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Vaghef-Mehrabani E, Bell RC, Field CJ, Jarman M, Evanchuk JL, Letourneau N, Dewey D, Giesbrecht GF. Maternal pre-pregnancy weight status and gestational weight gain in association with child behavior: The mediating role of prenatal systemic inflammation. Clin Nutr ESPEN 2024; 59:249-256. [PMID: 38220383 DOI: 10.1016/j.clnesp.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND AIMS Maternal pre-pregnancy obesity and excessive gestational weight gain (EGWG) may predispose children to behavioral problems through increased prenatal inflammation. We investigated the association between maternal body mass index (BMI) and gestational weight gain (GWG), and child behavioral problems (primary aim), and the mediating role of prenatal inflammation (secondary aim). METHODS We used self-reported pre-pregnancy BMI and estimated-GWG data (N = 1137) from a longitudinal cohort study. Maternal serum C-reactive protein (CRP) was measured in the 3rd-trimester. Parent-reported Child Behavior Checklist (CBCL) was used to assess child internalizing and externalizing behaviors at 3-years-of-age. We used analysis of covariance (ANCOVA), multiple linear regression, and mediation analyses for data analysis. RESULTS Maternal obesity (F = 21.98, df 3836), EGWG (F = 6.53, df 2764), and their combination (F = 18.51, df 3764) were associated with the 3rd trimester CRP, but not child behavior in the whole sample. Maternal underweight was associated with withdrawal problems in all children (β = 0.56, 95%CI, 0.11,1.00) and aggressive behaviors in female children (β = 2.59, 95%CI, 0.28,4.91). Obesity had a significant association with externalizing behaviors in female children after controlling for maternal CRP (β = 3.72, 95%CI, 0.12,7.32). Both inadequate and EGWG were associated with somatic complaints in male children (β = 0.50, 95%CI, 0.05,0.95; β = 0.36, 95%CI, 0.01,0.71, respectively). Combined obesity/EGWG was associated with externalizing (β = 6.12, 95%CI, 0.53,11.70) and aggressive (β = 4.23, 95%CI, 0.90,7.56) behaviors in female children. We found no significant effects through CRP. CONCLUSIONS Maternal pre-pregnancy BMI and GWG showed sex-specific associations with child behavioral problems. Prenatal CRP, although increased in obesity and EGWG, did not mediate these associations.
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Affiliation(s)
- Elnaz Vaghef-Mehrabani
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Megan Jarman
- School of Psychology, College of Health and Life Sciences, Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | - Jenna L Evanchuk
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | | | - Deborah Dewey
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Psychology, University of Calgary, Calgary, AB, Canada.
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Kling JL, Mistry-Patel S, Peoples SG, Caldera DR, Brooker RJ. Prenatal maternal depression predicts neural maturation and negative emotion in infants. Infant Behav Dev 2023; 70:101802. [PMID: 36508874 PMCID: PMC9870954 DOI: 10.1016/j.infbeh.2022.101802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
Despite widespread acceptance that prenatal symptoms of depression in mothers are detrimental to infants' long-term emotional and cognitive development, little is known about the mechanisms that may integrate outcomes across these domains. Rooted in the integrative perspective that emotional development is grounded in developing cognitive processes, we hypothesized that prenatal symptoms of depression in mothers would be associated with delays in neural maturation that support sociocognitive function in infants, leading to more problematic behaviors. We used a prospective longitudinal study of mothers (N = 92) and their infants to test whether self-reported symptoms of depression in mothers during the second and third trimesters were associated with neural development and infant outcomes at 4 months of age. While controlling for postpartum symptoms of depression, more prenatal symptoms of depression in mothers predicted less neural maturation in the parietal region of 4-month-old infants. Less neural maturation, in turn, was associated with greater infant negativity, suggesting neural maturation as a putative mechanism linking maternal symptoms of depression with infant outcomes. Differences in neural regions and developmental timing are also discussed.
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Affiliation(s)
- Jennifer L Kling
- Department of Psychological and Brain Sciences, Texas A&M University, USA.
| | - Sejal Mistry-Patel
- Department of Psychological and Brain Sciences, Texas A&M University, USA
| | - Sarah G Peoples
- Department of Psychological and Brain Sciences, Texas A&M University, USA
| | - Daniel R Caldera
- Department of Psychological and Brain Sciences, Texas A&M University, USA
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University, USA
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3
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Simoncic V, Deguen S, Enaux C, Vandentorren S, Kihal-Talantikite W. A Comprehensive Review on Social Inequalities and Pregnancy Outcome-Identification of Relevant Pathways and Mechanisms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416592. [PMID: 36554473 PMCID: PMC9779203 DOI: 10.3390/ijerph192416592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 05/12/2023]
Abstract
Scientific literature tends to support the idea that the pregnancy and health status of fetuses and newborns can be affected by maternal, parental, and contextual characteristics. In addition, a growing body of evidence reports that social determinants, measured at individual and/or aggregated level(s), play a crucial role in fetal and newborn health. Numerous studies have found social factors (including maternal age and education, marital status, pregnancy intention, and socioeconomic status) to be linked to poor birth outcomes. Several have also suggested that beyond individual and contextual social characteristics, living environment and conditions (or "neighborhood") emerge as important determinants in health inequalities, particularly for pregnant women. Using a comprehensive review, we present a conceptual framework based on the work of both the Commission on Social Determinants of Health and the World Health Organization (WHO), aimed at describing the various pathways through which social characteristics can affect both pregnancy and fetal health, with a focus on the structural social determinants (such as socioeconomic and political context) that influence social position, as well as on intermediary determinants. We also suggest that social position may influence more specific intermediary health determinants; individuals may, on the basis of their social position, experience differences in environmental exposure and vulnerability to health-compromising living conditions. Our model highlights the fact that adverse birth outcomes, which inevitably lead to health inequity, may, in turn, affect the individual social position. In order to address both the inequalities that begin in utero and the disparities observed at birth, it is important for interventions to target various unhealthy behaviors and psychosocial conditions in early pregnancy. Health policy must, then, support: (i) midwifery availability and accessibility and (ii) enhanced multidisciplinary support for deprived pregnant women.
