can cause depression in offspring. However, the underlying biological mechanism of these influences is still unclear. This work was implemented to investigate the molecular mechanisms of depressive-like behavior of offspring rats insulted with PS. METHODS Relative quantitative phosphoproteomics of the hippocampus of PS susceptibility (PS-S) and control (CON) rat offspring was performed using liquid chromatography-tandem mass spectrometry to confirm known pathways and to identify new mechanisms involved in depression. RESULTS A total of 6790 phosphopeptides, 9817 phosphorylation sites, and 2978 phosphoproteins were detected. Among the 2978 phosphoproteins, 1760 (59.09%) had more than two phosphorylated sites, the ENSRNOP00000023460 protein had more than 117 phosphorylated sites, and the average distribution of modification sites per 100 amino acids was 2.97. There were 197 different phosphopeptides, including 140 increased phosphopeptides and 57 decreased phosphopeptides in the PS-S offspring rats, compared to the CON offspring rats. These differential phosphopeptides corresponded to 100 upregulated and 44 downregulated phosphoproteins, respectively. Gene ontology enrichment analysis revealed that these different phosphoproteins in the top five enriched terms in the cellular component, molecular function, and biological proces categories were involved in a total of 35 different phosphoproteins, and these phosphoproteins were mainly related to myelin-, microtubule- and synapse-associated proteins. The enrichment of Kyoto Encyclopedia of Genes and Genome pathways was found to be involved in many essential biological pathways, and the top five pathways included amphetamine addiction, insulin secretion, Cushing syndrome, and the circadian entrainment signaling pathway. These first five pathways were related to nine phosphoproteins, including Adcy9, Apc, Cacna1c, Camk2a, Camk2b, Camk2g, Ctnnd2, Grin2a, and Stx1a. The full data are available via ProteomeXchange with identifier PXD019117. CONCLUSION We preliminarily identified 144 different phosphoproteins involved in myelin, microtubule, and synapse formation and plasticity in the hippocampus of susceptible offspring rats exposed to PS.
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Affiliation(s)
- Qinghong Li
- Department of Neonatology, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, P.R. China
| | - Dongge Cai
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Huimei Huang
- Department of Nephrology, Xi'an Children's Hospital (The Affiliated Children's Hospital of Xi'an Jiaotong University), Xi'an, Shaanxi, P.R. China
| | - Huiping Zhang
- Shaanxi Institute for Pediatric Diseases, Xi'an Key Laboratory of Children's Health and Diseases, Xi'an Children's Hospital (The Affiliated Children's Hospital of Xi'an Jiaotong University), Xi'an, Shaanxi, P.R. China
| | - Ruimiao Bai
- Department of Neonatology, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, P.R. China
| | - Xiaolin Zhao
- Department of Neonatology, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, P.R. China
| | - Hongli Sun
- Shaanxi Institute for Pediatric Diseases, Xi'an Key Laboratory of Children's Health and Diseases, Xi'an Children's Hospital (The Affiliated Children's Hospital of Xi'an Jiaotong University), Xi'an, Shaanxi, P.R. China
| | - Pei Qin
- Department of Anaesthesiology, Xi'an Children's Hospital (The Affiliated Children's Hospital of Xi'an Jiaotong University), Xi'an, Shaanxi, P.R. China
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16
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Camerota M, Graw S, Everson TM, McGowan EC, Hofheimer JA, O'Shea TM, Carter BS, Helderman JB, Check J, Neal CR, Pastyrnak SL, Smith LM, Dansereau LM, DellaGrotta SA, Marsit CJ, Lester BM. Prenatal risk factors and neonatal DNA methylation in very preterm infants. Clin Epigenetics 2021; 13:171. [PMID: 34507616 PMCID: PMC8434712 DOI: 10.1186/s13148-021-01164-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022] Open
Abstract
Background Prenatal risk factors are related to poor health and developmental outcomes for infants, potentially via epigenetic mechanisms. We tested associations between person-centered prenatal risk profiles, cumulative prenatal risk models, and epigenome-wide DNA methylation (DNAm) in very preterm neonates. Methods We studied 542 infants from a multi-center study of infants born < 30 weeks postmenstrual age. We assessed 24 prenatal risk factors via maternal report and medical record review. Latent class analysis was used to define prenatal risk profiles. DNAm was quantified from neonatal buccal cells using the Illumina MethylationEPIC Beadarray. Results We identified three latent profiles of women: a group with few risk factors (61%) and groups with elevated physical (26%) and psychological (13%) risk factors. Neonates born to women in higher risk subgroups had differential DNAm at 2 CpG sites. Higher cumulative prenatal risk was associated with methylation at 15 CpG sites, 12 of which were located in genes previously linked to physical and mental health and neurodevelopment. Conclusion We observed associations between prenatal risk factors and DNAm in very preterm infants using both person-centered and cumulative risk approaches. Epigenetics offers a potential biological indicator of prenatal risk exposure. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01164-9.
