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Tartour AI, Chivese T, Eltayeb S, Elamin FM, Fthenou E, Seed Ahmed M, Babu GR. Prenatal psychological distress and 11β-HSD2 gene expression in human placentas: Systematic review and meta-analysis. Psychoneuroendocrinology 2024; 166:107060. [PMID: 38677195 DOI: 10.1016/j.psyneuen.2024.107060] [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: 11/03/2023] [Revised: 03/10/2024] [Accepted: 04/18/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND The placenta acts as a buffer to regulate the degree of fetal exposure to maternal cortisol through the 11-Beta Hydroxysteroid Dehydrogenase isoenzyme type 2 (11-β HSD2) enzyme. We conducted a systematic review and meta-analysis to assess the effect of prenatal psychological distress (PPD) on placental 11-β HSD2 gene expression and explore the related mechanistic pathways involved in fetal neurodevelopment. METHODS We searched PubMed, Embase, Scopus, APA PsycInfo®, and ProQuest Dissertations for observational studies assessing the association between PPD and 11-β HSD2 expression in human placentas. Adjusted regression coefficients (β) and corresponding 95% confidence intervals (CIs) were pooled based on three contextual PPD exposure groups: prenatal depression, anxiety symptoms, and perceived stress. RESULTS Of 3159 retrieved records, sixteen longitudinal studies involving 1869 participants across seven countries were included. Overall, exposure to PPD disorders showed weak negative associations with the placental 11-β HSD2 gene expression as follows: prenatal depression (β -0.01, 95% CI 0.05-0.02, I2=0%), anxiety symptoms (β -0.02, 95% CI 0.06-0.01, I2=0%), and perceived stress (β -0.01 95% CI 0.06-0.04, I2=62.8%). Third-trimester PPD exposure was more frequently associated with lower placental 11-β HSD2 levels. PPD and placental 11-β HSD2 were associated with changes in cortisol reactivity and the development of adverse health outcomes in mothers and children. Female-offspring were more vulnerable to PPD exposures. CONCLUSION The study presents evidence of a modest role of prenatal psychological distress in regulating placental 11-β HSD2 gene expression. Future prospective cohorts utilizing larger sample sizes or advanced statistical methods to enhance the detection of small effect sizes should be planned. Additionally, controlling for key predictors such as the mother's ethnicity, trimester of PPD exposure, mode of delivery, and infant sex is crucial for valid exploration of PPD effects on fetal programming.
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Affiliation(s)
- Angham Ibrahim Tartour
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar.
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Safa Eltayeb
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Fatima M Elamin
- Office of Research Ethics and Integrity, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Eleni Fthenou
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Mohammed Seed Ahmed
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Giridhara Rathnaiah Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
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Meredith Weiss S, Aydin E, Lloyd-Fox S, Johnson MH. Trajectories of brain and behaviour development in the womb, at birth and through infancy. Nat Hum Behav 2024:10.1038/s41562-024-01896-7. [PMID: 38886534 DOI: 10.1038/s41562-024-01896-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 04/04/2024] [Indexed: 06/20/2024]
Abstract
Birth is often seen as the starting point for studying effects of the environment on human development, with much research focused on the capacities of young infants. However, recent imaging advances have revealed that the complex behaviours of the fetus and the uterine environment exert influence. Birth is now viewed as a punctuate event along a developmental pathway of increasing autonomy of the child from their mother. Here we highlight (1) increasing physiological autonomy and perceptual sensitivity in the fetus, (2) physiological and neurochemical processes associated with birth that influence future behaviour, (3) the recalibration of motor and sensory systems in the newborn to adapt to the world outside the womb and (4) the effect of the prenatal environment on later infant behaviours and brain function. Taken together, these lines of evidence move us beyond nature-nurture issues to a developmental human lifespan view beginning within the womb.
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Affiliation(s)
- Staci Meredith Weiss
- University of Cambridge, Department of Psychology, Cambridge, UK.
- University of Roehampton, School of Psychology, London, UK.
| | - Ezra Aydin
- University of Cambridge, Department of Psychology, Cambridge, UK
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Sarah Lloyd-Fox
- University of Cambridge, Department of Psychology, Cambridge, UK
| | - Mark H Johnson
- University of Cambridge, Department of Psychology, Cambridge, UK
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
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Dekel S, Papadakis JE, Quagliarini B, Pham CT, Pacheco-Barrios K, Hughes F, Jagodnik KM, Nandru R. Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 230:610-641.e14. [PMID: 38122842 PMCID: PMC11168224 DOI: 10.1016/j.ajog.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these events remains high in the United States. Currently, no recommended treatment exists in routine care to prevent or mitigate maternal childbirth-related posttraumatic stress disorder. We conducted a systematic review and meta-analysis of clinical trials that evaluated any therapy to prevent or treat childbirth-related posttraumatic stress disorder. DATA SOURCES PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for eligible trials published through September 2023. STUDY ELIGIBILITY CRITERIA Trials were included if they were interventional, if they evaluated any therapy for childbirth-related posttraumatic stress disorder for the indication of symptoms or before posttraumatic stress disorder onset, and if they were written in English. METHODS Independent coders extracted the sample characteristics and intervention information of the eligible studies and evaluated the trials using the Downs and Black's quality checklist and Cochrane's method for risk of bias evaluation. Meta-analysis was conducted to evaluate pooled effect sizes of secondary and tertiary prevention trials. RESULTS A total of 41 studies (32 randomized controlled trials, 9 nonrandomized trials) were reviewed. They evaluated brief psychological therapies including debriefing, trauma-focused therapies (including cognitive behavioral therapy and expressive writing), memory consolidation and reconsolidation blockage, mother-infant-focused therapies, and educational interventions. The trials targeted secondary preventions aimed at buffering childbirth-related posttraumatic stress disorder usually after traumatic childbirth (n=24), tertiary preventions among women with probable childbirth-related posttraumatic stress disorder (n=14), and primary prevention during pregnancy (n=3). A meta-analysis of the combined randomized secondary preventions showed moderate effects in reducing childbirth-related posttraumatic stress disorder symptoms when compared with usual treatment (standardized mean difference, -0.67; 95% confidence interval, -0.92 to -0.42). Single-session therapy within 96 hours of birth was helpful (standardized mean difference, -0.55). Brief, structured, trauma-focused therapies and semi-structured, midwife-led, dialogue-based psychological counseling showed the largest effects (standardized mean difference, -0.95 and -0.91, respectively). Other treatment approaches (eg, the Tetris game, mindfulness, mother-infant-focused treatment) warrant more research. Tertiary preventions produced smaller effects than secondary prevention but are potentially clinically meaningful (standardized mean difference, -0.37; -0.60 to -0.14). Antepartum educational approaches may help, but insufficient empirical evidence exists. CONCLUSION Brief trauma-focused and non-trauma-focused psychological therapies delivered early in the period following traumatic childbirth offer a critical and feasible opportunity to buffer the symptoms of childbirth-related posttraumatic stress disorder. Future research that integrates diagnostic and biological measures can inform treatment use and the mechanisms at work.
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Affiliation(s)
- Sharon Dekel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | | | | | - Christina T Pham
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Francine Hughes
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kathleen M Jagodnik
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Rasvitha Nandru
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
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Martínez Vázquez S, Perete AR, de la Torre-Luque A, Nakić Radoš S, Brekalo M, Amezcua-Prieto C, Caparros-Gonzalez RA. Assessment of Postpartum Stress Using the Maternal Postpartum Stress Scale (MPSS) in Spanish Women. Healthcare (Basel) 2024; 12:1032. [PMID: 38786442 PMCID: PMC11121621 DOI: 10.3390/healthcare12101032] [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: 03/19/2024] [Revised: 04/16/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale-Revised (BSS-R) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h2 < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations.
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Affiliation(s)
| | - Adrián Ruíz Perete
- Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (A.R.P.); (A.d.l.T.-L.)
| | - Alejandro de la Torre-Luque
- Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (A.R.P.); (A.d.l.T.-L.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Sandra Nakić Radoš
- University Department of Psychology, Catholic University of Croatia, 10 000 Zagreb, Croatia; (S.N.R.); (M.B.)
| | - Maja Brekalo
- University Department of Psychology, Catholic University of Croatia, 10 000 Zagreb, Croatia; (S.N.R.); (M.B.)
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs GRANADA, 18071 Granada, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Rafael A. Caparros-Gonzalez
- Instituto de Investigación Biosanitaria ibs GRANADA, 18071 Granada, Spain;
- Department of Nursing, University of Granada, 18016 Granada, Spain
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Xu X, Buzzell GA, Bowers ME, Shuffrey LC, Leach SC, McSweeney M, Yoder L, Fifer WP, Myers MM, Elliott AJ, Fox NA, Morales S. Electrophysiological correlates of inhibitory control in children: Relations with prenatal maternal risk factors and child psychopathology. Dev Psychopathol 2024:1-14. [PMID: 38654404 DOI: 10.1017/s0954579424000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Inhibitory control plays an important role in children's cognitive and socioemotional development, including their psychopathology. It has been established that contextual factors such as socioeconomic status (SES) and parents' psychopathology are associated with children's inhibitory control. However, the relations between the neural correlates of inhibitory control and contextual factors have been rarely examined in longitudinal studies. In the present study, we used both event-related potential (ERP) components and time-frequency measures of inhibitory control to evaluate the neural pathways between contextual factors, including prenatal SES and maternal psychopathology, and children's behavioral and emotional problems in a large sample of children (N = 560; 51.75% females; Mage = 7.13 years; Rangeage = 4-11 years). Results showed that theta power, which was positively predicted by prenatal SES and was negatively related to children's externalizing problems, mediated the longitudinal and negative relation between them. ERP amplitudes and latencies did not mediate the longitudinal association between prenatal risk factors (i.e., prenatal SES and maternal psychopathology) and children's internalizing and externalizing problems. Our findings increase our understanding of the neural pathways linking early risk factors to children's psychopathology.
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Affiliation(s)
- Xiaoye Xu
- Department of Psychology, State University of New York at Cortland, Cortland, NY, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - George A Buzzell
- Department of Psychology, Florida International University, Miami, FL, USA
- Center for Children and Families, Miami, FL, USA
| | - Maureen E Bowers
- Department of Human Development and Quantitative Methodology, The University of Maryland at College Park, College Park, MD, USA
| | - Lauren C Shuffrey
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Stephanie C Leach
- Department of Human Development and Quantitative Methodology, The University of Maryland at College Park, College Park, MD, USA
| | - Marco McSweeney
- Department of Human Development and Quantitative Methodology, The University of Maryland at College Park, College Park, MD, USA
| | - Lydia Yoder
- Department of Human Development and Quantitative Methodology, The University of Maryland at College Park, College Park, MD, USA
| | - William P Fifer
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Michael M Myers
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Amy J Elliott
- Avera Research Institute, Sioux Falls, SD, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, USA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, The University of Maryland at College Park, College Park, MD, USA
| | - Santiago Morales
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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Galbally M, Watson SJ, Newnham J, White S, Watkins A, Lewis AJ. The Relationship Between Early Term Birth and the Risk of Later Childhood Mental Disorders Within a Pregnancy Cohort. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01643-5. [PMID: 38165581 DOI: 10.1007/s10578-023-01643-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 01/04/2024]
Abstract
This study examines whether gestational age, birth weight, and early term birth is associated with childhood mental disorders in 342 pregnant women recruited at less than 20 weeks gestation and were then followed up until 4 years postpartum, including 93 children born at early term. Women were assessed at recruitment using the Structured Clinical Interview for DSM. At 4 years of age their children were assessed using the Preschool Age Psychiatric Assessment (PAPA) and the Child Behavior Checklist (CBCL). This study found earlier birth predicted an increased risk for anxiety disorders and demonstrated a significant interaction between gestational age and lower birthweight. The risk for ADHD increased with lower gestational age independent of birthweight. In contrast, gestational age was not associated with Oppositional Defiant Disorder, Conduct Disorder, internalizing or externalizing symptoms. These findings highlight the important differences in the association of early term birth and vulnerability for specific mental disorders.
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Affiliation(s)
- Megan Galbally
- School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia.