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Affiliation(s)
- Valentin Simoncic
- LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 67100 Strasbourg, France
- Correspondence:
| | - Séverine Deguen
- Equipe PHARes Population Health Translational Research, Inserm CIC 1401, Bordeaux Population Health Research Center, University of Bordeaux, 33076 Boedeaux, France
| | - Christophe Enaux
- LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 67100 Strasbourg, France
| | - Stéphanie Vandentorren
- Equipe PHARes Population Health Translational Research, Inserm CIC 1401, Bordeaux Population Health Research Center, University of Bordeaux, 33076 Boedeaux, France
- Santé Publique France, French National Public Health Agency, 94410 Saint-Maurice, France
| | - Wahida Kihal-Talantikite
- LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 67100 Strasbourg, France
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4
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Rees SJ, Mohsin M, Klein L, Steel Z, Tol W, Dadds M, Eapen V, da Costa Z, Savio E, Tam N, Silove D. The impact of maternal depressive symptoms and traumatic events on early childhood mental health in conflict-affected Timor-Leste. BJPsych Open 2022; 8:e51. [PMID: 35197139 PMCID: PMC8935917 DOI: 10.1192/bjo.2022.20] [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 Longitudinal studies are needed to examine the association between maternal depression, trauma and childhood mental health in conflict-affected settings. AIMS To examine maternal depressive symptoms, trauma-related adversities and child mental health by using a longitudinal path model in conflict-affected Timor-Leste. METHOD Women were recruited in pregnancy. At wave 1, 1672 of 1740 eligible women were interviewed (96% response rate). The final sample comprised 1118 women with complete data at all three time points. Women were followed up when the index child was aged 18 months (wave 2) and 36 months (wave 3). Measures included the Edinburgh Postnatal Depression Scale, lifetime traumatic events and the Child Behaviour Checklist. A longitudinal path analysis examined associations cross-sectionally and in a cross-lagged manner across time. RESULTS Maternal depressive symptom score was associated with child mental health (cross-sectional association at wave 2, β = 0.35, P < 0.001; cross-sectional association at wave 3, β = 0.33, P < 0.001). The maternal depressive symptom score at wave 1 was associated with child mental health at wave 2 (β = 0.12, P < 0.001), and the maternal depressive symptom score at wave 2 showed an indirect association with child mental health at wave 3 (indirect standardised coefficient 0.23, P < 0.001). There was a time-lagged relationship between child mental health at wave 2 and maternal depression at wave 3 (β = 0.08, P = 0.02). CONCLUSIONS Maternal depressive symptoms are longitudinally associated with child mental health, and traumatic events play a role. Maternal depression symptoms are also affected by child mental health. Findings suggest the need for skilled assessment for depression, trauma-informed maternity care and parenting support in a post-conflict country such as Timor-Leste.
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Affiliation(s)
- Susan J Rees
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia
| | - Mohammed Mohsin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia; and Mental Health Research Unit, Liverpool Hospital, New South Wales Health, Australia
| | - Louis Klein
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia; and Mental Health Research Unit, Liverpool Hospital, New South Wales Health, Australia
| | - Zachary Steel
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia
| | - Wietse Tol
- Department of Mental Health, Centre for Global Health, Johns Hopkins University, USA
| | - Mark Dadds
- School of Psychology, Faculty of Science, University of Sydney, Australia
| | - Valsamma Eapen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia; and Academic Mental Health Unit, Liverpool Hospital, New South Wales Health, Australia
| | - Zelia da Costa
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia
| | - Elisa Savio
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia
| | - Natalino Tam
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia
| | - Derrick Silove
- Brain Sciences, University of New South Wales, Australia
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5
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Eilertsen EM, Hannigan LJ, McAdams TA, Rijsdijk FV, Czajkowski N, Reichborn-Kjennerud T, Ystrom E, Gjerde LC. Parental Prenatal Symptoms of Depression and Offspring Symptoms of ADHD: A Genetically Informed Intergenerational Study. J Atten Disord 2021; 25:1554-1563. [PMID: 32338109 DOI: 10.1177/1087054720914386] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Objective: The primary aim of the present study was to separate the direct effect of maternal prenatal depression on offspring ADHD from the passive transmission of genetic liability. Method: A children-of-twins and siblings design including 17,070 extended-family units participating in the Norwegian Mother and Child Cohort Study was used. Self-ratings were obtained from parents using the Symptom Checklist during pregnancy. Maternal ratings using Conner's Parent Rating Scale were obtained when the children were 5 years of age. Results: Genetic influences were important for explaining similarity between parents and offspring. There was also evidence for a maternal effect after accounting for genetic transmission (m = 0.06, 95% confidence interval [CI] = [0.02, 0.09]). Conclusion: Our results were consistent with hypotheses suggesting that maternal prenatal depression influences symptoms of ADHD in offspring. However, the effect was weak and a substantial portion of the association could be accounted for by shared genetic influences.
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Affiliation(s)
| | | | | | | | - Nikolai Czajkowski
- Norwegian Institute of Public Health, Oslo, Norway.,University of Oslo, Norway
| | | | - Eivind Ystrom
- Norwegian Institute of Public Health, Oslo, Norway.,University of Oslo, Norway
| | - Line C Gjerde
- Norwegian Institute of Public Health, Oslo, Norway.,University of Oslo, Norway
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6
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Medina NY, Edwards RC, Zhang Y, Hans SL. A longitudinal investigation of young mothers' prenatal attachment, depressive symptoms, and early parenting behaviour. J Reprod Infant Psychol 2021; 40:196-211. [PMID: 33586534 DOI: 10.1080/02646838.2021.1886257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: This study explores whether young, low-income mothers' prenatal attachment to their infants is related to attachment and parenting behaviour postnatally.Background: A small literature has documented continuity in maternal attachment from pregnancy to postpartum and shown that early maternal attachment is associated with positive parenting behaviour. Less is known about whether prenatal attachment has a unique impact on parenting behaviour, or if it is primarily a step in the development of postnatal attachment, which in turn influences parenting. Additionally, it is unclear whether associations between attachment and early parenting might be attributable to other factors such as depressive symptoms.Method: This longitudinal study followed young primiparous mothers from pregnancy through 3-weeks postnatal. 240 ethnically/racially diverse low-income American women reported their attachment-related thoughts and feelings and their depressive symptoms during pregnancy and postnatally. At 3 weeks postpartum, mothers were observed interacting with their infant.Results: There was stability in attachment and depressive symptoms from pregnancy to postpartum. In multivariate path models, prenatal attachment was directly associated with two types of parenting behaviour: positive engagement and encouragement of learning, even when accounting for depressive symptoms and postnatal attachment. There was an indirect effect of prenatal attachment on sensitivity through postnatal attachment.Conclusion: The foundation of a mother's emotional connection to her infant begins before birth. Parenting support programmes for young mothers should begin during pregnancy. Supporting the establishment of positive prenatal attachment may also have a positive influence on later parenting behaviour among mothers, including mothers experiencing depressive symptoms.
