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Okoror TA, Nyamuame BM, Martin-Ikpe C, Gilani Y, Nyamuame SE. "… He's not beating me"-Socio-cultural construction of intimate partner violence and traditional birth attendants: implications for maternal & child health in rural communities in Hohoe, Ghana. Front Glob Womens Health 2024; 5:1352793. [PMID: 38567108 PMCID: PMC10985337 DOI: 10.3389/fgwh.2024.1352793] [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: 12/08/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Most research on Intimate Partner Violence (IPV) focuses on the physical, sexual and psychological abuse, with less focus on the financial abuse. This study explores nursing mothers' experiences and perceptions of financial and material support from their significant others and traditional birth attendants' (TBA) observations of support to nursing mothers in their communities. Methods Using purposive sampling, focus groups and interviews were conducted primarily in Ewe language among nursing mothers and TBAs in rural communities in Hohoe, Volta region, Ghana. All discussions were audio-recorded and transcribed for analysis. Thematic analysis guided by the social constructivist framework was used in data analysis. Results Twenty-seven women participated in the study, ranging in ages from 19 to 82 (20 nursing mothers; 7 TBAs). Most participants were married (19) and about 65% reported working outside the home (10 nursing mothers; 7 TBAs). Two themes emerged from the data analysis: Lack of support from partners for housekeeping chores and finances; and TBAs as mediators. Nursing mothers who reported lack of financial support did not perceive it as abuse, rather as hinderance to their efforts to care for their children. TBAs act as mediators interceding on behalf of nursing mothers with their husbands and fathers of their children, while also seeking resources to support them. Discussion Understanding the perceptions and socio-cultural meanings women attached to IPV experience is essential for effective intervention to reduce IPV. In addition, TBAs can be a resource in intervening to alleviate IPV in their communities, thereby improving maternal and child health.
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Affiliation(s)
- Titilayo A. Okoror
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
- Center for Health Equity and Evaluation Research (CHEER), School of Public Health, Texas A&M University, College Station, TX, United States
| | - Bless M. Nyamuame
- Department of Midwifery, Nursing & Midwifery Training College, Hohoe, Ghana
| | - Cordelia Martin-Ikpe
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
- Center for Health Equity and Evaluation Research (CHEER), School of Public Health, Texas A&M University, College Station, TX, United States
| | - Yasmeen Gilani
- Department of Africana Studies & Global Public Health Program, Binghamton, NY, United States
| | - Samuel Elikem Nyamuame
- Department of Africana Studies, Binghamton University (SUNY), Vestal Parkway East, Binghamton, NY, United States
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Stoinis N, Creeper K, Phillips J, Graham D, Lim EM. Diverse presentations of Cushing's syndrome during pregnancy - A case series. Aust N Z J Obstet Gynaecol 2024. [PMID: 38284434 DOI: 10.1111/ajo.13793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/11/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Cushing's syndrome (CS) encompasses various causes of hypercortisolism including adrenocorticotropic hormone (ACTH) secreting pituitary adenoma with or without bilateral adrenal hyperplasia, an adrenal adenoma or carcinoma, ectopic ACTH or corticotrophin-releasing hormone (CRH) secretion by a neoplasm or exogenous corticosteroid therapy. The diagnosis of CS in pregnancy presents a challenge due to overlapping clinical features of pregnancy (weight gain, striae, acne). If untreated, CS in pregnancy is associated with increased risk of maternal and fetal complications. AIMS With fewer than 250 cases currently published, we aim to review the clinical presentations, diagnostic methods, management, and outcomes of patients with CS in pregnancy to help optimise our clinical practice. MATERIALS AND METHODS This is a single-centre, retrospective review of woman with documented hypercortisolism receiving antenatal care at a tertiary maternity hospital in Perth between 2006 to 2022. Data were collated from electronic and chart reviews. OMNI calculator was used for birthweight calculations. Local ethics and patient consent were obtained. RESULTS Five women and seven pregnancies were identified. Four women had a pituitary source of ACTH-dependent CS as confirmed by brain magnetic resonance imaging. One woman had an ectopic source of ACTH. Two women were diagnosed during pregnancy. All pregnancies occurring prior to treatment of the Cushing's disease were complicated by secondary hypertension and diabetes. CONCLUSION CS represents a rare and difficult to diagnose condition in pregnancy. When untreated, maternal and fetal outcomes are compromised. Close monitoring of the associated complications with involvement of a multidisciplinary team are recommended.