- Health Futures Institute, Murdoch University, Perth, Australia.
| | - Stuart J Watson
- School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
- Health Futures Institute, Murdoch University, Perth, Australia
| | - John Newnham
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Australia
| | - Scott White
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Australia
| | | | - Andrew J Lewis
- Institute of Health and Wellbeing, Federation University, Ballarat, Australia
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Zhang Y, Tang C, Li Z, Aihaiti A, Wang C. Exposure of embryos to fenbuconazole causes persistent neurotoxicity in adult zebrafish. CHEMOSPHERE 2024; 347:140728. [PMID: 37981021 DOI: 10.1016/j.chemosphere.2023.140728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/18/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
In this study, the persistent effects of embryonic exposure to fenbuconazole (FBZ), a triazole fungicide, on neurobehaviour in zebrafish were investigated. After exposure of fertilized eggs to FBZ for 72 h (h), the larvae were cultured to adulthood in clean water. In adult zebrafish embryonically exposed to 50 and 500 ng L-1 FBZ, the ratio of brain weight/body weight was significantly decreased, and the number of apoptotic cells in the brain was significantly increased, accompanied by upregulated protein levels of P53 and downregulated levels of BCL2. The novel tank test showed a significant reduction in the moved distance and speed, and a longer period of adaptation to new environments in the 500 ng L-1 group. The social preference experiment showed impaired social interaction behaviour and reduced time of aggregation in the 500 ng L-1 group. Increased dopamine and norepinephrine levels in the brain might be responsible for this anxiety-like behaviour. In addition to upregulated protein levels of tyrosine hydroxylase and β2-adrenoceptor, the transcription of genes related to dopamine and norepinephrine synthesis in the brain such as th1, th2, ddc, drd1b, dat, and dbh, was increased. The methylation levels of related genes were reduced, which were matched with their increased transcriptional levels. These results demonstrate that embryonic FBZ exposure might cause persistent neurotoxicity in adulthood, which suggests the rational cautious use of FBZ.
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Affiliation(s)
- Ying Zhang
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, PR China
| | - Chen Tang
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, PR China
| | - Zihui Li
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, PR China
| | - Ailifeire Aihaiti
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, PR China
| | - Chonggang Wang
- State Key Laboratory of Cellular Stress Biology, School of Life Sciences, Xiamen University, Xiamen, PR China.
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Adane AA, Shepherd CCJ, Walker R, Bailey HD, Galbally M, Marriott R. Perinatal outcomes of Aboriginal women with mental health disorders. Aust N Z J Psychiatry 2023; 57:1331-1342. [PMID: 36927100 PMCID: PMC10517592 DOI: 10.1177/00048674231160986] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Maternal mental disorders have been associated with adverse perinatal outcomes such as low birthweight and preterm birth, although these links have been examined rarely among Australian Aboriginal populations. We aimed to evaluate the association between maternal mental disorders and adverse perinatal outcomes among Aboriginal births. METHODS We used whole population-based linked data to conduct a retrospective cohort study (N = 38,592) using all Western Australia singleton Aboriginal births (1990-2015). Maternal mental disorders were identified based on the International Classification of Diseases diagnoses and grouped into six broad diagnostic categories. The perinatal outcomes evaluated were preterm birth, small for gestational age, perinatal death, major congenital anomalies, foetal distress, low birthweight and 5-minute Apgar score. We employed log-binomial/-Poisson models to calculate risk ratios and 95% confidence intervals. RESULTS After adjustment for sociodemographic factors and pre-existing medical conditions, having a maternal mental disorder in the five years before the birth was associated with adverse perinatal outcomes, with risk ratios (95% confidence intervals) ranging from 1.26 [1.17, 1.36] for foetal distress to 2.00 [1.87, 2.15] for low birthweight. We found similar associations for each maternal mental illness category and neonatal outcomes, with slightly stronger associations when maternal mental illnesses were reported within 1 year rather than 5 years before birth and for substance use disorder. CONCLUSIONS This large population-based study demonstrated an increased risk of several adverse birth outcomes among Aboriginal women with mental disorders. Holistic perinatal care, treatment and support for women with mental disorders may reduce the burden of adverse birth outcomes.
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Affiliation(s)
- Akilew A Adane
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
| | - Carrington CJ Shepherd
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Roz Walker
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia
- School of Indigenous Studies, The University of Western Australia, Crawley, WA, Australia
| | - Helen D Bailey
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Megan Galbally
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia
- School of Clinical Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Rhonda Marriott
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia
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Chua KJ, Knorr DA, Jimenez J, Francia A, Rojas V, Garcia JI, Fox M. What Do Your Neighbors Think About You? How Perceived Neighbor Attitudes Toward Latinos Influence Mental Health Among a Pregnant Latina Cohort. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01684-5. [PMID: 37391606 PMCID: PMC10756922 DOI: 10.1007/s40615-023-01684-5] [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: 04/14/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
Latina women living in the USA experience disproportionately higher rates of psychological distress compared to their non-Latina White counterparts. Poor maternal mental health during pregnancy can contribute to intergenerational mental health disparities. Through this pathway, mothers' experiences, environments, and exposures (henceforth "exposures") during pregnancy become biologically embodied and can negatively affect the fetus and life-long developmental trajectories of her child. One of the exposures that can affect mother-offspring dyads is the neighborhood. With the goal of integrating anthropological and sociological theories to explain mental health disparities among pregnant Latina women, we explored how perceptions of neighbor attitudes may influence mental health during pregnancy. We analyzed self-reported responses from 239 pregnant Latina women in Southern California (131 foreign-born, 108 US-born) on their mental health and perceived attitudes of their neighbors using multiple linear regression models. Among foreign-born Latina women, living in neighborhoods with more favorable views of Latinos was associated with lower depression scores (pooled β = - .70, SE = .29, p = .019) and lower pregnancy-related anxiety scores (pooled β = - .11, SE = .05, p = .021), but greater state anxiety scores (pooled β = .09, SE = .04, p = .021). Among US-born women, there were no associations between neighbor attitudes and mental health. Overall, results suggest that social environments are correlated with mental health and that foreign-born and US-born Latinas have varied mental health experiences in the USA. Our findings highlight the importance of improving aspects of neighborhood cohesion as part of maternal-fetal care management.
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Affiliation(s)
- Kristine J Chua
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Delaney A Knorr
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Janelly Jimenez
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Arlene Francia
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Valeria Rojas
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Jhoana Infante Garcia
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Molly Fox
- Department of Anthropology, University of California Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA, 90095, USA.
- California Center for Population Research, University of California Los Angeles, Los Angeles, CA, 90095, USA.
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095, USA.
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Stentzel U, Grabe HJ, Schmidt S, Tomczyk S, van den Berg N, Beyer A. Mental health-related telemedicine interventions for pregnant women and new mothers: a systematic literature review. BMC Psychiatry 2023; 23:292. [PMID: 37118689 PMCID: PMC10148488 DOI: 10.1186/s12888-023-04790-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/14/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Pregnancy and the postpartum period are times when women are at increased risk for depression and mental problems. This may also negatively affect the foetus. Thus, there is a need for interventions with low-threshold access and care. Telemedicine interventions are a promising approach to address these issues. This systematic literature review examined the efficacy of telemedicine interventions for pregnant women and/or new mothers to address mental health-related outcomes. The primary objective was to analyse whether telemedicine interventions can reduce mental health problems in pregnant women and new mothers. The secondary aim was to clarify the impact of type of interventions, their frequency and their targets. METHODS Inclusion criteria: randomized controlled trials, with participants being pregnant women and/or new mothers (with infants up to twelve months), involving telemedicine interventions of any kind (e.g. websites, apps, chats, telephone), and addressing any mental health-related outcomes like depression, postnatal depression, anxiety, stress and others. Search terms were pregnant women, new mothers, telemedicine, RCT (randomised controlled trials), mental stress as well as numerous synonyms including medical subject headings. The literature search was conducted within the databases PubMed, Cochrane Library, Web of Science and PsycINFO. Screening, inclusion of records and data extraction were performed by two researchers according to the PRISMA guidelines, using the online tool CADIMA. RESULTS Forty four articles were included. A majority (62%) reported significantly improved mental health-related outcomes for participants receiving telemedicine interventions compared to control. In particular (internet-delivered) Cognitive Behavioural Therapy was successful for depression and stress, and peer support improved outcomes for postnatal depression and anxiety. Interventions with preventive approaches and interventions aimed at symptom reduction were largely successful. For the most part there was no significant improvement in the symptoms of anxiety. CONCLUSION Telemedicine interventions evaluated within RCTs were mostly successful. However, they need to be designed to specifically target a certain mental health issue because there is no one-size-fits-all approach. Further research should focus on which specific interventions are appropriate for which mental health outcomes in terms of intervention delivery modes, content, target approaches, etc. Further investigation is needed, in particular with regard to anxiety.
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Affiliation(s)
- Ulrike Stentzel
- Institute for Community Medicine, University Medicine Greifswald, Section Epidemiology of Health Care and Community Health, Ellernholzstraße 1-2, 17489, Greifswald, Germany.
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17489, Greifswald, Germany
| | - Silke Schmidt
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Samuel Tomczyk
- Department Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany
| | - Neeltje van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Section Epidemiology of Health Care and Community Health, Ellernholzstraße 1-2, 17489, Greifswald, Germany
| | - Angelika Beyer
- Institute for Community Medicine, University Medicine Greifswald, Section Epidemiology of Health Care and Community Health, Ellernholzstraße 1-2, 17489, Greifswald, Germany
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Pezley L, Cares K, Duffecy J, Koenig MD, Maki P, Odoms-Young A, Clark Withington MH, Lima Oliveira M, Loiacono B, Prough J, Tussing-Humphreys L, Buscemi J. Efficacy of behavioral interventions to improve maternal mental health and breastfeeding outcomes: a systematic review. Int Breastfeed J 2022; 17:67. [PMID: 36064573 PMCID: PMC9446548 DOI: 10.1186/s13006-022-00501-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/08/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite extensive benefits and high intentions, few mothers breastfeed exclusively for the recommended duration. Maternal mental health is an important underlying factor associated with barriers and reduced rates of breastfeeding intent, initiation, and continuation. Given evidence of a bidirectional association between maternal mental health and breastfeeding, it is important to consider both factors when examining the efficacy of interventions to improve these outcomes. The purpose of this manuscript is to review the literature on the efficacy of behavioral interventions focused on both maternal mental health and breastfeeding outcomes, examining the intersection of the two. METHODS This systematic review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Studies were selected if they were available in English, used primary experimental design, and used a behavioral intervention type to examine maternal mental health and breastfeeding outcomes. Articles were identified from PubMed, CINAHL, Embase, and PsycINFO from database inception to 3 March 2022. Study quality was assessed using the Cochrane Risk of Bias tool. Results were synthesized by intervention success for 1. Mental health and breastfeeding, 2. Breastfeeding only, 3. Mental health only, and 4. No intervention effect. PROSPERO CRD42021224228. RESULTS Thirty interventions reported in 33 articles were identified, representing 15 countries. Twelve studies reported statistically significant positive effect of the intervention on both maternal mental health and breastfeeding; most showing a decrease in self-report depressive and/or anxiety symptoms in parallel to an increase in breastfeeding duration and/or exclusivity. Common characteristics of successful interventions were a) occurring across pregnancy and postpartum, b) delivered by hospital staff or multidisciplinary teams, c) offered individually, and d) designed to focus on breastfeeding and maternal mental health or on breastfeeding only. Our results are not representative of all countries, persons, experiences, circumstances, or physiological characteristics. CONCLUSIONS Interventions that extend the perinatal period and offer individualized support from both professionals and peers who collaborate through a continuum of settings (e.g., health system, home, and community) are most successful in improving both mental health and breastfeeding outcomes. The benefits of improving these outcomes warrant continued development and implementation of such interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021224228.
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Affiliation(s)
- Lacey Pezley
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA.
| | - Kate Cares
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Jennifer Duffecy
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Mary Dawn Koenig
- Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Pauline Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Manoela Lima Oliveira
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | | | - Jilian Prough
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
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Parameswaran UD, Pentecost R, Williams M, Smid M, Latendresse G. Experiences with use of technology and telehealth among women with perinatal depression. BMC Pregnancy Childbirth 2022; 22:571. [PMID: 35850663 PMCID: PMC9289084 DOI: 10.1186/s12884-022-04889-4] [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: 10/20/2021] [Accepted: 05/05/2022] [Indexed: 11/28/2022] Open
Abstract
Background Perinatal depression (PD) affects 10–20% of childbearing women. Telehealth is increasingly utilized for mental health services to increase access to care and overcome COVID-19 pandemic barriers. Women’s perspectives on telehealth services for PD is unknown, however. This study’s primary objective was to obtain the perspectives of women who participated in an 8-week group videoconference intervention for PD symptoms, including how technology impacted their experience. Methods We utilized theoretical sampling and included perinatal women who had completed the 8-week mindfulness-based cognitive-behavioral intervention group. Semi-structured focus groups with four to six women were conducted on a videoconference platform. Primary analysis used grounded theory and a secondary analysis used qualitative description and was conducted by two coding teams. The teams collaborated on the final themes across the analyses. Results Three groups, with a total of 17 participants were conducted. Composition consisted of seven postpartum and ten pregnant women from the 47 total participants. Identified core themes regarding their experiences of the videoconference intervention were: positive experiences, negative experiences, suggestions and ideas, and screening and communication. Conclusion This study provides growing evidence informed by perinatal women of positive experiences with engagement in a videoconference intervention for PD. Telehealth may be a reasonable and acceptable platform to increase access and retention for mental health services in childbearing women. Further, this pilot work showcases videoconferencing delivery for a wide range of effective and affordable mental health services in low-resource communities.