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Affiliation(s)
- Nora Y Medina
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Renee C Edwards
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Yudong Zhang
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
| | - Sydney L Hans
- School of Social Service Administration, The University of Chicago, Chicago, IL, USA
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7
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Spry EA, Aarsman SR, Youssef GJ, Patton GC, Macdonald JA, Sanson A, Thomson K, Hutchinson DM, Letcher P, Olsson CA. Maternal and paternal depression and anxiety and offspring infant negative affectivity: A systematic review and meta-analysis. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2020.100934] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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8
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Van Adrichem DS, Huijbregts SCJ, Van Der Heijden KB, Van Goozen SHM, Swaab H. Aggressive behavior during toddlerhood: Interrelated effects of prenatal risk factors, negative affect, and cognition. Child Neuropsychol 2020; 26:982-1004. [PMID: 32448053 DOI: 10.1080/09297049.2020.1769582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Prenatal risk, temperamental negative affect, and specific cognitive abilities have all individually been identified as predictors of behavior problems during early childhood, but less is known about their interplay in relation to aggression during toddlerhood. This study examined the main and interaction effects of prenatal risk, negative affect, inhibitory control, attention, and vocabulary in the prediction of aggression in 150 children (75 boys). During pregnancy, a cumulative risk index was calculated based on the presence of 10 well-established maternal risk factors, such as prenatal substance use, maternal psychiatric disorder, and financial problems. Negative affect was measured at 6 and 20 months using maternal report. Child cognition was examined at 30 months using laboratory tasks for inhibitory control and attention, and a questionnaire was administered to assess vocabulary. In addition, mothers reported on their children's aggressive behavior at 30 months. Higher prenatal risk and negative affect at 20 months and, to a lesser extent, at 6 months were related to more aggression at 30 months. Poorer inhibitory control and, to a lesser extent, vocabulary at 30 months also predicted higher levels of aggressive behavior. Two-way interaction effects were found for cumulative risk and inhibitory control, negative affect (at 20 months) and inhibitory control, and negative affect (at 6 months) and vocabulary: aggressive behavior was most pronounced when combinations of high prenatal risk, high negative affect, and poor cognition were present. These results suggest that the impact of prenatal risk and child temperament depends in part on child's cognitive development during toddlerhood.
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Affiliation(s)
- Dide S Van Adrichem
- Clinical Neurodevelopmental Sciences, Leiden University , Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University , Leiden, The Netherlands
| | - Stephan C J Huijbregts
- Clinical Neurodevelopmental Sciences, Leiden University , Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University , Leiden, The Netherlands
| | - Kristiaan B Van Der Heijden
- Clinical Neurodevelopmental Sciences, Leiden University , Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University , Leiden, The Netherlands
| | - Stephanie H M Van Goozen
- Clinical Neurodevelopmental Sciences, Leiden University , Leiden, The Netherlands.,School of Psychology, Cardiff University , Cardiff, UK
| | - Hanna Swaab
- Clinical Neurodevelopmental Sciences, Leiden University , Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden University , Leiden, The Netherlands
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9
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Spry E, Moreno-Betancur M, Becker D, Romaniuk H, Carlin JB, Molyneaux E, Howard LM, Ryan J, Letcher P, McIntosh J, Macdonald JA, Greenwood CJ, Thomson KC, McAnally H, Hancox R, Hutchinson DM, Youssef GJ, Olsson CA, Patton GC. Maternal mental health and infant emotional reactivity: a 20-year two-cohort study of preconception and perinatal exposures. Psychol Med 2020; 50:827-837. [PMID: 30968786 DOI: 10.1017/s0033291719000709] [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: 01/09/2023]
Abstract
BACKGROUND Maternal mental health during pregnancy and postpartum predicts later emotional and behavioural problems in children. Even though most perinatal mental health problems begin before pregnancy, the consequences of preconception maternal mental health for children's early emotional development have not been prospectively studied. METHODS We used data from two prospective Australian intergenerational cohorts, with 756 women assessed repeatedly for mental health problems before pregnancy between age 13 and 29 years, and during pregnancy and at 1 year postpartum for 1231 subsequent pregnancies. Offspring infant emotional reactivity, an early indicator of differential sensitivity denoting increased risk of emotional problems under adversity, was assessed at 1 year postpartum. RESULTS Thirty-seven percent of infants born to mothers with persistent preconception mental health problems were categorised as high in emotional reactivity, compared to 23% born to mothers without preconception history (adjusted OR 2.1, 95% CI 1.4-3.1). Ante- and postnatal maternal depressive symptoms were similarly associated with infant emotional reactivity, but these perinatal associations reduced somewhat after adjustment for prior exposure. Causal mediation analysis further showed that 88% of the preconception risk was a direct effect, not mediated by perinatal exposure. CONCLUSIONS Maternal preconception mental health problems predict infant emotional reactivity, independently of maternal perinatal mental health; while associations between perinatal depressive symptoms and infant reactivity are partially explained by prior exposure. Findings suggest that processes shaping early vulnerability for later mental disorders arise well before conception. There is an emerging case for expanding developmental theories and trialling preventive interventions in the years before pregnancy.
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Affiliation(s)
- Elizabeth Spry
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
| | - Margarita Moreno-Betancur
- Murdoch Children's Research Institute, Clinical Epidemiology & Biostatistics Unit; Melbourne, Australia
- The University of Melbourne, Melbourne School of Population and Global Health, Melbourne, Australia
| | - Denise Becker
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
| | - Helena Romaniuk
- Murdoch Children's Research Institute, Clinical Epidemiology & Biostatistics Unit; Melbourne, Australia
- Deakin University Burwood, Biostatistics Unit, Faculty of Health, Melbourne, Australia
| | - John B Carlin
- Murdoch Children's Research Institute, Clinical Epidemiology & Biostatistics Unit; Melbourne, Australia
- The University of Melbourne, Melbourne School of Population and Global Health, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Emma Molyneaux
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience; King's College London, UK & South London and Maudsley NHS Foundation Trust, UK
| | - Louise M Howard
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience; King's College London, UK & South London and Maudsley NHS Foundation Trust, UK
| | - Joanne Ryan
- Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
| | - Primrose Letcher
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Jennifer McIntosh
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Jacqui A Macdonald
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Christopher J Greenwood
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
| | - Kimberley C Thomson
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Helena McAnally
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Robert Hancox
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Delyse M Hutchinson
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
- National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Australia
| | - George J Youssef
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
| | - Craig A Olsson
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - George C Patton
- Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
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10
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Webber E, Benedict J. Postpartum depression: A multi-disciplinary approach to screening, management and breastfeeding support. Arch Psychiatr Nurs 2019; 33:284-289. [PMID: 31227081 DOI: 10.1016/j.apnu.2019.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/13/2018] [Accepted: 01/24/2019] [Indexed: 01/16/2023]
Abstract
Postpartum depression (PPD) is a common condition affecting 11%-20% of all postpartum women. Depression can have significant consequences for both mother and infant. There are many risk factors associated with PPD, all of which contribute to an inflammatory response in the mother. An inverse relationship exists between PPD and breastfeeding; women with PPD are less likely to have a positive breastfeeding experience which can lead to early weaning, while long-term exclusive breastfeeding is associated with decreased rates of PPD. A multi-disciplinary approach to managing PPD, including strong breastfeeding support, will lead to improved mental health outcomes for women and their children.
