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Eaves LA, Harrington CE, Fry RC. Epigenetic Responses to Nonchemical Stressors: Potential Molecular Links to Perinatal Health Outcomes. Curr Environ Health Rep 2024; 11:145-157. [PMID: 38580766 DOI: 10.1007/s40572-024-00435-w] [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] [Accepted: 02/06/2024] [Indexed: 04/07/2024]
Abstract
PURPOSE OF REVIEW We summarize the recent literature investigating exposure to four nonchemical stressors (financial stress, racism, psychosocial stress, and trauma) and DNA methylation, miRNA expression, and mRNA expression. We also highlight the relationships between these epigenetic changes and six critical perinatal outcomes (preterm birth, low birth weight, preeclampsia, gestational diabetes, childhood allergic disease, and childhood neurocognition). RECENT FINDINGS Multiple studies have found financial stress, psychosocial stress, and trauma to be associated with DNA methylation and/or miRNA and mRNA expression. Fewer studies have investigated the effects of racism. The majority of studies assessed epigenetic or genomic changes in maternal blood, cord blood, or placenta. Several studies included multi-OMIC assessments in which DNA methylation and/or miRNA expression were associated with gene expression. There is strong evidence for the role of epigenetics in driving the health outcomes considered. A total of 22 biomarkers, including numerous HPA axis genes, were identified to be epigenetically altered by both stressors and outcomes. Epigenetic changes related to inflammation, the immune and endocrine systems, and cell growth and survival were highlighted across numerous studies. Maternal exposure to nonchemical stressors is associated with epigenetic and/or genomic changes in a tissue-specific manner among inflammatory, immune, endocrine, and cell growth-related pathways, which may act as mediating pathways to perinatal health outcomes. Future research can test the mediating role of the specific biomarkers identified as linked with both stressors and outcomes. Understanding underlying epigenetic mechanisms altered by nonchemical stressors can provide a better understanding of how chemical and nonchemical exposures interact.
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Affiliation(s)
- Lauren A Eaves
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Cailee E Harrington
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
- Curriculum in Toxicology and Environmental Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
- Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
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Mohazzab-Hosseinian S, Garcia E, Wiemels J, Marconett C, Corona K, Howe CG, Foley H, Farzan SF, Bastain TM, Breton CV. Effect of parental adverse childhood experiences on intergenerational DNA methylation signatures from peripheral blood mononuclear cells and buccal mucosa. Transl Psychiatry 2024; 14:89. [PMID: 38342906 PMCID: PMC10859367 DOI: 10.1038/s41398-024-02747-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/15/2023] [Accepted: 01/08/2024] [Indexed: 02/13/2024] Open
Abstract
In this study, the effect of cumulative ACEs experienced on human maternal DNA methylation (DNAm) was estimated while accounting for interaction with domains of ACEs in prenatal peripheral blood mononuclear cell samples from the Maternal and Developmental Risks from Environmental Stressors (MADRES) pregnancy cohort. The intergenerational transmission of ACE-associated DNAm was also explored used paired maternal (N = 120) and neonatal cord blood (N = 69) samples. Replication in buccal samples was explored in the Children's Health Study (CHS) among adult parental (N = 31) and pediatric (N = 114) samples. We used a four-level categorical indicator variable for ACEs exposure: none (0 ACEs), low (1-3 ACEs), moderate (4-6 ACEs), and high (>6 ACEs). Effects of ACEs on maternal DNAm (N = 240) were estimated using linear models. To evaluate evidence for intergenerational transmission, mediation analysis (N = 60 mother-child pairs) was used. Analysis of maternal samples displayed some shared but mostly distinct effects of ACEs on DNAm across low, moderate, and high ACEs categories. CLCN7 and PTPRN2 was associated with maternal DNAm in the low ACE group and this association replicated in the CHS. CLCN7 was also nominally significant in the gene expression correlation analysis among maternal profiles (N = 35), along with 11 other genes. ACE-associated methylation was observed in maternal and neonatal profiles in the COMT promoter region, with some evidence of mediation by maternal COMT methylation. Specific genomic loci exhibited mutually exclusive maternal ACE effects on DNAm in either maternal or neonatal population. There is some evidence for an intergenerational effect of ACEs, supported by shared DNAm signatures in the COMT gene across maternal-neonatal paired samples.