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Affiliation(s)
- Marie Camerota
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. .,Department of Pediatrics, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA.
| | - Stefan Graw
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Todd M Everson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA.,Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Elisabeth C McGowan
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | - Julie A Hofheimer
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - T Michael O'Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Brian S Carter
- Department of Pediatrics-Neonatology, Children's Mercy Hospital, Kansas City, MO, USA
| | - Jennifer B Helderman
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jennifer Check
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Charles R Neal
- Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Steven L Pastyrnak
- Department of Pediatrics, Spectrum Health-Helen DeVos Hospital, Grand Rapids, MI, USA
| | - Lynne M Smith
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Lynne M Dansereau
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA
| | - Sheri A DellaGrotta
- Department of Pediatrics, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Barry M Lester
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Department of Pediatrics, Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA.,Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
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17
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De Asis-Cruz J, Andersen N, Kapse K, Khrisnamurthy D, Quistorff J, Lopez C, Vezina G, Limperopoulos C. Global Network Organization of the Fetal Functional Connectome. Cereb Cortex 2021; 31:3034-3046. [PMID: 33558873 DOI: 10.1093/cercor/bhaa410] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/11/2020] [Accepted: 12/11/2020] [Indexed: 12/21/2022] Open
Abstract
Recent advances in brain imaging have enabled non-invasive in vivo assessment of the fetal brain. Characterizing brain development in healthy fetuses provides baseline measures for identifying deviations in brain function in high-risk clinical groups. We examined 110 resting state MRI data sets from fetuses at 19 to 40 weeks' gestation. Using graph-theoretic techniques, we characterized global organizational features of the fetal functional connectome and their prenatal trajectories. Topological features related to network integration (i.e., global efficiency) and segregation (i.e., clustering) were assessed. Fetal networks exhibited small-world topology, showing high clustering and short average path length relative to reference networks. Likewise, fetal networks' quantitative small world indices met criteria for small-worldness (σ > 1, ω = [-0.5 0.5]). Along with this, fetal networks demonstrated global and local efficiency, economy, and modularity. A right-tailed degree distribution, suggesting the presence of central areas that are more highly connected to other regions, was also observed. Metrics, however, were not static during gestation; measures associated with segregation-local efficiency and modularity-decreased with advancing gestational age. Altogether, these suggest that the neural circuitry underpinning the brain's ability to segregate and integrate information exists as early as the late 2nd trimester of pregnancy and reorganizes during the prenatal period. Significance statement. Mounting evidence for the fetal origins of some neurodevelopmental disorders underscores the importance of identifying features of healthy fetal brain functional development. Alterations in prenatal brain connectomics may serve as early markers for identifying fetal-onset neurodevelopmental disorders, which in turn provide improved surveillance of at-risk fetuses and support the initiation of early interventions.