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Affiliation(s)
- Elaine Webber
- University of Detroit Mercy, 4001 W McNichols Rd, Detroit, MI 48221, United States.
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11
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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: 33] [Impact Index Per Article: 5.5] [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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12
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Yogman M, Lavin A, Cohen G, Lemmon KM, Mattson G, Rafferty JR, Wissow LS. The Prenatal Visit. Pediatrics 2018; 142:peds.2018-1218. [PMID: 29941679 DOI: 10.1542/peds.2018-1218] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A pediatric prenatal visit during the third trimester is recommended for all expectant families as an important first step in establishing a child's medical home, as recommended by Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition As advocates for children and their families, pediatricians can support and guide expectant parents in the prenatal period. Prenatal visits allow general pediatricians to establish a supportive and trusting relationship with both parents, gather basic information from expectant parents, offer information and advice regarding the infant, and may identify psychosocial risks early and high-risk conditions that may require special care. There are several possible formats for this first visit. The one used depends on the experience and preference of the parents, the style of the pediatrician's practice, and pragmatic issues of payment.
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Affiliation(s)
- Michael Yogman
- Harvard Medical School and Mount Auburn Hospital, Boston, Massachusetts; and
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Bunston W, Franich-Ray C, Tatlow S. A Diagnosis of Denial: How Mental Health Classification Systems Have Struggled to Recognise Family Violence as a Serious Risk Factor in the Development of Mental Health Issues for Infants, Children, Adolescents and Adults. Brain Sci 2017; 7:E133. [PMID: 29039808 PMCID: PMC5664060 DOI: 10.3390/brainsci7100133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/06/2017] [Accepted: 10/10/2017] [Indexed: 11/16/2022] Open
Abstract
Child and adolescent mental health services (CAMHS) routinely overlook assessing for, and providing treatment to, infants and children living with family violence, despite family violence being declared endemic across the globe. As contemporary neuro-developmental research recognises the harm of being exposed to early relational trauma, key international diagnostic texts such as the DSM-5 and ICD-10 struggle to acknowledge or appreciate the relational complexities inherent in addressing family violence and its impacts during childhood. These key texts directly influence thinking, funding and research imperatives in adult services as well as CAMHS, however, they rarely reference family violence. Their emphasis is to pathologise conditions over exploring causality which may be attributable to relational violence. Consequently, CAMHS can miss important indicators of family violence, misdiagnose disorders and unwittingly, not address unacceptable risks in the child's caregiving environment. Notwithstanding urgent safety concerns, ongoing exposure to family violence significantly heightens the development of mental illness amongst children. CAMHS providers cannot and should not rely on current diagnostic manuals alone. They need to act now to see family violence as a significant and important risk factor to mental health and to treat its impacts on children before these develop into enduring neurological difficulties.
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Affiliation(s)
- Wendy Bunston
- wb Training and Consultancy, PO Box 750, Moonee Ponds, Victoria, Australia, 3039; La Trobe University, Bundoora 3086, Victoria, Australia.
| | - Candice Franich-Ray
- Mental Health, The Royal Children's Hospital, 50 Flemington Road, Parkville 3052, Victoria, Australia.
- The Murdoch Childrens Research Institute, Flemington Road, Parkville 3052, Victoria, Australia.
- Department of Paediatrics, The University of Melbourne; Level 2 West Building, The Royal Children's Hospital, 50 Flemington Street, Parkville 3052, Victoria, Australia.
| | - Sara Tatlow
- Mental Health, The Royal Children's Hospital, 50 Flemington Road, Parkville 3052, Victoria, Australia.
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Zhang W, Finik J, Dana K, Glover V, Ham J, Nomura Y. Prenatal Depression and Infant Temperament: The Moderating Role of Placental Gene Expression. INFANCY 2017; 23:211-231. [PMID: 30393466 DOI: 10.1111/infa.12215] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Prior research has demonstrated the link between maternal depression during pregnancy (i.e., prenatal depression) and increased neurodevelopmental dysregulation in offspring. However, little is known about the roles of key hypothalamic-pituitary axis regulatory genes in the placenta modulating this association. This study will examine whether placental gene expression levels of 11β-hydroxysteroid dehydrogenase type 2 (HSD11B2), glucocorticoid receptor (NR3C1), and mineralocorticoid receptor (NR3C2) can help elucidate the underlying mechanisms linking prenatal depression to infant temperament, particularly in infants with high negativity and low emotion regulation. Stored placenta tissues (N = 153) were used to quantify messenger ribonucleic acid levels of HSD11B2, NR3C1, and NR3C2. Assessments of prenatal depression and infant temperament at 6 months of age were ascertained via maternal report. Results found that prenatal depression was associated with increased Negative Affectivity (p < .05) after controlling for postnatal depression and psychosocial characteristics. Furthermore, the association between prenatal depression and Negative Affectivity was moderated by gene expression levels of HSD11B2, NR3C1, and NR3C2 such that greater gene expression significantly lessened the association between prenatal depression and Negative Affectivity. Our findings suggest that individual differences in placental gene expression may be used as an early marker of susceptibility or resilience to prenatal adversity.