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Affiliation(s)
- Natasha Stoinis
- Department of Obstetric Medicine, King Edward Memorial Hospital, Perth, Western Australia, Australia
- Department of General Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Katherine Creeper
- Department of Obstetric Medicine, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Jessica Phillips
- Department of Obstetric Medicine, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Dorothy Graham
- Department of Obstetric Medicine, King Edward Memorial Hospital, Perth, Western Australia, Australia
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Ee Mun Lim
- Department of Endocrinology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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Orenshtein S, Sheiner E, Sergienko R, Wainstock T. Syncope in pregnancy, immediate pregnancy outcomes, and offspring long-term neurologic health. Am J Obstet Gynecol MFM 2023; 5:101190. [PMID: 37838012 DOI: 10.1016/j.ajogmf.2023.101190] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND There are limited data regarding the perinatal consequences of maternal syncope during pregnancy, and even less is known about the potential long-term effect on offspring health. OBJECTIVE This study aimed to examine perinatal outcomes as well as long-term offspring neurologic morbidity associated with prenatal maternal syncope, and the possible differential effect by trimester of first syncope episode. STUDY DESIGN A retrospective cohort study was conducted, including all singleton deliveries occurring between 1991 and 2021 at a large tertiary medical center. Multivariable analyses were applied to study the associations between prenatal maternal syncope and various perinatal outcomes as well as offspring neurologic morbidity up to the age of 18 years, while adjusting for clinically relevant factors. Analyses were further conducted by trimester of first syncope episode. RESULTS The study population included 232,475 pregnancies, 774 (0.3%) were affected by maternal syncope, which most frequently first occurred during the second trimester (44.5%), followed by the first trimester (31.8%) and finally the third trimester (27.7%). Maternal syncope was independently associated with increased risk for intrauterine growth restriction (adjusted odds ratio, 1.52; 95% confidence interval, 1.01-2.29), which appeared to be mainly driven by first trimester syncope occurrence; as well as with increased risk for cesarean delivery (adjusted odds ratio, 1.33; 95% confidence interval, 1.10-1.61), and for long-term offspring neurologic morbidity (adjusted hazard ratio, 1.79; 95% confidence interval, 1.65-2.08), regardless of the trimester of syncope occurrence. CONCLUSION Prenatal maternal syncope is an independent risk factor for intrauterine growth restriction, cesarean delivery, and for long-term offspring neurologic morbidity.
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Affiliation(s)
- Shani Orenshtein
- Faculty of Health Sciences, Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Ms Orenshtein, Mr Sergienko, and Dr Wainstock).
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Prof Sheiner)
| | - Ruslan Sergienko
- Faculty of Health Sciences, Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Ms Orenshtein, Mr Sergienko, and Dr Wainstock)
| | - Tamar Wainstock
- Faculty of Health Sciences, Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (Ms Orenshtein, Mr Sergienko, and Dr Wainstock)
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Sur D, Agranyoni O, Kirby M, Cohen N, Bagaev A, Karandasheva K, Shmerkin E, Gorobets D, Savita BK, Avneri R, Divon MS, Lax E, Michaelevski I, Pinhasov A. Nurture outpaces nature: fostering with an attentive mother alters social dominance in a mouse model of stress sensitivity. Mol Psychiatry 2023; 28:3816-3828. [PMID: 37845494 DOI: 10.1038/s41380-023-02273-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
Maternal care is critical for epigenetic programming during postnatal brain development. Stress is recognized as a critical factor that may affect maternal behavior, yet owing to high heterogeneity in stress response, its impact varies among individuals. We aimed here to understand the connection between inborn stress vulnerability, maternal care, and early epigenetic programming using mouse populations that exhibit opposite poles of the behavioral spectrum (social dominance [Dom] and submissiveness [Sub]) and differential response to stress. In contrast to stress-resilient Dom dams, stress-vulnerable Sub dams exhibit significantly lower maternal attachment, serum oxytocin, and colonic Lactobacillus reuteri populations. Sub offspring showed a reduced hippocampal expression of key methylation genes at postnatal day (PND) 7 and a lack of developmentally-dependent increase in 5-methylcytosine (5-mC) at PND 21. In addition, Sub pups exhibit significant hypermethylation of gene promoters connected with glutamatergic synapses and behavioral responses. We were able to reverse the submissive endophenotype through cross-fostering Sub pups with Dom dams (Sub/D). Thus, Sub/D pups exhibited elevated hippocampal expression of DNMT3A at PND 7 and increased 5-mC levels at PND 21. Furthermore, adult Sub/D offspring exhibited increased sociability, social dominance, and hippocampal glutamate and monoamine levels resembling the neurochemical profile of Dom mice. We postulate that maternal inborn stress vulnerability governs epigenetic patterning sculpted by maternal care and intestinal microbiome diversity during early developmental stages and shapes the array of gene expression patterns that may dictate neuronal architecture with a long-lasting impact on stress sensitivity and the social behavior of offspring.
