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Tyson HR, Harrison DJ, Higgs MJ, Isles AR, John RM. Deficiency of the paternally-expressed imprinted Peg3 gene in mice has sexually dimorphic consequences for offspring communication and social behaviour. Front Neurosci 2024; 18:1374781. [PMID: 38595977 PMCID: PMC11002209 DOI: 10.3389/fnins.2024.1374781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Imprinted genes are expressed from one parental allele as a consequence of epigenetic processes initiated in the germline. Consequently, their ability to influence phenotype depends on their parent-of-origin. Recent research suggests that the sex of the individual expressing the imprinted gene is also important. We have previously reported that genetically wildtype (WT) dams carrying and caring for pups mutant for PEG3 exhibit anxiety-like behaviours and their mutant pups show a reduction in ultrasonic vocalisation when separated from their mothers. Sex-specificity was not examined. Methods WT female mice were mated with WT, heterozygous Peg3-/+ or homozygous Peg3-/- studs to generate all WT (control), 50:50 mixed or 100% mutant litters, respectively, followed by behavioural assessment of both dams and their pups. Results We reproduced our original finding that WT dams carrying and caring for 100% mutant litters exhibit postpartum anxiety-like symptoms and delayed pup retrieval. Additionally, these WT dams were found to allocate less time to pup-directed care behaviours relative to controls. Male Peg3-deficient pups demonstrated significantly reduced vocalisation with a more subtle communication deficit in females. Postweaning, male mutants exhibited deficits across a number of key social behaviours as did WT males sharing their environment with mutants. Only modest variations in social behaviour were detected in experimental females. Discussion We have experimentally demonstrated that Peg3 deficiency confined to the offspring causes anxiety in mouse mothers and atypical behaviour including deficits in communication in their male offspring. A male-specific reduction in expression PEG3 in the fetally-derived placenta has previously been associated with maternal depression in human pregnancy. Maternal mood disorders such as depression and anxiety are associated with delays in language development and neuroatypical behaviour more common in sons. Peg3 deficiency could drive the association of maternal and offspring behavioural disorders reported in humans.
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Affiliation(s)
- Hannah R. Tyson
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - David J. Harrison
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Mathew J. Higgs
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Anthony R. Isles
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Rosalind M. John
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, United Kingdom
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Matsas A, Panopoulou P, Antoniou N, Bargiota A, Gryparis A, Vrachnis N, Mastorakos G, Kalantaridou SN, Panoskaltsis T, Vlahos NF, Valsamakis G. Chronic Stress in Pregnancy Is Associated with Low Birth Weight: A Meta-Analysis. J Clin Med 2023; 12:7686. [PMID: 38137756 PMCID: PMC10743391 DOI: 10.3390/jcm12247686] [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: 10/09/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic activation of the stress system has cumulative effects on the body, and it places individuals at risk for adverse health outcomes. Chronic stress has been assessed by health questionnaires in pregnancy. During the perinatal period, mothers experience increased physical and emotional demands. Chronic stress interferes with hormonal functions in mothers and infants. This meta-analysis studies the effect of maternal chronic stress during pregnancy, as assessed by established stress questionnaires, on the birth weight of their full-term infants. DESIGN AND METHODS According to our criteria and after research collection, we obtained 107 studies and we conducted two types of analyses: a logistic (N = 22,342) and linear regression analysis (N = 7431). RESULTS Our results show that chronic stress is associated with a statistically significant risk of low birth weight (OR = 1.50, CI 95% = [1.13; 1.99], p ≤ 0.02). CONCLUSIONS Increased maternal chronic stress, as assessed by questionnaires, in pregnancy is associated with a low-birth-weight baby. The above meta-analysis indicates that maternal high chronic stress questionnaire scores could be used as a clinical tool in order to assess low-birth-weight risk.
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Affiliation(s)
- Alkis Matsas
- Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 76 Vasilisis Sofias Avenue, 11528 Athens, Greece
| | - Panagiota Panopoulou
- Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 76 Vasilisis Sofias Avenue, 11528 Athens, Greece
| | - Neofyta Antoniou
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, Chaidari, 12462 Athens, Greece
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Disorders, University Hospital of Larissa, Medical School of Larissa, University of Thessaly, 41334 Larissa, Greece
| | - Alexandros Gryparis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Goudi, 11527 Athens, Greece
| | - Nikolaos Vrachnis
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, Chaidari, 12462 Athens, Greece
| | - George Mastorakos
- Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 76 Vasilisis Sofias Avenue, 11528 Athens, Greece
| | - Sophia N. Kalantaridou
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Street, Chaidari, 12462 Athens, Greece
| | - Theodoros Panoskaltsis
- Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 76 Vasilisis Sofias Avenue, 11528 Athens, Greece
| | - Nikos F. Vlahos
- Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 76 Vasilisis Sofias Avenue, 11528 Athens, Greece
| | - Georgios Valsamakis
- Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 76 Vasilisis Sofias Avenue, 11528 Athens, Greece
- Department of Endocrinology and Metabolic Disorders, University Hospital of Larissa, Medical School of Larissa, University of Thessaly, 41334 Larissa, Greece
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Zhang L, Li P, Ge Q, Sun Z, Cai J, Xiao C, Yu C, Nosarti C, Liao J, Liu Z. Maternal Prenatal Depressive Symptoms and Fetal Growth During the Critical Rapid Growth Stage. JAMA Netw Open 2023; 6:e2346018. [PMID: 38048129 PMCID: PMC10696489 DOI: 10.1001/jamanetworkopen.2023.46018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Importance Fetal growth in the critical rapid growth stage (CRGS) before delivery, approximately between 30 to 37 gestational weeks, carries significant implications for subsequent overweight, obesity, and arterial health. Previous evidence has demonstrated the association between maternal depressive symptoms and fetal growth trajectories from early to late pregnancy, but there remains limited understanding of the association of these symptoms with the longitudinal fetal growth change within the CRGS. Objective To investigate the association between maternal depressive symptoms and fetal growth during the CRGS before delivery. Design, Setting, and Participants This prospective birth cohort study was conducted from January 2018 to December 2020. Volunteer pregnant women were enrolled in their first trimester of prenatal visits. Women with severe disease before pregnancy and multiple births, fetuses with congenital anomalies, and preterm or postterm births were excluded. This multicenter study was based in 13 hospitals covering 81 counties across 12 cities in Sichuan Province, China. Follow-up visits were performed at the second trimester, the third trimester, and 24 hours after delivery. The analysis was conducted from January to May 2023. Exposures Maternal depressive symptoms, as a continuous variable, measured by the Edinburgh Postpartum Depression Scale (EPDS) at a median gestational week of 24 (range, 14 to 27) weeks of gestation. A higher score on the EPDS indicates worse depressive symptoms. Main Outcomes and Measures The main outcomes included ultrasonography-measured biparietal diameter (BPD), femur length (FL), and abdominal circumference (AC), along with calculated estimated fetal weight (EFW). These parameters were evaluated longitudinally at a median gestational week of 30 (range, 28 to 32) and 37 (range, 35 to 39) weeks. Linear mixed models were used to estimate the associations between maternal depressive symptoms and fetal growth parameters. Results A total of 2676 mother-offspring dyads were included, in which the mean (SD) age of mothers was 28.0 (4.4) years, and 1294 (48.4%) of the offspring were female. The median (IQR) maternal EPDS score was 5.0 (4.0 to 9.0). After adjustment for confounders, a significant correlation was found between a higher score of depressive symptoms in mothers and a slower rate of fetal growth across FL (β = -0.40; 95% CI, -0.58 to -0.22), AC (β = -1.97; 95% CI, -2.90 to -1.03), and EFW (β = -50.11; 95% CI, -68.46 to -31.75). These associations were stronger in female fetuses or those with better family socioeconomic conditions. Conclusions and Relevance In this prospective cohort study, maternal depressive symptoms were associated with slower fetal growth rate in the CRGS before delivery. Early screening for depressive disorders in pregnant women appears to be essential for fetal growth and later health.
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Affiliation(s)
- Lu Zhang
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ping Li
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiaoyue Ge
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zeyuan Sun
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, United Kingdom
| | - Jiarui Cai
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chenghan Xiao
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuan Yu
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chiara Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, United Kingdom
| | - Jiaqiang Liao
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenmi Liu
- Department of Maternal and Child Health, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Ong YY, Rifas-Shiman SL, Perng W, Belfort MB, Law E, Hivert MF, Oken E, Tiemeier H, Aris IM. Growth Velocities Across Distinct Early Life Windows and Child Cognition: Insights from a Contemporary US Cohort. J Pediatr 2023; 263:113653. [PMID: 37541424 PMCID: PMC10837309 DOI: 10.1016/j.jpeds.2023.113653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE To evaluate the relative importance of overall and period-specific postnatal growth and their interaction with fetal growth on cognition in a generally well-nourished population. STUDY DESIGN We included 1052 children from Project Viva, a prospective cohort in Boston, Massachusetts. Using linear spline mixed-effects models, we modeled length/height and body mass index (BMI) trajectories from birth to 7 years and estimated standardized overall (0-7 years) and period-specific growth velocities ie, early infancy (0-4 months), late infancy (4-15 months), toddlerhood (15-37 months), and early childhood (37-84 months). We investigated associations of growth velocities as well as their interactions with birthweight-for-gestational age on mid-childhood (mean age: 7.9 years) IQ, visual memory and learning, and visual motor ability. RESULTS Greater overall height velocity was associated with modestly higher design memory score, (adjusted β [95% CI] 0.19 [-0.01,0.38] P = .057])points per SD increase but lower verbal IQ (-0.88 [-1.76,0.00] P = .051). Greater early infancy height velocity was associated with higher visual motor score (1.92 [0.67,3.18]). Greater overall BMI velocity was associated with lower verbal IQ (-0.71 [-1.52,0.11] P = .090). Greater late infancy BMI velocity was associated with lower verbal IQ (-1.21 [-2.07,-0.34]), design memory score (-0.22 [-0.42,-0.03)], but higher picture memory score (0.22 [0.01,0.43]). Greater early infancy height velocity (-1.5 SD vs 1.5 SD) was associated with higher nonverbal IQ (margins [95% CI] 102.6 [98.9106.3] vs 108.2 [104.9111.6]) among small-for-gestational age infants (P-interaction = 0.04). CONCLUSIONS Among generally well-nourished children, there might not be clear cognitive gains with faster linear growth except for those with lower birthweight-for-gestational age, revealing the potential importance of early infancy compensatory growth.
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Affiliation(s)
- Yi Ying Ong
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Evelyn Law
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA; Diabetes Unit, Massachusetts General Hospital, Boston, MA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA
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Yang Z, Wang X, Wang M, Yan S, Wu F, Zhang F. Trajectory of prenatal anxiety and depression and its association with fetal growth development. Early Hum Dev 2023; 187:105875. [PMID: 37866288 DOI: 10.1016/j.earlhumdev.2023.105875] [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: 07/04/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND The stability of anxiety and depression during pregnancy and the impact on women and offspring has been recognized, yet the distinction of impact between them remains unclear. The aim of this study was to investigate the trajectory of prenatal anxiety and depression and their coexistence, as well as to examine the potential variations in pregnancy outcomes and fetal/neonatal growth development. METHOD At baseline (11-13+6 weeks), women were recruited and subsequently monitored in the second (16-20+6 weeks) and third (28-31+6 weeks) trimesters. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. In the second (16-20+6 weeks), third (28-31+6 weeks), and prenatal period (37-40+6 weeks), fetal growth was assessed by ultrasound scans. The joint trajectory model was used to determine the trajectory groups of depressive/anxiety dominant or coexistence. Comparisons of fetal/neonatal growth between groups were conducted using analysis of covariance and a multilevel model. RESULT A total of 457 pregnant women were finally included. Four trajectory groups were identified: none-negative emotion (n = 190, 41.6 %), anxiety dominant (n = 195, 42.6 %), depression dominant (n = 33, 7.2 %), and anxiety and depression coexistence (n = 39, 8.6 %). There were significant differences in the antenatal abdominal circumference (335.44 vs 333.92 vs 330.82 vs 325.13 mm, p = 0.007) of fetuses and the birth length (50.14 vs 50.03 vs 49.91 vs 49.18, p = 0.008) of newborns among four groups, showing a clear decreasing trend. Anxiety and depression coexistence displayed a notable and statistically significant difference when compared to the other groups and had a lower increase of fetal abdominal circumference (β = -8.91, 95%CI: -16.15, -1.67, p = 0.016) after controlling for confounding factors. Anxiety and depression dominant groups found no difference in fetal/neonatal growth. CONCLUSIONS The more severe the negative emotional state of mothers, the more restricted their offspring's development, especially in terms of fetal abdominal circumference and birth length. The impact of anxiety or depressive symptoms does not show a pronounced difference. However, what is noteworthy is the tendency and evident impact on offspring development when anxiety and depression coexistence work synergistically. As a result, healthcare professionals should place greater emphasis on addressing anxiety and depression in expectant mothers, particularly among those experiencing anxiety and depression coexisting symptoms.
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Affiliation(s)
- Ziyi Yang
- Medical School of Nantong University, Nantong, Jiangsu 226007, China
| | - Xin Wang
- Medical School of Nantong University, Nantong, Jiangsu 226007, China
| | - Mingbo Wang
- Medical School of Nantong University, Nantong, Jiangsu 226007, China
| | - Shuhan Yan
- Medical School of Nantong University, Nantong, Jiangsu 226007, China
| | - Fan Wu
- Jiangsu Vocational College of Medicine, Yancheng, Jiangsu 224005, China
| | - Feng Zhang
- Medical School of Nantong University, Nantong, Jiangsu 226007, China.
