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Nazzari S, Pili MP, Günay Y, Provenzi L. Pandemic babies: A systematic review of the association between maternal pandemic-related stress during pregnancy and infant development. Neurosci Biobehav Rev 2024; 162:105723. [PMID: 38762129 DOI: 10.1016/j.neubiorev.2024.105723] [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: 04/24/2024] [Accepted: 05/11/2024] [Indexed: 05/20/2024]
Abstract
The COVID-19 pandemic, with its far-reaching influence on daily life, constituted a highly stressful experience for many people worldwide, jeopardizing individuals' mental health, particularly in vulnerable populations such as pregnant women. While a growing body of evidence links prenatal maternal stress to biological and developmental alterations in offspring, the specific impact of prenatal exposure to maternal pandemic-related stress (PRS) on infant development remains unclear. A comprehensive literature search was performed in October 2023 according to the PRISMA guidelines, which yielded a total of 28 records. The selected papers investigated a vast range of developmental and biological outcomes in the offspring with large methodological variations. The reviewed studies showed mixed results. Either direct associations between maternal PRS during pregnancy and infant temperament and socio-emotional development, or indirect links, mediated by maternal mental health, emerged in most studies. Furthermore, maternal PRS was associated with epigenetic and brain alterations in the offspring, although studies were limited in number. Collectively, the reviewed findings contribute to a deeper understanding of the role of early adverse exposures on infant development.
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Affiliation(s)
- Sarah Nazzari
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Miriam Paola Pili
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Yaren Günay
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Livio Provenzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
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Sacchi C, Girardi P, Buri A, De Carli P, Simonelli A. The perinatal health secondary to pandemic: association between women's delivery concerns and infant's behavioral problems. J Reprod Infant Psychol 2024:1-16. [PMID: 38493474 DOI: 10.1080/02646838.2024.2330662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND COVID-19 pandemic characterised a unique and vulnerable social, emotional, and health environment for pregnancy, with potential long-lasting risks to maternal and child health outcomes. In women who were pregnant at the peak of COVID-19 pandemic, we investigated the association between pandemic-related concerns about pregnancy and delivery and both the parent's (i.e. maternal parenting stress) and the infant's (i.e. emotional-behavioral problems) outcomes 12 months after birth. METHODS A sample of 352 Italian pregnant women completed a web-based survey from 8 April to 4 May 2020 and a follow-up at 12 months after delivery. Maternal assessment in pregnancy covered prenatal measures for: pandemic-related concerns about pregnancy and childbirth, COVID-19 stressful events exposure, pandemic psychological stress, and mental-health symptoms (i.e. depression, anxiety). The 12 months' assessment covered post-partum measures of social support, parenting stress and maternal reports of infants' behavioral problems. RESULTS The results of the Quasi-Poisson regression models on the association between COVID-19 related influencing factors and parenting stress and infant's behavioral problems showed that the presence of higher pandemic-related concerns about pregnancy and childbirth scores was associated with greater total and internalising behavioral problems but not with parenting stress levels. CONCLUSION Perinatal mother-infant health has been sensitively threatened by pandemic consequences with maternal concerns about childbirth in pregnancy being associated with 12 months' children's behavioral outcomes. There is a need to invest in psychological support for perinatal women throughout the transition to parenthood to protect risk conditions before they get chronic or severe and influence offspring development.
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Affiliation(s)
- Chiara Sacchi
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Venezia, Italy
| | - Alice Buri
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Pietro De Carli
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
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Ait Belkacem N, Gorgui J, Tchuente V, Aubin D, Lippé S, Bérard A. Maternal Mental Health in Pregnancy and Its Impact on Children's Cognitive Development at 18 Months, during the COVID-19 Pandemic (CONCEPTION Study). J Clin Med 2024; 13:1055. [PMID: 38398369 PMCID: PMC10889100 DOI: 10.3390/jcm13041055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly affected the mental health of pregnant persons. OBJECTIVE We aimed to evaluate the impact of maternal mental health and antidepressant use on children's cognitive development. METHODS We followed a cohort of children born during the COVID-19 pandemic. Maternal mental health was self-reported during pregnancy (Edinburgh Postnatal Depression Scale, General Anxiety Disorder-7, stress levels, and antidepressant use). The child's cognitive development was measured using the third edition of the Ages & Stages Questionnaires® (ASQ-3) at 18 months. Multivariate multinomial logistic regression models were built to assess the association between in utero exposure to maternal mental health and ASQ-3 domains: communication, gross motor, fine motor, problem-solving, and personal-social. RESULTS Overall, 472 children were included in our analyses. After adjusting for potential confounders, a need for further assessment in communication (adjusted odds ratio (aOR) 12.2, 95% confidence interval (CI) (1.60;92.4)), and for improvement in gross motricity (aOR 6.33, 95%CI (2.06;19.4)) were associated with in utero anxiety. The need for improvement in fine motricity (aOR 4.11, 95%CI (1.00; 16.90)) was associated with antidepressant exposure. In utero depression was associated with a decrease in the need for improvement in problem solving (aOR 0.48, 95%CI (0.24; 0.98)). CONCLUSIONS During the COVID-19 pandemic, maternal mental health appears to be associated with some aspects of children's cognitive development.