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Affiliation(s)
- Sahra Mohazzab-Hosseinian
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Joseph Wiemels
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Crystal Marconett
- Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
- Hastings Center for Pulmonary Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
- Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
- Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Karina Corona
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Caitlin G Howe
- Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH, 03756, USA
| | - Helen Foley
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
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Sosnowski DW, Rojo-Wissar DM, Peng G, Parade SH, Sharkey K, Hoyo C, Murphy SK, Hernandez RG, Johnson SB. Maternal Childhood Adversity and Infant Epigenetic Aging: Moderation by Restless Sleep During Pregnancy. Dev Psychobiol 2024; 66:e22464. [PMID: 38601952 PMCID: PMC11003750 DOI: 10.1002/dev.22464] [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: 05/26/2023] [Accepted: 01/11/2024] [Indexed: 04/12/2024]
Abstract
Maternal exposure to childhood adversity is associated with detrimental health outcomes throughout the lifespan and may have implications for offspring. Evidence links maternal adverse childhood experiences (ACEs) to detrimental birth outcomes, yet the impact on the infant's epigenome is unclear. Moreover, maternal sleep habits during pregnancy may influence this association. Here, we explore whether restless sleep during pregnancy moderates the association between exposure to maternal childhood adversity and infant epigenetic age acceleration in 332 mother-infant dyads (56% female; 39% Black; 25% Hispanic). During the 2nd trimester, mothers self-reported childhood adversity and past-week restless sleep; DNA methylation from umbilical vein endothelial cells was used to estimate five epigenetic clocks. Multivariable linear regression was used to test study hypotheses. Despite no evidence of main effects, there was evidence of an interaction between maternal ACEs and restless sleep in predicting infant epigenetic age acceleration using the EPIC Gestational Age clock. Only infants whose mothers reported exposure to both ACEs and restless sleep demonstrated accelerated epigenetic aging. Results provide preliminary evidence that maternal childhood adversity and sleep may influence the infant epigenome.
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Affiliation(s)
- David W. Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Darlynn M. Rojo-Wissar
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital
| | - Gang Peng
- Department of Medical & Molecular Genetics, Indiana University School of Medicine
| | - Stephanie H. Parade
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital
| | - Katherine Sharkey
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
- Department of Medicine, The Warren Alpert Medical School of Brown University
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment North Carolina State University
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University School of Medicine
| | | | - Sara B. Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
- Department of Pediatrics, Johns Hopkins School of Medicine
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Zhang L, Mersky JP, Gruber AMH, Kim JY. Intergenerational Transmission of Parental Adverse Childhood Experiences and Children's Outcomes: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3251-3264. [PMID: 36205317 DOI: 10.1177/15248380221126186] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Adverse childhood experiences (ACEs) are among the leading environmental causes of morbidity and mortality. Extending research on within-generation effects, more recent scholarship has explored between-generation consequences of ACEs. Despite growing interest in the intergenerational effects of parents' ACEs on children's outcomes, this line of scholarship has yet to be coalesced into a comprehensive review. The current study is a scoping review on the intergenerational transmission of parental ACEs and children's outcomes. Ten databases such as PubMed, APA PsycArticles, and Social Work Abstracts were searched. To be included, empirical studies must have been published in English and analyzed associations between a cumulative measure of at least four parental ACEs and children's outcomes. Sixty-eight studies qualified for the review and, among these, 60 were published in the most recent 5 years (2018-2022). Fifty-one studies had sample sizes smaller than 500, and 55 focused on the effect of maternal ACEs. Nearly all studies demonstrated that parental ACEs could affect children's outcomes directly or indirectly via mechanisms like maternal mental health problems or parenting-related factors. By scoping the extant literature, this review advances the knowledge base regarding the intergenerational impacts of parental childhood trauma and children's outcomes. It also reveals methodological limitations that should be addressed in future research to strengthen causal inferences along with practical implications for interventions that aim to interrupt the intergenerational transmission of trauma.