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Gerges S, DiPietro JA, Obeid S, Fekih-Romdhane F, Hallit S. Psychometric performance assessment of the Arabic version of the pregnancy experience scale-brief version (PES-brief) in an Arabic-speaking population. J Psychosom Res 2023; 174:111499. [PMID: 37801881 DOI: 10.1016/j.jpsychores.2023.111499] [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: 06/24/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE Although tools exist to assess psychological distress during pregnancy, a scarcity of instruments are designed to measure maternal perceptions of the more positive, uplifting features of pregnancy in addition to the more negative, hassling aspects. To address this shortcoming, DiPietro et al. developed the Pregnancy Experience Scale-Brief (PES-Brief). We aimed to assess the reliability and psychometric performance of an Arabic translation of the PES-Brief among Lebanese pregnant women. METHODS The PES-Brief, the Patient Health Questionnaire, the Lebanese Anxiety Scale, and the Multidimensional Scale of Perceived Social Support were administered to 433 participants. PES-Brief scores were computed as frequency and intensity, with Hassles to Uplifts frequency and intensity ratios. RESULTS The PES-Brief was internally consistent, with McDonald's ω = 0.87 for Uplifts and 0.81 for Hassles. Higher PES-Uplifts scores were significantly associated with lower depression and anxiety scores, and higher perceived social support; whereas higher PES-Hassles scores showed inverse correlations. The Hassles to Uplifts frequency and intensity ratios were 0.864 and 0.836, respectively, indicating that pregnant women were more uplifted than hassled. The CFA results confirmed the two-factor structure of the scale. CONCLUSION Our findings suggest that the Arabic PES-Brief is a psychometrically valid and reliable scale that may be employed as a legitimate indicator of pregnancy-specific uplifts and hassles among Arabic-speaking populations. Our study prompts clinicians and researchers to benefit from this tool for capturing the integral psychological/emotional experience of women during pregnancy, which may facilitate pregnant women's support when needed.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. box 446, Jounieh, Lebanon.
| | - Janet A DiPietro
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba 2010, Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. box 446, Jounieh, Lebanon; Applied Science Research Center, Applied Science Private University, Amman, Jordan; Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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John RM, Higgs MJ, Isles AR. Imprinted genes and the manipulation of parenting in mammals. Nat Rev Genet 2023; 24:783-796. [PMID: 37714957 DOI: 10.1038/s41576-023-00644-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/17/2023]
Abstract
Genomic imprinting refers to the parent-of-origin expression of genes, which originates from epigenetic events in the mammalian germ line. The evolution of imprinting may reflect a conflict over resource allocation early in life, with silencing of paternal genes in offspring soliciting increased maternal provision and silencing of maternal genes limiting demands on the mother. Parental caregiving has been identified as an area of potential conflict, with several imprinted genes serendipitously found to directly influence the quality of maternal care. Recent systems biology approaches, based on single-cell RNA sequencing data, support a more deliberate relationship, which is reinforced by the finding that imprinted genes expressed in the offspring influence the quality of maternal caregiving. These bidirectional, reiterative relationships between parents and their offspring are critical both for short-term survival and for lifelong wellbeing, with clear implications for human health.
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Huang Y, Alvernaz S, Kim SJ, Maki P, Dai Y, Bernabé BP. Predicting prenatal depression and assessing model bias using machine learning models. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.17.23292587. [PMID: 37503225 PMCID: PMC10371186 DOI: 10.1101/2023.07.17.23292587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Perinatal depression (PND) is one of the most common medical complications during pregnancy and postpartum period, affecting 10-20% of pregnant individuals. Black and Latina women have higher rates of PND, yet they are less likely to be diagnosed and receive treatment. Machine learning (ML) models based on Electronic Medical Records (EMRs) have been effective in predicting postpartum depression in middle-class White women but have rarely included sufficient proportions of racial and ethnic minorities, which contributed to biases in ML models for minority women. Our goal is to determine whether ML models could serve to predict depression in early pregnancy in racial/ethnic minority women by leveraging EMR data. We extracted EMRs from a hospital in a large urban city that mostly served low-income Black and Hispanic women (N=5,875) in the U.S. Depressive symptom severity was assessed from a self-reported questionnaire, PHQ-9. We investigated multiple ML classifiers, used Shapley Additive Explanations (SHAP) for model interpretation, and determined model prediction bias with two metrics, Disparate Impact, and Equal Opportunity Difference. While ML model (Elastic Net) performance was low (ROCAUC=0.67), we identified well-known factors associated with PND, such as unplanned pregnancy and being single, as well as underexplored factors, such as self-report pain levels, lower levels of prenatal vitamin supplement intake, asthma, carrying a male fetus, and lower platelet levels blood. Our findings showed that despite being based on a sample mostly composed of 75% low-income minority women (54% Black and 27% Latina), the model performance was lower for these communities. In conclusion, ML models based on EMRs could moderately predict depression in early pregnancy, but their performance is biased against low-income minority women.
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Affiliation(s)
- Yongchao Huang
- Department of Biomedical Engineering, Colleges of Engineering and Medicine, University of Illinois, Chicago, IL, USA
| | - Suzanne Alvernaz
- Department of Biomedical Engineering, Colleges of Engineering and Medicine, University of Illinois, Chicago, IL, USA
| | - Sage J Kim
- Division of Health Policy and Administration, School of Public Health, University of Illinois, Chicago, IL, USA
| | - Pauline Maki
- Department of Psychiatry, College of Medicine, University of Illinois, Chicago, IL, USA
- Department of Psychology, College of Medicine, University of Illinois, Chicago, IL, USA
- Department of Obstetrics and Gynecology, College of Medicine, University of Illinois, Chicago, IL, USA
| | - Yang Dai
- Department of Biomedical Engineering, Colleges of Engineering and Medicine, University of Illinois, Chicago, IL, USA
- Center of Bioinformatics and Quantitative Biology, University of Illinois, Chicago, IL, USA
| | - Beatriz Penñalver Bernabé
- Department of Biomedical Engineering, Colleges of Engineering and Medicine, University of Illinois, Chicago, IL, USA
- Center of Bioinformatics and Quantitative Biology, University of Illinois, Chicago, IL, USA
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Thomas EBK, Miller ML, Grekin R, O’Hara MW. Examining psychological inflexibility as a mediator of postpartum depressive symptoms: A longitudinal observational study of perinatal depression. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023; 27:11-15. [PMID: 36570435 PMCID: PMC9770600 DOI: 10.1016/j.jcbs.2022.11.005] [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] [Indexed: 11/26/2022]
Abstract
Background Depression is a common, serious complication during the postpartum period. Predictors of postpartum depression characterize who is at-risk for persistent symptoms. This study explored how psychological inflexibility affects depressive symptoms at 4 and 12 weeks postpartum. Methods Participants receiving prenatal care at a medical center were recruited during the second trimester. Participants (n = 180) completed online assessments and diagnostic interviews during the third trimester (≥ 28 weeks gestation), and at 4-, 8-, and 12-weeks postpartum. Online assessments measured psychological inflexibility (PI) and depressive symptoms, while diagnostic interviews measured lifetime history of depression. Results Mediation analysis examined pathways between 4-weeks postpartum depression, 8-weeks postpartum PI, and 12-weeks postpartum depression. Depressive symptoms at 4-weeks postpartum predicted PI at 8-weeks postpartum (β = 0.31, SE = 0.06, t(177) = 6.06, p < .001). Depressive symptoms at 4-weeks postpartum (β = 0.42, SE = 0.06, t(176) = 7.12, p < .001) and PI at 8-weeks postpartum (β = 0.32, SE = .08, t(176) = 4.09, p < .001) predicted depressive symptoms at 12-weeks postpartum. Depressive symptoms at 4-weeks, 8-week PI, and lifetime history of depression accounted for 42% of the variance in 12-week depressive symptoms (R2 = 0.42). The confidence interval of the indirect effect (0.04, 0.18) did not include zero, indicating significant mediation by PI. Conclusions PI mediated the relation between 4- and 12-weeks postpartum depressive symptoms when controlling for lifetime history of depression. Psychological inflexibility is a transdiagnostic target for future prevention and intervention research during the postpartum period.
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Affiliation(s)
| | | | - Rebecca Grekin
- University of Iowa, Psychological and Brain Sciences
- Great Lakes Perinatal Wellness, Ann Arbor, MI
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Allgood KL, Mack JA, Novak NL, Abdou CM, Fleischer NL, Needham BL. Vicarious structural racism and infant health disparities in Michigan: The Flint Water Crisis. Front Public Health 2022; 10:954896. [PMID: 36148337 PMCID: PMC9486078 DOI: 10.3389/fpubh.2022.954896] [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: 05/27/2022] [Accepted: 08/12/2022] [Indexed: 01/24/2023] Open
Abstract
Building on nascent literature examining the health-related effects of vicarious structural racism, we examined indirect exposure to the Flint Water Crisis (FWC) as a predictor of birth outcomes in Michigan communities outside of Flint, where residents were not directly exposed to lead-contaminated water. Using linear regression models, we analyzed records for all singleton live births in Michigan from 2013 to 2016, excluding Flint, to determine whether birth weight (BW), gestational age (GA), and size-for-gestational-age (SzGA) decreased among babies born to Black people, but not among babies born to White people, following the highly publicized January 2016 emergency declaration in Flint. In adjusted regression models, BW and SzGA were lower for babies born to both Black and White people in the 37 weeks following the emergency declaration compared to the same 37-week periods in the previous 3 years. There were no racial differences in the association of exposure to the emergency declaration with BW or SzGA. Among infants born to Black people, GA was 0.05 weeks lower in the 37-week period following the emergency declaration versus the same 37-week periods in the previous 3 years (95% CI: -0.09, -0.01; p = 0.0177), while there was no change in GA for infants born to White people following the emergency declaration (95% CI: -0.01, 0.03; p = 0.6962). The FWC, which was widely attributed to structural racism, appears to have had a greater impact, overall, on outcomes for babies born to Black people. However, given the frequency of highly publicized examples of anti-Black racism over the study period, it is difficult to disentangle the effects of the FWC from the effects of other racialized stressors.
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Affiliation(s)
- Kristi L. Allgood
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States,*Correspondence: Kristi L. Allgood
| | - Jasmine A. Mack
- 2Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Nicole L. Novak
- 3Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, United States
| | - Cleopatra M. Abdou
- 4Department of Children, Youth, and Families, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Nancy L. Fleischer
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Belinda L. Needham
- 1Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States
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Qin X, Xu S, Ma M, Fan X, Nie X, Zhang Y, Liu B, Li L. Differences in associations between family functioning and anxious and depressive symptoms in Chinese women and their partners in early pregnancy. BJPsych Open 2022; 8:e158. [PMID: 35983767 PMCID: PMC9438476 DOI: 10.1192/bjo.2022.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Family functioning is associated with anxiety and depression. Perinatal depression and anxiety are common and influence the well-being of women, partners and their offspring. However, little is known about differences in associations between family functioning and mood symptoms in women and their partners in early pregnancy. AIMS Investigating differences in associations between family functioning and anxious and depressive symptoms in women and their partners in early pregnancy. METHOD In total, 171 woman-partner pairs were enrolled. The Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item scale (GAD-7) and Family Assessment Device (FAD) were performed. Correlation analysis and multiple linear regression analysis were applied to investigate the associations. RESULTS In pregnant women, all the subscale scores on the FAD were correlated with total scores on the EPDS and GAD-7 (all P < 0.05), whereas only the Roles subscale showed a predicting effect in regression models (P < 0.01). In partners, all the subscale scores on the FAD were related to total scores on the PHQ-9 (all P < 0.05), whereas only the Problem Solving subscale showed a predicting effect (P = 0.029). CONCLUSIONS Our findings indicate that family functioning in the domain of roles is associated with anxious and depressive symptoms in pregnant women and functioning in the domain of problem solving is associated with depressive symptoms in partners. Clinicians should pay special attention to roles and problem solving when assessing mood symptoms in pregnant women and their partners. This study also provides a basis for family health education in early pregnancy.
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Affiliation(s)
- Xuemei Qin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; and Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Shuyin Xu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; and Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Mohan Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; and Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Xing Fan
- Changsha Hospital for Maternal and Child Health Care, Changsha 410011, Hunan, China
| | - Xueqing Nie
- Changsha Hospital for Maternal and Child Health Care, Changsha 410011, Hunan, China
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; and Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; and Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
| | - Lingjiang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; and Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha 410011, Hunan, China
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12
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Mujica-Coopman MF, Corvalán C, Flores M, Garmendia ML. The Chilean Maternal-Infant Cohort Study-II in the COVID-19 Era: A Study Protocol. Front Public Health 2022; 10:904668. [PMID: 35910889 PMCID: PMC9330369 DOI: 10.3389/fpubh.2022.904668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022] Open
Abstract
Background Pregnancy is a critical developmental window in which optimal maternal nutrition and health are key for pregnancy and infant development. The COVID-19 pandemic is considered as a “natural experiment” in which maternal and infant nutrition and health challenges were faced especially in developing countries. Therefore, understanding the health consequences for mothers and infants living in the COVID-19 era is key to revisit public health measures focused on maternal and infant health. The current work aims to describe the design, methods, and descriptive information at recruitment and preliminary findings of the Chilean Maternal & Infant Cohort Study II (CHiMINCs-II) cohort. Methods The CHiMINCs-II is an ongoing cohort that is part of the Chilean Maternal and Infant Nutrition Observatory of the South-East area of Santiago, Chile. In total, 1954 pregnant women beneficiaries of the public health systems and their offspring were recruited before 15 weeks of gestation and are followed across pregnancy (<15, 26–28, and 35–37 weeks of gestation) and up to 2 years of age in their offspring. Two studies are currently nested within the CHiMINCs-II cohort: (1) Breast Cancer Risk Assessment in Mothers (BRECAM) study, and (2) the CHiMINCs-COVID study. The primary objective of BRECAM study is to test the association between maternal metabolic indicators (i.e., insulin, glucose, insulin growth factor 1, and hemoglobin A1c concentrations) at early pregnancy (i.e., <15 and 26–28 weeks of gestation) and breast density 3 months after the cessation of lactation. For this purpose, we collect maternal obstetric, lifestyle, dietary intake, anthropometric, and biochemical information. The aim of the CHiMINCs-COVID study is to assess maternal dietary intake and mental health problems derived from the COVID-19 pandemic and their association with maternal and infant's health and nutrition. Thus, we collected detailed information on dietary behaviors, mental health, and COVID-related information at each trimester, along with neonatal and infant nutritional information. Discussion The findings of this study will provide novel and critical information to better understand maternal nutritional status, mental health, as well as infant growth and nutrition during the COVID-19 era. Clinical Trial Registration BRECAM study registration number NCT03920098 and CHiMINCs-COVID study registration number NCT01916603.
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Affiliation(s)
- María F. Mujica-Coopman
- Public Nutrition Department, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Camila Corvalán
- Public Nutrition Department, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Marcela Flores
- Corporación de Salud Municipal de Puente Alto, Santiago, Chile
| | - María Luisa Garmendia
- Public Nutrition Department, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
- *Correspondence: María Luisa Garmendia
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Gootjes DV, Posthumus AG, Jaddoe VWV, Steegers EAP. Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study. BMJ Open 2021; 11:e049075. [PMID: 34785546 PMCID: PMC8596053 DOI: 10.1136/bmjopen-2021-049075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes. DESIGN Prospective cohort study. SETTING The Netherlands, Rotterdam. PARTICIPANTS 8617 live singleton births from the Generation R cohort study. EXPOSITION Living in a deprived neighbourhood. MAIN OUTCOME MEASURES Fetal growth trajectories of head circumference, weight and length. SECONDARY OUTCOMES MEASURES Small-for-gestational age (SGA) and preterm birth (PTB). RESULTS Neighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01). CONCLUSIONS We found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.