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Affiliation(s)
- Josepheen De Asis-Cruz
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | - Nicole Andersen
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | - Kushal Kapse
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | | | - Jessica Quistorff
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | - Catherine Lopez
- Developing Brain Institute, Children's National, 111 Michigan Ave NW, Washington DC 20010
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, 111 Michigan Ave NW, Washington DC 20010
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18
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Szekely E, Neumann A, Sallis H, Jolicoeur-Martineau A, Verhulst FC, Meaney MJ, Pearson RM, Levitan RD, Kennedy JL, Lydon JE, Steiner M, Greenwood CMT, Tiemeier H, Evans J, Wazana A. Maternal Prenatal Mood, Pregnancy-Specific Worries, and Early Child Psychopathology: Findings From the DREAM BIG Consortium. J Am Acad Child Adolesc Psychiatry 2021; 60:186-197. [PMID: 32278003 DOI: 10.1016/j.jaac.2020.02.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/06/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Few studies have attempted to identify how distinct dimensions of maternal prenatal affective symptoms relate to offspring psychopathology. We defined latent dimensions of women's prenatal affective symptoms and pregnancy-specific worries to examine their association with early offspring psychopathology in three prenatal cohorts. METHOD Data were used from three cohorts of the DREAM-BIG consortium: Avon Longitudinal Study of Parents and Children (ALSPAC [N = 12,515]), Generation R (N = 6,803), and the Canadian prenatal cohort Maternal Adversity, Vulnerability, and Neurodevelopment (MAVAN [N = 578]). Maternal prenatal affective symptoms and pregnancy-specific worries were assessed using different measures in each cohort. Through confirmatory factor analyses, we determined whether comparable latent dimensions of prenatal maternal affective symptoms existed across the cohorts. We used structural equation models to examine cohort-specific associations between these dimensions and offspring psychopathology at 4 to 8 years of age (general psychopathology, specific internalizing and externalizing previously derived using confirmatory factor analyses). Cohort-based estimates were meta-analyzed using inverse variance-weighing. RESULTS Four prenatal maternal factors were similar in all cohorts: a general affective symptoms factor and three specific factors-an anxiety/depression factor, a somatic factor, and a pregnancy-specific worries factor. In meta-analyses, both the general affective symptoms factor and pregnancy-specific worries factor were independently associated with offspring general psychopathology. The general affective symptoms factor was further associated with offspring specific internalizing problems. There were no associations with specific externalizing problems. CONCLUSION These replicated findings of independent and adverse effects for prenatal general affective symptoms and pregnancy-specific worries on child mental health support the need for specific interventions in pregnancy.
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Affiliation(s)
- Eszter Szekely
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Alexander Neumann
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Hannah Sallis
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | | | - Frank C Verhulst
- Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark, and the Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Michael J Meaney
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Douglas Mental Health Institute, Montreal, Quebec, Canada, and Singapore Institute for Clinical Sciences, Singapore City, Singapore
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Robert D Levitan
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - James L Kennedy
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - John E Lydon
- McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | | | - Celia M T Greenwood
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Henning Tiemeier
- Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ashley Wazana
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Centre for Child Development and Mental Health, Jewish General Hospital, Montreal, Quebec, Canada.
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19
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Davis EP, Narayan AJ. Pregnancy as a period of risk, adaptation, and resilience for mothers and infants. Dev Psychopathol 2020; 32:1625-1639. [PMID: 33427164 PMCID: PMC7863987 DOI: 10.1017/s0954579420001121] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The pregnancy period represents a unique window of opportunity to identify risks to both the fetus and mother and to deter the intergenerational transmission of adversity and mental health problems. Although the maternal-fetal dyad is especially vulnerable to the effects of stress during pregnancy, less is known about how the dyad is also receptive to salutary, resilience-promoting influences. The present review adopts life span and intergenerational perspectives to review four key areas of research. The first part describes how pregnancy is a sensitive period for both the mother and fetus. In the second part, the focus is on antecedents of maternal prenatal risks pertaining to prenatal stress response systems and mental health. The third part then turns to elucidating how these alterations in prenatal stress physiology and mental health problems may affect infant and child outcomes. The fourth part underscores how pregnancy is also a time of heightened fetal receptivity to maternal and environmental signals, with profound implications for adaptation. This section also reviews empirical evidence of promotive and protective factors that buffer the mother and fetus from developmental and adaptational problems and covers a sample of rigorous evidence-based prenatal interventions that prevent maladaptation in the maternal-fetal dyad before babies are born. Finally, recommendations elaborate on how to further strengthen understanding of pregnancy as a period of multilevel risk and resilience, enhance comprehensive prenatal screening, and expand on prenatal interventions to promote maternal-fetal adaptation before birth.