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Affiliation(s)
- Debpali Sur
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Oryan Agranyoni
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Michael Kirby
- Dr. Miriam and Sheldon G. Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Naamah Cohen
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Anastasia Bagaev
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Kristina Karandasheva
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Elena Shmerkin
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Denis Gorobets
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Brajesh Kumar Savita
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Raphael Avneri
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Mali-Salmon Divon
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
- Dr. Miriam and Sheldon G. Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Elad Lax
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Izhak Michaelevski
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel
| | - Albert Pinhasov
- Department of Molecular Biology, Faculty of Natural Sciences, Ariel University, Ramat HaGolan St 65, 4077625, Ariel, Israel.
- Dr. Miriam and Sheldon G. Adelson School of Medicine, Ariel University, Ariel, Israel.
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Ross KM, Mander H, Rinne G, Okun M, Hobel C, Coussons-Read M, Dunkel Schetter C. Pregnancy-specific anxiety and gestational length: The mediating role of diurnal cortisol indices. Psychoneuroendocrinology 2023; 153:106114. [PMID: 37084672 PMCID: PMC10952551 DOI: 10.1016/j.psyneuen.2023.106114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Preterm birth or shorter gestation is a common adverse pregnancy outcome. Pregnancy-specific anxiety is robustly associated with risk for shorter gestation. Hypothalamic-pituitary-adrenal (HPA) dysregulation, indicated by diurnal cortisol index variability [slope, area-under-the-curve (AUC) or cortisol awakening response (CAR)], could mediate associations between pregnancy-specific anxiety and shorter gestation. The purpose of this study was to explore whether diurnal cortisol index variability mediates associations between pregnancy-specific anxiety and gestational length. METHODS A sample of 149 women from the Healthy Babies Before Birth study reported pregnancy-specific anxiety in early pregnancy. Saliva samples were taken at three times during pregnancy, for two days each, at wake, 30 min post wake, noon, and evening. Diurnal cortisol indices were calculated using standard approaches. Pregnancy cortisol index variability was calculated across pregnancy timepoints. Gestational length was derived from medical charts. Covariates were sociodemographics, parity and obstetric risk. Mediation models were tested using SPSS PROCESS. RESULTS There was a significant indirect effect of pregnancy-specific anxiety on gestational length via CAR variability, b(SE)= -0.102(0.057), .95CI [- 0.227,- 0.008]. Higher pregnancy-specific anxiety was associated with lower CAR variability, b(SE)= -0.019(0.008), p = .022, and lower CAR variability was associated with shorter gestation, b(SE)= 5.29(2.64), p = .047. Neither AUC or slope variability mediated associations between pregnancy-specific anxiety and gestational length. CONCLUSION Lower CAR variability during pregnancy mediated the association between higher pregnancy-specific anxiety and shorter gestational length. Pregnancy-specific anxiety could dysregulate HPA axis activity, as indicated by lower CAR variability, demonstrating the importance of the HPA axis system in regulating pregnancy outcomes.
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Affiliation(s)
- Kharah M Ross
- Psychology Department, Athabasca University, Athabasca, AB, Canada; Psychology Department, University of Calgary, Calgary, AB, Canada.
| | - Harmeen Mander
- Psychology Department, University of Calgary, Calgary, AB, Canada.