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Affiliation(s)
- Dionne V Gootjes
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Anke G Posthumus
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, Rotterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
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14
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Cheema AS, Stinson LF, Rea A, Lai CT, Payne MS, Murray K, Geddes DT, Gridneva Z. Human Milk Lactose, Insulin, and Glucose Relative to Infant Body Composition during Exclusive Breastfeeding. Nutrients 2021; 13:nu13113724. [PMID: 34835980 PMCID: PMC8625960 DOI: 10.3390/nu13113724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 12/27/2022] Open
Abstract
Human milk (HM) components may influence infant growth and development. This study aimed to investigate relationships between infant body composition (BC) and HM lactose, insulin, and glucose (concentrations and calculated daily intakes (CDI)) as well as 24-h milk intake and maternal BC at 3 months postpartum. HM samples were collected at 2 months postpartum. Infant and maternal BC was assessed with bioimpedance spectroscopy. Statistical analysis used linear regression accounting for infant birth weight. 24-h milk intake and CDI of lactose were positively associated with infant anthropometry, lean body mass and adiposity. Higher maternal BC measures were associated with lower infant anthropometry, z-scores, lean body mass, and adiposity. Maternal characteristics including BC and age were associated with concentrations and CDI of HM components, and 24-h milk intake. In conclusion, 24-h intake of HM and lactose as well as maternal adiposity are related to development of infant BC.
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Affiliation(s)
- Ali S. Cheema
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
| | - Lisa F. Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Murdoch, WA 6150, Australia;
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
| | - Matthew S. Payne
- Division of Obstetrics and Gynaecology, UWA Medical School, The University of Western Australia, Crawley, WA 6009, Australia;
- Women and Infants Research Foundation, Subiaco, WA 6008, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
- Correspondence: ; Tel.: +61-8-6488-4467
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15
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Influence of Maternal Infection and Pregnancy Complications on Cord Blood Telomere Length. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:3339456. [PMID: 34616503 PMCID: PMC8487834 DOI: 10.1155/2021/3339456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022]
Abstract
Background Exposure to suboptimal intrauterine environment might induce structural and functional changes that can affect neonatal health. Telomere length as an important indicator of cellular health has been associated with increased risk for disease development. Objectives This study was aimed to examine the independent and combined effects of maternal, obstetric, and foetal factors on cord blood telomere length (TL). Methods Pregnant women at the gestational age of 20th to 24th week who attended the antenatal clinic of a major local hospital in Hong Kong were recruited. Participants were asked to complete a questionnaire on demographics, health-related quality of life, and history of risk behaviors. Medical history including pregnancy complications and neonatal outcomes was obtained from electronic medical records of both mother and neonate. Umbilical cord blood was collected at delivery for TL determination. Results A total of 753 pregnant women (average age: 32.18 ± 4.51 years) were recruited. The prevalence of maternal infection, anaemia, and hypertension during pregnancy was 30.8%, 30.0%, and 6.0%, respectively. The adjusted regression model displayed that maternal infection was negatively associated with cord blood TL (β = -0.18, p = 0.026). This association became even stronger in the presence of antenatal anaemia, hypertension, delivery complications, or neonatal jaundice (β = -0.25 to -0.45). Conclusions This study consolidates evidence on the impact of adverse intrauterine environment at the cellular level. Maternal infection was significantly associated with shorter cord blood TL in a unique manner such that its presence may critically determine the susceptibility of telomere to other factors.
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16
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Chen S, Chen S. Are prenatal anxiety or depression symptoms associated with asthma or atopic diseases throughout the offspring's childhood? An updated systematic review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:435. [PMID: 34158009 PMCID: PMC8218439 DOI: 10.1186/s12884-021-03909-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 05/28/2021] [Indexed: 12/04/2022] Open
Abstract
Background Asthma is the most common respiratory disease among children, while atopic diseases such as atopic dermatitis affect about 20% of infants under 2 years of age. Studies suggested that these conditions might be related to prenatal depression or anxiety. This study aimed to explore the association between prenatal mental disorders and childhood asthma or atopic disease in a systematic review and meta-analysis. Methods PubMed, Embase, and the Cochrane Library were searched up to May 2020. The primary outcome was childhood asthma and childhood atopic dermatitis. Random-effects models were used because of high heterogeneity indicated by I2 > 50% and Q-test P < 0.10. Results A total of 598 studies were initially identified, but nine studies met the inclusion criteria. Prenatal mental disorder was associated with childhood asthma (n = 6 studies; ES = 1.146, 95%CI: 1.054–1.245, P = 0.001; I2 = 93.5%, Pheterogeneity < 0.001) whereas no significant association was found for childhood atopic dermatitis (n = 4 studies; ES = 1.211, 95%CI: 0.982–1.494, P = 0.073; I2 = 78.5%, Pheterogeneity < 0.001). Childhood asthma seems to be related more to depression (n = 1 study; ES = 1.170, 95%CI: 1.061–1.291, P = 0.002) and anxiety/depression (n = 4 studies; ES = 1.157, 95%CI: 1.050–1.275, P = 0.073; I2 = 95.3%, Pheterogeneity < 0.001). Conclusion This meta-analysis demonstrated that prenatal mental disorders increase the risk of childhood asthma. We limited the included samples to pregnant women to investigate the association between prenatal psychological factors and offspring’s physical health. Future studies should include large high-quality cohort studies to investigate the behavioral, environmental, and genetic causes for this association. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03909-z.
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Affiliation(s)
- Shuguang Chen
- Department of Dermatology, Southwest Hospital, Third Military M, edical University, Chongqing, China
| | - Sheng Chen
- Department of Pediatrics, Southwest Hospital, Third Military Medical University, Chongqing, 400030, China.
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Sammallahti S, Cortes Hidalgo AP, Tuominen S, Malmberg A, Mulder RH, Brunst KJ, Alemany S, McBride NS, Yousefi P, Heiss JA, McRae N, Page CM, Jin J, Pesce G, Caramaschi D, Rifas-Shiman SL, Koen N, Adams CD, Magnus MC, Baïz N, Ratanatharathorn A, Czamara D, Håberg SE, Colicino E, Baccarelli AA, Cardenas A, DeMeo DL, Lawlor DA, Relton CL, Felix JF, van IJzendoorn MH, Bakermans-Kranenburg MJ, Kajantie E, Räikkönen K, Sunyer J, Sharp GC, Houtepen LC, Nohr EA, Sørensen TIA, Téllez-Rojo MM, Wright RO, Annesi-Maesano I, Wright J, Hivert MF, Wright RJ, Zar HJ, Stein DJ, London SJ, Cecil CAM, Tiemeier H, Lahti J. Maternal anxiety during pregnancy and newborn epigenome-wide DNA methylation. Mol Psychiatry 2021; 26:1832-1845. [PMID: 33414500 PMCID: PMC8595870 DOI: 10.1038/s41380-020-00976-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/31/2020] [Accepted: 11/30/2020] [Indexed: 01/29/2023]
Abstract
Maternal anxiety during pregnancy is associated with adverse foetal, neonatal, and child outcomes, but biological mechanisms remain unclear. Altered foetal DNA methylation (DNAm) has been proposed as a potential underlying mechanism. In the current study, we performed a meta-analysis to examine the associations between maternal anxiety, measured prospectively during pregnancy, and genome-wide DNAm from umbilical cord blood. Sixteen non-overlapping cohorts from 12 independent longitudinal studies of the Pregnancy And Childhood Epigenetics Consortium participated, resulting in a combined dataset of 7243 mother-child dyads. We examined prenatal anxiety in relation to genome-wide DNAm and differentially methylated regions. We observed no association between the general symptoms of anxiety during pregnancy or pregnancy-related anxiety, and DNAm at any of the CpG sites, after multiple-testing correction. Furthermore, we identify no differentially methylated regions associated with maternal anxiety. At the cohort-level, of the 21 associations observed in individual cohorts, none replicated consistently in the other cohorts. In conclusion, contrary to some previous studies proposing cord blood DNAm as a promising potential mechanism explaining the link between maternal anxiety during pregnancy and adverse outcomes in offspring, we found no consistent evidence for any robust associations between maternal anxiety and DNAm in cord blood. Larger studies and analysis of DNAm in other tissues may be needed to establish subtle or subgroup-specific associations between maternal anxiety and the foetal epigenome.
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Affiliation(s)
- Sara Sammallahti
- Erasmus MC, University Medical Center Rotterdam, Department of Adolescent and Child Psychiatry and Psychology, Rotterdam, The Netherlands
- Erasmus MC, University Medical Center Rotterdam, Generation R Study Group, Rotterdam, The Netherlands
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Science, Boston, MA, USA
- University of Helsinki, Department of Psychology and Logopedics, Helsinki, Finland
| | - Andrea P Cortes Hidalgo
- Erasmus MC, University Medical Center Rotterdam, Department of Adolescent and Child Psychiatry and Psychology, Rotterdam, The Netherlands
- Erasmus MC, University Medical Center Rotterdam, Generation R Study Group, Rotterdam, The Netherlands
| | - Samuli Tuominen
- University of Helsinki, Department of Psychology and Logopedics, Helsinki, Finland
| | - Anni Malmberg
- University of Helsinki, Department of Psychology and Logopedics, Helsinki, Finland
| | - Rosa H Mulder
- Erasmus MC, University Medical Center Rotterdam, Department of Adolescent and Child Psychiatry and Psychology, Rotterdam, The Netherlands
- Erasmus MC, University Medical Center Rotterdam, Generation R Study Group, Rotterdam, The Netherlands
- Leiden University, Institute of Education and Child Studies, Leiden, The Netherlands
| | - Kelly J Brunst
- University of Cincinnati, College of Medicine, Department of Environmental Health, Cincinnati, OH, USA
| | - Silvia Alemany
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Nancy S McBride
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Paul Yousefi
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Jonathan A Heiss
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, New York, NY, USA
| | - Nia McRae
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christian M Page
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | - Giancarlo Pesce
- INSERM UMR-S 1136, EPAR, Saint-Antoine Medical School, Paris, France
- Sorbonne Université, Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louis Institute of Epidemiology and Public Health (IPLESP), Paris, France
| | - Doretta Caramaschi
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Sheryl L Rifas-Shiman
- Harvard Medical School, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Nastassja Koen
- University of Cape Town, Department of Psychiatry and Mental Health, Cape Town, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
- University of Cape Town, Neuroscience Institute, Cape Town, South Africa
| | - Charleen D Adams
- Beckman Research Institute of City of Hope, Department of Population Sciences, Duarte, CA, USA
| | - Maria C Magnus
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Nour Baïz
- INSERM UMR-S 1136, EPAR, Saint-Antoine Medical School, Paris, France
- Sorbonne Université, Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louis Institute of Epidemiology and Public Health (IPLESP), Paris, France
| | - Andrew Ratanatharathorn
- Columbia University, Department of Epidemiology, New York City, NY, USA
- Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA
| | - Darina Czamara
- Max-Planck-Institute of Psychiatry, Department of Translational Research in Psychiatry, Munich, Germany
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Elena Colicino
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, New York, NY, USA
| | - Andrea A Baccarelli
- Columbia University Mailman School of Public Health, Precision Environmental Health Lab, New York, NY, USA
| | - Andres Cardenas
- University of California, Division of Environmental Health Sciences, School of Public Health, Berkeley, CA, USA
| | - Dawn L DeMeo
- Brigham and Women's Hospital, Channing Division of Network Medicine, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Deborah A Lawlor
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Caroline L Relton
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Janine F Felix
- Erasmus MC, University Medical Center Rotterdam, Generation R Study Group, Rotterdam, The Netherlands
- Erasmus MC, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, The Netherlands
| | - Marinus H van IJzendoorn
- Erasmus University Rotterdam, Department of Psychology, Education, and Child Studies, Rotterdam, The Netherlands
- University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Marian J Bakermans-Kranenburg
- Leiden University, Leiden Institute for Brain and Cognition, Leiden, The Netherlands
- Vrije Universiteit Amsterdam, Clinical Child & Family Studies, Amsterdam, The Netherlands
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Oulu University Hospital and University of Oulu, PEDEGO Research Unit, MRC Oulu, Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Norwegian University of Science and Technology, Department of Clinical and Molecular Medicine, Trondheim, Norway
| | - Katri Räikkönen
- University of Helsinki, Department of Psychology and Logopedics, Helsinki, Finland
| | - Jordi Sunyer
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Gemma C Sharp
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Lotte C Houtepen
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Ellen A Nohr
- University of Southern Denmark, Institute of Clinical Research and Department of Gynaecology and Obstetrics, Odense, Denmark
| | - Thorkild I A Sørensen
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Copenhagen, Denmark
- University of Copenhagen, Faculty of Medical and Health Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, Copenhagen, Denmark
| | - Martha M Téllez-Rojo
- National Institute of Public Health, Center for Nutrition and Health Research, Cuernavaca, Mor, Mexico
| | | | - Isabella Annesi-Maesano
- INSERM UMR-S 1136, EPAR, Saint-Antoine Medical School, Paris, France
- Sorbonne Université, Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louis Institute of Epidemiology and Public Health (IPLESP), Paris, France
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals, NHS Foundation Trust, Bradford, UK
| | - Marie-France Hivert
- Harvard Medical School, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Massachusetts General Hospital, Diabetes Unit, Boston, MA, USA
| | - Rosalind J Wright
- Icahn School of Medicine at Mount Sinai, Environmental Medicine & Public Health, Institute for Exposomic Research, New York, NY, USA
| | - Heather J Zar
- University of Cape Town, Department of Paediatrics and Child Health, Cape Town, South Africa
- South African Medical Research Council (SAMRC) Unit on Child and Adolescent Health, Cape Town, Cape Town, South Africa
| | - Dan J Stein
- University of Cape Town, Department of Psychiatry and Mental Health, Cape Town, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
- University of Cape Town, Neuroscience Institute, Cape Town, South Africa
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Charlotte A M Cecil
- Erasmus MC, University Medical Center Rotterdam, Department of Adolescent and Child Psychiatry and Psychology, Rotterdam, The Netherlands
- Erasmus MC, University Medical Center Rotterdam, Generation R Study Group, Rotterdam, The Netherlands
- Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
- Leiden University Medical Center, Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden, The Netherlands
| | - Henning Tiemeier
- Erasmus MC, University Medical Center Rotterdam, Department of Adolescent and Child Psychiatry and Psychology, Rotterdam, The Netherlands.