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Affiliation(s)
- Uma D Parameswaran
- Department of Psychology, University of Utah, Salt Lake City, USA. .,Department of Applied Psychology, New York University, New York, USA.
| | | | | | - Marcela Smid
- Maternal Fetal Medicine, University of Utah Hospital, Salt Lake City, USA
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Doroftei B, Ilie OD, Diaconu R, Hutanu D, Stoian I, Ilea C. An Updated Narrative Mini-Review on the Microbiota Changes in Antenatal and Post-Partum Depression. Diagnostics (Basel) 2022; 12:diagnostics12071576. [PMID: 35885482 PMCID: PMC9315700 DOI: 10.3390/diagnostics12071576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Antenatal depression (AND) and post-partum depression (PPD) are long-term debilitating psychiatric disorders that significantly influence the composition of the gut flora of mothers and infants that starts from the intrauterine life. Not only does bacterial ratio shift impact the immune system, but it also increases the risk of potentially life-threatening disorders. Material and Methods: Therefore, we conducted a narrative mini-review aiming to gather all evidence published between 2018–2022 regarding microflora changes in all three stages of pregnancy. Results: We initially identified 47 potentially eligible studies, from which only 7 strictly report translocations; 3 were conducted on rodent models and 4 on human patients. The remaining studies were divided based on their topic, precisely focused on how probiotics, breastfeeding, diet, antidepressants, exogenous stressors, and plant-derived compounds modulate in a bidirectional way upon behavior and microbiota. Almost imperatively, dysbacteriosis cause cognitive impairments, reflected by abnormal temperament and personality traits that last up until 2 years old. Thankfully, a distinct technique that involves fecal matter transfer between individuals has been perfected over the years and was successfully translated into clinical practice. It proved to be a reliable approach in diminishing functional non- and gastrointestinal deficiencies, but a clear link between depressive women’s gastrointestinal/vaginal microbiota and clinical outcomes following reproductive procedures is yet to be established. Another gut-dysbiosis-driving factor is antibiotics, known for their potential to trigger inflammation. Fortunately, the studies conducted on mice that lack microbiota offer, without a shadow of a doubt, insight. Conclusions: It can be concluded that the microbiota is a powerful organ, and its optimum functionality is crucial, likely being the missing puzzle piece in the etiopathogenesis of psychiatric disorders.
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Affiliation(s)
- Bogdan Doroftei
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (B.D.); (I.S.); (C.I.)
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No. 34, 700038 Iasi, Romania;
- Origyn Fertility Center, Palace Street, No. 3C, 700032 Iasi, Romania
| | - Ovidiu-Dumitru Ilie
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue, No. 20A, 700505 Iasi, Romania
- Correspondence:
| | - Roxana Diaconu
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No. 34, 700038 Iasi, Romania;
- Origyn Fertility Center, Palace Street, No. 3C, 700032 Iasi, Romania
| | - Delia Hutanu
- Department of Biology, Faculty of Chemistry-Biology-Geography, West University of Timisoara, Vasile Pârvan Avenue, No. 4, 300115 Timisoara, Romania;
| | - Irina Stoian
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (B.D.); (I.S.); (C.I.)
| | - Ciprian Ilea
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (B.D.); (I.S.); (C.I.)
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No. 34, 700038 Iasi, Romania;
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Pezley L, Tussing-Humphreys L, Koenig MD, Maki P, Odoms-Young A, Freels S, DiPiazza B, Cann F, Cares K, Depa C, Klejka G, Lima Oliveira M, Prough J, Roe T, Buscemi J, Duffecy J. Feasibility of a Web-Based Intervention to Prevent Perinatal Depression and Promote Human Milk Feeding: Randomized Pilot Trial. JMIR Form Res 2022; 6:e32226. [PMID: 35503244 PMCID: PMC9115661 DOI: 10.2196/32226] [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: 07/19/2021] [Revised: 11/22/2021] [Accepted: 03/21/2022] [Indexed: 11/27/2022] Open
Abstract
Background Mothers who identify as Black or African American are more likely to report depressed moods in late pregnancy and early postpartum and have the lowest rates of human milk feeding compared with all other racial groups in the United States. Internet interventions offer the potential to extend preventative and supportive services as they address key barriers, particularly for those navigating the complex and vulnerable early postpartum period. However, there is limited evidence on the feasibility of such interventions for preventing perinatal mental health disorders and improving human milk feeding outcomes in Black mothers. Objective This pilot study aimed to assess the feasibility and preliminary findings of a web-based cognitive behavioral therapy–based internet intervention, with and without human milk feeding education and support, to prevent perinatal depression and promote human milk feeding in Black mothers. Methods Participants were Black-identifying individuals between 20 and 28 weeks of pregnancy with human milk feeding intention and mild to moderate depressive symptoms (Patient Health Questionnaire scores 5-14). Participants were randomized to either Sunnyside, a 6-week cognitive behavioral therapy–based web-based intervention, or Sunnyside Plus, which included additional education and support to promote human milk feeding. Assessments occurred at baseline, third trimester (end of antenatal treatment), 6 weeks postpartum (end of postpartum treatment), and 12 weeks postpartum. The primary focus of this randomized pilot trial was the feasibility and preliminary outcomes of mental health and human milk feeding. Results A total of 22 tertiary-educated participants were randomized. The mean number of log-ins was 7.3 (SD 5.3) for Sunnyside and 13.8 (SD 10.5) for Sunnyside Plus. Scores of depression and anxiety measures remained below the clinical threshold for referral to treatment in both groups. All the participants initiated human milk feeding (18/18, 100%). Most participants reported at least some human milk feeding at both 6 and 12 weeks postpartum (6/7, 86%; 11/11, 100%, or 10/10, 100%, for Sunnyside and Sunnyside Plus, respectively). Conclusions The results suggest that tertiary-educated Black mothers at risk for perinatal depression and who intended to human milk feed were receptive to and satisfied with a web-based cognitive behavioral therapy–based internet intervention, with and without human milk feeding education and support. Preliminary findings indicate that both Sunnyside and Sunnyside Plus interventions have the potential to affect symptoms of depression, anxiety, and human milk feeding outcomes. Trial Registration ClinicalTrials.gov NCT04128202; https://www.clinicaltrials.gov/ct2/show/NCT04128202
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Affiliation(s)
- Lacey Pezley
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Mary Dawn Koenig
- Department of Human Development Nursing Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, United States
| | - Pauline Maki
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Angela Odoms-Young
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Sally Freels
- Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | - Brittany DiPiazza
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Felicity Cann
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Kate Cares
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Courtney Depa
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Gintare Klejka
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Manoela Lima Oliveira
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Jilian Prough
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Taylor Roe
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Joanna Buscemi
- Department of Psychology, College of Science and Health, DePaul University, Chicago, IL, United States
| | - Jennifer Duffecy
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
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15
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Prenatal internalizing symptoms as a mediator linking maternal adverse childhood experiences with infant temperament. Early Hum Dev 2022; 168:105577. [PMID: 35489299 DOI: 10.1016/j.earlhumdev.2022.105577] [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: 09/15/2021] [Revised: 04/04/2022] [Accepted: 04/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Maternal adverse childhood experiences are known to significantly influence offspring development. However, mediators linking maternal early-life adversity with infant temperament remain largely unknown. AIMS The current study investigated whether prenatal internalizing symptoms mediate the association between maternal adverse childhood experiences and infant temperament at two months. Maternal sensitivity/responsiveness during the postpartum period was also examined as a moderator of these associations. STUDY DESIGN We used a repeated-measures design, with self-report measures administered during pregnancy. Self-report and observational data were also collected at 2 months postpartum. SUBJECTS The study included a community sample of 64 pregnant women and their infants. OUTCOME MEASURES Participants completed measures assessing their early-life adversity and current depression/anxiety symptoms. At two months postpartum, mothers reported on their infant's temperament and participated in a parent-child interaction task designed to assess maternal sensitivity/responsiveness. RESULTS AND CONCLUSIONS Maternal adverse childhood experiences indirectly predicted poor self-regulation during early infancy via prenatal internalizing symptoms. Maternal sensitivity/responsiveness was also found to moderate the association between maternal adverse childhood experiences and certain aspects of infant regulatory capacity and positive affectivity at two months. This research has implications for mental health screening procedures during pregnancy and the development of early intervention programs.
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Epigenomic and Proteomic Changes in Fetal Spleens Persistently Infected with Bovine Viral Diarrhea Virus: Repercussions for the Developing Immune System, Bone, Brain, and Heart. Viruses 2022; 14:v14030506. [PMID: 35336913 PMCID: PMC8949278 DOI: 10.3390/v14030506] [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: 02/04/2022] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 12/10/2022] Open
Abstract
Bovine viral diarrhea virus (BVDV) infection during early gestation results in persistently infected (PI) immunotolerant calves that are the primary reservoirs of the virus. Pathologies observed in PI cattle include congenital defects of the brain, heart, and bone as well as marked functional defects in their immune system. It was hypothesized that fetal BVDV infection alters T cell activation and signaling genes by epigenetic mechanisms. To test this, PI and control fetal splenic tissues were collected on day 245 of gestation, 170 days post maternal infection. DNA was isolated for reduced representation bisulfite sequencing, protein was isolated for proteomics, both were analyzed with appropriate bioinformatic methods. Within set parameters, 1951 hypermethylated and 691 hypomethylated DNA regions were identified in PI compared to control fetuses. Pathways associated with immune system, neural, cardiac, and bone development were associated with heavily methylated DNA. The proteomic analysis revealed 12 differentially expressed proteins in PI vs. control animals. Upregulated proteins were associated with protein processing, whereas downregulated proteins were associated with lymphocyte migration and development in PI compared to control fetal spleens. The epigenetic changes in DNA may explain the immune dysfunctions, abnormal bone formation, and brain and heart defects observed in PI animals.
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Liu Y, Heron J, Hickman M, Zammit S, Wolke D. Prenatal stress and offspring depression in adulthood: The mediating role of childhood trauma. J Affect Disord 2022; 297:45-52. [PMID: 34670130 PMCID: PMC8641663 DOI: 10.1016/j.jad.2021.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND There is repeated evidence for a prenatal programming effect for the development of offspring depression. However, examination of environmental influences along this pathway is sparse. This study aimed to investigate the direct and indirect effects of pre- and postnatal stress on offspring depression in adulthood, via increased exposure to childhood trauma. METHODS A large longitudinal population-based cohort (N = 3506) was followed up from birth and assessed at 24 years. Diagnosis of depression was derived using the International Classification of Diseases-10th revision (ICD-10). Two separate sources of pre- and postnatal stress were examined - maternal depression and family adversity, and childhood trauma was assessed prospectively across childhood until 17 years. RESULTS Both pre- and postnatal maternal depression and family adversity were associated with offspring depression at 24 years in simple logistic regression models. When all pathways were modelled simultaneously, only childhood trauma was directly associated with offspring depression, and mediated all pathways from both sources of pre- and postnatal stress to offspring depression (7-16% of the total effect mediated). Sensitivity analysis on specific trauma found stronger evidence for a mediated pathway via physical, emotional abuse and peer bullying, compared to emotional neglect, sexual abuse and domestic violence. CONCLUSIONS These findings indicate that reducing childhood trauma could be a target to decrease depression in the general population, and the focus should also be on families at high risk of experiencing pre- or postnatal stress, to provide them with better support.
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Affiliation(s)
- Yiwen Liu
- Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Stanley Zammit
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom; MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, United Kingdom
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom; Division of Health Sciences, Warwick Medical School, University of Warwick, United Kingdom.
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Török B, Fazekas CL, Szabó A, Zelena D. Epigenetic Modulation of Vasopressin Expression in Health and Disease. Int J Mol Sci 2021; 22:ijms22179415. [PMID: 34502322 PMCID: PMC8430944 DOI: 10.3390/ijms22179415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 12/14/2022] Open
Abstract
Vasopressin is a ubiquitous molecule playing an important role in a wide range of physiological processes thereby implicated in the pathomechanism of many disorders. Its effect is well characterized through V2 receptors, which regulates the water resorption in kidney, while its vasoconstrictory effect through V1a receptor also received a lot of attention in the maintenance of blood pressure during shock. However, the most striking is its central effect both through the V1b receptors in stress-axis regulation as well as through V1a receptors regulating many aspects of our behavior (e.g., social behavior, learning and memory). Vasopressin has been implicated in the development of depression, due to its connection with chronic stress, as well as schizophrenia because of its involvement in social interactions and memory processes. Epigenetic changes may also play a role in the development of these disorders. The possible mechanism includes DNA methylation, histone modification and/or micro RNAs, and these possible regulations will be in the focus of our present review.
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Affiliation(s)
- Bibiána Török
- Institute of Experimental Medicine, 1083 Budapest, Hungary; (B.T.); (C.L.F.); (A.S.)
- János Szentágothai School of Neurosciences, Semmelweis University, 1085 Budapest, Hungary
| | - Csilla Lea Fazekas
- Institute of Experimental Medicine, 1083 Budapest, Hungary; (B.T.); (C.L.F.); (A.S.)
- János Szentágothai School of Neurosciences, Semmelweis University, 1085 Budapest, Hungary
| | - Adrienn Szabó
- Institute of Experimental Medicine, 1083 Budapest, Hungary; (B.T.); (C.L.F.); (A.S.)