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Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
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20
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Suarez A, Lahti J, Lahti-Pulkkinen M, Girchenko P, Czamara D, Arloth J, Malmberg ALK, Hämäläinen E, Kajantie E, Laivuori H, Villa PM, Reynolds RM, Provençal N, Binder EB, Räikkönen K. A polyepigenetic glucocorticoid exposure score at birth and childhood mental and behavioral disorders. Neurobiol Stress 2020; 13:100275. [PMID: 33344728 PMCID: PMC7739178 DOI: 10.1016/j.ynstr.2020.100275] [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: 07/08/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Maternal depression and anxiety during pregnancy may enhance fetal exposure to glucocorticoids (GCs) and harm neurodevelopment. We tested whether a novel cross-tissue polyepigenetic biomarker indicative of in utero exposure to GC is associated with mental and behavioral disorders and their severity in children, possibly mediating the associations between maternal prenatal depressive and anxiety symptoms and these child outcomes. METHODS Children (n = 814) from the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study were followed-up from birth to age 7.1-10.7 years. A weighted polyepigenetic GC exposure score was calculated based on the methylation profile of 24 CpGs from umbilical cord blood. Child diagnosis of mental and behavioral disorder (n = 99) and its severity, defined as the number of days the child had received treatment (all 99 had received outpatient treatment and 8 had been additionally in inpatient treatment) for mental or behavioral disorder as the primary diagnosis, came from the Care Register for Health Care. Mothers (n = 408) reported on child total behavior problems at child's age of 2.3-5.8 years and their own depressive and anxiety symptoms during pregnancy (n = 583). RESULTS The fetal polyepigenetic GC exposure score at birth was not associated with child hazard of mental and behavioral disorder (HR = 0.82, 95% CI 0.54; 1.24, p = 0.35) or total behavior problems (unstandardized beta = -0.10, 95% CI -0.31; 0.10, p = 0.33). However, for one standard deviation decrease in the polyepigenetic score, the child had spent 2.94 (95%CI 1.59; 5.45, p < 0.001) more days in inpatient or outpatient treatment with any mental and behavioral disorder as the primary diagnosis. Criteria for mediation tests were not met. CONCLUSIONS These findings suggest that fetal polyepigenetic GC exposure score at birth was not associated with any mental or behavioral disorder diagnosis or mother-rated total behavior problems, but it may contribute to identifying children at birth who are at risk for more severe mental or behavioral disorders.