- Erasmus MC, University Medical Center Rotterdam, Generation R Study Group, Rotterdam, The Netherlands.
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Science, Boston, MA, USA.
| | - Jari Lahti
- University of Helsinki, Department of Psychology and Logopedics, Helsinki, Finland
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18
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Lara-Cinisomo S, D'Anna-Hernandez K, Non AL. Recommendations for Clinical Practice, Research, and Policy to Address the Effects of the COVID-19 Pandemic on Anxiety Symptoms in Immigrant and U.S.-Born Latina Mothers. Womens Health Issues 2021; 31:301-305. [PMID: 33893016 DOI: 10.1016/j.whi.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/25/2021] [Accepted: 03/10/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Sandraluz Lara-Cinisomo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois.
| | | | - Amy L Non
- Department of Anthropology, University of California San Diego, La Jolla, California
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19
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Li C, Huo L, Wang R, Qi L, Wang W, Zhou X, Zhou Y, Zhang X. The prevalence and risk factors of depression in prenatal and postnatal women in China with the outbreak of Corona Virus Disease 2019. J Affect Disord 2021; 282:1203-1209. [PMID: 33601697 PMCID: PMC7800140 DOI: 10.1016/j.jad.2021.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The prevalence of depression increase with the outbreaks of epidemic disease. The prevalence of depression during the outbreak of Corona Virus Disease 2019 (COVID-19) in prenatal and postnatal women was examined in China. METHODS 2201 prenatal and postnatal women in mainland China were recruited in this cross-sectional study from February 28th to April 26th, 2020. The Patient Health Questionnaire (PHQ-9) was used to assess depression in prenatal and postnatal women. RESULTS The prevalence rate of depression was 35.4%. The risk factors for depression included drinking (p = 0.04; adjusted OR = 2.81, 95%CI: 1.26~6.24), nausea and vomiting during pregnancy (p < 0.001; adjusted OR = 3.54, 95%CI: 1.10~11.44), pregnancy's influence on mobility (p = 0.02; adjusted OR = 1.42, 95%CI: 1.11~1.83), anxiety (p < 0.001; adjusted OR = 1.66, 95%CI: 1.57~1.75), insomnia (p < 0.001; adjusted OR = 1.17, 95%CI: 1.14~1.21) and daily attention to fetal movement (p < 0.001; adjusted OR = 0.41, 95%CI: 0.31~0.56). LIMITATIONS This study used a cross-sectional design, and cannot compare changes in the incidence of depression before and after the COVID-19 outbreak. CONCLUSIONS During the COVID-19 outbreak, the prevalence rate of depression among Chinese prenatal and postnatal women was 35.4%. Moreover, anxiety, insomnia, drinking, nausea and vomiting during pregnancy, as well as the impaired movement and less daily monitoring of fetal movement were risk factors for depression.
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Affiliation(s)
- Chuanxiao Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Lijuan Huo
- Department of Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, 430023, China
| | - Wenjia Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xin Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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20
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Luciano M, Sampogna G, Del Vecchio V, Giallonardo V, Perris F, Carfagno M, Raia ML, Di Vincenzo M, La Verde M, Torella M, Fiorillo A. The Transition From Maternity Blues to Full-Blown Perinatal Depression: Results From a Longitudinal Study. Front Psychiatry 2021; 12:703180. [PMID: 34803751 PMCID: PMC8595294 DOI: 10.3389/fpsyt.2021.703180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The aims of the present study are to: (1) assess the frequency of maternity blues (MB); (2) identify the clinical and social characteristics more frequently associated with the onset of depressive symptoms after delivery; and (3) verify the hypothesis that the presence of maternity blues is a risk factor for the onset of a full-blown depressive episode in the 12 months after delivery. Methods: This is a longitudinal observational study. All pregnant women who gave birth at the inpatient unit of Gynecology and Obstetrics of the University of Campania "Luigi Vanvitelli" from December 2019 to February 2021 have been invited to participate in the study. Upon acceptance, women were asked to complete the Italian version of the Edinburgh Postnatal Depression Scale along with an ad-hoc questionnaire on the women's sociodemographic, gynecological and peripartum characteristics as well as their psychiatric history. Women have been reassessed after one, 3, 6 and 12 months. Results: A total of 359 women were recruited within 3 days from delivery, with a mean EPDS total score of 5.51 (±4.20). Eighty-three women (23.1%) reported the presence of maternity blues. Mean EPDS total scores were 12.8 (±0.2) in the MB group vs. 4.26 (±0.2) in the group without MB (p <0.0001). MB predictors were the presence of an anxiety disorder with an onset 6 months prior to pregnancy, of preeclampsia, of increased fetal health rate, of conflicts with relatives other than partner and having a partner with an anxiety disorder. At multivariate analyses the presence of MB increased 7-time the risk to have a higher EPDS score at follow-up assessments (OR: 7.79; CI: 6.88-8.70, p <0.000). This risk is almost four times higher 1 months after the delivery (OR: 4.66; CI: 2.54-6.75, p < 0.000), almost three times higher after 3 months (OR: 2.98; CI: 0.50-5.46, p < 0.01) and almost six times higher after 12 months (OR: 5.88; CI: 3.20-8.54, p < 0.000). Conclusions: Although MB was a self-limiting condition in the majority of cases, depressive symptoms arose quite often immediately after the childbirth. Professionals should be trained to monitor symptoms of MB and its transition toward a depressive episode.
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Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania, "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania, "L. Vanvitelli", Naples, Italy
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania, "L. Vanvitelli", Naples, Italy
| | - Vincenzo Giallonardo
- Department of Psychiatry, University of Campania, "L. Vanvitelli", Naples, Italy
| | - Francesco Perris
- Department of Psychiatry, University of Campania, "L. Vanvitelli", Naples, Italy
| | - Marco Carfagno
- Department of Psychiatry, University of Campania, "L. Vanvitelli", Naples, Italy
| | - Maria Luce Raia
- Department of Psychiatry, University of Campania, "L. Vanvitelli", Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania, "L. Vanvitelli", Naples, Italy
| | - Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynaecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Torella
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynaecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Fiorillo
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynaecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
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21
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Antenatal Antidepressant Prescription Associated With Reduced Fetal Femur Length but Not Estimated Fetal Weight: A Retrospective Ultrasonographic Study. J Clin Psychopharmacol 2021; 41:571-578. [PMID: 34412105 PMCID: PMC8440368 DOI: 10.1097/jcp.0000000000001446] [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] [Indexed: 11/27/2022]
Abstract
PURPOSE/BACKGROUND Antidepressants are among the most frequently prescribed medications during pregnancy and may affect fetal weight. Associations between antenatal antidepressant use and ultrasonographic measures of fetal development have rarely been examined. We hypothesized that the prescription of an antenatal antidepressant would be associated with lower estimated fetal weight (EFW). METHODS/PROCEDURES A retrospective analysis of routine ultrasonographic data extracted from electronic medical records was performed on a cohort of pregnant women with psychiatric diagnoses and grouped according to the presence of an antenatal antidepressant prescription (n = 32 antidepressant-prescribed and n = 44 antidepressant prescription-free). After stratifying for gestational age, comparisons included 13 ultrasonographic parameters, frequency of oligohydramnios and polyhydramnios and growth deceleration, and maternal serum protein markers assessed per routine care, including α-fetoprotein, free β-human chorionic gonadotropin, and unconjugated estriol levels, using t tests, nonparametric and Fisher tests, and effect sizes (ESs) were computed. FINDINGS/RESULTS No statistically significant EFW differences between groups at any time point were detected (P > 0.05). Antenatal antidepressant prescription was associated with lower femur length at weeks 33 to 40 (P = 0.046, ES = 0.75) and greater left ventricular diameter at weeks 25 to 32 (P = 0.04, ES = 1.18). No differences for frequency of oligohydramnios or polyhydramnios or growth deceleration were observed (P > 0.05). We did not detect group differences for maternal proteins (P > 0.05). IMPLICATIONS/CONCLUSIONS Our evidence suggested a lack of association between antenatal antidepressant prescription and lower EFW but indicated an association with lower femur length and greater left ventricular diameter in mid-late gestation. Future research should examine the clinical implications of these findings.
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22
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Bais B, Kamperman AM, Bijma HH, Hoogendijk WJ, Souman JL, Knijff E, Lambregtse-van den Berg MP. Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial. BMJ Open 2020; 10:e038030. [PMID: 33115894 PMCID: PMC7594358 DOI: 10.1136/bmjopen-2020-038030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Approximately 11%-13% of pregnant women suffer from depression. Bright light therapy (BLT) is a promising treatment, combining direct availability, sufficient efficacy, low costs and high safety for both mother and child. Here, we examined the effects of BLT on depression during pregnancy. DESIGN Randomised, double-blind controlled trial. SETTING Primary and secondary care in The Netherlands, from November 2016 to March 2019. PARTICIPANTS 67 pregnant women (12-32 weeks gestational age) with a DSM-5 diagnosis of depressive disorder (Diagnostic and Statistical Manual of Mental Disorders). INTERVENTIONS Participants were randomly allocated to treatment with either BLT (9000 lux, 5000 K) or dim red light therapy (DRLT, 100 lux, 2700 K), which is considered placebo. For 6 weeks, both groups were treated daily at home for 30 min on awakening. Follow-up took place weekly during the intervention, after 6 weeks of therapy, 3 and 10 weeks after treatment and 2 months postpartum. PRIMARY AND SECONDARY OUTCOME MEASURES Depressive symptoms were measured primarily with the Structured Interview Guide for the Hamilton Depression Scale-Seasonal Affective Disorder. Secondary measures were the Hamilton Rating Scale for Depression and the Edinburgh Postnatal Depression Scale. Changes in rating scale scores of these questionnaires over time were analysed using generalised linear mixed models. RESULTS Median depression scores decreased by 40.6%-53.1% in the BLT group and by 50.9%-66.7% in the DRLT group. We found no statistically significant difference in symptom change scores between BLT and DRLT. Sensitivity and post-hoc analyses did not change our findings. CONCLUSIONS Depressive symptoms of pregnant women with depression improved in both treatment arms. More research is necessary to determine whether these responses represent true treatment effects, non-specific treatment responses, placebo effects or a combination hereof. TRIAL REGISTRATION NUMBER NTR5476.
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Affiliation(s)
- Babette Bais
- Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Astrid M Kamperman
- Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Hilmar H Bijma
- Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Witte Jg Hoogendijk
- Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Jan L Souman
- Lighting Applications, Signify NV, Eindhoven, Noord-Brabant, The Netherlands
| | - Esther Knijff
- Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Mijke P Lambregtse-van den Berg
- Psychiatry, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
- Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
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23
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Finlay-Jones AL, Davis JA, O'Donovan A, Kottampally K, Ashley RA, Silva D, Ohan JL, Prescott SL, Downs J. Comparing Web-Based Mindfulness With Loving-Kindness and Compassion Training for Promoting Well-Being in Pregnancy: Protocol for a Three-Arm Pilot Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e19803. [PMID: 33052131 PMCID: PMC7593853 DOI: 10.2196/19803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Promoting psychological well-being and preventing distress among pregnant women is an important public health goal. In addition to adversely impacting the mother's health and well-being, psychological distress in pregnancy increases the risk of poor pregnancy outcomes, compromises infant socioemotional development and bonding, and heightens maternal and child vulnerability in the postpartum period. Mindfulness and compassion-based interventions show potential for prevention and early intervention for perinatal distress. As there is an established need for accessible, scalable, flexible, and low-cost interventions, there is increased interest in the delivery of these programs on the web. This project aims to pilot a three-arm randomized controlled trial (RCT) to determine the feasibility of a full-scale RCT comparing 2 web-based interventions (mindfulness vs loving-kindness and compassion) with a web-based active control condition (progressive muscle relaxation). OBJECTIVE The primary objective of this study is to assess the feasibility of an RCT protocol comparing the 3 conditions delivered on the web as a series of instructional materials and brief daily practices over a course of 8 weeks. The second objective is to explore the experiences of women in the different intervention conditions. The third objective is to estimate SD values for the outcome measures to inform the design of an adequately powered trial to determine the comparative efficacy of the different conditions. METHODS Pregnant women (n=75) participating in a longitudinal birth cohort study (the ORIGINS project) will be recruited to this study from 18 weeks of gestational age. We will assess the acceptability and feasibility of recruitment and retention strategies and the participants' engagement and adherence to the interventions. We will also assess the experiences of women in each of the 3 intervention conditions by measuring weekly changes in their well-being and engagement with the program and by conducting a qualitative analysis of postprogram interviews. RESULTS This project was funded in September 2019 and received ethics approval on July 8, 2020. Enrollment to the study will commence in September 2020. Feasibility of a full-scale RCT will be assessed using ADePT (a process for decision making after pilot and feasibility trials) criteria. CONCLUSIONS If the study is shown to be feasible, results will be used to inform future full-scale RCTs. Evidence for flexible, scalable, and low-cost interventions could inform population health strategies to promote well-being and reduce psychological distress among pregnant women. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry Number 12620000672954p; http://anzctr.org.au/ACTRN12620000672954p.aspx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/19803.
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Affiliation(s)
- Amy Louise Finlay-Jones
- Telethon Kids Institute, Nedlands, Australia.,Curtin University, Bentley, Australia.,University of Western Australia, Crawley, Australia
| | - Jacqueline Ann Davis
- Telethon Kids Institute, Nedlands, Australia.,Curtin University, Bentley, Australia.,University of Western Australia, Crawley, Australia
| | | | - Keerthi Kottampally
- Telethon Kids Institute, Nedlands, Australia.,University of Western Australia, Crawley, Australia
| | | | - Desiree Silva
- Telethon Kids Institute, Nedlands, Australia.,University of Western Australia, Crawley, Australia.,Edith Cowan University, Joondalup, Australia.,Joondalup Health Campus, Joondalup, Australia
| | | | - Susan L Prescott
- Telethon Kids Institute, Nedlands, Australia.,University of Western Australia, Crawley, Australia.,Perth Children's Hospital, Nedlands, Australia
| | - Jenny Downs
- Telethon Kids Institute, Nedlands, Australia.,Curtin University, Bentley, Australia
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24
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Pundir S, Gridneva Z, Pillai A, Thorstensen EB, Wall CR, Geddes DT, Cameron-Smith D. Human Milk Glucocorticoid Levels Are Associated With Infant Adiposity and Head Circumference Over the First Year of Life. Front Nutr 2020; 7:166. [PMID: 33015131 PMCID: PMC7516011 DOI: 10.3389/fnut.2020.00166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 08/11/2020] [Indexed: 11/17/2022] Open
Abstract
Human milk (HM) is a complex and dynamic biological fluid, which contains appreciable concentrations of the glucocorticoids, cortisol and cortisone. Experimental studies in non-human primates suggest the HM glucocorticoids' impact on infant growth and body composition. In this current study, analysis is made of the relationships between HM glucocorticoid concentrations and the infant growth and development over the first year of life. HM was collected by lactating healthy women (n = 18), using a standardized protocol, at 2, 5, 9, and 12 months after childbirth. Cortisol and cortisone concentrations in the HM were measured using liquid chromatography mass spectrometry. Infant weight, length and head circumference were measured by standard protocols and percentage fat mass (% FM) determined by whole body bioimpedance. Cortisol and cortisone concentrations were unaltered over the analyzed lactation period (2–12 months), and were altered by infant sex. Although, HM cortisol was positively associated with infant percentage fat mass (% FM) (p = 0.008) and cortisone positively associated with infant head circumference (p = 0.01). For the first 12 months of life, the concentration of HM glucocorticoids levels was positively associated with infant adiposity (%FM) and head circumference. This preliminary evidence provides insight to a possible relationship between ingested HM glucocorticoids and infant body composition. Further studies are required to determine the mechanisms regulating HM glucocorticoids.
