Prenatal Maternal Depressive Symptoms Predict Early Infant Health Concerns

INTRODUCTION

Recent research suggests that health disparities among low-SES and ethnic minority populations may originate from prenatal and early life exposures. Postpartum maternal depressive symptoms have been linked to poorer infant physical health, yet prenatal depressive symptoms not been thoroughly examined in relation to infant health.

METHODS

In a prospective study of low-income Mexican American mothers and their infants, women (N = 322, median age 27.23, IQR = 22.01-32.54) completed surveys during pregnancy (median gestation 39.50, IQR = 38.71-40.14 weeks) and 12 weeks after birth. We investigated (1) if prenatal depressive symptoms predicted infant physical health concerns at 12 weeks of age, (2) whether these associations occurred above and beyond concurrent depressive symptoms, and (3) if birth weight, gestational age, and breastfeeding were mediators of prenatal depression predicting subsequent infant health.

RESULTS

Higher prenatal depressive symptoms were associated with more infant physical health concerns at 12 weeks (p < .001), after accounting for 12-week maternal depressive symptoms, breastfeeding, gestational age, and birth weight. Twelve-week maternal depressive symptoms were concurrently associated with more infant health concerns (p < .01). Birth weight, gestational age, and breastfeeding were not associated with maternal depression or infant health concerns.

DISCUSSION

Results establish a link between prenatal depressive symptoms and an elevated risk of poor health evident shortly after birth. These findings underscore the importance of the prenatal period as a possible sensitive period for infants' health, and the need for effective interventions for depression during pregnancy to mitigate potentially teratogenic effects on the developing fetus and reduce risks for later health concerns.

Multiple domains of stress predict postpartum depressive symptoms in low-income Mexican American women: the moderating effect of social support

Prenatal stress can have a lasting effect on women's mental health after childbirth. The negative effects may be particularly salient in women from low income and ethnic minority backgrounds, who are at increased risk for postpartum depression. However, social support may have the potential to attenuate the negative impact of stress. The present study evaluated 269 Mexican American women (ages 18-42; 83 % Spanish-speaking; median income $10,000-$15,000) for prenatal stress (daily hassles, family stress, partner stress, and culture-specific stress) in relation to depressive symptoms 6 weeks postpartum. Prenatal social support was examined as a buffer against the impact of prenatal stress. Partner stress, family stress, and daily hassles uniquely predicted depressive symptoms. Moderate and high levels of social support attenuated risk for depression due to family stressors. Prenatal interpersonal and daily stressors negatively impact the mental health of women after birth, but social support can mitigate some of these effects. Among Mexican American pregnant women, effective interpersonal support and stress management may be associated with reduced risk for postpartum depression.

Attachment and loss experiences during childhood are associated with adult hostility, depression, and social support

OBJECTIVES

This study examined developmental antecedents to psychosocial traits in adulthood that have been linked in prior studies to increased risk of heart disease. The hypothesis was tested that early parental loss coupled with poor-quality family relationships (FR) during childhood would be associated with increased hostility and depression, and lower social support in adulthood.

METHODS

Participants included 30 university students who experienced the death of one parent before the age of 16, and 31 control participants. Questionnaires were completed measuring current social support, hostility, depression, and the quality of FR.

RESULTS

Multivariate analysis of variance (MANOVA) supported the hypothesis of maladaptive psychosocial characteristics in loss participants reporting poorer-quality FR. Significant interactions of loss and FR were found for individual variables of depressive symptoms, social support, and hostility.

CONCLUSION

These results provide evidence that parental loss in childhood is associated with health-damaging psychosocial characteristics in adulthood only if the quality of the surviving FR is poor.

Childhood attachment and loss experiences affect adult cardiovascular and cortisol function

OBJECTIVE

This study proposes to test the hypothesis that early loss of a parent, coupled with poor quality family relationships, would result in long-term increased cardiovascular and cortisol reactivity to stress.

METHODS

Subjects included 30 university students who lost one parent before age 16, and 31 control subjects. Blood pressure (BP) was measured continuously during 5-minute baseline and recovery periods, and during each of 2 tasks--viewing a 7-minute video clip depicting the death of a parent, and giving a 3-minute impromptu speech (1-hour rest between tasks). Salivary cortisol samples were collected immediately before each task, and at 5 and 20 minutes posttask. Quality of family relationships (FR) was measured using the Moos Family Environment Scale.

RESULTS

Repeated-measures analysis of covariance revealed significant main effects on BP of both parental loss and FR for both tasks (all p values < .05) such that subjects who lost a parent or reported poor quality FR showed higher BP across all periods. The loss by FR by period interaction was not significant. An FR by period interaction was found for cortisol during the movie, in which poor quality FR subjects showed increased cortisol, whereas all others showed decreases. A loss by period interaction was found for cortisol during the speech, in which cortisol increased in loss subjects and decreased in non-loss subjects.

CONCLUSIONS

These findings indicate that both childhood loss of a parent and poor quality of caretaking are associated with long-term increases in BP and altered neurohormonal responses to stress.