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Key Words
- 11β-HSD2, 11-beta-hydroxysteroid-dehydrogenase type 2
- ADHD, Attention deficit/hyperactivity disorder
- BMI, Body-mass index
- CES‐D, Center for epidemiologic studies depression scale
- Childhood mental health
- Cord blood methylation
- DNAm, DNA methylation
- GC, Glucocorticoid
- GR, Glucocorticoid receptor
- GRE, Glucocorticoid response element
- Glucocorticoids
- HILMO, Care register for health care
- HPA-axis, Hypothalamic-pituitary-adrenal axis
- PREDO, Prediction and prevention of preeclampsia and intrauterine growth restriction
- Polyepigenetic biomarker
- Prenatal psychopathology
- Prospective study
- STAI, Spielberger state anxiety inventory
- ZINB, Zero-inflated negative binomial regression
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Affiliation(s)
- Anna Suarez
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- Turku Institute for Advanced Studies, University of Turku, Turku, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Janine Arloth
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Institute of Computational Biology, Helmholtz Zentrum München, Germany
| | - Anni LK. Malmberg
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Esa Hämäläinen
- Department of Clinical Chemistry, University of Eastern Finland, Kuopio, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hannele Laivuori
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pia M. Villa
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, Hyvinkää Hospital, Helsinki and Uusimaa Hospital District, Finland
| | - Rebecca M. Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Nadine Provençal
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
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21
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Maselko J, Sikander S, Turner EL, Bates LM, Ahmad I, Atif N, Baranov V, Bhalotra S, Bibi A, Bibi T, Bilal S, Biroli P, Chung E, Gallis JA, Hagaman A, Jamil A, LeMasters K, O’Donnell K, Scherer E, Sharif M, Waqas A, Zaidi A, Zulfiqar S, Rahman A. Effectiveness of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal: a cluster randomised trial in Pakistan. Lancet Psychiatry 2020; 7:775-787. [PMID: 32828167 PMCID: PMC8015797 DOI: 10.1016/s2215-0366(20)30258-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Maternal depression has a recurring course that can influence offspring outcomes. Evidence on how to treat maternal depression to improve longer-term maternal outcomes and reduce intergenerational transmission of psychopathology is scarce, particularly for task-shifted, low-intensity, and scalable psychosocial interventions. We evaluated the effects of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal. METHODS 40 village clusters in Pakistan were randomly allocated using a computerised randomisation sequence to receive a group-based, psychosocial intervention and enhanced usual care for 36 months, or enhanced usual care alone. Pregnant women (≥18 years) were screened for moderate or severe symptoms of depression (patient health questionnaire-9 [PHQ-9] score ≥10) and were recruited into the trial (570 participants), and a cohort without depression (PHQ-9 score <10) was also enrolled (584 participants). Including the non-depressed dyads enabled us to determine how much of the excess risk due to maternal depression exposure the intervention could mitigate. Research teams responsible for identifying, obtaining consent, and recruiting trial participants were blind to the allocation status throughout the duration of the study, and principal investigators, site coordinators, statisticians, and members of the trial steering committee were also blinded to the allocation status until the analysis of 6-month data for the intervention. Primary outcomes were maternal depression symptoms and remission (PHQ-9 score <10) and child socioemotional skills (strengths and difficulties questionnaire [SDQ-TD]) at 36-months postnatal. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, NCT02658994. FINDINGS From Oct 15, 2014 to Feb 25, 2016 46 village clusters were assessed for eligibility, of which 40 (including 1910 mothers were enrolled. After exclusions, 288 women were randomly assigned to the enhanced usual care group and 284 to the intervention group, and 1159 women were included in a group without prenatal depression. At 36-months postnatal, complete data were available from 889 mother-child dyads: 206 (72·5%) in the intervention group, 216 (75·3%) in the enhanced usual care group, and 467 (80·0%) women who did not have prenatal-depression. We did not observe significant outcome differences between the intervention group and the enhanced usual care group for the primary outcomes. The standardised mean difference of PHQ-9 total score was -0·13 (95% CI -0·33 to 0·07), relative risk of patient health questionnaire-9 remission was 1·00 (95% CI 0·88 to 1·14), and the SDQ-TD treatment estimate was -0·10 (95% CI -1·39 to 1·19). INTERPRETATION Reduced symptom severity and high remission rates were seen across both the intervention and enhanced usual care groups, possibly masking any effects of the intervention. A multi-year, psychosocial intervention can be task-shifted via peers but might be susceptible to reductions in fidelity and dosage over time (which were not among the outcomes of this trial). Early intervention efforts might need to rely on multiple models (eg, collaborative care), be of greater intensity, and potentially targeted at mothers who are at high risk for depression to reduce the intergenerational transmission of psychopathology from mothers to children. FUNDING National Institutes of Health.