- János Szentágothai School of Neurosciences, Semmelweis University, 1085 Budapest, Hungary
| | - Dóra Zelena
- Institute of Experimental Medicine, 1083 Budapest, Hungary; (B.T.); (C.L.F.); (A.S.)
- Centre for Neuroscience, Szentágothai Research Centre, Institute of Physiology, Medical School, University of Pécs, 7624 Pécs, Hungary
- Correspondence:
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Power J, van IJzendoorn M, Lewis AJ, Chen W, Galbally M. Maternal perinatal depression and child executive function: A systematic review and meta-analysis. J Affect Disord 2021; 291:218-234. [PMID: 34049191 DOI: 10.1016/j.jad.2021.05.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Maternal depression during the perinatal period predicts adverse developmental outcomes for children, via poorly understood mechanisms. One plausible pathway may involve child executive function, a suite of cognitive capacities associated with social, emotional and educational outcomes. Systematic review and meta-analysis are applied to evaluate evidence of association between maternal perinatal depression and child executive function. METHODS Medline, Embase, PubMed, PsycInfo, and SCOPUS were searched for relevant articles to August 2020, with hand-search of relevant bibliographies. Original research published in English measuring maternal depressive symptoms during pregnancy and the first year postpartum, and child executive function outcomes at any age was included. 27 studies met criteria for review. 16 studies reporting raw data of the association between depressive symptoms and executive function were used for meta-analysis. RESULTS Our systematic review identified inadequate assessment of maternal depression, and unreliable measures of executive function in many studies. Assessment of confounders was also inconsistent. Our meta-analysis identified a small, statistically significant relationship between perinatal depression and child executive function (effect size r = 0.07; 95% CI 0.03-0.10); equivalent to Cohen's d = 0.14. LIMITATIONS Variable quality of available studies leads to cautious interpretation of results. CONCLUSIONS This meta-analysis is consistent with the hypothesis that maternal perinatal depression does have an impact on executive function in offspring. Future studies must use robust measurement of depression and executive function, and account for the chronicity of maternal depression, and developmental context to produce meaningful results.
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Affiliation(s)
- Josephine Power
- University of Notre Dame, Fremantle, Australia; Mercy Hospital for Women, Melbourne, Victoria; Austin Health, Melbourne, Victoria.
| | - Marinus van IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - Andrew J Lewis
- Murdoch University, Discipline of Psychology, Perth, Australia
| | - Wai Chen
- University of Notre Dame, Fremantle, Australia; Murdoch University, Discipline of Psychology, Perth, Australia; Mental Health Service, Fiona Stanley Hospital, Australia; CAMHS, Pilbara Mental Health, Australia; Postgraduate School of Education, University of Western Australia, Australia
| | - Megan Galbally
- University of Notre Dame, Fremantle, Australia; Mercy Hospital for Women, Melbourne, Victoria; Murdoch University, Discipline of Psychology, Perth, Australia
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Rodriguez N, Tun HM, Field CJ, Mandhane PJ, Scott JA, Kozyrskyj AL. Prenatal Depression, Breastfeeding, and Infant Gut Microbiota. Front Microbiol 2021; 12:664257. [PMID: 34394021 PMCID: PMC8363245 DOI: 10.3389/fmicb.2021.664257] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/23/2021] [Indexed: 02/01/2023] Open
Abstract
Depressive symptoms are common during pregnancy and are estimated to affect 7-20% of pregnant women, with higher prevalence found in those with a prior history of depression, in ethnic minorities, and those with increased exposure to stressful life events. Maternal depression often remains undiagnosed, and its symptoms can increase adverse health risks to the infant, including impaired cognitive development, behavioral problems, and higher susceptibility to physical illnesses. Accumulating research evidence supports the association between maternal physical health elements to infant gut health, including factors such as mode of delivery, medication, feeding status, and antibiotic use. However, specific maternal prenatal psychosocial factors and their effect on infant gut microbiota and immunity remains an area that is not well understood. This article reviews the literature and supplements it with new findings to show that prenatal depression alters: (i) gut microbial composition in partially and fully formula-fed infants at 3-4 months of age, and (ii) gut immunity (i.e., secretory Immunoglobulin A) in all infants independent of breastfeeding status. Understanding the implications of maternal depression on the infant gut microbiome is important to enhance both maternal and child health and to better inform disease outcomes and management.
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Affiliation(s)
- Nicole Rodriguez
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Hein M Tun
- HKU-Pasteur Research Pole, Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | | | - James A Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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21
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Yong HEJ, Chan SY. Current approaches and developments in transcript profiling of the human placenta. Hum Reprod Update 2021; 26:799-840. [PMID: 33043357 PMCID: PMC7600289 DOI: 10.1093/humupd/dmaa028] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 06/05/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The placenta is the active interface between mother and foetus, bearing the molecular marks of rapid development and exposures in utero. The placenta is routinely discarded at delivery, providing a valuable resource to explore maternal-offspring health and disease in pregnancy. Genome-wide profiling of the human placental transcriptome provides an unbiased approach to study normal maternal–placental–foetal physiology and pathologies. OBJECTIVE AND RATIONALE To date, many studies have examined the human placental transcriptome, but often within a narrow focus. This review aims to provide a comprehensive overview of human placental transcriptome studies, encompassing those from the cellular to tissue levels and contextualize current findings from a broader perspective. We have consolidated studies into overarching themes, summarized key research findings and addressed important considerations in study design, as a means to promote wider data sharing and support larger meta-analysis of already available data and greater collaboration between researchers in order to fully capitalize on the potential of transcript profiling in future studies. SEARCH METHODS The PubMed database, National Center for Biotechnology Information and European Bioinformatics Institute dataset repositories were searched, to identify all relevant human studies using ‘placenta’, ‘decidua’, ‘trophoblast’, ‘transcriptome’, ‘microarray’ and ‘RNA sequencing’ as search terms until May 2019. Additional studies were found from bibliographies of identified studies. OUTCOMES The 179 identified studies were classifiable into four broad themes: healthy placental development, pregnancy complications, exposures during pregnancy and in vitro placental cultures. The median sample size was 13 (interquartile range 8–29). Transcriptome studies prior to 2015 were predominantly performed using microarrays, while RNA sequencing became the preferred choice in more recent studies. Development of fluidics technology, combined with RNA sequencing, has enabled transcript profiles to be generated of single cells throughout pregnancy, in contrast to previous studies relying on isolated cells. There are several key study aspects, such as sample selection criteria, sample processing and data analysis methods that may represent pitfalls and limitations, which need to be carefully considered as they influence interpretation of findings and conclusions. Furthermore, several areas of growing importance, such as maternal mental health and maternal obesity are understudied and the profiling of placentas from these conditions should be prioritized. WIDER IMPLICATIONS Integrative analysis of placental transcriptomics with other ‘omics’ (methylome, proteome and metabolome) and linkage with future outcomes from longitudinal studies is crucial in enhancing knowledge of healthy placental development and function, and in enabling the underlying causal mechanisms of pregnancy complications to be identified. Such understanding could help in predicting risk of future adversity and in designing interventions that can improve the health outcomes of both mothers and their offspring. Wider collaboration and sharing of placental transcriptome data, overcoming the challenges in obtaining sufficient numbers of quality samples with well-defined clinical characteristics, and dedication of resources to understudied areas of pregnancy will undoubtedly help drive the field forward.
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Affiliation(s)
- Hannah E J Yong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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22
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Ding X, Wang J, Li N, Su W, Wang H, Song Q, Guo X, Liang M, Qin Q, Sun L, Chen M, Sun Y. Individual, Prenatal, Perinatal, and Family Factors for Anxiety Symptoms Among Preschool Children. Front Psychiatry 2021; 12:778291. [PMID: 34987428 PMCID: PMC8721098 DOI: 10.3389/fpsyt.2021.778291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/19/2021] [Indexed: 01/21/2023] Open
Abstract
Anxiety is one of the most common psychological disorders among children. Few studies have investigated the prevalence and comprehensive factors for anxiety among preschool children in China. This study aimed to assess the prevalence of anxiety and explore influential factors at multiple levels including individual, prenatal and perinatal, and family factors, associated with anxiety symptoms among preschool children. The multisite cross-sectional study was conducted in Anhui Province and included 3,636 preschool children aged 3-6 years. Anxiety symptoms of children were assessed using the Chinese version of the Spence Preschool Anxiety Scale. Logistic regression analyses were performed to explore associations between factors at multiple levels and significant anxiety symptoms, and the model was validated internally using 10-fold cross-validation. Among the participants, 9.1% of children had significant anxiety symptoms. Girls reported more significant anxiety symptoms. Children's poor dietary habits, sleep disturbances, autistic tendencies, and left-behind experience; maternal poor prenatal emotional symptoms; and more caregivers' anxiety symptoms were significantly associated with anxiety symptoms among children. The result of 10-fold cross-validation indicated that the mean area under the curve, sensitivity, specificity, and accuracy were 0.78, 70.45%, 78.18%, and 71.15%, respectively. These factors were slightly different among different subtypes of anxiety symptoms. The results of this study suggested that anxiety symptoms in preschool children were prevalent, particularly in girls. Understanding early-life risk factors for anxiety is crucial, and efficient prevention and intervention strategies should be implemented in early childhood even pregnancy.
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Affiliation(s)
- Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Jun Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Qirong Qin
- Ma'anshan Center for Disease Control and Prevention, Ma'anshan, China
| | - Liang Sun
- Fuyang Center for Disease Control and Prevention, Fuyang, China
| | - Mingchun Chen
- Changfeng Center for Disease Control and Prevention, Changfeng, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
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23
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Marbin J, Balk SJ, Gribben V, Groner J. Health Disparities in Tobacco Use and Exposure: A Structural Competency Approach. Pediatrics 2021; 147:peds.2020-040253. [PMID: 33386342 DOI: 10.1542/peds.2020-040253] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Fourteen percent of US adults use tobacco products. Because many of those who use tobacco are parents and/or caregivers, children are disproportionately exposed to tobacco smoke. People who use tobacco products often become addicted to nicotine, resulting in tobacco dependence, a chronic, relapsing disease. Tobacco use and exposure are more likely to occur in vulnerable and marginalized groups, including those living in poverty. Although some view tobacco use as a personal choice, evidence suggests that structural forces play an important role in tobacco uptake, subsequent nicotine addiction, and perpetuation of use. Viewing tobacco use and tobacco dependence through a structural competency lens promotes recognition of the larger systemic forces perpetuating tobacco use, including deliberate targeting of groups by the tobacco industry, lack of enforcement of age-for-sale laws, inferior access to health insurance and health care, poor access to cessation resources, and economic stress. Each of these forces perpetuates tobacco initiation and use; in turn, tobacco use perpetuates the user's adverse health and economic conditions. Pediatricians are urged to view family tobacco use as a social determinant of health. In addition to screening adolescents for tobacco use and providing resources and treatment of tobacco dependence, pediatricians are encouraged to systematically screen children for secondhand smoke exposure and support family members who smoke with tobacco cessation. Additionally, pediatricians can address the structural issues perpetuating tobacco use by becoming involved in policy and advocacy initiatives.
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Affiliation(s)
- Jyothi Marbin
- University of California, San Francisco, San Francisco, California;
| | - Sophie J Balk
- Albert Einstein College of Medicine and Children's Hospital at Montefiore, Bronx, New York; and
| | - Valerie Gribben
- University of California, San Francisco, San Francisco, California
| | - Judith Groner
- College of Medicine, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
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24
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Bangma JT, Hartwell H, Santos HP, O'Shea TM, Fry RC. Placental programming, perinatal inflammation, and neurodevelopment impairment among those born extremely preterm. Pediatr Res 2021; 89:326-335. [PMID: 33184498 PMCID: PMC7658618 DOI: 10.1038/s41390-020-01236-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/02/2020] [Accepted: 10/08/2020] [Indexed: 01/30/2023]
Abstract
Individuals born extremely preterm are at significant risk for impaired neurodevelopment. After discharge from the neonatal intensive care, associations between the child's well-being and factors in the home and social environment become increasingly apparent. Mothers' prenatal health and socioeconomic status are associated with neurodevelopmental outcomes, and emotional and behavioral problems. Research on early life risk factors and on mechanisms underlying inter-individual differences in neurodevelopment later in life can inform the design of personalized approaches to prevention. Here, we review early life predictors of inter-individual differences in later life neurodevelopment among those born extremely preterm. Among biological mechanisms that mediate relationships between early life predictors and later neurodevelopmental outcomes, we highlight evidence for disrupted placental processes and regulated at least in part via epigenetic mechanisms, as well as perinatal inflammation. In relation to these mechanisms, we focus on four prenatal antecedents of impaired neurodevelopment, namely, (1) fetal growth restriction, (2) maternal obesity, (3) placental microorganisms, and (4) socioeconomic adversity. In the future, this knowledge may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm. IMPACT: This review highlights early life risk factors and mechanisms underlying inter-individual differences in neurodevelopment later in life. The review emphasizes research on early life risk factors (fetal growth restriction, maternal obesity, placental microorganisms, and socioeconomic adversity) and on mechanisms (disrupted placental processes and perinatal inflammation) underlying inter-individual differences in neurodevelopment later in life. The findings highlighted here may inform efforts to detect and prevent adverse outcomes in infants born extremely preterm.