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Collender P, Bozack AK, Veazie S, Nwanaji-Enwerem JC, Van Der Laan L, Kogut K, Riddell C, Eskenazi B, Holland N, Deardorff J, Cardenas A. Maternal adverse childhood experiences (ACEs) and DNA methylation of newborns in cord blood. Clin Epigenetics 2023; 15:162. [PMID: 37845746 PMCID: PMC10577922 DOI: 10.1186/s13148-023-01581-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) increase the risk of poor health outcomes later in life. Psychosocial stressors may also have intergenerational health effects by which parental ACEs are associated with mental and physical health of children. Epigenetic programming may be one mechanism linking parental ACEs to child health. This study aimed to investigate epigenome-wide associations of maternal preconception ACEs with DNA methylation patterns of children. In the Center for the Health Assessment of Mothers and Children of Salinas study, cord blood DNA methylation was measured using the Illumina HumanMethylation450 BeadChip. Preconception ACEs, which occurred during the mothers' childhoods, were collected using a standard ACE questionnaire including 10 ACE indicators. Maternal ACE exposures were defined in this study as (1) the total number of ACEs; (2) the total number of ACEs categorized as 0, 1-3, and > 4; and (3) individual ACEs. Associations of ACE exposures with differential methylated positions, regions, and CpG modules determined using weighted gene co-expression network analysis were evaluated adjusting for covariates. RESULTS Data on maternal ACEs and cord blood DNA methylation were available for 196 mother/newborn pairs. One differential methylated position was associated with maternal experience of emotional abuse (cg05486260/FAM135B gene; q value < 0.05). Five differential methylated regions were significantly associated with the total number of ACEs, and 36 unique differential methylated regions were associated with individual ACEs (Šidák p value < 0.05). Fifteen CpG modules were significantly correlated with the total number of ACEs or individual ACEs, of which 8 remained significant in fully adjusted models (p value < 0.05). Significant modules were enriched for pathways related to neurological and immune development and function. CONCLUSIONS Maternal ACEs prior to conception were associated with cord blood DNA methylation of offspring at birth. Although there was limited overlap between differential methylated regions and CpGs in modules associated with ACE exposures, statistically significant regions and networks were related to genes involved in neurological and immune function. Findings may provide insights to pathways linking psychosocial stressors to health. Further research is needed to understand the relationship between changes in DNA methylation and child health.
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Affiliation(s)
- Phillip Collender
- Division of Environmental Health Sciences, University of California, Berkeley, CA, USA
| | - Anne K Bozack
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Research Park, 1701 Page Mill Road, Stanford, CA, 94304, USA
| | - Stephanie Veazie
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Jamaji C Nwanaji-Enwerem
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Emergency Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Lars Van Der Laan
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Katherine Kogut
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
- Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA, USA
| | - Corinne Riddell
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, USA
| | - Brenda Eskenazi
- Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA, USA
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Nina Holland
- Division of Environmental Health Sciences, University of California, Berkeley, CA, USA
- Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA, USA
| | - Julianna Deardorff
- Center for Environmental Research of Community Health, CERCH, School of Public Health, University of California, Berkeley, CA, USA
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Andres Cardenas
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Research Park, 1701 Page Mill Road, Stanford, CA, 94304, USA.
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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Fransquet PD, Macdonald JA, Ryan J, Greenwood CJ, Olsson CA. Exploring perinatal biopsychosocial factors and epigenetic age in 1-year-old offspring. Epigenomics 2023; 15:927-939. [PMID: 37905426 DOI: 10.2217/epi-2023-0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Background: Little is known about the determinants of epigenetic aging in pediatric populations. Methods: Epigenetic age was estimated from 258 1-year-olds, using pediatric buccal epigenetic and Horvath clocks. We explored associations between epigenetic age and maternal indicators of mental and relational health, substance use and general physical health assessed during trimester three. Results: Higher anxiety and stress, BMI and higher parent-parent relationship quality were associated with pediatric buccal epigenetic clock differences. High blood pressure during pregnancy was associated with Horvath age acceleration. Third-trimester smoking and pre-pregnancy weight were associated with acceleration and deceleration respectively, and concordant across clocks. Conclusion: A broad range of maternal factors may shape epigenetic age in infancy; further research is needed to explore the possible effects on health and development.