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Affiliation(s)
| | - Jackie Finik
- Queens College, CUNY and Icahn School of Medicine at Mount Sinai and Graduate School of Public Health and Health Policy, CUNY
| | - Kathryn Dana
- Queens College, CUNY and The Graduate Center, CUNY
| | | | - Jacob Ham
- Icahn School of Medicine at Mount Sinai
| | - Yoko Nomura
- Queens College, CUNY and Icahn School of Medicine at Mount Sinai and The Graduate Center, CUNY
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15
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Broberg L, Backhausen M, Damm P, Bech P, Tabor A, Hegaard HK. Effect of supervised exercise in groups on psychological well-being among pregnant women at risk of depression (the EWE Study): study protocol for a randomized controlled trial. Trials 2017; 18:210. [PMID: 28476136 PMCID: PMC5420113 DOI: 10.1186/s13063-017-1938-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 04/11/2017] [Indexed: 11/20/2022] Open
Abstract
Background Pregnant women with depression and/or anxiety prior to pregnancy are at higher risk of preterm birth, breastfeeding problems, postpartum depression, and disruption of the mother-infant attachment. It is well documented that exercise improves psychological well-being in nonpregnant subjects with symptoms of depression. However, in only a few small studies have researchers examined the effect of exercise on symptoms of depression among pregnant women. We hypothesize that physiotherapist-supervised group exercise for pregnant women at risk of antenatal depression increases their psychological well-being. This paper describes the study protocol of a randomized controlled trial (RCT) on a supervised group exercise intervention for pregnant women with a current or previous history of depression and/or anxiety. Methods/design The RCT is being carried out at the Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, in the period 2016–2019. The inclusion criteria are pregnant women ≥18 years of age with depression and/or anxiety requiring treatment by a psychiatrist or a psychologist within the last 10 years and/or intake of antidepressants in the 3 months prior to conception and/or during pregnancy. The women must have appropriate Danish language skills, be pregnant with a single fetus, give written informed consent, and be at 17–22 gestational weeks when the intervention begins. The primary outcome is psychological well-being (the five-item World Health Organization Well-being Index). Secondary outcomes are symptoms of depression (Edinburgh Postnatal Depression Scale), functional ability (General Health Questionnaire), clinical symptoms of anxiety (State-Trait Anxiety Inventory), sleep quality and sleep disturbances (Pittsburgh Sleep Quality Index), and pregnancy and delivery outcomes. The intervention is supervised group exercise twice weekly for 12 weeks. The control group will receive standard antenatal care. On the basis of sample size calculation, a total of 300 women will be randomly assigned to either the intervention or the control group in a ratio of 1:1. Discussion The trial is expected to contribute to the body of knowledge used in planning antenatal care for pregnant women at risk of depression. Trial registration ClinicalTrials.gov, NCT02833519. Registered on 19 May 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1938-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lotte Broberg
- Research Unit Women's and Children's Health, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. .,Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Mette Backhausen
- Research Unit Women's and Children's Health, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Peter Damm
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Per Bech
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
| | - Ann Tabor
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Hanne Kristine Hegaard
- Research Unit Women's and Children's Health, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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16
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Socio-demographic inequalities across a range of health status indicators and health behaviours among pregnant women in prenatal primary care: a cross-sectional study. BMC Pregnancy Childbirth 2015; 15:261. [PMID: 26463046 PMCID: PMC4604767 DOI: 10.1186/s12884-015-0676-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 10/02/2015] [Indexed: 11/15/2022] Open
Abstract
Background Suboptimal maternal health conditions (such as obesity, underweight, depression and stress) and health behaviours (such as smoking, alcohol consumption and unhealthy nutrition) during pregnancy have been associated with negative pregnancy outcomes. Our first aim was to give an overview of the self-reported health status and health behaviours of pregnant women under midwife-led primary care in the Netherlands. Our second aim was to identify potential differences in these health status indicators and behaviours according to educational level (as a proxy for socio-economic status) and ethnicity (as a proxy for immigration status). Methods Our cross-sectional study (data obtained from the DELIVER multicentre prospective cohort study conducted from September 2009 to March 2011) was based on questionnaires about maternal health and prenatal care, which were completed by 6711 pregnant women. The relationships of education and ethnicity with 13 health status indicators and 10 health behaviours during pregnancy were examined using multilevel multiple logistic regression analyses, adjusted for age, parity, number of weeks pregnant and either education or ethnicity. Results Lower educated women were especially more likely to smoke (Odds Ratio (OR) 11.3; 95 % confidence interval (CI) 7.6– 16.8); have passive smoking exposure (OR 6.9; 95 % CI 4.4–11.0); have low health control beliefs (OR 10.4; 95 % CI 8.5–12.8); not attend antenatal classes (OR 4.5; 95 % CI 3.5–5.8) and not take folic acid supplementation (OR 3.4; 95 % CI 2.7–4.4). They were also somewhat more likely to skip breakfast daily, be obese, underweight and depressed or anxious. Non-western women were especially more likely not to take folic acid supplementation (OR 4.5; 95 % CI 3.5–5.7); have low health control beliefs (OR 4.1; 95 % CI 3.1–5.2) and not to attend antenatal classes (OR 3.3; 95 % CI 2.0–5.4). They were also somewhat more likely to have nausea, back pains and passive smoking exposure. Conclusions Substantial socio-demographic inequalities persist with respect to many health-related issues in medically low risk pregnancies in the Netherlands. Improved strategies are needed to address the specific needs of socio-demographic groups at higher risk and the structures underlying social inequalities in pregnant women.
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Bicking Kinsey C, Baptiste-Roberts K, Zhu J, Kjerulff KH. Effect of previous miscarriage on depressive symptoms during subsequent pregnancy and postpartum in the first baby study. Matern Child Health J 2015; 19:391-400. [PMID: 24894728 DOI: 10.1007/s10995-014-1521-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Our objective was to test the hypothesis that nulliparous women with a history of miscarriage have an increased risk of depression during late pregnancy, and at 1, 6, and 12 months postpartum compared to women without a history of miscarriage. We conducted secondary analysis of a longitudinal cohort study, the First Baby Study, and compared 448 pregnant women with a history of miscarriage to 2,343 pregnant women without a history of miscarriage on risk of probable depression (score >12 on the Edinburgh Postnatal Depression Scale). Logistic regression models were used to estimate odds ratios at each time point and generalized estimating equations were used to obtain estimates in longitudinal analysis. Women with a history of miscarriage were not more likely than woman without a history of miscarriage to score in the probable depression range during the third trimester or at 6 or 12 months postpartum but were more likely at 1 month postpartum, after adjustment for sociodemographic factors (OR 1.66, 95% CI 1.03-2.69). Women with a history of miscarriage may be more vulnerable to depression during the first month postpartum than women without prior miscarriage, but this effect does not appear to persist beyond this time period. We support the promotion of awareness surrounding this issue and recommend that research is planned to identify risk factors that may position a woman with a history of miscarriage to be at higher risk for depression.
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Affiliation(s)
- Cara Bicking Kinsey
- College of Nursing, The Pennsylvania State University, University Park, PA, USA,
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18
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Finnish mothers’ and fathers’ reports of their boys and girls by using the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). Infant Behav Dev 2015; 39:136-47. [DOI: 10.1016/j.infbeh.2015.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 02/01/2015] [Accepted: 02/10/2015] [Indexed: 11/21/2022]
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Babineau V, Green CG, Jolicoeur-Martineau A, Minde K, Sassi R, St-André M, Carrey N, Atkinson L, Meaney M, Wazana A. Prenatal depression and 5-HTTLPR interact to predict dysregulation from 3 to 36 months--a differential susceptibility model. J Child Psychol Psychiatry 2015; 56:21-9. [PMID: 24827922 PMCID: PMC5398894 DOI: 10.1111/jcpp.12246] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND Childhood dysregulation, which reflects deficits in the capacity to regulate or control one's thoughts, emotions and behaviours, is associated with psychopathology throughout childhood and into adulthood. Exposures to adversity during the prenatal period, including prenatal depression, can influence the development of dysregulation, and a number of candidate genes have been suggested as moderators of prenatal exposure, including polymorphisms in the promoter region of the serotonin transporter gene (5-HTTLPR). We examined whether prenatal depression and child 5-HTTLPR interact to predict childhood dysregulation. METHOD Sample of N = 213 mother-child pairs from the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) project. Mothers reported the IBQ-R at 3 and 6 months, and the ECBQ at 18 and 36 months, from which measures of dysregulation were extracted. Mothers' self-reported symptoms of depression on the CES-D at 24-36 weeks of gestation, and at 6, 12, 24 and 36 months postnatal. 5-HTTLPR genotype was extracted from buccal swabs. Mixed-model and confirmatory analyses were conducted. RESULTS Prenatal depression and 5-HTTLPR interacted to predict dysregulation from 3 to 36 months, within a model of strong differential susceptibility. CONCLUSION Children with S or LG alleles, when exposed to prenatal depression, have higher levels of dysregulation, and when exposed to lower or little prenatal depression, have higher capacity for regulation. Our findings support efforts to identify, support and treat prenatal depression.