| | - Gabrielle Rinne
- Psychology Department, University of California - Los Angeles, Los Angeles, CA, United States
| | - Michele Okun
- Psychology Department, University of Colorado - Colorado Springs, Colorado Springs, CO, United States
| | - Calvin Hobel
- Cedars-Sinai Medical Centre, Los Angeles, CA, United States
| | - Mary Coussons-Read
- Psychology Department, University of Colorado - Colorado Springs, Colorado Springs, CO, United States
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Biadgilign S, Mgutshini T, Deribew A, Gelaye B, Memiah P. Association of maternal psychological distress with children with overweight/obesity in Ethiopia. Child Care Health Dev 2023; 49:392-399. [PMID: 36073145 PMCID: PMC10087200 DOI: 10.1111/cch.13057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 08/15/2022] [Accepted: 09/02/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Poor maternal mental health is a major risk factor for adverse offspring health outcomes, including overweight/obesity status. Maternal mental distress is highly prevalent and associated with parenting practices influencing child weight. To date, there is little information documented in Ethiopia on maternal mental distress and children with overweight/obesity status. This study examined the association between maternal mental distress and children with overweight/obesity among mother-child dyads in Addis Ababa, Ethiopia. METHODS An observational population-based cross-sectional study was conducted among mother-child dyads in representative samples in Addis Ababa, Ethiopia. Maternal mental distress was measured using the Self-Reporting Questionnaire (SRQ)-20. Child/adolescent overweight/obesity was defined as more than 1 SD above the median World Health Organization (WHO) growth reference. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The prevalence of maternal mental distress and children with overweight/obesity was estimated to be 10.1% and 28.8%, respectively. After adjusting for confounders, including maternal education, maternal occupation, average monthly household income, maternal body mass index (BMI) and the number of household members/family size, maternal psychological distress was not associated with offspring overweight/obesity status (adjusted OR [aOR] = 0.54; 95% CI: 0.25, 1.14). CONCLUSIONS There is no evidence of an association between maternal psychological distress and children with overweight/obesity. This lack of association might be attributable to our cross-sectional study design. Future epidemiologic studies, particularly those using prospectively collected data, are warranted to examine better the effects of maternal psychological distress on offspring body weight.
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Affiliation(s)
- Sibhatu Biadgilign
- Department of Health Studies, College of Human Science, University of South Africa, Pretoria, South Africa
| | - Tennyson Mgutshini
- Department of Health Studies, College of Human Science, University of South Africa, Pretoria, South Africa
| | - Amare Deribew
- School of Public Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.,Nutrition International, Addis Ababa, Ethiopia
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Peter Memiah
- Division of Epidemiology and Prevention: Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
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Tien Nguyen S, Bui Minh T, Trung Dinh H, Dinh Le T, Phi Thi Nguyen N, Tran TTH, Hien Vu T, Luong Cong T, Ho Thi Nguyen L, Tuan Pham P, Viet Tran T, Xuan Nguyen K. Relationship Between Maternal Serum Cortisol and Maternal Insulin Resistance and Fetal Ultrasound Characteristics in Gestational Diabetes Mellitus. Diabetes Metab Syndr Obes 2023; 16:365-372. [PMID: 36788989 PMCID: PMC9922503 DOI: 10.2147/dmso.s400995] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/27/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Cortisol is proven to play a crucial role in hyperglycemia and fetal development in gestational diabetes mellitus (GDM). This research aims to investigate the relationship between maternal serum cortisol and insulin resistance indices and fetal ultrasound characteristics in women with GDM. METHODS A cross-sectional and descriptive study on 144 GDM in Vietnam from January 2015 to December 2020. Serum cortisol was measured using electrochemiluminescence immunoassay at 8 a.m. on the examination day in the vicinity of the 24th gestational week. Fetal ultrasound was performed by an experienced person who was blind to the study. RESULTS The mean cortisol level in the GDM group was 627.04 nmol/L. Serum cortisol levels positively correlated with abdominal circumference (AC), fasting plasma glucose (FPG), insulin, triglycerides, HOMA2-IR, and Mathew indices (with r of 0.18, 0.22, 0.18, 0.17, 0.18, and 0.22, respectively). Serum cortisol levels negatively correlated with QUICKI and McAuley indices (with r of -0.19 and -0.21), respectively. In a univariate linear regression, maternal serum cortisol positively correlated with fetal AC, head circumference (HC), and biparietal diameter (BPD) (with r of 0.21; 0.23; and 0.25, respectively). In a multivariate linear regression analysis, cortisol positively correlated with fetal AC, HC, and BPD after adjusting to maternal McAuley index. CONCLUSION Serum cortisol levels in GDM correlated with fasting blood glucose, triglycerides, and insulin resistance. Besides, serum cortisol levels in GDM positively correlated with fetal development.