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Affiliation(s)
- Peter D Fransquet
- Deakin University, Centre for Social & Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social & Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Population Studies of Adolescents, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- The University of Melbourne, Department of Paediatrics, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Joanne Ryan
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Christopher J Greenwood
- Deakin University, Centre for Social & Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Population Studies of Adolescents, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- The University of Melbourne, Department of Paediatrics, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social & Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Population Studies of Adolescents, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- The University of Melbourne, Department of Paediatrics, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
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Zhou A, Ryan J. Biological Embedding of Early-Life Adversity and a Scoping Review of the Evidence for Intergenerational Epigenetic Transmission of Stress and Trauma in Humans. Genes (Basel) 2023; 14:1639. [PMID: 37628690 PMCID: PMC10454883 DOI: 10.3390/genes14081639] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Severe or chronic stress and trauma can have a detrimental impact on health. Evidence suggests that early-life adversity can become biologically embedded and has the potential to influence health outcomes decades later. Epigenetics is one mechanism that has been implicated in these long-lasting effects. Observational studies in humans indicate that the effects of stress could even persist across generations, although whether or not epigenetic mechanisms are involved remains under debate. Here, we provide an overview of studies in animals and humans that demonstrate the effects of early-life stress on DNA methylation, one of the most widely studied epigenetic mechanisms, and summarize findings from animal models demonstrating the involvement of epigenetics in the transmission of stress across generations. We then describe the results of a scoping review to determine the extent to which the terms intergenerational or transgenerational have been used in human studies investigating the transmission of trauma and stress via epigenetic mechanisms. We end with a discussion of key areas for future research to advance understanding of the role of epigenetics in the legacy effects of stress and trauma.
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Affiliation(s)
- Aoshuang Zhou
- Division of Epidemiology, Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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Mohazzab-Hosseinian S, Garcia E, Wiemels J, Marconett C, Corona K, Howe C, Foley H, Lerner D, Lurvey N, Farzan S, Bastain T, Breton C. Effect of Parental Adverse Childhood Experiences on Intergenerational DNA Methylation Signatures. RESEARCH SQUARE 2023:rs.3.rs-2977515. [PMID: 37461498 PMCID: PMC10350189 DOI: 10.21203/rs.3.rs-2977515/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
Adverse Childhood Experiences (ACEs) are events that occur before a child turns 18 years old that may cause trauma. In this study, the effect of cumulative ACEs experienced on human maternal DNA methylation (DNAm) was estimated while accounting for interaction with domains of ACEs in prenatal peripheral blood mononuclear cell samples from the Maternal and Developmental Risks from Environmental Stressors (MADRES) pregnancy cohort. The intergenerational transmission of ACE-associated DNAm was also explored used paired maternal and neonatal cord blood samples. Replication in buccal samples was explored in the Children's Health Study (CHS). We used a four-level categorical indicator variable for ACEs exposure: none (0 ACEs), low (1-3 ACEs), moderate (4-6 ACEs), and high (> 6 ACEs). Effects of ACEs on maternal DNAm (N = 240) were estimated using linear models. To evaluate evidence for intergenerational transmission, mediation analysis was used. Analysis of maternal samples displayed some shared but mostly distinct effects of ACEs on DNAm across low, moderate, and high ACEs categories. CLCN7 and PTPRN2 was associated with maternal DNAm in the low ACE group and this association replicated in the CHS. ACE-associated methylation was observed in maternal and neonatal profiles in the COMT promoter region, with some evidence of mediation by maternal COMT methylation. Specific genomic loci exhibited mutually exclusive maternal ACE effects on DNAm in either maternal or neonatal population. There is some evidence for an intergenerational effect of ACEs, supported by shared DNAm signatures in the COMT gene across maternal-neonatal paired samples.