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20
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Korhonen M, Luoma I, Salmelin R, Tamminen T. Maternal depressive symptoms: associations with adolescents' internalizing and externalizing problems and social competence. Nord J Psychiatry 2014; 68:323-32. [PMID: 24070429 DOI: 10.3109/08039488.2013.838804] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The negative effect of maternal depressive symptoms on child wellbeing has been quite extensively studied. There is, however, debate as to whether it is the timing, the recurrence or the chronicity of maternal depressive symptoms that puts the child's wellbeing at risk. AIMS This study explores the associations between the timing, recurrence and the patterns of maternal depressive symptoms and adolescent psychosocial functioning. METHODS One hundred and ninety-one mothers and 192 adolescents were followed up from the mother's pregnancy to the child's adolescence. Maternal depressive symptoms were screened with the Edinburgh Postnatal Depression Scale prenatally, postnatally, in early and middle childhood, and at adolescence. The adolescents' outcomes were screened using Child Behavior Checklists and Youth Self Reports. RESULTS The results indicate that the initial exposure to maternal depressive symptoms at pregnancy is associated with more externalizing problems in adolescence, 2 months postnatally with more internalizing problems, in early childhood with poorer social competence and concurrently with more externalizing problems. Combined analyses indicate that recurrent maternal depressive symptoms best explain adolescents' internalizing problems and the chronic pattern of maternal depressive symptoms externalizing problems. The chronic and intermittent patterns of maternal depressive symptoms best explained adolescents' poorer social competence. CONCLUSIONS Recurrent or chronic maternal depressive symptoms rather than the timing predict adolescents' psychosocial problems better. The timing, however, may explain the different kinds of problems in adolescence depending on the developmental task at the time of the exposure. The findings should be noted when treating both mothers and children in psychiatric clinics and other health services.
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Affiliation(s)
- Marie Korhonen
- Marie Korhonen, M.D., School of Medicine, University of Tampere , Tampere , Finland
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21
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Culture in Prenatal Development: Parental Attitudes, Availability of Care, Expectations, Values, and Nutrition. CHILD & YOUTH CARE FORUM 2014. [DOI: 10.1007/s10566-014-9251-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Prevalence and predictors of postpartum depression among Arabic Muslim Jordanian women serving in the military. J Perinat Neonatal Nurs 2013; 27:25-33; quiz 34-5. [PMID: 23360938 DOI: 10.1097/jpn.0b013e31827ed6db] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this cross-sectional correlational study was to investigate the prevalence of symptoms and psychosocial predictors of postpartum depression (PPD) among Arabic Muslim Jordanian women serving in the military. Jordanian active-duty military women who had given birth within the last year (n = 300) and were working in 4 military hospitals participated in the study. Tools used included the Edinburgh Postnatal Depression Scale, the Impact of Event Scale-Revised, and the Multidimensional Perception of Social Support. Sixty-seven percent of study participants had mild to moderate symptoms of PPD, and 16% had high levels of symptoms of PPD. Seventy-five percent reported having adequate social support, and 75% reported perceived stress above the cutoff score. There was a strong positive significant relationship between symptoms of PPD and perceptions of stress. There was a significant moderate negative relationship between symptoms of PPD and perception of social support. Income, intendedness of pregnancy, mode of birth, family social support, and perception of stress were the strongest predictors of PPD. There was a reciprocal relationship between PPD and psychosocial variables, with women having low levels of perceived stress and satisfaction with social support having fewer symptoms of postpartum. These findings demonstrate the need to address the psychosocial needs of Arabic Muslim Jordanian childbearing women serving in the military through comprehensive interventions. Findings highlight the importance of social support in decreasing perceived stress and symptoms of PPD in these women.
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Bicking C, Moore GA. Maternal perinatal depression in the neonatal intensive care unit: the role of the neonatal nurse. Neonatal Netw 2012; 31:295-304. [PMID: 22908050 DOI: 10.1891/0730-0832.31.5.295] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The onset of depressive symptoms during pregnancy or the first year postpartum, termed perinatal depression, occurs in approximately 15 percent of women. Perinatal depression can have a significant negative impact on health outcomes for the mother and her infant including maternal emotional distress and parenting difficulties and infant behavioral and developmental problems. Nurses caring for patients in the neonatal intensive care unit (NICU) are in a key position to affect positive change in the lives of families affected by perinatal depression. An overview of antepartum and postpartum depression is provided that has been tailored to the educational needs of the neonatal nurse. A discussion of the role of neonatal nurses in the identification and treatment of perinatal depression follows in order that neonatal nurses may improve both short- and long-term outcomes for mothers, infants, and families in the NICU affected by perinatal depression.
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Affiliation(s)
- Cara Bicking
- Pennsylvania State University School of Nursing, Hershey, 17033–0855, USA.
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Predicting internalizing and externalizing problems at five years by child and parental factors in infancy and toddlerhood. Child Psychiatry Hum Dev 2012; 43:153-70. [PMID: 21956275 DOI: 10.1007/s10578-011-0255-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examined child and parental factors in infancy and toddlerhood predicting subclinical or clinical levels of internalizing and externalizing problems at 5 years of age. Ninety-six children and their families participated. They were assessed when the children were 4-10 weeks old (T1), 2 years (T2) and 5 years old (T3). Child risks (difficult temperament, health problems, early emotional and behavioral problems), parental risks (psychopathology, parenting stress and perception of the child) and family risks (socio-economic status, quality of marital relationship and family violence) were examined. At 5 years, internalizing problems were predicted by family violence during the child's infancy and parenting stress at age 2. Externalizing problems were predicted by psychiatric problems of the mother before pregnancy and child's externalizing problems at 2 years of age. When interventions aiming at preventing emotional and behavioral problems in children are considered, these issues should be recognized early and effective intervention initiated.