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Affiliation(s)
- Shikha Pundir
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Avinesh Pillai
- Department of Statistics, The University of Auckland, Auckland, New Zealand
| | - Eric B Thorstensen
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Clare R Wall
- Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - David Cameron-Smith
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
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25
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Shay M, MacKinnon AL, Metcalfe A, Giesbrecht G, Campbell T, Nerenberg K, Tough S, Tomfohr-Madsen L. Depressed mood and anxiety as risk factors for hypertensive disorders of pregnancy: a systematic review and meta-analysis. Psychol Med 2020; 50:2128-2140. [PMID: 32912348 DOI: 10.1017/s0033291720003062] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Psychosocial factors have been implicated as both a cause and consequence of hypertension in the general population but are less understood in relation to hypertensive disorders of pregnancy (HDP). The aims of this review were to (1) synthesize the existing literature examining associations between depression and/or anxiety in pregnancy and HDP and (2) assess if depression and/or anxiety in early pregnancy was a risk factor for HDP. METHODS A comprehensive search of Medline, Embase, CINAHL, and PsycINFO was conducted from inception to March 2020 using terms related to 'pregnancy', 'anxiety', 'depression', and 'hypertensive disorders'. English-language cohort and case-control studies were included if they reported: (a) the presence or absence of clinically significant symptoms of depression/anxiety, or a medical record diagnosis of depression or an anxiety disorder in pregnancy; (b) diagnosis of HDP; and/or (c) data comparing the depressed/anxious group to the non-depressed/anxious group on HDP. Data related to depression/anxiety, HDP, study characteristics, and aspects related to study quality were extracted independently by two reviewers. Random-effects meta-analyses of estimated pooled relative risks (RRs) were conducted for depression/anxiety in pregnancy and HDP. RESULTS In total, 6291 citations were retrieved, and 44 studies were included across 61.2 million pregnancies. Depression and/or anxiety were associated with HDP [RR = 1.39; 95% confidence interval (CI) 1.25-1.54]. CONCLUSIONS When measurement of anxiety or depression preceded diagnosis of hypertension, the association remained (RR = 1.27; 95% CI 1.07-1.50). Women experiencing depression or anxiety in pregnancy have an increased prevalence of HDP compared to their non-depressed or non-anxious counterparts.
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Affiliation(s)
- Matthew Shay
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Anna L MacKinnon
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amy Metcalfe
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gerald Giesbrecht
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Kara Nerenberg
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne Tough
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Caropreso L, Saliba S, Hasegawa L, Lawrence J, Davey CJ, Frey BN. Quality assurance assessment of a specialized perinatal mental health clinic. BMC Pregnancy Childbirth 2020; 20:485. [PMID: 32831041 PMCID: PMC7444031 DOI: 10.1186/s12884-020-03174-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mood and anxiety issues are the main mental health complaints of women during pregnancy and the postpartum period. Services targeting such women can reduce perinatal complications related to psychiatric difficulties. This quality assurance project aimed to examine changes in mood and anxiety symptoms in pregnant and postpartum women referred to the Women’s Health Concerns Clinic (WHCC), a specialized outpatient women’s mental health program. Methods We extracted patient characteristics and service utilization from electronic medical records of women referred between 2015 and 2016. We also extracted admission and discharge scores on the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Results Most patients accessed the WHCC during pregnancy (54%), had a diagnosis of major depressive disorder (54.9%), were prescribed a change in their medication or dose (61.9%), and accessed psychotherapy for perinatal anxiety (30.1%). There was a significant decrease in EPDS scores between admission and discharge (t(214) = 11.57; p = .000; effect size d = .86), as well as in GAD-7 scores (t(51) = 3.63; p = .001; effect size d = .61). A secondary analysis showed that patients with more severe depression and anxiety symptoms demonstrated even greater effect sizes. Conclusions Changes in EPDS and GAD-7 scores indicate that the WHCC is effective in reducing mood and anxiety symptoms associated with the perinatal period. This project highlights the importance of quality assurance methods in evaluating the effectiveness of clinical services targeting perinatal mental health, in order to inform policy and funding strategies.
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Affiliation(s)
- Luisa Caropreso
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Sarah Saliba
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Hasegawa
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jack Lawrence
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Caitlin J Davey
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St Joseph's Healthcare Hamilton, 100 West 5th St., Suite C124, Hamilton, Ontario, L8N 3K7, Canada
| | - Benicio N Frey
- Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada. .,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. .,Mood Disorders Program, St Joseph's Healthcare Hamilton, 100 West 5th St., Suite C124, Hamilton, Ontario, L8N 3K7, Canada.
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Vehmeijer FOL, Balkaran SR, Santos S, Gaillard R, Felix JF, Hillegers MHJ, El Marroun H, Jaddoe VWV. Psychological Distress and Weight Gain in Pregnancy: a Population-Based Study. Int J Behav Med 2020; 27:30-38. [PMID: 31853868 PMCID: PMC7058670 DOI: 10.1007/s12529-019-09832-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Psychological distress and inappropriate or excessive weight gain are common in pregnancy and are associated with adverse maternal and offspring outcomes. Psychological well-being and weight status of women during pregnancy might be interrelated. We aimed to examine whether psychological distress during pregnancy is associated with gestational weight gain. Method In a population-based cohort of 3393 pregnant women, information about psychological distress, depressive and anxiety symptoms was assessed at 20 weeks of gestation using the Brief Symptom Inventory questionnaire. Weight was repeatedly measured during pregnancy and obtained by questionnaire before and after pregnancy. Linear regression and multinomial logistic regression models were used. Weight gain in the second half of pregnancy, total weight gain, and the risks of inadequate and excessive total weight gain were the main outcome measures. Results In total, 7.0% of all women experienced psychological distress. Overall psychological distress and anxiety were associated with lower weight gain in the second half of pregnancy (differences − 1.00 kg (95% confidence interval (CI) − 1.62, − 0.37) and − 0.68 kg (95% CI - 1.24, -0.11), respectively). These associations fully attenuated into non-significance after taking account for socio-demographic variables. Similar results were observed for total weight gain. Only women with anxiety symptoms had, independently of potential confounders, a lower risk of excessive weight gain (odds ratio (OR) 0.61 (95% CI 0.48, 0.91)). Conclusions In this large prospective cohort study, the observed associations of psychological distress with weight gain during pregnancy seem to be largely explained by common socio-demographic factors. Electronic supplementary material The online version of this article (10.1007/s12529-019-09832-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Florianne O L Vehmeijer
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sangeeta R Balkaran
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Hanan El Marroun
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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Alikamali M, Khodabandeh S, Motesaddi M, Bagheri Z, Esmaeili MA. The Association Between Demographic Characteristics and Attempting of Pregnancy with Postpartum Depression and Anxiety Among Women Referring to Community Health Centres: A Cross Sectional Study. Malays J Med Sci 2020; 27:93-104. [PMID: 32684810 PMCID: PMC7337948 DOI: 10.21315/mjms2020.27.3.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 05/08/2020] [Indexed: 12/02/2022] Open
Abstract
Background Postpartum depression (PPD) and anxiety are considered as a risk factor for mother and infant health. Therefore, the present study aims to explore the association between demographic characteristics and pregnancies with PPD and anxiety. Methods A cross-sectional study was conducted on 400 Iranian women referring to health centres of the Zarand City four weeks to six months from the date of their childbirth, in the first half of 2018. Result The results showed that employed women with pregnancies who were categorised as depression and anxiety were more likely to have low gestational age, food insecurity, several deliveries, cesarean delivery and unintended pregnancy as well as they were not satisfied with their infant’s gender. Also, women with several deliveries had lower risk for PPD before and after adjustment for confounders (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.88–0.97, P < 0.001) and had lower risk for postpartum anxiety only after adjustment for confounders (OR = 0.82, 95% CI: 0.75–0.89, P < 0.001). Conclusion Eventually, demographic characteristics and attempting of pregnancy were independently associated with PPD and postpartum anxiety in women. There need to be more social and governmental support of employed women after delivery to decrease their occupational stresses to deal with PPD and anxiety in the studied population.
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Affiliation(s)
- Maryam Alikamali
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Maryam Motesaddi
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Zeinab Bagheri
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
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The effect of consuming milk and related products during human pregnancy over birth weight and perinatal outcomes: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 251:235-245. [PMID: 32554191 DOI: 10.1016/j.ejogrb.2020.05.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Data addressing the effect of milk and related products (M&RPs) on fetal growth are contradictory. The aim was to meta-analyze the effect of consuming M&RPs during human pregnancy over perinatal outcomes. METHOD A systematic literature search was performed in PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library. Eligibility criteria for selection were: studies evaluating the effect of consuming M&RPs during pregnancy over birth weight and different perinatal outcomes. Random effect models were used for meta-analyses, and effects are reported as mean differences (MD) or odds ratio (OR) and their 95 % confidence intervals (CIs). RESULTS Fourteen studies (111,184 pregnant women) reported on the targeted perinatal outcomes. The meta-analysis of ten studies revealed a positive association between consuming a higher amount of M&RPs and birth weight (MD =51.0 g, 95 % CI 24.7-77.3), whereas in five studies a positive effect was observed on infant length (MD =0.33 cm, 95 % CI: 0.03-0.64). The higher birth weight was detected both in Western world gravids, consuming standard/conventional diets, as well as in vegetarian women from India. There were no significant differences in ultrasound measured fetal head circumference, biparietal diameter, abdominal circumference and femur length. The consumption of a higher amount of M&RPs was associated with a reduced risk of small-for-gestational age (SGA) (OR = 0.69, 95 % CI: 0.56-0.84) and low birth weight infants (OR = 0.63, 95 % CI: 0.48-0.84); in addition to a higher risk of large-for-gestational age (LGA) infants (OR = 1.11, 95 % CI: 1.02-1.21). CONCLUSION The consumption of a higher amount of M&RPs during pregnancy was associated with greater infant birth weight and length; in addition to a lower risk of having SGA and low birth weight infants, and a higher risk of LGA infants.
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30
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Peñalver Bernabé B, Maki PM, Dowty SM, Salas M, Cralle L, Shah Z, Gilbert JA. Precision medicine in perinatal depression in light of the human microbiome. Psychopharmacology (Berl) 2020; 237:915-941. [PMID: 32065252 DOI: 10.1007/s00213-019-05436-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/11/2019] [Indexed: 12/17/2022]
Abstract
Perinatal depression is the most common complication of pregnancy and affects the mother, fetus, and infant. Recent preclinical studies and a limited number of clinical studies have suggested an influence of the gut microbiome on the onset and course of mental health disorders. In this review, we examine the current state of knowledge regarding genetics, epigenetics, heritability, and neuro-immuno-endocrine systems biology in perinatal mood disorders, with a particular focus on the interaction between these factors and the gut microbiome, which is mediated via the gut-brain axis. We also provide an overview of experimental and analytical methods that are currently available to researchers interested in elucidating the influence of the gut microbiome on mental health disorders during pregnancy and postpartum.
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Affiliation(s)
- Beatriz Peñalver Bernabé
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States.
| | - Pauline M Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL, USA
| | - Shannon M Dowty
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Mariana Salas
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Lauren Cralle
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Zainab Shah
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Jack A Gilbert
- Scripts Oceanographic Institute, University of California San Diego, La Jolla, CA, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA
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31
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Savory K, Garay S, Sumption L, Kelleher J, Daughters K, Janssen A, Van Goozen S, John R. Prenatal symptoms of anxiety and depression associated with sex differences in both maternal perceptions of one year old infant temperament and researcher observed infant characteristics. J Affect Disord 2020; 264:383-392. [PMID: 32056774 PMCID: PMC7005670 DOI: 10.1016/j.jad.2019.11.057] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/29/2019] [Accepted: 11/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sex differences in the behaviour of children exposed to prenatal maternal depression and anxiety have been reported. This study compared depression and anxiety symptoms reported by mothers at term with maternal perceptions of one year old male and female infant temperament and with researcher observed infant characteristics, identifying differences for males and females with both approaches. METHODS Infant behaviour and temperament was assessed via maternally completed questionnaires including Infant Behavioural Questionnaire Revised - Short form and by researcher administered subcomponents of Laboratory Temperament Assessment Battery and Bayley Scales of Infant Development III. RESULTS For female infants, higher prenatal scores for depression and anxiety were associated with maternal perceptions of lower bonding, higher aggression and negativity, and lower soothability (n = 67 mother-infant dyads). In the laboratory assessment, intensity of escape was the only female infant factor significantly associated with maternal mood (n = 41). For male infants, there was minimal association between prenatal mood scores and maternal perceptions (n = 46) whereas in the laboratory assessment (n = 35) depression scores were associated with expressive language, facial interest and facial fear while anxiety scores were associated with expressive and receptive language, parent behaviour and facial fear. LIMITATIONS Findings may be restricted to a single ethnicity or mode of delivery. Fewer infants attended the infant assessment. A laboratory setting may mask symptomatology in females. CONCLUSIONS Atypical maternal perceptions may present a barrier to the early identification of male infants impacted by maternal depression and anxiety.
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Affiliation(s)
- K. Savory
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX United Kingdom
| | - S.M. Garay
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX United Kingdom
| | - L.A. Sumption
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX United Kingdom
| | - J.S. Kelleher
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX United Kingdom
| | - K. Daughters
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, CF24 4HQ United Kingdom
| | - A.B. Janssen
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX United Kingdom
| | - S. Van Goozen
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, CF10 3AT United Kingdom
| | - R.M. John
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX United Kingdom,Corresponding author.