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Affiliation(s)
- Son Tien Nguyen
- Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Tien Bui Minh
- Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Hoa Trung Dinh
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
- National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Tuan Dinh Le
- Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Nga Phi Thi Nguyen
- Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Thi Thanh Hoa Tran
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Trinh Hien Vu
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Thuc Luong Cong
- Cardiovascular Center, Military Hospital 103, Vietnam Medical Military University, Ha Noi, Vietnam
| | - Lan Ho Thi Nguyen
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Phuong Tuan Pham
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
- National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Tien Viet Tran
- Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, 10000, Vietnam
| | - Kien Xuan Nguyen
- Department of Military Medical Command and Organization, Vietnam Medical Military University, Ha Noi, Vietnam
- Correspondence: Kien Xuan Nguyen, Department of Military Medical Command and Organization, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi city, Vietnam, Email
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Bhamani SS, Arthur D, Van Parys AS, Letourneau N, Wagnild G, Premji SS, Asad N, Degomme O. Resilience and prenatal mental health in Pakistan: a qualitative inquiry. BMC Pregnancy Childbirth 2022; 22:839. [PMID: 36376896 PMCID: PMC9664804 DOI: 10.1186/s12884-022-05176-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention. Methods The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A total of 17 semi-structured interviews were conducted with pregnant women, purposefully selected with heterogeneous characteristics to explore diverse perspectives, while symptoms of depression were quantified by the Edinburgh Postnatal Depression Scale before the interview. Verbatim transcriptions were coded openly and merged into categories and themes. Result A total of six themes emerged from in-depth thematic analysis: 1) purpose of life, 2) dealing with emotions, 3) believing in yourself, 4) optimistic approach, 5) strengthening support and relationship and 6) spirituality and humanity. Women agreed that these characteristics could help them improve their mental health. Conclusion In conclusion, these themes were the core components of pregnant women’s resilience which ultimately could help to promote prenatal mental health. These pave a pathway towards developing culturally and contextually resilience interventions aimed at enhancing mental health of pregnant women which then may improve neonatal and family mental wellbeing.
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Smith CL, Waters SF, Spellacy D, Burduli E, Brooks O, Carty CL, Ranjo S, McPherson S, Barbosa-Leiker C. Substance use and mental health in pregnant women during the COVID-19 pandemic. J Reprod Infant Psychol 2022; 40:465-478. [PMID: 33870821 PMCID: PMC8963362 DOI: 10.1080/02646838.2021.1916815] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 04/09/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES We examined the prevalence of substance use as a coping mechanism and identified relationships between maternal mental health over time and use of substances to cope during the Coronavirus Disease 2019 (COVID-19) pandemic among pregnant women in the U.S.A. METHODS Self-reported repeated measures from 83 pregnant women were collected online in April 2020 and May 2020. Women retrospectively reported their mental/emotional health before the pandemic, as well as depression, stress, and substance use as a result of the pandemic at both time points. Linear regression measured cross-sectional and longitudinal associations between mental health and substance use. RESULTS Pre-COVID-19 reports of poorer mental/emotional health (b = 0.46) were significantly (p < .05) associated with number of substances used to cope with the pandemic. Elevated stress (b = 0.35) and depressive symptoms (b = 0.27) and poorer mental/emotional health (b = 0.14) in April were also significantly related to higher numbers of substances used in May (p < .05). CONCLUSION Pregnant women's psychological well-being may be a readily measured indicator substance use risk during crises such as the COVID-19 pandemic. Interventions addressing increased stress and depression may also mitigate the emergence of greater substance use among pregnant women.
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Affiliation(s)
- Crystal Lederhos Smith
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
- Program of Excellence in Addictions Research, Washington State University, Spokane, WA, U.S.A
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, U.S.A
| | - Sara F. Waters
- Department of Human Development, Washington State University, Vancouver, WA, U.S.A
| | - Danielle Spellacy
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
| | - Ekaterina Burduli
- Program of Excellence in Addictions Research, Washington State University, Spokane, WA, U.S.A
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, U.S.A
- College of Nursing, Washington State University, Spokane, WA, U.S.A
| | - Olivia Brooks
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
- Program of Excellence in Addictions Research, Washington State University, Spokane, WA, U.S.A
| | - Cara L. Carty
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
| | - Samantha Ranjo
- College of Nursing, Washington State University, Spokane, WA, U.S.A
| | - Sterling McPherson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
- Program of Excellence in Addictions Research, Washington State University, Spokane, WA, U.S.A
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, U.S.A
| | - Celestina Barbosa-Leiker
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, U.S.A
- College of Nursing, Washington State University, Spokane, WA, U.S.A
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Baughcum AE, Clark OE, Lassen S, Fortney CA, Rausch JA, Dunnells ZDO, Geller PA, Olsavsky A, Patterson CA, Gerhardt CA. Preliminary Validation of the Psychosocial Assessment Tool in the Neonatal Intensive Care Unit. J Pediatr Psychol 2022:6780153. [PMID: 36308772 DOI: 10.1093/jpepsy/jsac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Research suggests families whose infants are admitted to the Neonatal Intensive Care Unit (NICU) experience elevated distress and may have pre-existing risk factors for maladjustment. This study sought to validate the newly developed Psychosocial Assessment Tool (PAT-NICU/Cardiac Intensive Care Unit [CICU]), a comprehensive screening measure for family psychosocial risk in the NICU. METHODS The sample included 171 mothers, who completed the PAT-NICU/CICU and other related measures within 2 weeks of their infant's NICU admission at a level 4 unit within a large pediatric hospital. PAT-NICU/CICU scores were compared to a companion risk survey completed by NICU social workers. Test-retest reliability was assessed through repeated measures at 2-month follow-up. RESULTS Analyses suggest the PAT-NICU/CICU is effective in classifying psychosocial risk. This is supported by statistically significant correlations between the PAT-NICU/CICU and validated measures, in addition to elevated scores on concurrent measures by risk classification. Internal consistency, test-retest reliability, and acceptability for the PAT-NICU/CICU were satisfactory. CONCLUSIONS This preliminary study demonstrates the validity, reliability, and acceptability of the PAT-NICU/CICU as a psychosocial screening tool to aid identification of families who may benefit from supportive services during NICU admission. This new measure is a more comprehensive tool that assesses a wide variety of risk factors and stress responses. However, future studies of this measure are needed with more diverse samples. Prompt screening of NICU parents may facilitate earlier linkage with appropriate levels of resources or intervention. This research is crucial in improving risk assessment and psychosocial care for families in the NICU.