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Affiliation(s)
- Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Siham Sikander
- Human Development Research Foundation (HDRF) and Health Services Academy, Islamabad, Pakistan
| | - Elizabeth L. Turner
- Department of Biostatistics and Bioinformatics, and Duke Global Health Institute, Duke University, Durham, NC USA
| | - Lisa M. Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | | | - Najia Atif
- Human Development Research Foundation (HDRF)
| | - Victoria Baranov
- Department of Economics, University of Melbourne, Melbourne, Australia
| | - Sonia Bhalotra
- Department of Economics, Univesity of Essex, Colchester, UK
| | - Amina Bibi
- Human Development Research Foundation (HDRF)
| | | | | | - Pietro Biroli
- Department of Economics, University of Zurich, Zurich, Switzerland
| | - Esther Chung
- Department of Epidemiology, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - John A. Gallis
- Department of Biostatistics and Bioinformatics, and Duke Global Health Institute, Duke University, Durham, NC USA
| | - Ashley Hagaman
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Anam Jamil
- Human Development Research Foundation (HDRF)
| | - Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | | | - Elissa Scherer
- Department of Epidemiology, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
- Research Triangle International, Research Triangle Park, USA
| | | | - Ahmed Waqas
- Human Development Research Foundation (HDRF)
| | - Ahmed Zaidi
- Human Development Research Foundation (HDRF)
| | | | - Atif Rahman
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool UK
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22
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Maternal stress or sleep during pregnancy are not reflected on telomere length of newborns. Sci Rep 2020; 10:13986. [PMID: 32814800 PMCID: PMC7438332 DOI: 10.1038/s41598-020-71000-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 08/06/2020] [Indexed: 11/08/2022] Open
Abstract
Telomeres play an important role in maintaining chromosomal integrity. With each cell division, telomeres are shortened and leukocyte telomere length (LTL) has therefore been considered a marker for biological age. LTL is associated with various lifetime stressors and health-related outcomes. Transgenerational effects have been implicated in newborns, with maternal stress, depression, and anxiety predicting shorter telomere length at birth, possibly reflecting the intrauterine growth environment. Previous studies, with relatively small sample sizes, have reported an effect of maternal stress, BMI, and depression during pregnancy on the LTL of newborns. Here, we attempted to replicate previous findings on prenatal stress and newborn LTL in a sample of 1405 infants using a qPCR-based method. In addition, previous research has been expanded by studying the relationship between maternal sleep quality and LTL. Maternal prenatal stress, anxiety, depression, BMI, and self-reported sleep quality were evaluated with self-reported questionnaires. Despite sufficient power to detect similar or even considerably smaller effects than those previously reported in the literature, we were unable to replicate the previous correlation between maternal stress, anxiety, depression, or sleep with LTL. We discuss several possible reasons for the discrepancies between our findings and those previously described.
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23
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Mareckova K, Marecek R, Andryskova L, Brazdil M, Nikolova YS. Maternal Depressive Symptoms During Pregnancy and Brain Age in Young Adult Offspring: Findings from a Prenatal Birth Cohort. Cereb Cortex 2020; 30:3991-3999. [DOI: 10.1093/cercor/bhaa014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Abstract
Maternal depression during pregnancy is associated with elevated risk of anxiety and depression in offspring, but the mechanisms are incompletely understood. Here we conducted a neuroimaging follow-up of a prenatal birth cohort from the European Longitudinal Study of Pregnancy and Childhood (n = 131; 53% women, age 23–24) to test whether deviations from age-normative structural brain development in young adulthood may partially underlie this link. Structural brain age was calculated based on previously published neuroanatomical age prediction models using cortical thickness maps from healthy controls aged 6–89. Brain age gap was computed as the difference between chronological and structural brain age. Participants also completed self-report measures of anxiety and mood dysregulation. Further, mothers of a subset of participants (n = 103, 54% women) answered a self-report questionnaire in 1990–1992 about depressive symptoms during pregnancy. Higher exposure to maternal depressive symptoms in utero showed a linear relationship with elevated brain age gap, which showed a quadratic relationship with anxiety and mood dysregulation in the young adult offspring. Our findings suggest that exposure to maternal depressive symptoms in utero may be associated with accelerated brain maturation and that deviations from age-normative structural brain development in either direction predict more anxiety and dysregulated mood in young adulthood.