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25
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Ordway MR. Depressed mothers as informants on child behavior: methodological issues. Res Nurs Health 2011; 34:520-32. [PMID: 21964958 DOI: 10.1002/nur.20463] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2011] [Indexed: 12/19/2022]
Abstract
Mothers with depressive symptoms more frequently report behavioral problems among their children than non-depressed mothers leading to a debate regarding the accuracy of depressed mothers as informants of children's behavior. The purpose of this integrative review was to identify methodological challenges in research related to the debate. Data were extracted from 43 articles (6 theoretical, 36 research reports, and 1 instrument scoring manual). The analysis focused on the methodologies considered when using depressed mothers as informants. Nine key themes were identified and I concluded that researchers should incorporate multiple informants, identify the characteristics of maternal depression, and incorporate advanced statistical methodology. The use of a conceptual framework to understand informant discrepancies within child behavior evaluations is suggested for future research.
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Smith AK, Newport DJ, Ashe MP, Brennan PA, LaPrairie JL, Calamaras M, Nemeroff CB, Ritchie JC, Cubells JF, Stowe ZN. Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery. Clin Endocrinol (Oxf) 2011; 75:90-5. [PMID: 21521269 PMCID: PMC3367094 DOI: 10.1111/j.1365-2265.2011.03998.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Clinical and preclinical studies indicate that maternal stress during pregnancy may exert long-lasting adverse effects on offspring. This investigation sought to identify factors mediating the relationship between maternal and neonatal hypothalamic-pituitary-adrenal (HPA) axes in pregnant women with past or family psychiatric history. PATIENTS Two hundred and five pairs of maternal and umbilical cord blood samples from a clinical population were collected at delivery. MEASUREMENTS Maternal and neonatal HPA axis activity measures were plasma adrenocorticotrophic hormone (ACTH), total cortisol, free cortisol and cortisol-binding globulin concentrations. The effects of maternal race, age, body mass index, psychiatric diagnosis (DSM-IV), birth weight, delivery method and estimated gestational age (EGA) at delivery on both maternal and neonatal HPA axis measures were also examined. Incorporating these independent predictors as covariates where necessary, we evaluated whether neonatal HPA axis activity measures could be predicted by the same maternal measure using linear regression. RESULTS Delivery method was associated with umbilical cord plasma ACTH and both total and free cord cortisol concentrations (T = 10·53-4·21; P < 0·0001-0·010). After accounting for method of delivery and EGA, we found that maternal plasma ACTH concentrations predicted 23·9% of the variance in foetal plasma ACTH concentrations (T = 6·76; P < 0·0001), and maternal free and total plasma cortisol concentrations predicted 39·8% and 32·3% of the variance in foetal plasma free and total cortisol concentrations (T = 5·37-6·90; P < 0·0001), respectively. CONCLUSION These data suggest that neonatal response is coupled with maternal HPA axis activity at delivery. Future investigations will scrutinize the potential long-term sequelae for the offspring.
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Affiliation(s)
- Alicia K. Smith
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA
| | - D. Jeffrey Newport
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA
| | - Morgan P. Ashe
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA
| | | | | | - Martha Calamaras
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA
| | - Charles B. Nemeroff
- Department of Psychiatry & Behavioral Sciences, University of Miami, Miami, FL
| | - James C. Ritchie
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA
- Department of Pathology, Emory University, Atlanta, GA, USA
| | - Joseph F. Cubells
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Zachary N. Stowe
- Department of Psychiatry & Behavioral Sciences, Emory University, Atlanta, GA
- Department of Gynecology & Obstetrics, Emory University, Atlanta, GA, USA
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Hernández-Martínez C, Canals Sans J, Fernández-Ballart J. Parents' perceptions of their neonates and their relation to infant development. Child Care Health Dev 2011; 37:484-92. [PMID: 21392053 DOI: 10.1111/j.1365-2214.2011.01210.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Father and mother neonatal perceptions can alter the parents' behaviour towards their child and influence their relationship and, consequently, his/her development. The aim of this study was to examine how mother-father perceptions of their neonates evolve during the first month of life, and whether these perceptions, and the psychological and social characteristics of the mothers are good predictors of infant development. METHODS Seventy-two mother-father-child triads participated. Maternal personality, including neuroticism, and maternal depression and anxiety symptoms were assessed. Parents' neonatal perceptions and neonatal behaviour were assessed at 3 days and at 1 month post partum and infant development at 4 and 12 months post partum. RESULTS Parents' initial perceptions were positive, decreased in both parents during the first month and evolved differently according to the child's gender. High maternal neuroticism was related to worse neonatal perceptions, and high father perception was related to better infant development at 12 months. CONCLUSIONS These results support the contribution of parents' neonatal perception on infant development and may have social implications regarding the role of fathers in the parenting of their children.
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Affiliation(s)
- C Hernández-Martínez
- Psychology Department, Research Center for the Behavioural Assessment, Universitat Rovira i Virgili, Tarragona, Spain.
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Prenatal depression effects on early development: A review. Infant Behav Dev 2011; 34:1-14. [DOI: 10.1016/j.infbeh.2010.09.008] [Citation(s) in RCA: 379] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 08/17/2010] [Accepted: 09/24/2010] [Indexed: 11/18/2022]
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Abstract
As advocates for children and their families, pediatricians can support and guide expectant parents in the prenatal period. Prenatal visits allow the pediatrician to gather basic information from expectant parents, offer them information and advice, and identify high-risk conditions that may require special care. In addition, a prenatal visit is the first step in establishing a relationship between the family and the pediatrician (the infant's medical home) and in helping the parents develop parenting skills and confidence. There are several possible formats for this first visit. The one used depends on the experience and preference of the parents, the style of the pediatrician's practice, and pragmatic issues of reimbursement.
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Butner J, Berg CA, Osborn P, Butler JM, Godri C, Fortenberry KT, Barach I, Le H, Wiebe DJ. Parent-adolescent discrepancies in adolescents' competence and the balance of adolescent autonomy and adolescent and parent well-being in the context of Type 1 diabetes. Dev Psychol 2009; 45:835-49. [PMID: 19413435 DOI: 10.1037/a0015363] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined whether intrafamily discrepancies in perceptions of the adolescent's competence and independence were associated with autonomy and well-being for adolescents and parents. The ways in which mothers and fathers consistently differed from their adolescent across measures of independence and competence regarding Type 1 diabetes, a stressful context for families, were examined with the latent discrepancy model. A sample of 185 adolescents (mean age = 12.5 years, SD = 1.3), their mothers, and participating fathers completed measures of the adolescent's independence in completing diabetes tasks, problems with diabetes management, adherence to the medical regimen, measures of well-being, and metabolic control. The latent discrepancy model was conducted via structural equation modeling that generated latent discrepancies from the adolescent for mothers and fathers. Both mothers and fathers viewed the adolescent's competence more negatively than did the adolescent. These discrepancies related to more parental encouragement of independence and adolescent autonomy but also to poorer metabolic control and poorer parental psychosocial well-being. The results are interpreted within a developmental perspective that views discrepancies as reflecting normative developmental processes of autonomy but as being associated with disruptions in well-being in the short term.