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Affiliation(s)
- Amy E Baughcum
- Division of Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Olivia E Clark
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Stephen Lassen
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christine A Fortney
- Martha S. Pitzer Center for Women, Children & Youth, College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Joseph A Rausch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Zackery D O Dunnells
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Pamela A Geller
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA.,Department of Psychiatry, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Anna Olsavsky
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Chavis A Patterson
- Department of Psychiatry, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Cynthia A Gerhardt
- Division of Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA.,Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Psychology, The Ohio State University, Columbus, OH, USA
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11
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Chauhan A, Potdar J. Maternal Mental Health During Pregnancy: A Critical Review. Cureus 2022; 14:e30656. [DOI: 10.7759/cureus.30656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022] Open
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12
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Bermúdez-González M, Álvarez-Silvares E, Santa-María-Ortiz J, Castro-Vilar L, Vázquez-Rodriguez M. Impact of the COVID-19 pandemic on maternal anxiety during pregnancy: A prevalence study. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022; 49:100776. [PMID: 35693637 PMCID: PMC9174146 DOI: 10.1016/j.gine.2022.100776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Abstract
Aim Material and method Results Conclusions
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13
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Lobo E, Ana Y, Deepa R, Shriyan P, Sindhu ND, Karthik M, Kinra S, Murthy GVS, Babu GR. Cohort profile: maternal antecedents of adiposity and studying the transgenerational role of hyperglycaemia and insulin (MAASTHI). BMJ Open 2022; 12:e063794. [PMID: 36130760 PMCID: PMC9494597 DOI: 10.1136/bmjopen-2022-063794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/07/2022] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The Maternal Antecedents of Adiposity and Studying the transgenerational role of Hyperglycaemia and Insulin cohort in Bengaluru, South India, aims to understand the transgenerational role of increased circulating glucose levels or hyperglycaemia and other nutrients and psychosocial environment, on the risk of childhood obesity, as an early marker of chronic diseases. PARTICIPANTS Through this paper, we describe the baseline characteristics of the cohort participants and their children, along with plans and challenges. A total of 5694 pregnant women were screened, with 4862 (85.4%) eligible pregnant women recruited at baseline. We assessed anthropometry, Haemoglobin status, Oral Glucose Tolerance Test (OGTT), dietary practices, depressive symptoms using the Edinburgh Postnatal Depression Scale and social support in all women. Follow-up visits involved assessing anthropometry and the health profile of mothers and children. FINDINGS TO DATE Among 4862 eligible participants recruited, 3260 (67%) underwent OGTT, while 2962 participants completed OGTT (90.9%). During the pregnancy, 9.7% of women were obese (>90th percentile of skinfold thickness), and 14.3% had gestational diabetesmellitus. Moreover, 6.2% and 16.8% of women had symptoms suggestive of depression during pregnancy and the immediate postnatal period, respectively. We found that 3.3% of children were small for gestational age, 10.8% were large for gestational age and 9.7% of children were obese at birth. FUTURE PLANS We have completed recruitment and baseline data collection in 2019, and are conducting annual follow-ups until age 4 of the participant's children. For delineating causal pathways of childhood obesity, blood aliquots are stored in the biorepository. The study will inform policy formulation and community awareness in the prevention and control of non-communicable diseases and health promotion.