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Vehmeijer FOL, C V Silva C, Derks IPM, El Marroun H, Oei EHG, Felix JF, Jaddoe VWV, Santos S. Associations of Maternal Psychological Distress during Pregnancy with Childhood General and Organ Fat Measures. Child Obes 2019; 15:313-322. [PMID: 31058541 DOI: 10.1089/chi.2018.0300] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Psychological distress during pregnancy may influence offspring adiposity. No studies assessed the associations with organ fat measures. We examined the associations of maternal psychological distress, depression, and anxiety during pregnancy with child general and organ fat measures. Methods: In 4161 mother-offspring pairs, psychological distress was self-reported in pregnancy. We obtained general fat measures, including BMI and fat mass index by dual-energy X-ray absorptiometry, and organ fat measures (in a subsample of 2447 children), including subcutaneous, visceral, and pericardial fat indices and liver fat fraction by magnetic resonance imaging at 10 years. Linear and logistic regression models were used. Results: Children of mothers with psychological distress had higher fat mass index [difference 0.14 (95% confidence interval {CI} 0.04-0.24) standard deviation scores (SDS)] and higher risk of obesity [odds ratio (OR) 1.73 (95% CI 1.09-2.74)]. Maternal anxiety was associated with higher BMI [difference 0.16 (95% CI 0.05-0.26) SDS], fat mass index [difference 0.19 (95% CI 0.10-0.28) SDS], and higher risks of overweight and obesity [OR 1.36 (95% CI 1.03-1.81), 1.78 (95% CI 1.13-2.81)]. Maternal anxiety was associated with higher subcutaneous and visceral fat indices and liver fat fraction [differences 0.16 (95% CI 0.03-0.29), 0.15 (95% CI 0.01-0.29), and 0.16 (95% CI 0.02-0.29) SDS]. No associations were observed for maternal depression. Conclusions: Psychological distress and anxiety, but not depression, during pregnancy were associated with higher child general and organ fat measures. A healthy mental state during pregnancy may be important for preventing child adiposity.
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Affiliation(s)
- Florianne O L Vehmeijer
- 1 The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carolina C V Silva
- 1 The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ivonne P M Derks
- 1 The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,4 Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hanan El Marroun
- 1 The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,4 Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Edwin H G Oei
- 5 Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Janine F Felix
- 1 The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- 1 The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,2 Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Susana Santos
- 1 The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,3 Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Silva CCV, Vehmeijer FOL, El Marroun H, Felix JF, Jaddoe VWV, Santos S. Maternal psychological distress during pregnancy and childhood cardio-metabolic risk factors. Nutr Metab Cardiovasc Dis 2019; 29:572-579. [PMID: 30956027 DOI: 10.1016/j.numecd.2019.02.008] [Citation(s) in RCA: 11] [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: 11/08/2018] [Revised: 02/13/2019] [Accepted: 02/26/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Previous studies suggest that psychological distress during pregnancy may lead to fetal developmental adaptations, which programme cardio-metabolic disease of the offspring. We examined the associations of maternal overall psychological distress, depression and anxiety during pregnancy with cardio-metabolic risk factors in 10-year-old children and explore potential sex-specific differences. METHODS AND RESULTS In a population-based prospective cohort study among 4,088 mothers and their children, information about overall psychological distress, including depression and anxiety was obtained through the Brief Symptom Inventory during pregnancy. We measured child blood pressure and heart rate and insulin, glucose, serum lipids and C-reactive protein blood concentrations at 10 years. Analyses were performed in the total group and in boys and girls separately. Psychological distress during pregnancy was associated with higher childhood heart rate among boys only (differences 0.34 (95% Confidence Interval (CI) 0.18, 0.50) standard deviation scores (SDS), 0.22 (95% CI 0.06, 0.38) SDS, 0.33 (95% CI 0.19, 0.48) SDS, for overall psychological distress, depression and anxiety, respectively). Maternal anxiety during pregnancy was associated with higher childhood triglycerides among girls (difference 0.35 (95% CI 0.17, 0.53) SDS). Maternal psychological distress was not associated with childhood blood pressure, cholesterol, insulin, glucose and C-reactive protein concentrations. CONCLUSIONS Maternal psychological distress may influence their offspring heart rate and triglycerides concentrations. Further studies are needed to replicate these findings and assess the long-term cardio-metabolic consequences of maternal psychological distress.
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Affiliation(s)
- C C V Silva
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands
| | - F O L Vehmeijer
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, the Netherlands
| | - H El Marroun
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, the Netherlands; Erasmus University Rotterdam, Department of Psychology, Education and Child Studies, Rotterdam, the Netherlands
| | - J F Felix
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, the Netherlands
| | - V W V Jaddoe
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, the Netherlands.
| | - S Santos
- Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, Rotterdam, the Netherlands
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Cardenas A, Faleschini S, Cortes Hidalgo A, Rifas-Shiman SL, Baccarelli AA, DeMeo DL, Litonjua AA, Neumann A, Felix JF, Jaddoe VWV, El Marroun H, Tiemeier H, Oken E, Hivert MF, Burris HH. Prenatal maternal antidepressants, anxiety, and depression and offspring DNA methylation: epigenome-wide associations at birth and persistence into early childhood. Clin Epigenetics 2019; 11:56. [PMID: 30925934 PMCID: PMC6441191 DOI: 10.1186/s13148-019-0653-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Maternal mood disorders and their treatment during pregnancy may have effects on the offspring epigenome. We aim to evaluate associations of maternal prenatal antidepressant use, anxiety, and depression with cord blood DNA methylation across the genome at birth and test for persistence of associations in early and mid-childhood blood DNA. METHODS A discovery phase was conducted in Project Viva, a prospective pre-birth cohort study with external replication in an independent cohort, the Generation R Study. In Project Viva, pregnant women were recruited between 1999 and 2002 in Eastern Massachusetts, USA. In the Generation R Study, pregnant women were recruited between 2002 and 2006 in Rotterdam, the Netherlands. In Project Viva, 479 infants had data on maternal antidepressant use, anxiety, depression, and cord blood DNA methylation, 120 children had DNA methylation measured in early childhood (~ 3 years), and 460 in mid-childhood (~ 7 years). In the Generation R Study, 999 infants had data on maternal antidepressants and cord blood DNA methylation. The prenatal antidepressant prescription was obtained from medical records. At-mid pregnancy, symptoms of anxiety and depression were assessed with the Pregnancy-Related Anxiety Scale and the Edinburgh Postnatal Depression Scale in Project Viva and with the Brief Symptom Inventory in the Generation R Study. Genome-wide DNA methylation was measured using the Infinium HumanMethylation450 BeadChip in both cohorts. RESULTS In Project Viva, 2.9% (14/479) pregnant women were prescribed antidepressants, 9.0% (40/445) experienced high pregnancy-related anxiety, and 8.2% (33/402) reported symptoms consistent with depression. Newborns exposed to antidepressants in pregnancy had 7.2% lower DNA methylation (95% CI, - 10.4, - 4.1; P = 1.03 × 10-8) at cg22159528 located in the gene body of ZNF575, and this association replicated in the Generation R Study (β = - 2.5%; 95% CI - 4.2, - 0.7; P = 0.006). In Project Viva, the association persisted in early (β = - 6.2%; 95% CI - 10.7, - 1.6) but not mid-childhood. We observed cohort-specific associations for maternal anxiety and depression in Project Viva that did not replicate. CONCLUSIONS The ZNF575 gene is involved in transcriptional regulation but specific functions are largely unknown. Given the widespread use of antidepressants in pregnancy, as well as the effects of exposure to anxiety and depression, implications of potential fetal epigenetic programming by these risk factors and their impacts on development merit further investigation.
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Affiliation(s)
- Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA USA
| | | | - Andrea Cortes Hidalgo
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA USA
| | - Andrea A. Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Dawn L. DeMeo
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Augusto A. Litonjua
- Division of Pediatric Pulmonary Medicine, University of Rochester Medical Center, Rochester, NY USA
| | - Alexander Neumann
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Janine F. Felix
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Vincent W. V. Jaddoe
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC – Sophia Children’s Hospital, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Emily Oken
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA USA
| | - Heather H. Burris
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
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Bellido-González M, Robles-Ortega H, Castelar-Ríos MJ, Díaz-López MÁ, Gallo-Vallejo JL, Moreno-Galdó MF, de Los Santos-Roig M. Psychological distress and resilience of mothers and fathers with respect to the neurobehavioral performance of small-for-gestational-age newborns. Health Qual Life Outcomes 2019; 17:54. [PMID: 30922371 PMCID: PMC6437857 DOI: 10.1186/s12955-019-1119-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 03/11/2019] [Indexed: 01/04/2023] Open
Abstract
Background The existence of psychological distress (PD) during pregnancy is well established. Nevertheless, few studies have analyzed the PD and resilience of mothers and fathers during high-risk pregnancy. This study analyzes the differences between parents’ PD and resilience and the relation between them and the neurobehavioral performance of their SGA newborns. Methods This prospective study compares two groups of parents and newborns: case group (52 parents and 26 SGA fetuses) and comparison group (68 parents and 34 appropriate-for-gestational-age, AGA, fetuses). In each group, the parents were evaluated during the last trimester of pregnancy, to obtain standardized measures of depression, stress, anxiety, and resilience. At 40 ± 1 weeks corrected gestational age, psychologists evaluated the state of neonatal neuromaturity achieved. Results Multivariate analysis of variance showed, in gender comparisons, that mothers obtained higher scores than fathers for psychological distress but lower ones for resilience. Similar differences were obtained in the comparison of parents’ distress to intrauterine growth by SGA vs. AGA newborns. Mothers of SGA newborns were more distressed than the other groups. However, there were no differences between the fathers of SGA vs. AGA newborns. Regarding neurobehavioral performance, the profiles of SGA newborns reflected a lower degree of maturity than those of AGA newborns. Hierarchical regression analyses showed that high stress and low resilience among mothers partially predict low neurobehavioral performance in SGA newborns. Conclusions These findings indicate that mothers of SGA newborns may need psychological support to relieve stress and improve their resilience. Furthermore, attention should be paid to the neurobehavioral performance of their babies in case early attention is needed.
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Affiliation(s)
- Mercedes Bellido-González
- Department of Developmental Psychology and Education, Faculty of Education Sciences, University of Granada, Granada, Spain. .,Department of Developmental Psychology and Education, Faculty of Education Sciences, University of Granada, Campus de Cartuja, 18071, Granada, Spain.
| | - Humbelina Robles-Ortega
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - María José Castelar-Ríos
- Department of Developmental Psychology and Education, Faculty of Education Sciences, University of Granada, Granada, Spain
| | | | | | | | - Macarena de Los Santos-Roig
- Department of Methodology of Behavioral Sciences, Faculty of Psychology, University of Granada, Granada, Spain
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Faleschini S, Rifas-Shiman SL, Tiemeier H, Oken E, Hivert MF. Associations of Prenatal and Postnatal Maternal Depressive Symptoms with Offspring Cognition and Behavior in Mid-Childhood: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061007. [PMID: 30897718 PMCID: PMC6466510 DOI: 10.3390/ijerph16061007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/15/2019] [Accepted: 03/18/2019] [Indexed: 12/23/2022]
Abstract
Exposure to maternal depressive symptoms in the peri-pregnancy periods may be associated with poorer child development, but research is often limited to only maternal assessments of behavior and cognition. This study investigates the specific periods of prenatal and postnatal exposure to maternal depressive symptoms in association with child development using reports from teachers and mothers. This study is based on 1225 mother–child pairs from Project Viva, a prospective pre-birth cohort study. Mothers reported depressive symptoms on the Edinburgh Postpartum Depression Scale (EPDS) in mid-pregnancy as well as at 6 months and 12 months postpartum. Teachers and mothers reported child executive functions using the Behavioral Rating Inventory of Executive Function (BRIEF) and behavior using the Strengths and Difficulties Questionnaire (SDQ). Children completed the Kaufman Brief Intelligence Test (KBIT-2), the Wide Range Assessment of Visual Motor Abilities (WRAVMA), and the Visual Memory Index of the Wide Range Assessment of Memory and Learning (WRAML). We used multivariable linear regression models to examine associations of prenatal and postpartum depressive symptoms with outcomes. Many of the crude associations observed were attenuated after adjusting for demographic factors and maternal IQ, yet some remained significant. For example, high prenatal maternal depressive symptoms were associated with poorer scores on the BRIEF Behavior Regulation Index and some SDQ scales based on reports from teachers and mothers. High prenatal maternal depressive symptoms were associated with poorer behavioral development. Postpartum symptoms did not show strong associations with outcomes once we adjusted for the prenatal period.
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Affiliation(s)
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA.
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA.
- Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
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Wisner KL, Sit D, O’Shea K, Bogen DL, Clark CT, Pinheiro E, Yang A, Ciolino JD. Bipolar disorder and psychotropic medication: Impact on pregnancy and neonatal outcomes. J Affect Disord 2019; 243:220-225. [PMID: 30248632 PMCID: PMC6548542 DOI: 10.1016/j.jad.2018.09.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/29/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The hypotheses were: (1) pregnant women with bipolar disorder (BD) have less favorable pregnancy outcomes than unaffected women, and (2) psychotropic treated women with BD have better outcomes than un-medicated women. METHOD This prospective study included 174 mother-infant dyads. Women had BD without psychotropic exposure (BD-NP, n = 38), BD with psychotropic treatment (BD-P, n = 49), or neither psychotropic exposure nor major mood disorder (Comp, n = 87). Maternal characteristics were completed at 20 weeks gestation and evaluated for associations with delivery and birth outcomes. We performed multiple regressions on infant outcomes with adjustment for maternal age, race, employment status, use of illicit drugs and pre-pregnancy BMI. RESULTS The BP-P, BP-NP and Comp groups varied significantly on sociodemographic characteristics. Women with BD were more likely to be less educated, unemployed, single, and use tobacco and illicit drugs than women in the Comp group. Compared to women with BD-NP, women with BD-P were more likely to be older and educated. Approximately 10% of all infants were delivered preterm. No significant differences in outcome occurred for APGAR scores < 8, NICU admissions, sex or infant length. Infants of mothers with BD-NP had significantly smaller head circumferences (HC) than the other groups, adjustment for confounding variables mitigated this association. CONCLUSIONS The overall pregnancy outcomes for women with BD were similar to those in the Comp group. The reduced HC in women with untreated BD appears due to factors related to disadvantaged sociodemographic status, a higher proportion of female births, and/or a protective effect of medication in the BD-P group.