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Affiliation(s)
- Narimene Ait Belkacem
- Faculty of Pharmacy, University of Montreal, Montreal, QC H3T 1J4, Canada; (N.A.B.); (J.G.)
- Research Center, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (V.T.); (D.A.); (S.L.)
| | - Jessica Gorgui
- Faculty of Pharmacy, University of Montreal, Montreal, QC H3T 1J4, Canada; (N.A.B.); (J.G.)
- Research Center, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (V.T.); (D.A.); (S.L.)
| | - Vanina Tchuente
- Research Center, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (V.T.); (D.A.); (S.L.)
| | - Delphine Aubin
- Research Center, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (V.T.); (D.A.); (S.L.)
- Department of Psychology, University of Montreal, Montreal, QC H2V 2S9, Canada
| | - Sarah Lippé
- Research Center, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (V.T.); (D.A.); (S.L.)
- Department of Psychology, University of Montreal, Montreal, QC H2V 2S9, Canada
| | - Anick Bérard
- Faculty of Pharmacy, University of Montreal, Montreal, QC H3T 1J4, Canada; (N.A.B.); (J.G.)
- Research Center, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (V.T.); (D.A.); (S.L.)
- Faculty of Medicine, Université Claude Bernard, Lyon 1, 69003 Lyon, France
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Maccarini J, Nazzari S, Grumi S, Provenzi L. Prenatal maternal pandemic-related stress was associated with a greater risk of children having disturbed sleep at 24 months of age. Acta Paediatr 2024; 113:256-258. [PMID: 38062561 DOI: 10.1111/apa.17042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Julia Maccarini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sarah Nazzari
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Serena Grumi
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
| | - Livio Provenzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
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Nazzari S, Cagliero L, Grumi S, Pisoni E, Mallucci G, Bergamaschi R, Maccarini J, Giorda R, Provenzi L. Prenatal exposure to environmental air pollution and psychosocial stress jointly contribute to the epigenetic regulation of the serotonin transporter gene in newborns. Mol Psychiatry 2023; 28:3503-3511. [PMID: 37542161 DOI: 10.1038/s41380-023-02206-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023]
Abstract
Antenatal exposures to maternal stress and to particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5) have been independently associated with developmental outcomes in early infancy and beyond. Knowledge about their joint impact, biological mechanisms of their effects and timing-effects, is still limited. Both PM2.5 and maternal stress exposure during pregnancy might result in altered patterns of DNA methylation in specific stress-related genes, such as the serotonin transporter gene (SLC6A4 DNAm), that might, in turn, influence infant development across several domains, including bio-behavioral, cognitive and socio-emotional domains. Here, we investigated the independent and interactive influence of variations in antenatal exposures to maternal pandemic-related stress (PRS) and PM2.5 on SLC6A4 DNAm levels in newborns. Mother-infant dyads (N = 307) were enrolled at delivery during the COVID-19 pandemic. Infants' methylation status was assessed in 13 CpG sites within the SLC6A4 gene's region (chr17:28562750-28562958) in buccal cells at birth and women retrospectively report on PRS. PM2.5 exposure throughout the entire gestation and at each gestational trimester was estimated using a spatiotemporal model based on residential address. Among several potentially confounding socio-demographic and health-related factors, infant's sex was significantly associated with infants' SLC6A4 DNAm levels, thus hierarchical regression models were adjusted for infant's sex. Higher levels of SLC6A4 DNAm at 6 CpG sites were found in newborns born to mothers reporting higher levels of antenatal PRS and greater PM2.5 exposure across gestation, while adjusting for infant's sex. These effects were especially evident when exposure to elevated PM2.5 occurred during the second trimester of pregnancy. Several important brain processes (e.g., synaptogenesis and myelination) occur during mid-pregnancy, potentially making the second trimester a sensitive time window for the effects of stress-related exposures. Understanding the interplay between environmental and individual-level stressors has important implications for the improvement of mother-infant health during and after the pandemic.
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Affiliation(s)
- Sarah Nazzari
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Lucia Cagliero
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
| | - Serena Grumi
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
| | - Enrico Pisoni
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Giulia Mallucci
- Multiple Sclerosis Center, Neurocenter of South of Switzerland, EOC, Lugano, Switzerland
| | | | - Julia Maccarini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy
| | - Roberto Giorda
- Molecular Biology Lab, Scientific Institute IRCCS E. Medea, Bosisio Parini, Italy
| | - Livio Provenzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia, Italy.
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