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Affiliation(s)
- Klara Mareckova
- Brain and Mind Research, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno 62500, Czech Republic
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5T 1R8, Canada
| | - Radek Marecek
- Brain and Mind Research, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno 62500, Czech Republic
| | - Lenka Andryskova
- RECETOX, Faculty of Science, Masaryk University, Brno 62500, Czech Republic
| | - Milan Brazdil
- Brain and Mind Research, Central European Institute of Technology, Masaryk University (CEITEC MU), Brno 62500, Czech Republic
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
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24
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Barkin JL, Osborne LM, Buoli M, Bridges CC, Callands TA, Ezeamama AE. Training Frontline Providers in the Detection and Management of Perinatal Mood and Anxiety Disorders. J Womens Health (Larchmt) 2020; 29:889-890. [PMID: 32031880 DOI: 10.1089/jwh.2019.8287] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Jennifer L Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia
| | - Lauren M Osborne
- Department of Psychiatry & Behavioral Sciences and Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Christy C Bridges
- Department of Basic Science, Mercer University School of Medicine, Macon, Georgia
| | - Tamora A Callands
- Department of Health Promotion and Behavior, University of Georgia, Athens, Georgia
| | - Amara E Ezeamama
- Department of Psychiatry, Michigan State University, East Lansing, Michigan
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25
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Boardman JP, Counsell SJ. Invited Review: Factors associated with atypical brain development in preterm infants: insights from magnetic resonance imaging. Neuropathol Appl Neurobiol 2019; 46:413-421. [PMID: 31747472 PMCID: PMC7496638 DOI: 10.1111/nan.12589] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/13/2019] [Indexed: 12/18/2022]
Abstract
Preterm birth (PTB) is a leading cause of neurodevelopmental and neurocognitive impairment in childhood and is closely associated with psychiatric disease. The biological and environmental factors that confer risk and resilience for healthy brain development and long‐term outcome after PTB are uncertain, which presents challenges for risk stratification and for the discovery and evaluation of neuroprotective strategies. Neonatal magnetic resonance imaging reveals a signature of PTB that includes dysconnectivity of neural networks and atypical development of cortical and deep grey matter structures. Here we provide a brief review of perinatal factors that are associated with the MRI signature of PTB. We consider maternal and foetal factors including chorioamnionitis, foetal growth restriction, socioeconomic deprivation and prenatal alcohol, drug and stress exposures; and neonatal factors including co‐morbidities of PTB, nutrition, pain and medication during neonatal intensive care and variation conferred by the genome/epigenome. Association studies offer the first insights into pathways to adversity and resilience after PTB. Future challenges are to analyse quantitative brain MRI data with collateral biological and environmental data in study designs that support causal inference, and ultimately to use the output of such analyses to stratify infants for clinical trials of therapies designed to improve outcome.