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Affiliation(s)
- Katherine L. Wisner
- Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Asher Center for the Study and Treatment of Depressive Disorders, Northwestern University, Chicago, IL, USA,Corresponding author. (K.L. Wisner)
| | - Dorothy Sit
- Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Asher Center for the Study and Treatment of Depressive Disorders, Northwestern University, Chicago, IL, USA
| | - Kelly O’Shea
- Department of Psychiatry and Behavioral Sciences, Asher Center for the Study and Treatment of Depressive Disorders, Northwestern University, Chicago, IL, USA
| | - Debra L. Bogen
- Professor of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Crystal T. Clark
- Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Asher Center for the Study and Treatment of Depressive Disorders, Northwestern University, Chicago, IL, USA
| | | | - Amy Yang
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Jody D. Ciolino
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
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McNamara GI, Creeth HDJ, Harrison DJ, Tansey KE, Andrews RM, Isles AR, John RM. Loss of offspring Peg3 reduces neonatal ultrasonic vocalizations and increases maternal anxiety in wild-type mothers. Hum Mol Genet 2019; 27:440-450. [PMID: 29186532 PMCID: PMC5886183 DOI: 10.1093/hmg/ddx412] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 11/21/2017] [Indexed: 12/22/2022] Open
Abstract
Depression and anxiety are the most common mental health conditions during pregnancy and can impair the normal development of mother-infant interactions. These adversities are associated with low birth weight and increased risk of behavioural disorders in children. We recently reported reduced expression of the imprinted gene PATERNALLY EXPRESSED GENE 3 (PEG3) in placenta of human infants born to depressed mothers. Expression of Peg3 in the brain has previously been linked maternal behaviour in rodents, at least in some studies, with mutant dams neglecting their pups. However, in our human study decreased expression was in the placenta derived from the fetus. Here, we examined maternal behaviour in response to reduced expression of Peg3 in the feto-placental unit. Prenatally we found novelty reactivity was altered in wild-type females carrying litters with a null mutation in Peg3. This behavioural alteration was short-lived and there were no significant differences the transcriptomes of either the maternal hypothalamus or hippocampus at E16.5. In contrast, while maternal gross maternal care was intact postnatally, the exposed dams were significantly slower to retrieve their pups and displayed a marked increase in anxiety. We also observed a significant reduction in the isolation-induced ultrasonic vocalizations (USVs) emitted by mutant pups separated from their mothers. USVs are a form of communication known to elicit maternal care suggesting Peg3 mutant pups drive the deficit in maternal behaviour. These data support the hypothesis that reduced placental PEG3 in human pregnancies occurs as a consequence of prenatal depression but leaves scope for feto-placental Peg3 dosage, during gestation, influencing aspects of maternal behaviour.
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Affiliation(s)
- G I McNamara
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
| | - H D J Creeth
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
| | - D J Harrison
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
| | - K E Tansey
- Core Bioinformatics and Statistics Team, College of Biomedical & Life Sciences
| | - R M Andrews
- Systems Immunity University Research Institute, Cardiff University, Cardiff CF10 3XQ, UK
| | - A R Isles
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK
| | - R M John
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
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Tsakiridis I, Dagklis T, Zerva C, Mamopoulos A, Athanasiadis A, Papazisis G. Depression in pregnant women hospitalized due to intrauterine growth restriction: Prevalence and associated factors. Midwifery 2018; 70:71-75. [PMID: 30584971 DOI: 10.1016/j.midw.2018.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/12/2018] [Accepted: 12/11/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Pregnancies complicated with intrauterine growth restriction (IUGR) may require hospitalization in a high-risk pregnancy unit (HRPU). A complicated pregnancy and hospital admission may negatively affect the pregnant woman's mental health. Several factors have been identified as possible risk factors for depression, which is proven to lead to several adverse perinatal outcomes. The purpose of this study was to screen for depression in women admitted to an HRPU due to IUGR pregnancy and also to identify associated risk factors. STUDY DESIGN All pregnant women admitted at ≥ 24 gestational weeks with the diagnosis of IUGR were eligible for the study. The Greek version of the Edinburgh Postnatal Depression Scale was used as screening tool on admission. A cut-off score ≥ 13 was used to identify depression, while possible risk factors were also investigated. RESULTS Overall, 73 women were eligible for the study and agreed to complete the questionnaire. The mean age of the pregnant women was 31.4 ± 6.7 years and the mean gestational week at admission was 33.6 ± 2.9 weeks. The prevalence of depressive symptoms (score ≥ 13) was 32.9% (24/73). In the multivariable model, depressive symptoms were significantly correlated with lower gestational age (OR: 3.459 95%CI: 1.124-10.648) and smoking during pregnancy (OR: 3.926 95% CI: 1.141-13.507). CONCLUSIONS About one third of pregnant women hospitalized in the HRPU with IUGR pregnancies showed signs of depression at the time of admission. Early-IUGR and smoking were found to be associated with antenatal depressive symptoms.
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Affiliation(s)
- Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Christina Zerva
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece; Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Apostolos Mamopoulos
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Apostolos Athanasiadis
- 3rd Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Greece.
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Lifestyle intervention strategies in early life to improve pregnancy outcomes and long-term health of offspring: a narrative review. J Dev Orig Health Dis 2018; 10:314-321. [PMID: 30409238 DOI: 10.1017/s2040174418000855] [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: 11/06/2022]
Abstract
Adverse exposures during fetal life and the postnatal period influence physical, cognitive and emotional development, and predispose to an increased risk of various chronic diseases throughout the life course. Findings from large observational studies in various populations and experimental animal studies have identified different modifiable risk factors in early life. Adverse maternal lifestyle factors, including overweight, unhealthy diet, sedentary behavior, smoking, alcohol consumption and stress in the preconception period and during pregnancy, are the most common modifiable risk factors leading to a suboptimal in-utero environment for fetal development. In the postnatal period, breastfeeding, infant growth and infant dietary intake are important modifiable factors influencing long-term offspring health outcomes. Despite the large amount of findings from observational studies, translation to lifestyle interventions seems to be challenging. Currently, randomized controlled trials focused on the influence of lifestyle interventions in these critical periods on short-term and long-term maternal and offspring health outcomes are scarce, have major limitations and do not show strong effects on maternal and offspring outcomes. New and innovative approaches are needed to move from describing these causes of ill-health to start tackling them using intervention approaches. Future randomized controlled lifestyle intervention studies and innovative observational studies, using quasi-experimental designs, are needed focused on the effects of an integrated lifestyle advice from preconception onwards on pregnancy outcomes and long-term health outcomes in offspring on a population level.
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Maternal psychological distress during pregnancy and childhood health outcomes: a narrative review. J Dev Orig Health Dis 2018; 10:274-285. [PMID: 30378522 DOI: 10.1017/s2040174418000557] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Maternal psychological distress is common in pregnancy and may influence the risk of adverse outcomes in children. Psychological distress may cause a suboptimal intrauterine environment leading to growth and developmental adaptations of the fetus and child. In this narrative review, we examined the influence of maternal psychological distress during pregnancy on fetal outcomes and child cardiometabolic, respiratory, atopic and neurodevelopment-related health outcomes. We discussed these findings from an epidemiological and life course perspective and provided recommendations for future studies. The literature in the field of maternal psychological distress and child health outcomes is extensive and shows that exposure to stress during pregnancy is associated with multiple adverse child health outcomes. Because maternal psychological distress is an important and potential modifiable factor during pregnancy, it should be a target for prevention strategies in order to optimize fetal and child health. Future studies should use innovative designs and strategies in order to address the issue of causality.
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Maternal socioeconomic factors and the risk of premature birth and low birth weight in Cyprus: a case-control study. Reprod Health 2018; 15:157. [PMID: 30231873 PMCID: PMC6146509 DOI: 10.1186/s12978-018-0603-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/12/2018] [Indexed: 11/14/2022] Open
Abstract
Background Prematurity and low birth weight are significant predictors of perinatal morbidity and mortality and are influenced by the overall health and socioeconomic status of the pregnant mother. Although Cyprus is characterized by the highest prematurity rate in Europe (13.1% in 2014), the relationship between maternal health and socioeconomic characteristics with prematurity and low birth weight has never been investigated. We aimed to investigate the association of maternal demographic, clinical and socioeconomic characteristics with premature delivery and low neonatal birth weight in Cyprus. Methods In a case-control design, questionnaire data were collected from 348 women who gave birth prematurely (cases) and 349 women who gave birth at term (controls). Information was obtained on gestation duration and birth weight as well as maternal demographic, socioeconomic and clinical profiles, including parameters such as smoking, body mass index, alcohol consumption, presence of gestational diabetes and mental health factors. Results Premature delivery was associated with greater maternal age (OR: 1.12, 95% CI: 1.06–1.18), absence of gestational diabetes (OR: 0.53, 95% CI: 0.30–0.97), long working hours (OR: 3.77, 95% CI: 2.08–6.84) and emotional stress (OR: 8.5, 95% CI: 3.03–23.89). Within the cases group, emotional stress was also associated with lower birth-weight (β: -323.68 (95% CI: -570.36, − 77.00). Conclusions The findings of this study demonstrate the positive association of maternal psychological factors, working conditions as well as maternal age with prematurity and low birth weight in Cyprus. Additional, prospective, studies are needed in the country to further investigate these associations and inform public health intervention measures. Electronic supplementary material The online version of this article (10.1186/s12978-018-0603-7) contains supplementary material, which is available to authorized users.
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Janssen AB, Savory KA, Garay SM, Sumption L, Watkins W, Garcia-Martin I, Savory NA, Ridgway A, Isles AR, Penketh R, Jones IR, John RM. Persistence of anxiety symptoms after elective caesarean delivery. BJPsych Open 2018; 4:354-360. [PMID: 30202597 PMCID: PMC6127961 DOI: 10.1192/bjo.2018.48] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/05/2018] [Accepted: 07/16/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In the UK, 11.8% of expectant mothers undergo an elective caesarean section (ELCS) representing 92 000 births per annum. It is not known to what extent this procedure has an impact on mental well-being in the longer term. AIMS To determine the prevalence and postpartum progression of anxiety and depression symptoms in women undergoing ELCS in Wales. METHOD Prevalence of depression and anxiety were determined in women at University Hospital Wales (2015-16; n = 308) through completion of the Edinburgh Postnatal Depression Scale (EPDS; ≥13) and State-Trait Anxiety Inventory (STAI; ≥40) questionnaires 1 day prior to ELCS, and three postpartum time points for 1 year. Maternal characteristics were determined from questionnaires and, where possible, confirmed from National Health Service maternity records. RESULTS Using these criteria the prevalence of reported depression symptoms was 14.3% (95% CI 10.9-18.3) 1 day prior to ELCS, 8.0% (95% CI 4.2-12.5) within 1 week, 8.7% (95% CI 4.2-13.8) at 10 weeks and 12.4% (95% CI 6.4-18.4) 1 year postpartum. Prevalence of reported anxiety symptoms was 27.3% (95% CI 22.5-32.4), 21.7% (95% CI 15.8-28.0), 25.3% (95% CI 18.5-32.7) and 35.1% (95% CI 26.3-44.2) at these same stages. Prenatal anxiety was not resolved after ELCS more than 1 year after delivery. CONCLUSIONS Women undergoing ELCS experience prolonged anxiety postpartum that merits focused clinical attention. DECLARATION OF INTEREST None.
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Affiliation(s)
- Anna B Janssen
- Research Associate, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - Katrina A Savory
- Research Assistant, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - Samantha M Garay
- PhD student, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - Lorna Sumption
- PhD student, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - William Watkins
- Statistician, Infection and Immunity Team Bioinformatics and Statistics, College of Biomedical & Life Sciences, Cardiff University, UK
| | - Isabel Garcia-Martin
- PhD student, Biomedicine Division, School of Biosciences, Cardiff University, UK
| | - Nicola A Savory
- Research Midwife, Department of Obstetrics and Gynaecology, University Hospital Wales, UK
| | - Anouk Ridgway
- Research Midwife, Department of Obstetrics and Gynaecology, University Hospital Wales, UK
| | - Anthony R Isles
- Professor, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK
| | - Richard Penketh
- Consultant Obstetrician and Gynaecologist, Department of Obstetrics and Gynaecology, University Hospital Wales, UK
| | - Ian R Jones
- Professor, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, UK
| | - Rosalind M John
- Professor, Biomedicine Division, School of Biosciences, Cardiff University, UK
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Brunst KJ, Tignor N, Just A, Liu Z, Lin X, Hacker MR, Bosquet Enlow M, Wright RO, Wang P, Baccarelli AA, Wright RJ. Cumulative lifetime maternal stress and epigenome-wide placental DNA methylation in the PRISM cohort. Epigenetics 2018; 13:665-681. [PMID: 30001177 DOI: 10.1080/15592294.2018.1497387] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Evolving evidence links maternal stress exposure to changes in placental DNA methylation of specific genes regulating placental function that may have implications for the programming of a host of chronic disorders. Few studies have implemented an epigenome-wide approach. Using the Infinium HumanMethylation450 BeadChip (450K), we investigated epigenome-wide placental DNA methylation in relation to maternal experiences of traumatic and non-traumatic stressors over her lifetime assessed using the Life Stressor Checklist-Revised (LSC-R) survey (n = 207). We found differential DNA methylation at epigenome-wide statistical significance (FDR = 0.05) for 112 CpGs. Additionally, we observed three clusters that exhibited differential methylation in response to high maternal lifetime stress. Enrichment analyses, conducted at an FDR = 0.20, revealed lysine degradation to be the most significant pathway associated with maternal lifetimes stress exposure. Targeted enrichment analyses of the three largest clusters of probes, identified using the gap statistic, were enriched for genes associated with endocytosis (i.e., SMAP1, ANKFY1), tight junctions (i.e., EPB41L4B), and metabolic pathways (i.e., INPP5E, EEF1B2). These pathways, also identified in the top 10 KEGG pathways associated with maternal lifetime stress exposure, play important roles in multiple physiological functions necessary for proper fetal development. Further, two genes were identified to exhibit multiple probes associated with maternal lifetime stress (i.e., ANKFY1, TM6SF1). The methylation status of the probes belonging to each cluster and/or genes exhibiting multiple hits, may play a role in the pathogenesis of adverse health outcomes in children born to mothers with increased lifetime stress exposure.