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Affiliation(s)
- Jacqueline T Bangma
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hadley Hartwell
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hudson P Santos
- Biobehavioral Laboratory, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - T Michael O'Shea
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rebecca C Fry
- Biobehavioral Laboratory, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Curriculum in Toxicology and Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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25
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Martínez-Olcina M, Rubio-Arias JA, Reche-García C, Leyva-Vela B, Hernández-García M, Hernández-Morante JJ, Martínez-Rodríguez A. Eating Disorders in Pregnant and Breastfeeding Women: A Systematic Review. ACTA ACUST UNITED AC 2020; 56:medicina56070352. [PMID: 32679923 PMCID: PMC7404459 DOI: 10.3390/medicina56070352] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022]
Abstract
Background: Pregnancy is a stage associated with various biopsychosocial changes. These changes, along with concerns about keeping an adequate weight, can modulate an individual's risk for psychological disorders, especially eating disorders (EDs). The aim of this review was to investigate the prevalence, associated risks, and consequences of eating disorders in pregnancy and in breastfeeding mothers. Materials and Methods: A systematic review was carried out following the PRISMA guidelines in the scientific databases: PubMed, Web of Science, Scopus, and PsycINFO. Search terms related to EDs, pregnancy, and breastfeeding were used. The evaluation of the methodological quality of the studies was carried out using different scales; CASP (Checklist for Cohort Study), NICE (Methodology Checklist for Cohort Study), ARHQ (Methodology Checklist for Cross-Sectional), and NOS (Newcastle-Ottawa Scale for Cohort). Results: From 2920 studies, 16 were selected to study EDs in pregnant women and 2 studies in nursing mothers. Most of the studies used questionnaires and scales as tools for the diagnosis of EDs. Binge eating, anxiety, and depression were the most common comorbidities of EDs, accompanied in most cases by excessive concern about weight gain. The consequences of EDs are diverse. The prevalence of EDs in this population is estimated to be 1 out of 20. Conclusions: Eating disorders are related to anxiety and depression and have negative consequences for both mothers and fetuses (cesarean, miscarriages, premature births). More research on the field to determine the risk factors for EDs in the population of pregnant and lactating women is needed.
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Affiliation(s)
- María Martínez-Olcina
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.M.-O.); (M.H.-G.)
| | - Jacobo A. Rubio-Arias
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Polytechnic University of Madrid, 28040 Madrid, Spain;
| | - Cristina Reche-García
- Faculty of Nursing, San Antonio Catholic University of Murcia, 30107 Murcia, Spain;
- Correspondence:
| | - Belén Leyva-Vela
- Department of Health, Vinalopó University Hospital, 03293 Elche, Spain;
| | - María Hernández-García
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.M.-O.); (M.H.-G.)
| | | | - Alejandro Martínez-Rodríguez
- Department of Analytical Chemistry, Nutrition and Food Science, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain;
- Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), 03010 Alicante, Spain
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26
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Lindsay KL, Entringer S, Buss C, Wadhwa PD. Intergenerational transmission of the effects of maternal exposure to childhood maltreatment on offspring obesity risk: A fetal programming perspective. Psychoneuroendocrinology 2020; 116:104659. [PMID: 32240906 PMCID: PMC7293953 DOI: 10.1016/j.psyneuen.2020.104659] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/12/2020] [Accepted: 03/19/2020] [Indexed: 12/19/2022]
Abstract
Childhood obesity constitutes a major global public health challenge. A substantial body of evidence suggests that conditions and states experienced by the embryo/fetus in utero can result in structural and functional changes in cells, tissues, organ systems and homeostatic set points related to obesity. Furthermore, growing evidence suggests that maternal conditions and states experienced prior to conception, such as stress, obesity and metabolic dysfunction, may spill over into pregnancy and influence those key aspects of gestational biology that program offspring obesity risk. In this narrative review, we advance a novel hypothesis and life-span framework to propose that maternal exposure to childhood maltreatment may constitute an important and as-yet-underappreciated risk factor implicated in developmental programming of offspring obesity risk via the long-term psychological, biological and behavioral sequelae of childhood maltreatment exposure. In this context, our framework considers the key role of maternal-placental-fetal endocrine, immune and metabolic pathways and also other processes including epigenetics, oocyte mitochondrial biology, and the maternal and infant microbiomes. Finally, our paper discusses future research directions required to elucidate the nature and mechanisms of the intergenerational transmission of the effects of maternal childhood maltreatment on offspring obesity risk.
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Affiliation(s)
- Karen L Lindsay
- Department of Pediatrics, University of California, Irvine, School of Medicine, California 92697, U.S.A,Departments of Development, Health and Disease Research Program, University of California, Irvine, School of Medicine, California 92697, U.S.A
| | - Sonja Entringer
- Department of Pediatrics, University of California, Irvine, School of Medicine, California 92697, U.S.A,Departments of Development, Health and Disease Research Program, University of California, Irvine, School of Medicine, California 92697, U.S.A,Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology
| | - Claudia Buss
- Department of Pediatrics, University of California, Irvine, School of Medicine, California 92697, U.S.A,Departments of Development, Health and Disease Research Program, University of California, Irvine, School of Medicine, California 92697, U.S.A,Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology
| | - Pathik D Wadhwa
- Department of Pediatrics, University of California, Irvine, School of Medicine, CA 92697, USA; Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine, CA 92697, USA; Department of Obstetrics and Gynecology, University of California, Irvine, School of Medicine, CA 92697, USA; Department of Epidemiology, University of California, Irvine, School of Medicine, CA 92697, USA; UCI Development, Health and Disease Research Program, University of California, Irvine, School of Medicine, CA 92697, USA.
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27
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Li R, Guo W, Lei L, Zhang L, Liu Y, Han J, Chen L, Zhou B. Early-life exposure to the organophosphorus flame-retardant tris (1,3-dichloro-2-propyl) phosphate induces delayed neurotoxicity associated with DNA methylation in adult zebrafish. ENVIRONMENT INTERNATIONAL 2020; 134:105293. [PMID: 31731001 DOI: 10.1016/j.envint.2019.105293] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/22/2019] [Accepted: 10/28/2019] [Indexed: 06/10/2023]
Abstract
Early-life exposure to toxicants could affect health outcomes in adulthood. We determined the effects of early-life exposure to the organophosphorus flame-retardant tris (1,3-dichloro-2-propyl) phosphate (TDCIPP) in adult zebrafish. Embryos were exposed to TDCIPP from early embryogenesis (2 h post-fertilization) to 10 days post-fertilization (dpf), and larvae were transferred to clean water until adulthood (150 dpf). TDCIPP showed accumulation in larvae, but returned to control levels after 7 days of depuration. In adult zebrafish exposed to TDCIPP in early life, vulnerability to anxiety-like behavior was observed in females but not males, suggesting gender-dependent neurotoxicity. Decreased dopamine (DA) concentration and down-regulation of dopaminergic signaling related genes were observed in the brains of adult females. Upregulation of DNA methylation transferases (dnmt1, dnmt3a, and dnmt3b) genes were observed in larvae and brains of adult females. Further, the promoter regions of the selected key genes (bdnf, drd4b, zc4h2 and th) showed increased DNA methylation status, accompanied by down-regulation of gene transcription in larvae and brains of adult females. Our results indicate that early-life exposure to TDCIPP could cause delayed neurotoxicity in adult zebrafish.
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Affiliation(s)
- Ruiwen Li
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; Department of Nutrition and Toxicology, School of Public Health, and Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, China
| | - Wei Guo
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Lei Lei
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Ling Zhang
- Department of Nutrition and Toxicology, School of Public Health, and Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, China
| | - Yunhao Liu
- Department of Nutrition and Toxicology, School of Public Health, and Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, China
| | - Jian Han
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Lianguo Chen
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China
| | - Bingsheng Zhou
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China.
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28
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Bischoff M, Howland V, Klinger-König J, Tomczyk S, Schmidt S, Zygmunt M, Heckmann M, van den Berg N, Bethke B, Corleis J, Günther S, Liutkus K, Stentzel U, Neumann A, Penndorf P, Ludwig T, Hammer E, Winter T, Grabe HJ. Save the children by treating their mothers (PriVileG-M-study) - study protocol: a sequentially randomized controlled trial of individualized psychotherapy and telemedicine to reduce mental stress in pregnant women and young mothers and to improve Child's health. BMC Psychiatry 2019; 19:371. [PMID: 31775668 PMCID: PMC6880484 DOI: 10.1186/s12888-019-2279-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As early as pregnancy, maternal mental stress impinges on the child's development and health. Thus, this may cause enhanced risk for premature birth, lowered fetal growth, and lower fetal birth weight as well as enhanced levels of the stress hormone cortisol and lowered levels of the bonding hormone oxytocin. Maternal stress further reduces maternal sensitivity for the child's needs which impairs the mother-child-interaction and bonding. Therefore, prevention and intervention studies on mental stress are necessary, beginning prenatally and applying rigorous research methodology, such as randomized controlled trials, to ensure high validity. METHODS A randomized controlled trial is used to assess the impact of psychotherapy and telemedicine on maternal mental stress and the child's mental and physical health. Mentally stressed pregnant women are randomized to an intervention (IG) and a not intervened control group. The IG receives an individualized psychotherapy starting prenatal and lasting for 10 months. Afterwards, a second randomization is used to investigate whether the use of telemedicine can stabilize the therapeutic effects. Using ecological momentary assessments and video recordings, the transfer into daily life, maternal sensitivity and mother-child-bonding are assessed. Psycho-biologically, the synchronicity of cortisol and oxytocin levels between mother and child are assessed as well as the peptidome of the colostrum and breast milk, which are assumed to be essential for the adaptation to the extra-uterine environment. All assessments are compared to an additional control group of healthy women. Finally, the results of the study will lead to the development of a qualification measure for health professionals to detect mental stress, to treat it with low-level interventions and to refer those women with high stress levels to mental health professionals. DISCUSSION The study aims to prevent the transgenerational transfer of psychiatric and somatic disorders from the mother to her child. The effects of the psychotherapy will be stabilized through telemedicine and long-term impacts on the child's and mothers' mental health are enhanced. The combination of psychotherapy, telemedicine and methodologies of ecological momentary assessment, video recording and bio banking are new in content-related and methodological manner. TRIAL REGISTRATION German Clinical Trials Register: DRKS00017065. Registered 02 May 2019. World Health Organization, Universal Trial Number: U1111-1230-9826. Registered 01 April 2019.
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Affiliation(s)
- M. Bischoff
- Department of Health and Prevention, Institute of Psychology, University Greifswald, Greifswald, Germany
| | - V. Howland
- Department of Neonatology and Paediatric Intensive Care, University Medicine Greifswald, Greifswald, Germany
| | - J. Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - S. Tomczyk
- Department of Health and Prevention, Institute of Psychology, University Greifswald, Greifswald, Germany
| | - S. Schmidt
- Department of Health and Prevention, Institute of Psychology, University Greifswald, Greifswald, Germany
| | - M. Zygmunt
- Clinic and Polyclinic for Obstetrics and Gynecology, University Medicine Greifswald, Greifswald, Germany
| | - M. Heckmann
- Department of Neonatology and Paediatric Intensive Care, University Medicine Greifswald, Greifswald, Germany
| | - N. van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - B. Bethke
- Department of Health, Nursing and Administration, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
| | - J. Corleis
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - S. Günther
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - K. Liutkus
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - U. Stentzel
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - A. Neumann
- Department of Health, Nursing and Administration, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
| | - P. Penndorf
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - T. Ludwig
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - E. Hammer
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - T. Winter
- Integrated Research Biobank, University Medicine Greifswald, Greifswald, Germany
| | - H. J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
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29
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A Comparison of the effects of preterm birth and institutional deprivation on child temperament. Dev Psychopathol 2019; 32:1524-1533. [PMID: 31711549 DOI: 10.1017/s0954579419001457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Both preterm birth and early institutional deprivation are associated with neurodevelopmental impairment-with both shared and distinctive features. To explore shared underlying mechanisms, this study directly compared the effects of these putative risk factors on temperament profiles in six-year-olds: Children born very preterm (<32 weeks gestation) or at very low birthweight (<1500 g) from the Bavarian Longitudinal Study (n = 299); and children who experienced >6 months of deprivation in Romanian institutions from the English and Romanian Adoptees Study (n = 101). The former were compared with 311 healthy term born controls and the latter with 52 nondeprived adoptees. At 6 years, temperament was assessed via parent reports across 5 dimensions: effortful control, activity, shyness, emotionality, and sociability. Very preterm/very low birthweight and postinstitutionalized children showed similarly aberrant profiles in terms of lower effortful control, preterm = -0.50, 95% CI [-0.67, -0.33]; postinstitutionalized = -0.48, 95% CI [-0.82, -0.14], compared with their respective controls. Additionally, postinstitutionalized children showed higher activity, whereas very preterm/very low birthweight children showed lower shyness. Preterm birth and early institutionalization are similarly associated with poorer effortful control, which might contribute to long-term vulnerability. More research is needed to examine temperamental processes as common mediators of negative long-term outcomes following early adversity.