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Affiliation(s)
- Eunice Lobo
- Indian Institute of Public Health, Public Health Foundation, Bangalore, Karnataka, India
| | - Yamuna Ana
- Indian Institute of Public Health, Public Health Foundation, Bangalore, Karnataka, India
| | - R Deepa
- Indian Institute of Public Health, Public Health Foundation, Bangalore, Karnataka, India
| | - Prafulla Shriyan
- Indian Institute of Public Health, Public Health Foundation, Bangalore, Karnataka, India
| | - N D Sindhu
- Indian Institute of Public Health, Public Health Foundation, Bangalore, Karnataka, India
| | - Maithili Karthik
- Indian Institute of Public Health, Public Health Foundation, Bangalore, Karnataka, India
| | - Sanjay Kinra
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - G V S Murthy
- IIPH Hyderabad, Public Health Foundation, Hyderabad, Telangana, India
| | - Giridhara R Babu
- Indian Institute of Public Health, Public Health Foundation, Bangalore, Karnataka, India
- Wellcome Trust DBT India Alliance, Hyderabad, Telangana, India
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14
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Gaviria-Arbeláez SL, Uribe-Holguín A, Gil-Castaño LS, Uribe-Bravo SE, Serna-Galeano LE, Álvarez-Mesa C, Palacio-Moná R, Vélez-Cuervo SM. Prevalencia del riesgo de depresión y preocupaciones en mujeres gestantes en el contexto de la pandemia por COVID-19 en Antioquia, Colombia, 2020-2021. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGÍA 2022; 73:194-202. [PMID: 35939413 PMCID: PMC9395201 DOI: 10.18597/rcog.3821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Abstract
Objetivos: Describir la prevalencia de los síntomas de depresión y las preocupaciones que afectaron a las gestantes durante la pandemia por COVID-19. Materiales y métodos: Estudio transversal descriptivo, se incluyeron mujeres gestantes, con acceso a un medio tecnológico (celular, computador o tableta) y conectividad a internet, residentes en Antioquia, Colombia. Se excluyeron mujeres con analfabetismo literario y tecnológico. Se encuestaron, en línea, las condiciones sociodemográficas y clínicas basales y las principales preocupaciones generadas por la pandemia, además se aplicó la Escala de Depresión de Edimburgo (EPDS) para medir el riesgo de depresión. Se usó el software Jamovi para el procesamiento y análisis estadístico. Resultados: Se encuestaron 345 mujeres gestantes de 15 a 44 años, se identificó una prevalencia de riesgo de depresión en 30,4 % de las mujeres encuestadas. Se identificó violencia intrafamiliar en el 4,9 % y ausencia de red de apoyo en el 8,4 %. Se encontraron como mayores preocupaciones temor a ser separadas del bebé el día del parto, la posibilidad de no tener acompañante durante el parto, y temor al contagio por los efectos en el bebé in útero o en el recién nacido. Conclusiones: Los síntomas de depresión han sido frecuentes en las mujeres gestantes durante la pandemia del COVID-19. Es importante averiguar por factores de estrés y síntomas de depresión en el control prenatal, el parto y el postparto. Se requieren nuevos estudios locales que evalúen otros trastornos de salud mental que se hayan podido incrementar durante la pandemia por COVID-19.
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15
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Ryan CP, Rege RJ, Lee NR, Carba DB, Kobor MS, MacIsaac JL, Lin DS, Atashzay P, Kuzawa CW. Maternal epigenetic clocks measured during pregnancy do not predict gestational age at delivery or offspring birth outcomes: a replication study in metropolitan Cebu, Philippines. Clin Epigenetics 2022; 14:78. [PMID: 35733189 PMCID: PMC9219190 DOI: 10.1186/s13148-022-01296-6] [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: 03/11/2022] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
Adverse birth outcomes, such as early gestational age and low birth weight, can have lasting effects on morbidity and mortality, with impacts that persist into adulthood. Identifying the maternal factors that contribute to adverse birth outcomes in the next generation is thus a priority. Epigenetic clocks, which have emerged as powerful tools for quantifying biological aging and various dimensions of physiological dysregulation, hold promise for clarifying relationships between maternal biology and infant health, including the maternal factors or states that predict birth outcomes. Nevertheless, studies exploring the relationship between maternal epigenetic age and birth outcomes remain few. Here, we attempt to replicate a series of analyses previously reported in a US-based sample, using a larger similarly aged sample (n = 296) of participants of a long-running study in the Philippines. New pregnancies were identified prospectively, dried blood spot samples were collected during the third trimester, and information was obtained on gestational age at delivery and offspring weight after birth. Genome-wide DNA methylation was assessed with the Infinium EPIC array. Using a suite of 15 epigenetic clocks, we only found one significant relationship: advanced age on the epigenetic clock trained on leptin predicted a significantly earlier gestational age at delivery (β = - 0.15, p = 0.009). Of the other 29 relationships tested predicting gestational age and offspring birth weight, none were statistically significant. In this sample of Filipino women, epigenetic clocks capturing multiple dimensions of biology and health do not predict birth outcomes in offspring.