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Affiliation(s)
- Jonathan Butner
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA.
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Turner K, Piazzini A, Franza A, Marconi AM, Canger R, Canevini MP. Epilepsy and postpartum depression. Epilepsia 2009; 50 Suppl 1:24-7. [DOI: 10.1111/j.1528-1167.2008.01965.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gao W, Paterson J, Abbott M, Carter S, Iusitini L. Maternal mental health and child behaviour problems at 2 years: findings from the Pacific Islands Families Study. Aust N Z J Psychiatry 2007; 41:885-95. [PMID: 17924241 DOI: 10.1080/00048670701634929] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The present study investigated associations between the timing and persistence of maternal psychological disorder and child behaviour problems in a cohort of Pacific 2-year-old children in New Zealand. METHOD Mothers of a cohort of 1,398 Pacific infants born in South Auckland, New Zealand were interviewed when their children were 6 weeks, 12 and 24 months of age. Within the context of a wider interview, data regarding maternal mental health were obtained at these times and maternal reports of child behaviour were gathered when the children were 2 years old. RESULTS Prevalence rates for internalizing problems were significantly higher in children of mothers who had self-reported symptoms of psychological disorder (11.9% in no symptoms, 27.8% in early symptoms of postnatal depression, 21.1% in late symptoms of psychological disorder and 42.9% in persistent or recurrent symptoms). The adjusted odds ratio (OR) of a child having internalizing problems was 1.38 (95% confidence interval (CI): 0.79-2.43) in those of mothers reporting early symptoms of postnatal depression, 1.45 (95%CI: 0.85-2.49) in late symptoms of psychological disorder, and 2.93 (95%CI: 1.54-5.57) in persistent or recurrent symptoms relative to the no symptoms group. For externalizing problems, the effects of maternal psychological disorder were not significant. CONCLUSIONS Maternal persistent or recurrent symptoms of psychological disorder may contribute to the behaviour problems of children as young as 2 years old. However, the timing of disorder, whether it is infant or toddler exposure, does not appear to be as crucial. Improved understanding of the associations between maternal psychological disorder and early child behaviour problems may help maternal and child health professionals design appropriate and effective screening and intervention programs to help Pacific mothers and children.
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Affiliation(s)
- Wanzhen Gao
- Pacific Islands Families Study, Division of Public Health and Psychosocial Studies, Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand.
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Vitolo MR, Benetti SPDC, Bortolini GA, Graeff A, Drachler MDL. Depressão e suas implicações no aleitamento materno. ACTA ACUST UNITED AC 2007. [DOI: 10.1590/s0101-81082007000100009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: O objetivo deste estudo foi avaliar a prevalência de sintomas depressivos num grupo de mães de crianças entre 12 e 16 meses do município de São Leopoldo (RS) e suas associações com tempo de aleitamento materno e aspectos do desenvolvimento da criança. MÉTODO: Foram avaliadas 263 mães de crianças recrutadas ao nascimento em uma maternidade que atende população de baixo nível socioeconômico. Os sintomas depressivos foram avaliados por meio do Inventário para Depressão de Beck. RESULTADOS: Foi observado que 35,7% das mães apresentaram sintomas de depressão. Quanto à classificação, 18,3% apresentaram depressão leve, 11%, depressão moderada, e 6,5%, grave. As mães sem companheiros (razão de prevalência - RP = 1,70; IC95% = 1,20-2,38) e provenientes de famílias não-nucleares apresentaram mais sintomas depressivos (RP = 1,38; IC95% = 0,99-1,92). As freqüências de aleitamento materno exclusivo por 6 meses (RP = 1,86; IC95% = 0,94-3,68) e aleitamento materno aos 12 meses (RP = 1,80; IC95% = 1,26-2,58) foram maiores no grupo de mães sem sintomas depressivos. CONCLUSÃO: É necessária maior atenção à saúde mental das mulheres, considerando a alta prevalência de sintomas depressivos nessa população e a forte associação com o menor tempo de aleitamento materno.
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Field T, Diego M, Hernandez-Reif M. Prenatal depression effects on the fetus and newborn: a review. Infant Behav Dev 2006; 29:445-55. [PMID: 17138297 DOI: 10.1016/j.infbeh.2006.03.003] [Citation(s) in RCA: 352] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2005] [Revised: 02/01/2006] [Accepted: 03/20/2006] [Indexed: 10/24/2022]
Abstract
A review of research on prenatal depression effects on the fetus and newborn suggests that they experience prenatal, perinatal and postnatal complications. Fetal activity is elevated, prenatal growth is delayed, and prematurity and low birthweight occur more often. Newborns of depressed mothers then show a biochemical/physiological profile that mimics their mothers' prenatal biochemical/physiological profile including elevated cortisol, lower levels of dopamine and serotonin, greater relative right frontal EEG activation and lower vagal tone. Elevated prenatal maternal cortisol is the strongest predictor of these neonatal outcomes. Moderate pressure massage can alleviate these effects including reducing prematurity.
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Affiliation(s)
- Tiffany Field
- Touch Research Institutes, University of Miami, School of Medicine, P.O. Box 016820, Miami, Florida, 33101, United States.
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Pascoe JM, Stolfi A, Ormond MB. Correlates of mothers' persistent depressive symptoms: a national study. J Pediatr Health Care 2006; 20:261-9. [PMID: 16831634 DOI: 10.1016/j.pedhc.2006.01.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2006] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to examine the prevalence, persistence, and correlates of mothers' depressive symptoms over a 5-year period in a nationally representative sample of the United States population. METHOD Data from 2235 mothers in the National Survey of Families and Households, Wave I, 1987-1988, and Wave II, 1992-1994, were analyzed. Outcome measures were scores on the Center for Epidemiological Studies Depression Scale (CES-D, 12-item version) and a validated three-item depression screen. RESULTS One fifth of study mothers had positive CES-D scores and almost half (48%) had negative CES-D scores in both waves. Wave I risk factors for persistent "positive" CES-D scores were maternal age less than 30 years (24%), African-American (33%), never married (26%) or divorced (32%), education less than high school (35%), and indigent (32%). Adjusted odds ratios (AOR) and 95% confidence intervals for persistent "positive" versus persistent "negative" CES-D scores were: age less than 30 years (Wave I), AOR = 1.64, (1.22-2.21); unmarried (Wave II), AOR = 2.60, (1.89-3.56); education less than high school (Wave II), AOR = 2.18, (1.41-3.38); and indigent (Wave II), AOR = 2.09 (1.36-3.21). DISCUSSION About one fifth of the study sample reported high depressive symptoms twice over a 5-year period. Depression in women, especially mothers, is an urgent public health problem.
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Affiliation(s)
- John M Pascoe
- Department of Pediatrics, Wright State University School of Medicine, Children's Medical Center, One Children's Plaza, Dayton, OH 45404, USA.
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