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Litzky JF, Marsit CJ. Epigenetically regulated imprinted gene expression associated with IVF and infertility: possible influence of prenatal stress and depression. J Assist Reprod Genet 2019; 36:1299-1313. [PMID: 31127477 PMCID: PMC6642239 DOI: 10.1007/s10815-019-01483-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 05/09/2019] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Despite the growing body of research implying an impact of in vitro fertilization (IVF) on imprinted genes and epigenetics, few studies have examined the effects of underlying subfertility or prenatal stress on epigenetics, particularly in terms of their role in determining infant birthweights. Both subfertility and prenatal stressors have been found to impact epigenetics and may be confounding the effect of IVF on epigenetics and imprinted genes. Like IVF, both of these exposures-infertility and prenatal stressors-have been associated with lower infant birthweights. The placenta, and specifically epigenetically regulated placental imprinted genes, provides an ideal but understudied mechanism for evaluating the relationship between underlying genetics, environmental exposures, and birthweight. METHODS AND RESULTS In this review, we discuss the impacts of IVF and infertility on birthweight, epigenetic mechanisms and genomic imprinting, and the role of these mechanisms in the IVF population and discuss the role and importance of the placenta in infant development. We then highlight recent work on the relationships between infertility, IVF, and prenatal stressors in terms of placental imprinting. CONCLUSIONS In combination, the studies discussed, as well as two recent projects of our own on placental imprinted gene expression, suggest that lower birthweights in IVF infants are secondary to a combination of exposures including the infertility and prenatal stress that couples undergoing IVF are experiencing. The work highlighted herein emphasizes the need for appropriate control populations that take infertility into account and also for consideration of prenatal psychosocial stressors as confounders and causes of variation in IVF infant outcomes.
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Affiliation(s)
- Julia F Litzky
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, 03755, USA
| | - Carmen J Marsit
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, CNR 202, Atlanta, GA, 30322, USA.
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Goodman JH. Perinatal depression and infant mental health. Arch Psychiatr Nurs 2019; 33:217-224. [PMID: 31227073 DOI: 10.1016/j.apnu.2019.01.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/24/2019] [Indexed: 12/19/2022]
Abstract
A mother's mental health during pregnancy and the first year postpartum is of the utmost importance to the cognitive, social, and emotional development of her child. Perinatal depression is associated with increased risk for wide-ranging adverse child development effects that can affect infant and early childhood mental health. Although effective treatments for perinatal depression exist, it is currently unclear if treatment of maternal depression alone is sufficient to ameliorate the negative effects of maternal depression on child outcomes. Interventions focused on the mother-infant relationship and dyadic interaction may be required to address the potential effect of maternal depression on the child. This paper provides an overview of maternal perinatal depression, the risk it poses for infant/early-childhood mental health, strategies for intervention that include mitigating depression and decreasing risk to the child, and implications for psychiatric nurses who work with perinatal women. Early identification and treatment of perinatal depression are critical to ensure optimal infant development and the child's future mental health.
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Affiliation(s)
- Janice H Goodman
- MGH Institute of Health Professions, School of Nursing, 36 1st Avenue, Boston, MA 02129, United States of America.
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Dunn EC, Soare TW, Zhu Y, Simpkin AJ, Suderman MJ, Klengel T, Smith ADAC, Ressler KJ, Relton CL. Sensitive Periods for the Effect of Childhood Adversity on DNA Methylation: Results From a Prospective, Longitudinal Study. Biol Psychiatry 2019; 85:838-849. [PMID: 30905381 PMCID: PMC6552666 DOI: 10.1016/j.biopsych.2018.12.023] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 12/04/2018] [Accepted: 12/16/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Exposure to early-life adversity is known to predict DNA methylation (DNAm) patterns that may be related to psychiatric risk. However, few studies have investigated whether adversity has time-dependent effects based on the age at exposure. METHODS Using a two-stage structured life course modeling approach, we tested the hypothesis that there are sensitive periods when adversity induces greater DNAm changes. We tested this hypothesis in relation to two alternatives: an accumulation hypothesis, in which the effect of adversity increases with the number of occasions exposed, regardless of timing; and a recency model, in which the effect of adversity is stronger for more proximal events. Data came from the Accessible Resource for Integrated Epigenomic Studies, a subsample of mother-child pairs from the Avon Longitudinal Study of Parents and Children (n = 691-774). RESULTS After covariate adjustment and multiple testing correction, we identified 38 CpG sites that were differentially methylated at 7 years of age following exposure to adversity. Most loci (n = 35) were predicted by the timing of adversity, namely exposures before 3 years of age. Neither the accumulation nor recency of the adversity explained considerable variability in DNAm. A standard epigenome-wide association study of lifetime exposure (vs. no exposure) failed to detect these associations. CONCLUSIONS The developmental timing of adversity explains more variability in DNAm than the accumulation or recency of exposure. Very early childhood appears to be a sensitive period when exposure to adversity predicts differential DNAm patterns. Classification of individuals as exposed versus unexposed to early-life adversity may dilute observed effects.
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Affiliation(s)
- Erin C Dunn
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Stanley Center for Psychiatric Research, The Broad Institute of Harvard University and Massachusetts Institute of Technology, Cambridge, Massachusetts.
| | - Thomas W Soare
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Stanley Center for Psychiatric Research, The Broad Institute of Harvard University and Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Yiwen Zhu
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Andrew J Simpkin
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Matthew J Suderman
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Torsten Klengel
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Massachusetts; Department of Psychiatry and Psychotherapy, University Medical Center Gottingen, Germany
| | - Andrew D A C Smith
- Applied Statistics Group, University of the West of England, Bristol, United Kingdom
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Caroline L Relton
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; Institute of Genetic Medicine, University of Newcastle, Newcastle upon Tyne, United Kingdom
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Okun ML. Sleep Disturbances and Modulations in Inflammation: Implications for Pregnancy Health. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2019; 13:e12451. [PMID: 31737088 PMCID: PMC6857810 DOI: 10.1111/spc3.12451] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
When a woman becomes pregnant, there is a vast series of physiological, vascular, and psychological changes. Among the most commonly reported changes are those involving sleep. Pregnant women report that their ability to maintain sleep and acquire continuous refreshing sleep is impaired during the perinatal period as compared to the non-pregnant period. A growing literature supports the hypothesis that disturbed sleep (which comes in many forms) during the perinatal period is associated with an increased risk of adverse maternal, delivery, and infant outcomes. Among the suggested biological pathways linking sleep and adverse outcomes are disturbances in the immune and hormonal systems. The following paper will discuss (1) the various sleep processes that are commonly disturbed during the perinatal period and the methods used to collect sleep data; (2) the evidence linking sleep to adverse outcomes; and (3) how one specific biological pathway, the immune system, likely mediates these associations. The goal of this paper is to clarify the role that sleep disturbance has during pregnancy.
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Mughal MK, Giallo R, Arnold PD, Kehler H, Bright K, Benzies K, Wajid A, Kingston D. Trajectories of maternal distress and risk of child developmental delays: Findings from the All Our Families (AOF) pregnancy cohort. J Affect Disord 2019; 248:1-12. [PMID: 30690110 DOI: 10.1016/j.jad.2018.12.132] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 12/19/2018] [Accepted: 12/26/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Existing literature on the impact of the course of maternal distress symptoms in the perinatal period and beyond has mainly focused on one source of distress (e.g., anxiety or depression) and only selected aspects of child development. This study examined the relative impact of trajectories of maternal depression, anxiety, and stress symptoms from mid-pregnancy to early childhood on child communication, gross motor, fine motor, problem solving, and personal social development at three years of age. METHODS Data were analyzed from 1983 mother-child dyads who participated in the three-year follow-up of the All Our Families (AOF) study. Maternal distress and child development across five domains were measured using validated tools. Latent class analysis (LCA) was conducted to identify trajectories of maternal distress over time. Multivariable logistic regression was used to explore the relationship between the trajectories and child development while adjusting for the covariates. RESULTS At age three years, 5.2% of children were at risk communication delay; 12.7% for gross motor delay; 15.4% for fine motor delay; 11.2 for problem solving delay; and 5.6% for personal-social delay on ASQ-3 domains. Multivariable analysis showed children born to mothers with persistent high anxiety symptoms from pregnancy to 3-years postpartum had an increased risk of delays in communication and personal-social domains. LIMITATIONS The use of self-reported maternal mental health symptoms and maternal reported child development are the study limitations. CONCLUSIONS The impact of high levels of maternal anxiety symptoms on the increased risk of child developmental delay in communication and personal-social domains highlights the importance of early intervention and addressing maternal anxiety from pregnancy through early childhood.
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Affiliation(s)
- Muhammad Kashif Mughal
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta T2N 1N4, Canada.
| | - Rebecca Giallo
- Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia.
| | - Paul D Arnold
- Mathison Center for Mental Health Research & Education, Cumming Schol of Medicine, University of Calgary, 3280 Hospital Dr. N.W., Calgary, Alberta T2N 4Z6, Canada.
| | - Heather Kehler
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta T2N 1N4, Canada.
| | - Katherine Bright
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta T2N 1N4, Canada.
| | - Karen Benzies
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta T2N 1N4, Canada.
| | - Abdul Wajid
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta T2N 1N4, Canada.
| | - Dawn Kingston
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, Alberta T2N 1N4, Canada.
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Karlsson L, Barbaro M, Ewing E, Gomez-Cabrero D, Lajic S. Epigenetic Alterations Associated With Early Prenatal Dexamethasone Treatment. J Endocr Soc 2019; 3:250-263. [PMID: 30623163 PMCID: PMC6320242 DOI: 10.1210/js.2018-00377] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 12/07/2018] [Indexed: 11/19/2022] Open
Abstract
Prenatal treatment with dexamethasone (DEX) reduces virilization in girls with congenital adrenal hyperplasia (CAH). It has potential short- and long-term risks and has been shown to affect cognitive functions. Here, we investigate whether epigenetic modification of DNA during early developmental stages may be a key mediating mechanism by which prenatal DEX treatment could result in poor outcomes in the offspring. We analyzed genome-wide CD4+ T cell DNA methylation, assessed using the Infinium HumanMethylation450 BeadChip array in 29 individuals (mean age = 16.4 ± 5.9 years) at risk for CAH and treated with DEX during the first trimester and 37 population controls (mean age = 17.0 years, SD = 6.1 years). We identified 9672 differentially methylated probes (DMPs) associated with DEX treatment and 7393 DMPs associated with a DEX × sex interaction. DMPs were enriched in intergenic regions located near epigenetic markers for active enhancers. Functional enrichment of DMPs was mostly associated with immune functioning and inflammation but also with nonimmune-related functions. DEX-associated DMPs enriched near single nucleotide polymorphisms (SNPs) associated with inflammatory bowel disease, and DEX × sex-associated DMPs enriched near SNPs associated with asthma. DMPs in genes involved in the regulation and maintenance of methylation and steroidogenesis were identified as well. Methylation in the BDNF, FKBP5, and NR3C1 genes were associated with the performance on several Wechsler Adult Intelligence Scale-Fourth Edition subscales. In conclusion, this study indicates that DNA methylation is altered after prenatal DEX treatment. This finding may have implications for the future health of the exposed individual.
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Affiliation(s)
- Leif Karlsson
- Department of Women’s and Children’s Health, Karolinska Institutet, Paediatric Endocrinology Unit (Q2:08), Karolinska University Hospital, Stockholm, Sweden
| | - Michela Barbaro
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Center for Inherited Metabolic Diseases (CMMS L7:05), Karolinska University Hospital, Stockholm, Sweden
| | - Ewoud Ewing
- Department of Clinical Neuroscience, Centre for Molecular Medicine, Karolinska Institutet (L8:05), Karolinska University Hospital, Stockholm, Sweden
| | - David Gomez-Cabrero
- Unit for Computational Medicine, Karolinska Institutet (L8:05), Karolinska University Hospital, Stockholm, Sweden
- Mucosal and Salivary Biology Division, King’s College, London Dental Institute, London, United Kingdom
- Translational Bioinformatics Unit, NavarraBiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
| | - Svetlana Lajic
- Department of Women’s and Children’s Health, Karolinska Institutet, Paediatric Endocrinology Unit (Q2:08), Karolinska University Hospital, Stockholm, Sweden
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Viuff AC, Sharp GC, Rai D, Henriksen TB, Pedersen LH, Kyng KJ, Staunstrup NH, Cortes A, Neumann A, Felix JF, Tiemeier H, Jaddoe VWV, Relton CL. Maternal depression during pregnancy and cord blood DNA methylation: findings from the Avon Longitudinal Study of Parents and Children. Transl Psychiatry 2018; 8:244. [PMID: 30405117 PMCID: PMC6221892 DOI: 10.1038/s41398-018-0286-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 08/26/2018] [Accepted: 09/10/2018] [Indexed: 12/21/2022] Open
Abstract
Up to 13% of women may experience symptoms of depression during pregnancy or in the postpartum period. Depression during pregnancy has been associated with an increased risk of adverse neurodevelopmental outcomes in the child and epigenetic mechanisms could be one of the biological pathways to explain this association. In 844 mother-child pairs from the Avon Longitudinal Study of Parents and Children, we carried out an epigenome-wide association study (EWAS) to investigate associations between prospectively collected data on maternal depression ascertained by the Edinburgh Postnatal Depression Scale in pregnancy and DNA methylation in the cord blood of newborn offspring. In individual site analysis, we identified two CpG sites associated with maternal depression in the middle part of pregnancy. In our regional analysis, we identified 39 differentially methylated regions (DMRs). Seven DMRs were associated with depression at any time point during pregnancy, 7 associated with depression in mid-pregnancy, 23 were associated with depression in late pregnancy, and 2 DMRs were associated with depression throughout pregnancy. Several of these map to genes associated with psychiatric disease and brain development. We attempted replication in The Generation R Study and could not replicate our results. Although our findings in ALSPAC suggest that maternal depression could be associated with cord blood DNA methylation the results should be viewed as preliminary and hypothesis generating until further replicated in a larger sample.