Stress in employed women: impact of marital status and children at home on neurohormone output and home strain

OBJECTIVE

To evaluate the biological and psychological effects of role overload, we examined the effects of marital (or partnership) status and parental status (defined as having children at home) on daily excretion of urinary catecholamines and cortisol in a sample of 109 employed women. Other measures included work and home strain, and social support.

METHODS

Urine collection was conducted on two consecutive workdays in three separate aliquots, a) overnight, b) daytime, and c) evening. Repeated-measures analysis of covariance with age and caffeine consumption as covariates was conducted on levels of epinephrine, norepinephrine, and cortisol in the three aliquots averaged across the 2 days.

RESULTS

We found a significant main effect of parental status on 24-hour cortisol excretion, (p < .01) such that women with at least one child living at home excreted significantly more cortisol, independent of marital status or social support. Women with children at home also reported higher home strain (p < .001) but not work strain. A significant period of day effect for catecholamine levels was found (norepinephrine, p < .001; epinephrine, p < .0001) with all subjects showing an increase during the workday and little or no decline in levels during the evening. Catecholamine levels were unrelated to marital status, parental status, or social support.

CONCLUSIONS

These findings indicate that working women with children at home, independent of marital status or social support, excrete greater amounts of cortisol and experience higher levels of home strain than those without children at home.

Modulation of immune status by a conditioned aversive stimulus: evidence for the involvement of endogenous opioids

Recent research has shown that presentations of an unconditioned aversive stimulus, such as electric shock, can induce alterations of immune function in rats. Furthermore, it has been demonstrated that an innocuous stimulus paired with an unconditioned aversive stimulus can acquire immunomodulatory properties. Research has suggested that endogenous opioid activity is responsible for the alterations of immune function by unconditioned aversive stimulation. The present study evaluated the effect of administration of opiate receptor antagonists, naltrexone and N-methylnaltrexone, on the immunomodulatory effect of a conditioned stimulus (CS) that had been paired with electric footshock. Naltrexone dose-dependently attenuated the CS-induced suppression of the in vitro proliferative response of splenic lymphocytes to concanavalin A, lipopolysaccharide, and a combination of ionomycin and phorbol myristate acetate. Naltrexone also attenuated the CS-induced reduction in natural-killer cell activity. In contrast, the quaternary form of naltrexone, N-methylnaltrexone, did not significantly attenuate the CS-induced immunomodulatory effects. Collectively, these findings indicate that endogenous opioid activity is involved in CS-induced alterations of immune function. Moreover, the lack of effectiveness of N-methylnaltrexone in attenuating the CS-induced immunomodulatory effect suggests that the opioid receptors involved in the effect are located in the central nervous system.

Evidence for the involvement of β-adrenergic receptors in conditioned immunomodulation

This study investigates the role of beta-adrenergic receptors in the immunomodulatory effects of a conditioned aversive stimulus (CS). A CS is an environmental event that is not inherently aversive, but acquires aversive properties through pairings with a stimulus such as electric shock. This study evaluated the effects of administration of the beta 1-receptor selective antagonist atenolol, and the beta 2-receptor antagonist ICI 118,551 on conditioned immune alterations. Administration of either antagonist prior to presentation of the CS resulted in a dose-dependent attenuation of the CS-induced suppression of splenic T-cell proliferative response to concanavalin A, phytohemagglutinin, and the combination of ionomycin/phorbol-myristate-acetate. Furthermore, both antagonists dose-dependently attenuated the CS-induced suppression of gamma-interferon production by concanavalin-A (ConA)-stimulated splenocytes. In contrast, neither antagonist significantly attenuated the CS-induced suppression of the B-cell mitogenic response to LPS, interleukin-2 production, natural killer cell activity, or mitogenic responsiveness of blood lymphocytes. Thus it is likely that multiple mechanisms are involved in CS-induced immune alterations and these results clearly implicate beta 1 and beta 2-adrenergic receptors in a subset of immunomodulatory effects.

Suppression of the development of adjuvant arthritis by a conditioned aversive stimulus

The present study evaluated the effect of a conditioned aversive stimulus (CS) on the development of adjuvant-induced arthritis in Lewis rats. Experiment 1 showed that presentation of a CS, on days 12, 14, and 16 following injection with adjuvant containing mycobacterium tuberculosis, resulted in a pronounced suppression of the development of arthritis as measured by a clinical disease severity rating scale and spleen weight. In contrast, presentation of the CS on days 0, 2, and 4 following injection did not have any effect on the development of arthritis. Experiment 2 showed that the suppression of adjuvant arthritis by exposure to the CS was blocked by administration of propranolol, a nonselective beta-adrenergic receptor antagonist. These results demonstrate that a CS can alter the development of adjuvant-induced arthritis, but the effect is dependent upon the timing of the antigen exposure and the presentation of the CS. Moreover, the present findings suggest that blocking beta-adrenergic receptors during presentations of the CS prevents the suppressive effect of the CS.