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Lugo-Candelas C, Talati A, Glickman C, Hernandez M, Scorza P, Monk C, Kubo A, Wei C, Sourander A, Duarte CS. Maternal Mental Health and Offspring Brain Development: An Umbrella Review of Prenatal Interventions. Biol Psychiatry 2023; 93:934-941. [PMID: 36754341 PMCID: PMC10512172 DOI: 10.1016/j.biopsych.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/20/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
The idea that risk for psychiatric disorders may be transmitted intergenerationally via prenatal programming places interest in the prenatal period as a critical moment during which intervention efforts may have a strong impact, yet studies testing whether prenatal interventions also protect offspring are limited. The present umbrella review of systematic reviews and meta-analyses (SRMAs) of randomized controlled trials aimed to synthesize the available evidence and highlight promising avenues for intervention. Overall, the literature provides mixed and limited evidence in support of prenatal interventions. Thirty SRMAs were included. Of the 23 SRMAs that reported on prenatal depression interventions, 16 found a significant effect (average standard mean difference = -0.45, SD = 0.25). Similarly, 13 of the 20 SRMAs that reported on anxiety outcomes documented significant reductions (average standard mean difference = -0.76, SD = 0.95 or -0.53/0.53 excluding one outlier). Only 4 SRMAs reported child outcomes, and only 2 (of 10) analyses showed significant effects of prenatal interventions (massage and telephone support on neonatal resuscitation [relative risk = 0.43] and neonatal intensive care unit admissions [relative risk = 0.91]). Notably missing, perhaps due to our strict inclusion criteria (inclusion of randomized controlled trials only), were interventions focusing on key facets of prenatal health (e.g., whole diet, sleep). Structural interventions (housing, access to health care, economic security) were not included, although initial success has been documented in non-SRMAs. Most notably, none of the SRMAs focused on offspring mental health or neurodevelopmental outcomes. Given the possibility that interventions deployed in this period will positively impact the next generation, randomized trials that focus on offspring outcomes are urgently needed.
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Affiliation(s)
- Claudia Lugo-Candelas
- New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Ardesheer Talati
- New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Caila Glickman
- New York State Psychiatric Institute, New York, New York
| | - Mariely Hernandez
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Pamela Scorza
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Catherine Monk
- New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Ai Kubo
- Division of Research, Kaiser Permanente, Oakland, California
| | - Chiaying Wei
- New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Andre Sourander
- Department of Child Psychiatry, Turku University Hospital, Turku University, Turku, Finland
| | - Cristiane S Duarte
- New York State Psychiatric Institute, New York, New York; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.
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Aydin E, Weiss SM, Glasgow KA, Barlow J, Austin T, Johnson MH, Lloyd-Fox S. COVID-19 in the context of pregnancy, infancy and parenting (CoCoPIP) study: protocol for a longitudinal study of parental mental health, social interactions, physical growth and cognitive development of infants during the pandemic. BMJ Open 2022; 12:e053800. [PMID: 35667736 PMCID: PMC9170803 DOI: 10.1136/bmjopen-2021-053800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION While the secondary impact of the COVID-19 pandemic on the psychological well-being of pregnant women and parents has become apparent over the past year, the impact of these changes on early social interactions, physical growth and cognitive development of their infants is unknown, as is the way in which a range of COVID-19-related changes have mediated this impact. This study (CoCoPIP) will investigate: (1) how parent's experiences of the social, medical and financial changes during the pandemic have impacted prenatal and postnatal parental mental health and parent-infant social interaction; and (2) the extent to which these COVID-19-related changes in parental prenatal and postnatal mental health and social interaction are associated with fetal and infant development. METHODS AND ANALYSIS The CoCoPIP study is a national online survey initiated in July 2020. This ongoing study (n=1700 families currently enrolled as of 6 May 2021) involves both quantitative and qualitative data being collected across pregnancy and infancy. It is designed to identify the longitudinal impact of the pandemic from pregnancy to 2 years of age as assessed using a range of parent- and self-report measures, with the aim of identifying if stress-associated moderators (ie, loss of income, COVID-19 illness, access to ante/postnatal support) appear to impact parental mental health, and in turn, infant development. In addition, we aim to document individual differences in social and cognitive development in toddlers who were born during restrictions intended to mitigate COVID-19 spread (eg, social distancing, national lockdowns). ETHICS AND DISSEMINATION Ethical approval was given by the University of Cambridge, Psychology Research Ethics Committee (PRE.2020.077). Findings will be made available via community engagement, public forums (eg, social media,) and to national (eg, NHS England) and local (Cambridge Universities Hospitals NHS Foundation Trust) healthcare partners. Results will be submitted for publication in peer-reviews journals.
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Affiliation(s)
- Ezra Aydin
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Psychiatry, Columbia University, New York City, NY, USA
| | - Staci M Weiss
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Kevin A Glasgow
- Department of Education, University of Cambridge, Cambridge, UK
| | - Jane Barlow
- Department of Social Policy, University of Oxford, Oxford, Oxfordshire, UK
| | - Topun Austin
- Rosie Hospital, Cambridge, Cambridgeshire, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge, Cambridgeshire, UK
| | - Mark H Johnson
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Sarah Lloyd-Fox
- Department of Psychology, University of Cambridge, Cambridge, UK
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