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Affiliation(s)
- A. C. Viuff
- 0000 0001 1956 2722grid.7048.bPerinatal Epidemiology Research Unit, Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - G. C. Sharp
- 0000 0004 1936 7603grid.5337.2MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK ,0000 0004 1936 7603grid.5337.2School of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | - D. Rai
- 0000 0004 1936 7603grid.5337.2Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK ,Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - T. B. Henriksen
- 0000 0001 1956 2722grid.7048.bPerinatal Epidemiology Research Unit, Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark ,0000 0004 0512 597Xgrid.154185.cDepartment of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - L. H. Pedersen
- 0000 0001 1956 2722grid.7048.bPerinatal Epidemiology Research Unit, Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark ,0000 0004 0512 597Xgrid.154185.cDepartment of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark
| | - K. J. Kyng
- 0000 0004 0512 597Xgrid.154185.cDepartment of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - N. H. Staunstrup
- 0000 0000 9817 5300grid.452548.aThe Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark ,0000 0004 0512 597Xgrid.154185.cTranslational Neuropsychiatric Unit, Aarhus University Hospital, Risskov, Denmark
| | - A. Cortes
- 000000040459992Xgrid.5645.2Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - A. Neumann
- 000000040459992Xgrid.5645.2Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - J. F. Felix
- 000000040459992Xgrid.5645.2Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands
| | - H. Tiemeier
- 000000040459992Xgrid.5645.2Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - V. W. V. Jaddoe
- 000000040459992Xgrid.5645.2Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands
| | - C. L. Relton
- 0000 0004 1936 7603grid.5337.2MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK ,0000 0004 1936 7603grid.5337.2Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Guo W, Zhu X, Yan L, Qiao J. The present and future of whole-exome sequencing in studying and treating human reproductive disorders. J Genet Genomics 2018; 45:517-525. [DOI: 10.1016/j.jgg.2018.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 12/16/2022]
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Schoeps A, Peterson ER, Mia Y, Waldie KE, Underwood L, D'Souza S, Morton SMB. Prenatal alcohol consumption and infant and child behavior: Evidence from the Growing Up in New Zealand Cohort. Early Hum Dev 2018; 123:22-29. [PMID: 30036725 DOI: 10.1016/j.earlhumdev.2018.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND High levels of alcohol exposure during pregnancy can damage developing brains and influence child behavior and learning. AIM To examine the effects of lower levels of alcohol and very early exposure to alcohol on infant temperament and child behavior. STUDY DESIGN, SUBJECTS, AND OUTCOME MEASURES The Growing Up in New Zealand study involves a prospective birth cohort of 6822 pregnant women of whom 6156 provided information on their child's temperament using the Infant Behavior Questionnaire-Revised (IBQ-R VSF) at 9 months and their child's behavior using the Strengths and Difficulties Questionnaire at 2 years. RESULTS A series of adjusted linear regression models controlling for socio-demographic factors found alcohol consumption during pregnancy was most consistently related to Lower Positive Affect, Affiliation/Regulation, and Orienting Capacity temperament scores. Mothers who stopped drinking after becoming aware of their pregnancy, but had an unplanned pregnancy (hence may have a baby exposed to alcohol for longer), also reported infants with lower Orienting Capacity, Affiliation/Regulation, and Fear temperament scores compared to those that did not drink. Children whose mothers drank four or more drinks per week during pregnancy were more likely to report their child as having conduct problems, with higher total difficulties scores at age 2. CONCLUSIONS Alcohol consumption during pregnancy has a negative effect especially on infant temperament, even if small amounts of alcohol are consumed. Our findings have implications for men and women who drink, medical professionals, and for the availability of contraception to those who drink, but do not plan to get pregnant.
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Affiliation(s)
- Anja Schoeps
- Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
| | - Elizabeth R Peterson
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Yasmine Mia
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Karen E Waldie
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Stephanie D'Souza
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand; School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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Rodriguez VJ, Matseke G, Cook R, Bellinger S, Weiss SM, Alcaide ML, Peltzer K, Patton D, Lopez M, Jones DL. Infant Development and Pre- and Post-partum Depression in Rural South African HIV-Infected Women. AIDS Behav 2018; 22:1766-1774. [PMID: 28986652 DOI: 10.1007/s10461-017-1925-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
HIV-exposed infants born to depressed women may be at risk for adverse developmental outcomes. Half of HIV-infected women in rural South Africa (SA) may suffer from pregnancy-related depression. This pilot study examined the impact of depression in HIV-infected women in rural SA on infant development. Mother-infant dyads (N = 69) were recruited in rural SA. Demographics, HIV disclosure, depression, male involvement, and alcohol use at baseline (18.35 ± 5.47 weeks gestation) were assessed. Male involvement, depression, infant HIV serostatus and development were assessed 12 months postnatally. Half of the women (age = 29 ± 5) reported depression prenatally and one-third reported depression postnatally. In multivariable logistic regression, not cohabiting with their male partner, nondisclosure of HIV status, and postnatal depression predicted cognitive delay; decreased prenatal male involvement predicted delayed gross motor development (ps < 0.05). Assessing pregnancy-related depression among HIV-infected women and infant development and increasing male involvement may reduce negative developmental outcomes among HIV-exposed or infected infants.
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40
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Litzky JF, Deyssenroth MA, Everson TM, Lester BM, Lambertini L, Chen J, Marsit CJ. Prenatal exposure to maternal depression and anxiety on imprinted gene expression in placenta and infant neurodevelopment and growth. Pediatr Res 2018; 83. [PMID: 29538358 PMCID: PMC5959758 DOI: 10.1038/pr.2018.27] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BackgroundDepression and/or anxiety during pregnancy have been associated with impaired fetal growth and neurodevelopment. Because placental imprinted genes play a central role in fetal development and respond to environmental stressors, we hypothesized that imprinted gene expression would be affected by prenatal depression and anxiety.MethodsPlacental gene expression was compared between mothers with prenatal depression and/or anxiety/obsessive compulsive disorder/panic and control mothers without psychiatric history (n=458) in the Rhode Island Child Health Study.ResultsTwenty-nine genes were identified as being significantly differentially expressed between placentae from infants of mothers with both depression and anxiety (n=54), with depression (n=89), or who took perinatal psychiatric medications (n=29) and control mother/infant pairs, with most genes having decreased expression in the stressed group. Among placentae from infants of mothers with depression, we found no differences in expression by medication use, indicating that our results are related to the stressor rather than the treatments. We did not find any relationship between the stress-associated gene expression and neonatal neurodevelopment, as measured using the Neonatal Intensive Care Unit Network Neurobehavioral Scale.ConclusionsThis variation in expression may be part of an adaptive mechanism by which the placenta buffers the infant from the effects of maternal stress.
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Affiliation(s)
- Julia F Litzky
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH
| | - Maya A Deyssenroth
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York, NY
| | - Todd M Everson
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Barry M. Lester
- Center for the Study of Children at Risk, Warren Alpert Medical School of Brown University, Providence, RI
| | - Luca Lambertini
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York, NY,Department of Obstetrics, Gynecology and Reproductive Science; Icahn School of Medicine at Mount Sinai; New York; NY
| | - Jia Chen
- Department of Environmental Medicine and Public Health; Icahn School of Medicine at Mount Sinai; New York, NY,Department of Pediatrics; Icahn School of Medicine at Mount Sinai; New York, NY
| | - Carmen J Marsit
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA,Corresponding Author: Carmen Marsit, 1518 Clifton Road, CNR 202, Atlanta, GA 30322, Phone: (404) 712-8912, Fax: (404) 727-8744,
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Shore L, Toumbourou JW, Lewis AJ, Kremer P. Review: Longitudinal trajectories of child and adolescent depressive symptoms and their predictors - a systematic review and meta-analysis. Child Adolesc Ment Health 2018; 23:107-120. [PMID: 32677332 DOI: 10.1111/camh.12220] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND With depression predicted to contribute to an increased disease burden in coming decades, prevention efforts have become increasingly important. In order to prevent depression it is valuable to identify and classify longitudinal patterns of depressive symptoms across development, ideally beginning early in childhood. To achieve this, longitudinal studies are increasingly using person-centered data-analytic methods to model subgroups with similar developmental patterns (trajectories) of depressive symptoms. METHOD A search was completed for English language studies that longitudinally modeled depressive symptom trajectories in nonclinical populations with a baseline age of <19 years. Study characteristics were extracted, prevalence rates and risk factors were summarized, a random-effect meta-analysis was undertaken, and risk of bias analysis completed. RESULTS Twenty studies published between 2002 and 2015 were included. Participants were recruited at ages 4 through 17 (average age 12.34) and followed longitudinally for an average of 7.45 years. Between 3 and 11 trajectory subgroups were identified. A random pooled effect estimate identified 56% [95% Confidence Interval (CI) 46-65%] of the sampled study populations (N = 41,236) on 'No or low' depressive symptom trajectories and 26% (CI 14-40%) on a 'Moderate' trajectory. 'High', 'Increasing', and 'Decreasing' depressive symptom subgroups were evident for 12% (CI 8-17%). Moderate symptoms were associated with poorer adjustment and outcomes relative to low symptom groups. 'High' or 'Increasing' trajectories were predominantly predicted by: female gender, low socioeconomic status, higher stress reactivity; conduct issues; substance misuse, and problems in peer and parental relationships. CONCLUSIONS The review highlighted consistent evidence of subgroups of children and adolescents who differ in their depressive symptom development over time. The findings suggest preventative interventions should evaluate the longer term benefits of increasing membership in low and moderate trajectories, while also targeting reductions in high-risk subgroups. Considerable between-study method and measurement variation indicate the need for future trajectory studies to use standardized methods.
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Affiliation(s)
- Lori Shore
- School of Psychology and Centre for Social and Early Emotional Development (SEED), Deakin University, 1 Gheringhap Street, Geelong, Vic, 3220, Australia
| | - John W Toumbourou
- School of Psychology and Centre for Social and Early Emotional Development (SEED), Deakin University, 1 Gheringhap Street, Geelong, Vic, 3220, Australia
| | - Andrew J Lewis
- School of Psychology & Exercise Science, Murdoch University, Murdoch, WA, Australia
| | - Peter Kremer
- School of Exercise and Nutrition Sciences and Centre for Sport Research, Deakin University, Geelong, Vic., Australia
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Epigenetic Programming of Synthesis, Release, and/or Receptor Expression of Common Mediators Participating in the Risk/Resilience for Comorbid Stress-Related Disorders and Coronary Artery Disease. Int J Mol Sci 2018; 19:ijms19041224. [PMID: 29670001 PMCID: PMC5979500 DOI: 10.3390/ijms19041224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 02/07/2023] Open
Abstract
Corticotrophin releasing factor, vasopressin, oxytocin, natriuretic hormones, angiotensin, neuregulins, some purinergic substances, and some cytokines contribute to the long-term modulation and restructuring of cardiovascular regulation networks and, at the same time, have relevance in situations of comorbid abnormal stress responses. The synthesis, release, and receptor expression of these mediators seem to be under epigenetic control since early stages of life, possibly underlying the comorbidity to coronary artery disease (CAD) and stress-related disorders (SRD). The exposure to environmental conditions, such as stress, during critical periods in early life may cause epigenetic programming modifying the development of pathways that lead to stable and long-lasting alterations in the functioning of these mediators during adulthood, determining the risk of or resilience to CAD and SRD. However, in contrast to genetic information, epigenetic marks may be dynamically altered throughout the lifespan. Therefore, epigenetics may be reprogrammed if the individual accepts the challenge to undertake changes in their lifestyle. Alternatively, epigenetics may remain fixed and/or even be inherited in the next generation. In this paper, we analyze some of the common neuroendocrine functions of these mediators in CAD and SRD and summarize the evidence indicating that they are under early programming to put forward the theoretical hypothesis that the comorbidity of these diseases might be epigenetically programmed and modified over the lifespan of the individual.