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Affiliation(s)
- J P Boardman
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - S J Counsell
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
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26
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Ene D, Der G, Fletcher-Watson S, O’Carroll S, MacKenzie G, Higgins M, Boardman JP. Associations of Socioeconomic Deprivation and Preterm Birth With Speech, Language, and Communication Concerns Among Children Aged 27 to 30 Months. JAMA Netw Open 2019; 2:e1911027. [PMID: 31509207 PMCID: PMC6739726 DOI: 10.1001/jamanetworkopen.2019.11027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
IMPORTANCE Successful acquisition of language is foundational for health and well-being across the life course and is patterned by medical and social determinants that operate in early life. OBJECTIVE To investigate the associations of neighborhood disadvantage, gestational age, and English as first language with speech, language, and communication concerns among children aged 27 to 30 months. DESIGN, SETTING, AND PARTICIPANTS This cohort study used birth data from the National Health Service maternity electronic medical record linked to the Child Health Surveillance Programme for preschool children. The cohort included 28 634 children in the United Kingdom (NHS Lothian, Scotland) born between January 2011 and December 2014 who were eligible for a health review at age 27 to 30 months between April 2013 and April 2016. Data analysis was conducted between January 2018 and February 2019. EXPOSURES The associations of neighborhood deprivation (using the Scottish Index of Multiple Deprivation 2016 quintiles), gestational age, and whether English was the first language spoken in the home with preschool language function were investigated using mutually adjusted logistic regression models. MAIN OUTCOMES AND MEASURES Speech, language, and communication (SLC) concern ascertained at age 27 to 30 months. RESULTS Records of 28 634 children (14 695 [51.3%] boys) with a mean (SD) age of 27.7 (2.2) months were matched. After excluding records with missing data, there were 26 341 records. The prevalence of SLC concern was 13.0% (3501 of 26 963 children with SLC data). In fully adjusted analyses, each 1-week increase in gestational age from 23 to 36 weeks was associated with an 8.8% decrease in the odds of a child having an SLC concern reported at 27 months (odds ratio, 0.92; 95% CI, 0.90-0.93). The odds of a child for whom English is not the first language of having SLC concern at age 27 to 30 months were 2.1-fold higher than those for a child whose first language is English (OR, 2.09; 95% CI, 1.66-2.64). The odds ratio for having an SLC concern among children living in the most deprived neighborhoods, compared with the least deprived neighborhoods, was 3.15 (95% CI, 2.79-3.56). The estimated probabilities for preterm children having an SLC concern were highest for those living in the most deprived areas. CONCLUSIONS AND RELEVANCE This study found that SLC concerns at age 27 to 30 months are common and independently associated with increasing levels of neighborhood deprivation and lower gestational age. Policies that reduce childhood deprivation could be associated with improved preschool language ability and potentially avoid propagation of disadvantage across the life course, including for children born preterm.
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Affiliation(s)
- Daniela Ene
- Information Services Division, NHS Lothian, NHS Scotland, Edinburgh, United Kingdom
| | - Geoff Der
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | | | - Sinéad O’Carroll
- Patrick Wild Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Graham MacKenzie
- Information Services Division, NHS Lothian, NHS Scotland, Edinburgh, United Kingdom
| | - Martin Higgins
- Public Health and Health Policy, NHS Lothian, NHS Scotland, Edinburgh, United Kingdom
| | - James P. Boardman
- Medical Research Council Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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27
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Quinn MA, McCalla A, He B, Xu X, Cidlowski JA. Silencing of maternal hepatic glucocorticoid receptor is essential for normal fetal development in mice. Commun Biol 2019; 2:104. [PMID: 30911679 PMCID: PMC6420645 DOI: 10.1038/s42003-019-0344-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 01/17/2019] [Indexed: 12/19/2022] Open
Abstract
Excessive or chronic stress can lead to a variety of diseases due to aberrant activation of the glucocorticoid receptor (GR), a ligand activated transcription factor. Pregnancy represents a particular window of sensitivity in which excessive stress can have adverse outcomes, particularly on the developing fetus. Here we show maternal hepatic stress hormone responsiveness is diminished via epigenetic silencing of the glucocorticoid receptor during pregnancy. Provocatively, reinstallation of GR to hepatocytes during pregnancy by adeno-associated viral transduction dysregulates genes involved in proliferation, resulting in impaired pregnancy-induced hepatomegaly. Disruption of the maternal hepatic adaptation to pregnancy results in in utero growth restriction (IUGR). These data demonstrate pregnancy antagonizes the liver-specific effects of stress hormone signaling in the maternal compartment to ultimately support the healthy development of embryos.
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Affiliation(s)
- Matthew A. Quinn
- Department of Pathology, Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina 27517 USA
| | - Amy McCalla
- Signal Transduction Laboratory, Research Triangle Park, North Carolina USA
| | - Bo He
- Signal Transduction Laboratory, Research Triangle Park, North Carolina USA
| | - Xiaojiang Xu
- Laboratory of Integrative Bioinformatics, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709 USA
| | - John A. Cidlowski
- Signal Transduction Laboratory, Research Triangle Park, North Carolina USA
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