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Affiliation(s)
- Kelly J Brunst
- a Department of Environmental Health , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Nicole Tignor
- b Icahn Institute for Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences , Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place , New York , NY , USA
| | - Allan Just
- c Department of Environmental Medicine and Public Health , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Zhonghua Liu
- d Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Xihong Lin
- d Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Michele R Hacker
- e Department of Obstetrics and Gynecology , Beth Israel Deaconess Medical Center , Boston , MA , USA.,f Department of Obstetrics , Gynecology and Reproductive Biology, Harvard Medical School , Boston , MA , USA
| | - Michelle Bosquet Enlow
- g Department of Psychiatry, Program for Behavioral Science, Boston Children's Hospital and Department of Psychiatry , Harvard Medical School , Boston , MA , USA
| | - Robert O Wright
- c Department of Environmental Medicine and Public Health , Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Pei Wang
- b Icahn Institute for Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences , Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place , New York , NY , USA
| | - Andrea A Baccarelli
- h Department of Environmental Health Sciences , Mailman School of Public Health, Columbia University , New York , NY , USA
| | - Rosalind J Wright
- c Department of Environmental Medicine and Public Health , Icahn School of Medicine at Mount Sinai , New York , NY , USA.,i Department of Pediatrics , Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Gilles M, Otto H, Wolf IAC, Scharnholz B, Peus V, Schredl M, Sütterlin MW, Witt SH, Rietschel M, Laucht M, Deuschle M. Maternal hypothalamus-pituitary-adrenal (HPA) system activity and stress during pregnancy: Effects on gestational age and infant's anthropometric measures at birth. Psychoneuroendocrinology 2018; 94:152-161. [PMID: 29783163 DOI: 10.1016/j.psyneuen.2018.04.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Prenatal maternal stress might be a risk for the developing fetus and may have long-lasting effects on child and adult vulnerability to somatic and psychiatric disease. Over-exposure of the unborn to excess glucocorticoids and subsequent alteration of fetal development is hypothesized to be one of the key mechanisms linking prenatal stress with negative child outcome. METHODS In this prospective longitudinal study, mothers-to-be (n = 405) in late pregnancy (36.8 ± 1.9 weeks of gestational age) and their singleton neonates were studied. We investigated the impact of different prenatal stress indices derived from six stress variables (perceived stress, specific prenatal worries, negative life events, symptoms of depression, trait anxiety, neuroticism) and diurnal maternal saliva cortisol secretion on gestational age and anthropometric measures at birth. RESULTS Maternal prenatal distress during late gestation was associated with significant reduction in birth weight (-217 g; p = .005), birth length (-1.2 cm; p = .005) and head circumference (-0.8 cm; p = .001). Prenatal stress was modestly but significantly associated with altered diurnal cortisol pattern (flattened cortisol decline and higher evening cortisol), which in turn was significantly related to reduced length of gestation. No evidence for a profound interaction between maternal cortisol level in late pregnancy and infant's anthropometric measures at birth (i.e., birth weight, length, head circumference) was found. CONCLUSION Prenatal stress is associated with flattened circadian saliva cortisol profiles and reduced infant's anthropometric measures at birth. HPA system activity during pregnancy may be related to low gestational age. The effect of prenatal stress might be partly mediated by maternal-placental-fetal neuroendocrine mechanisms especially the dysregulation of diurnal cortisol profile.
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Affiliation(s)
- Maria Gilles
- Department of Psychiatry and Psychotherapy, RG Stress, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
| | - Henrike Otto
- Department of Psychiatry and Psychotherapy, RG Stress, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Isabell A C Wolf
- Department of Psychiatry and Psychotherapy, RG Stress, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Barbara Scharnholz
- Department of Psychiatry and Psychotherapy, RG Stress, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Verena Peus
- Department of Psychiatry and Psychotherapy, RG Stress, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Michael Schredl
- Department of Psychiatry and Psychotherapy, RG Stress, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Marc W Sütterlin
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Manfred Laucht
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany; Department of Psychology, University of Potsdam, Potsdam, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, RG Stress, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
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Eick SM, Barrett ES, van’t Erve TJ, Nguyen RH, Bush NR, Milne G, Swan SH, Ferguson KK. Association between prenatal psychological stress and oxidative stress during pregnancy. Paediatr Perinat Epidemiol 2018; 32:318-326. [PMID: 29603338 PMCID: PMC6103836 DOI: 10.1111/ppe.12465] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Prenatal psychological stress during pregnancy has been associated with adverse reproductive outcomes. A growing animal literature supports an association between psychological stress and oxidative stress. We assessed this relationship in pregnant women, hypothesising that psychological stress is associated with higher concentrations of oxidative stress biomarkers during pregnancy. METHODS Psychosocial status and stressful life events (SLE) were self-reported. 8-iso-prostaglandin F2α (8-iso-PGF2α ) was measured as a biomarker of oxidative stress in urine samples at median 32 weeks' gestation. We examined SLEs individually (ever vs never) and in summary (any vs none) and psychosocial status as measured by individual subscales and in summary (poor vs good). Linear models estimated associations between these parameters and urinary 8-iso-PGF2α concentrations after adjusting for covariates. RESULTS The geometric mean of 8-iso-PGF2α was significantly higher among pregnant women who were non-White, smokers, had less than a college education, higher pre-pregnancy BMI and were unmarried. Having ever had a death in the family (n = 39) during pregnancy was associated with a 22.9% increase in 8-iso-PGF2α in unadjusted models (95% confidence interval [CI] 1.50, 48.8). Poor psychosocial status was associated with a 13.1% (95% CI 2.43, 25.0) greater mean 8-iso-PGF2α in unadjusted analyses. Associations were attenuated, but remained suggestive, after covariate adjustment. CONCLUSIONS These data suggest that 8-iso-PGF2α is elevated in pregnant women with who are at a sociodemographic disadvantage and who have higher psychological stress in pregnancy. Previous studies have observed that 8-iso-PGF2α levels are associated with adverse birth outcomes, oxidative stress could be a mediator in these relationships.
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Affiliation(s)
- Stephanie M. Eick
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Emily S. Barrett
- Department of Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, New Jersey, USA
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Thomas J. van’t Erve
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Ruby H.N. Nguyen
- Division of Epidemiology and Community Health, School of Public Health University of Minnesota, Minneapolis, MN, USA
| | - Nicole R. Bush
- Department of Psychiatry and Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Ginger Milne
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232-6602, USA
| | - Shanna H. Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
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El Marroun H, Zou R, Muetzel RL, Jaddoe VW, Verhulst FC, White T, Tiemeier H. Prenatal exposure to maternal and paternal depressive symptoms and white matter microstructure in children. Depress Anxiety 2018; 35:321-329. [PMID: 29394520 DOI: 10.1002/da.22722] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 11/09/2017] [Accepted: 12/28/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Prenatal maternal depression has been associated with multiple problems in offspring involving affect, cognition, and neuroendocrine functioning. This suggests that prenatal depression influences neurodevelopment. However, the underlying neurodevelopmental mechanism remains unclear. We prospectively assessed whether maternal depressive symptoms during pregnancy and at the child's age 3 years are related to white matter microstructure in 690 children. The association of paternal depressive symptoms with childhood white matter microstructure was assessed to evaluate genetic or familial confounding. METHODS Parental depressive symptoms were measured using the Brief Symptom Inventory. In children aged 6-9 years, we used diffusion tensor imaging to assess white matter microstructure characteristics including fractional anisotropy (FA) and mean diffusivity (MD). RESULTS Exposure to maternal depressive symptoms during pregnancy was associated with higher MD in the uncinate fasciculus and to lower FA and higher MD in the cingulum bundle. No associations of maternal depressive symptoms at the child's age of 3 years with white matter characteristics were observed. Paternal depressive symptoms also showed a trend toward significance for a lower FA in the cingulum bundle. CONCLUSIONS Prenatal maternal depressive symptoms were associated with higher MD in the uncinate fasciculus and the cingulum bundle. These structures are part of the limbic system, which is involved in motivation, emotion, learning, and memory. As paternal depressive symptoms were also related to lower FA in the cingulum, the observed effect may partly reflect a genetic predisposition and shared environmental family factors and to a lesser extent a specific intrauterine effect.
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Affiliation(s)
- Hanan El Marroun
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Runyu Zou
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Ryan L Muetzel
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Vincent W Jaddoe
- The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.,The Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Frank C Verhulst
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Clinical Medicine at the Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tonya White
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,The Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Henning Tiemeier
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,The Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,The Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
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48
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Brunst KJ, Sanchez-Guerra M, Chiu YHM, Wilson A, Coull BA, Kloog I, Schwartz J, Brennan KJ, Bosquet Enlow M, Wright RO, Baccarelli AA, Wright RJ. Prenatal particulate matter exposure and mitochondrial dysfunction at the maternal-fetal interface: Effect modification by maternal lifetime trauma and child sex. ENVIRONMENT INTERNATIONAL 2018; 112:49-58. [PMID: 29248865 PMCID: PMC6094933 DOI: 10.1016/j.envint.2017.12.020] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND Prenatal ambient fine particulate matter (PM2.5) and maternal chronic psychosocial stress have independently been linked to changes in mithochondrial DNA copy number (mtDNAcn), a marker of mitochondrial response and dysfunction. Further, overlapping research shows sex-specific effects of PM2.5 and stress on developmental outcomes. Interactions among PM2.5, maternal stress, and child sex have not been examined in this context. METHODS We examined associations among exposure to prenatal PM2.5, maternal lifetime traumatic stressors, and mtDNAcn at birth in a sociodemographically diverse pregnancy cohort (N=167). Mothers' daily exposure to PM2.5 over gestation was estimated using a satellite-based spatio-temporally resolved prediction model. Lifetime exposure to traumatic stressors was ascertained using the Life Stressor Checklist-Revised; exposure was categorized as high vs. low based on a median split. Quantitative real-time polymerase chain reaction (qPCR) was used to determine mtDNAcn in placenta and cord blood leukocytes. Bayesian Distributed Lag Interaction regression models (BDLIMs) were used to statistically model and visualize the PM2.5 timing-dependent pattern of associations with mtDNAcn and explore effect modification by maternal lifetime trauma and child sex. RESULTS Increased PM2.5 exposure across pregnancy was associated with decreased mtDNAcn in cord blood (cumulative effect estimate=-0.78; 95%CI -1.41, -0.16). Higher maternal lifetime trauma was associated with reduced mtDNAcn in placenta (β=-0.33; 95%CI -0.63, -0.02). Among women reporting low trauma, increased PM2.5 exposure late in pregnancy (30-38weeks gestation) was significantly associated with decreased mtDNAcn in placenta; no significant association was found in the high trauma group. BDLIMs identified a significant 3-way interaction between PM2.5, maternal trauma, and child sex. Specifically, PM2.5 exposure between 25 and 40weeks gestation was significantly associated with increased placental mtDNAcn among boys of mothers reporting high trauma. In contrast, PM2.5 exposure in this same window was significantly associated with decreased placental mtDNAcn among girls of mothers reporting low trauma. Similar 3-way interactive effects were observed in cord blood. CONCLUSIONS These results indicate that joint exposure to PM2.5 in late pregnancy and maternal lifetime trauma influence mtDNAcn at the maternal-fetal interface in a sex-specific manner. Additional studies will assist in understanding if the sex-specific patterns reflect distinct pathophysiological processes in addition to mitochondrial dysfunction.
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Affiliation(s)
- Kelly J Brunst
- Department of Environmental Health, University of Cincinnati College of Medicine, 160 Panzeca Way, Cincinnati, OH 45267, United States.
| | - Marco Sanchez-Guerra
- Department of Developmental Neurobiology, National Institute of Perinatology, Montes Urales 800, Lomas Virreyes, Mexico City 11000, Mexico.
| | - Yueh-Hsiu Mathilda Chiu
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States.
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, United States.
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Ave., Boston, MA 02115, United States.
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B 653, Beer Sheva, Israel.
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States.
| | - Kasey J Brennan
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, 722 W 168th St., New York, NY 10032, United States.
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02215, United States; Department of Psychiatry, Harvard Medical School, 401 Park Dr., Boston, MA 02215, United States.
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102nd St., New York, NY 10029, United States; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, 17 East 102nd St., New York, NY 10029, United States.
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, 722 W 168th St., New York, NY 10032, United States.
| | - Rosalind J Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, United States; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, 17 East 102nd St., New York, NY 10029, United States.
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49
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Brunst KJ, Sanchez Guerra M, Gennings C, Hacker M, Jara C, Bosquet Enlow M, Wright RO, Baccarelli A, Wright RJ. Maternal Lifetime Stress and Prenatal Psychological Functioning and Decreased Placental Mitochondrial DNA Copy Number in the PRISM Study. Am J Epidemiol 2017; 186:1227-1236. [PMID: 28595325 PMCID: PMC5859981 DOI: 10.1093/aje/kwx183] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 01/12/2017] [Accepted: 01/26/2017] [Indexed: 12/17/2022] Open
Abstract
Psychosocial stress contributes to placental oxidative stress. Mitochondria are vulnerable to oxidative stress, which can lead to changes in mitochondrial DNA copy number (mtDNAcn). We examined associations of maternal lifetime stress, current negative life events, and depressive and posttraumatic-stress-disorder symptom scores with placental mtDNAcn in a racially/ethnically diverse sample (n = 147) from the Programming of Intergenerational Stress Mechanisms (PRISM) study (Massachusetts, March 2011 to August 2012). In linear regression analyses adjusted for maternal age, race/ethnicity, education, prenatal fine particulate matter exposure, prenatal smoking exposure, and the sex of the child, all measures of stress were associated with decreased placental mtDNAcn (all P values < 0.05). Weighted-quantile-sum (WQS) regression showed that higher lifetime stress and depressive symptoms accounted for most of the effect on mtDNAcn (WQS weights: 0.25 and 0.39, respectively). However, among white individuals, increased lifetime stress and posttraumatic stress disorder symptoms explained the majority of the effect (WQS weights: 0.20 and 0.62, respectively) while among nonwhite individuals, lifetime stress and depressive symptoms accounted for most of the effect (WQS weights: 0.27 and 0.55, respectively). These analyses are first to link increased maternal psychosocial stress with reduced placental mtDNAcn and add to literature documenting racial/ethnic differences in the psychological sequelae of chronic stress that may contribute to maternal-fetal health.
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Affiliation(s)
- Kelly J Brunst
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Marco Sanchez Guerra
- Laboratory of Environmental Epigenetics, Exposure Epidemiology and Risk Program, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michele Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Calvin Jara
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michelle Bosquet Enlow
- Program for Behavioral Science, Department of Psychiatry, Boston Children’s Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, New York
| | - Rosalind J Wright
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
- Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, New York
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50
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Maternal depression and anxiety and fetal-neonatal growth. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2017.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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