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Vaiserman AM, Koliada AK. Early-life adversity and long-term neurobehavioral outcomes: epigenome as a bridge? Hum Genomics 2017; 11:34. [PMID: 29246185 PMCID: PMC5732459 DOI: 10.1186/s40246-017-0129-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 12/04/2017] [Indexed: 12/12/2022] Open
Abstract
Accumulating evidence suggests that adversities at critical periods in early life, both pre- and postnatal, can lead to neuroendocrine perturbations, including hypothalamic-pituitary-adrenal axis dysregulation and inflammation persisting up to adulthood. This process, commonly referred to as biological embedding, may cause abnormal cognitive and behavioral functioning, including impaired learning, memory, and depressive- and anxiety-like behaviors, as well as neuropsychiatric outcomes in later life. Currently, the regulation of gene activity by epigenetic mechanisms is suggested to be a key player in mediating the link between adverse early-life events and adult neurobehavioral outcomes. Role of particular genes, including those encoding glucocorticoid receptor, brain-derived neurotrophic factor, as well as arginine vasopressin and corticotropin-releasing factor, has been demonstrated in triggering early adversity-associated pathological conditions. This review is focused on the results from human studies highlighting the causal role of epigenetic mechanisms in mediating the link between the adversity during early development, from prenatal stages through infancy, and adult neuropsychiatric outcomes. The modulation of epigenetic pathways involved in biological embedding may provide promising direction toward novel therapeutic strategies against neurological and cognitive dysfunctions in adult life.
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Affiliation(s)
- Alexander M Vaiserman
- Laboratory of Epigenetics, Institute of Gerontology, Vyshgorodskaya st. 67, Kiev, 04114, Ukraine.
| | - Alexander K Koliada
- Laboratory of Epigenetics, Institute of Gerontology, Vyshgorodskaya st. 67, Kiev, 04114, Ukraine
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Isaksson J, Deyessa N, Berhane Y, Högberg U. Early adversity and psychiatric symptoms - a prospective study on Ethiopian mothers and their children. BMC Psychiatry 2017; 17:344. [PMID: 29020947 PMCID: PMC5637326 DOI: 10.1186/s12888-017-1500-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 10/02/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Maternal exposure to adversity during the perinatal period has been associated with increased susceptibility for psychiatric symptoms in the offspring. The aim of this study was to investigate a possible developmental effect of maternal perinatal stressors on emotional and behavioural symptoms in the offspring in a developing country. METHODS We followed an Ethiopian birth cohort (N = 358), assessing intimate partner violence (IPV) and maternal psychiatric symptoms during the perinatal period and at follow-up 10 years later, as a proxy for adversity, and maternal ratings on the Child Behavior Checklist (CBCL) 10 years later as the outcome. RESULTS Among the women, exposure to IPV was common (60.6%) during the perinatal period and predicted IPV (29.9% of the mothers) at follow-up (ρ = 0.132; p = 0.012). There was also an association between maternal psychiatric symptoms at the two time points (ρ = 0.136; p = 0.010) and between maternal symptoms and IPV. Current maternal symptoms of anxiety and depression (β = 0.057; p < 0.001), but not during the perinatal period, were associated with child CBCL-scores. CONCLUSION Our findings do not support the hypothesis that early adversity increase susceptibility for psychiatric symptoms. However, the findings emphasize the public health problem of IPV in this population, adding to the women's mental health problem.
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Affiliation(s)
- Johan Isaksson
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden. .,Department of Women's and Children's Health, Paediatric Neuropsychiatry Unit, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden.
| | - Negussie Deyessa
- 0000 0001 1250 5688grid.7123.7Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yemane Berhane
- grid.458355.aAddis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Ulf Högberg
- 0000 0004 1936 9457grid.8993.bDepartment of Women’s and children’s health, Uppsala University, Uppsala, Sweden
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Apter G, Bobin A, Genet MC, Gratier M, Devouche E. Update on Mental Health of Infants and Children of Parents Affected With Mental Health Issues. Curr Psychiatry Rep 2017; 19:72. [PMID: 28831672 DOI: 10.1007/s11920-017-0820-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This paper highlights the most recent publications, in the field of psychiatry, on offspring of patients with psychiatric illnesses such as schizophrenia and bipolar disorder, and then summarizes what we know about the progeny of adults with mood disorders, the most prevalent of parental disorders. Studies examining personality disorders and contextual factors such as stress and trauma are examined with a focus on the crucial question of development and attachment status in children. Findings converge to reveal that offspring of parents (generally mothers) with most major psychiatric disorders present a higher risk for all mental disorders, and a wide range of disorders are also found in children, adolescent, and finally adult offspring of mothers with mood and anxiety disorders. Developmental psychopathology and infant and child psychiatry have focused on early relationship formation through social interaction and attachment patterns as pathways affected by vulnerability or resilience factors. First year of life longitudinal studies following mothers and infants has shown that maternal psychopathology is positively correlated with higher risk of attachment issues. It would seem that pathology appears when adaptation to real-life contexts becomes difficult in association with an accumulation of negative individual characteristics and environmental circumstances. We suggest that in order to move forward psychiatry should embrace a developmental cascade model, which posits a cumulative pathway for the emergence of psychopathology in the developing child. We propose that we have sufficient knowledge today to start implementing multilevel approaches to enhance the health and mental health of the next generation.
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Affiliation(s)
- Gisèle Apter
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France.
| | - Anne Bobin
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France
- EA 3456 - LABORATOIRE ETHOLOGIE COGNITION DEVELOPPEMENT (LECD), Paris Ouest Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France
| | - Marie-Camille Genet
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France
| | - Maya Gratier
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France
- EA 3456 - LABORATOIRE ETHOLOGIE COGNITION DEVELOPPEMENT (LECD), Paris Ouest Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France
| | - Emmanuel Devouche
- Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France
- Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Paris Descartes University, 71 avenue Edouard Vaillant, 92774, Boulogne-Billancourt Cedex, France
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Galbally M, Lewis AJ. Depression and parenting: the need for improved intervention models. Curr Opin Psychol 2017; 15:61-65. [DOI: 10.1016/j.copsyc.2017.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 02/08/2017] [Indexed: 02/07/2023]
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47
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Driscoll KE, Sit DKY, Moses-Kolko EL, Pinheiro E, Yang A, Ciolino JD, Eng HF, Luther JF, Clark CT, Wisniewski SR, Wisner KL. Mood symptoms in pregnant and postpartum women with bipolar disorder: a naturalistic study. Bipolar Disord 2017; 19:295-304. [PMID: 28665044 PMCID: PMC6594856 DOI: 10.1111/bdi.12500] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/08/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We conducted a prospective naturalistic study of pregnant women with bipolar disorder (BD) to evaluate symptoms of BD across childbearing and assess whether pharmacotherapy reduced their severity. METHODS Assessments were scheduled at 20, 30, and 36 weeks' gestation and 2, 12, 26, and 52 weeks postpartum. Symptoms were assessed using the Structured Interview Guide for the Hamilton Depression Rating Scale-Atypical Depression Supplement (SIGH-ADS) and Mania Rating Scale (MRS). RESULTS Pregnant women (N=152) with BD were evaluated; 88 women (58%) were treated and 64 untreated (42%) with psychotropic drugs during pregnancy. Among the 88 women treated, 23 (26%) discontinued their medication in the first trimester and the remaining 65 (74%) were exposed throughout pregnancy or in the second and third trimesters. More than two-thirds (73%) of the women who remained in the study took psychotropic agents postpartum. The mean scores on the SIGH-ADS were in the mild range of depressive symptoms in both the psychotropic-treated and untreated groups in both pregnancy and postpartum. The majority of women had no or few symptoms of mania. Of the pregnant women treated with psychotropic agents, 66% received a guideline-concordant drug, and 34% received either antidepressant monotherapy (for BD I) or mono- or polypharmacy with a variety of other agents. CONCLUSIONS This sample of perinatal women with BD was characterized by mild residual symptoms of depression independent of pharmacotherapy, which poses a risk for recurrence and impaired parenting. The treatment of childbearing women with BD deserves urgent clinical and research attention to improve psychiatric outcomes.
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Affiliation(s)
| | - Dorothy K Y Sit
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | | | - Emily Pinheiro
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Amy Yang
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Jody D Ciolino
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Heather F Eng
- Department of Epidemiology, Graduate School of Public Health, Epidemiology Data Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - James F Luther
- Department of Epidemiology, Graduate School of Public Health, Epidemiology Data Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Crystal T Clark
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Stephen R Wisniewski
- Department of Epidemiology, Graduate School of Public Health, Epidemiology Data Center, University of Pittsburgh, Pittsburgh, PA, USA
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Faa G, Manchia M, Pintus R, Gerosa C, Marcialis MA, Fanos V. Fetal programming of neuropsychiatric disorders. ACTA ACUST UNITED AC 2016; 108:207-223. [DOI: 10.1002/bdrc.21139] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Gavino Faa
- Division of Pathology, Department of Surgery; University Hospital San Giovanni di Dio; Cagliari Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine; University of Cagliari; Cagliari Italy
- Department of Pharmacology; Dalhousie University; Halifax Nova Scotia Canada
| | - Roberta Pintus
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section; AOU Cagliari and University of Cagliari; Cagliari Italy
| | - Clara Gerosa
- Division of Pathology, Department of Surgery; University Hospital San Giovanni di Dio; Cagliari Italy
| | - Maria Antonietta Marcialis
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section; AOU Cagliari and University of Cagliari; Cagliari Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section; AOU Cagliari and University of Cagliari; Cagliari Italy
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Infant EEG and temperament negative affectivity: Coherence of vulnerabilities to mothers' perinatal depression. Dev Psychopathol 2016; 28:895-911. [DOI: 10.1017/s0954579416000614] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AbstractAssociations between infants' frontal EEG asymmetry and temperamental negative affectivity (NA) across infants' first year of life and the potential moderating role of maternal prenatal depressive symptoms were examined prospectively in infants (n = 242) of mothers at elevated risk for perinatal depression. In predicting EEG, in the context of high prenatal depressive symptoms, infant NA and frontal EEG asymmetry were negatively associated at 3 months of age and positively associated by 12 months of age. By contrast, for low depression mothers, infant NA and EEG were not significantly associated at any age. Postnatal depressive symptoms did not add significantly to the models. Dose of infants' exposure to maternal depression mattered: infants exposed either pre- or postnatally shifted from a positive association at 3 months to a negative association at 12 months; those exposed both pre- and postnatally shifted from a negative association at 3 months to a positive association at 12 months. Prenatal relative to postnatal exposure did not matter for patterns of association between NA and EEG. The findings highlight the importance of exploring how vulnerabilities at two levels of analysis, behavioral and psychophysiological, co-occur over the course of infancy and in the context of mothers' depressive symptomatology.
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Seth S, Lewis AJ, Galbally M. Perinatal maternal depression and cortisol function in pregnancy and the postpartum period: a systematic literature review. BMC Pregnancy Childbirth 2016; 16:124. [PMID: 27245670 PMCID: PMC4886446 DOI: 10.1186/s12884-016-0915-y] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 05/24/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Perinatal depression has a significant impact on both mother and child. However, the influence of hormonal changes during pregnancy and the postpartum period remains unclear. This article provides a systematic review of studies examining the effects of maternal cortisol function on perinatal depression. METHOD A systematic search was conducted of six electronic databases for published research on the relationship between cortisol and perinatal depression. The databases included; MEDLINE complete, PsychINFO, SCOPUS, Psychology and Behavioural Sciences, Science Direct and EBSCO, for the years 1960 to May 2015. Risk of bias was assessed and data extraction verified by two investigators. RESULTS In total, 47 studies met criteria and studies showed considerable variation in terms of methodology including sample size, cortisol assays, cortisol substrates, sampling processes and outcome measures. Those studies identified as higher quality found that the cortisol awakening response is positively associated with momentary mood states but is blunted in cases of major maternal depression. Furthermore, results indicate that hypercortisolemia is linked to transient depressive states while hypocortisolemia is related to chronic postpartum depression. DISCUSSION AND CONCLUSION Future research should aim to improve the accuracy of cortisol measurement over time, obtain multiple cortisol samples in a day and utilise diagnostic measures of depression. Future studies should also consider both antenatal and postnatal depression and the differential impact of atypical versus melancholic depression on cortisol levels, as this can help to further clarify the relationship between perinatal depression and maternal cortisol function across pregnancy and the postpartum period.
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Affiliation(s)
- Sunaina Seth
- School of Psychology, Deakin University, Melbourne, 3125, Australia
| | - Andrew J Lewis
- School of Psychology and Exercise Science, Murdoch University, Perth, 6150, Australia. .,Harry Perkins South Medical Research Institute, Perth, Western Australia, 6009, Australia.
| | - Megan Galbally
- School of Psychology and Exercise Science, Murdoch University, Perth, 6150, Australia.,School of Medicine, University of Notre Dame, Perth, Western Australia, 6959, Australia.,Fiona Stanley Hospital, Perth, 6150, Australia.,Harry Perkins South Medical Research Institute, Perth, Western Australia, 6009, Australia
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