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Affiliation(s)
- Calen P Ryan
- Department of Epidemiology, Robert N. Butler Columbia Aging Center, Columbia University Mailman School of Public Health, Columbia University, New York, NY, 10032, USA. .,Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA.
| | - Raviraj J Rege
- Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA
| | - Nanette R Lee
- USC-Office of Population Studies Foundation, University of San Carlos, Talamban, Cebu City, Philippines
| | - Delia B Carba
- USC-Office of Population Studies Foundation, University of San Carlos, Talamban, Cebu City, Philippines
| | - Michael S Kobor
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Vancouver, BC, Canada
| | - Julie L MacIsaac
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Vancouver, BC, Canada
| | - David S Lin
- BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Vancouver, BC, Canada
| | - Parmida Atashzay
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, Canada.,BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Vancouver, BC, Canada
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA.,Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA
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16
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Abstract
OBJECTIVES Prenatal maternal stress is associated with adverse offspring outcomes, which may be mediated by maternal stress hormones. However, evidence supporting the association between maternal stress and cortisol levels in high-risk pregnancies is limited. This study aims to determine the relationship between self-reported maternal mental distress and maternal salivary cortisol levels in pregnancies complicated by foetal CHD compared with healthy pregnancies. METHODS We recruited women with pregnancies complicated by foetal CHD and healthy pregnancies. Maternal saliva was collected between 22 and 40 gestational weeks. Standardized questionnaires measuring stress, depression, and anxiety were completed by patients. Generalized estimating equation was used to evaluate associations between maternal mental distress scales and cortisol levels. RESULTS We studied 165 women (55 CHD, 110 controls) and collected 504 cortisol samples (160 CHD, 344 controls). Women carrying CHD foetuses had higher stress, anxiety, and depression scores compared to women carrying healthy foetuses. However, maternal cortisol levels did not significantly differ in CHD and controls. Cortisol levels were higher in women carrying foetuses with functionally single-ventricle versus two-ventricle CHD. In both CHD and controls, there was no significant association between maternal stress, depression or anxiety scores and cortisol levels. CONCLUSION Our data suggest that self-reported maternal stress, anxiety, and depression are not associated with maternal salivary cortisol levels in CHD and healthy pregnancies. The impact of maternal mental distress on foetal health may be through other mediating pathways other than maternal cortisol concentrations.
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17
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Maternal childhood maltreatment and perinatal outcomes: A systematic review. J Affect Disord 2022; 302:139-159. [PMID: 35041871 DOI: 10.1016/j.jad.2022.01.062] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Maternal childhood maltreatment (MCM) is linked to poor perinatal outcomes but the evidence base lacks cohesion. We explore the impact of MCM on four perinatal outcome domains: pregnancy and obstetric; maternal mental health; infant; and the quality of the care-giving environment. Mechanisms identified in the included studies are discussed in relation to the maternal programming hypothesis and directions for future research. METHOD We completed a comprehensive literature search of eight electronic databases. Independent quality assessments were conducted and PRISMA protocols applied to data extraction. RESULTS Inclusion criteria was met by N = 49 studies. MCM was consistently associated with difficulties in maternal and infant emotional regulation and with disturbances in the mother-infant relationship. Directly observed and maternal-reported difficulties in the mother-infant relationship were often mediated by mothers' current symptoms of psychopathology. Direct and mediated associations between MCM and adverse pregnancy and obstetric outcomes were suggested by a limited number of studies. Emotional and sexual abuse were the most consistent MCM subtype significantly associated with adverse perinatal outcomes. LIMITATIONS A meta-analysis was not possible due to inconsistent reporting and the generally small number of studies for most perinatal outcomes. CONCLUSIONS MCM is associated with adverse perinatal outcomes for mothers' and infants. Evidence suggests these associations are mediated by disruptions to maternal emotional functioning. Future research should explore biological and psychosocial mechanisms underpinning observed associations between specific subtypes of MCM and adverse perinatal outcomes. Services have a unique opportunity to screen for MCM and detect women and infants at risk of adverse outcomes during the perinatal period.
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18
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Sudirman J, Bachri N, Syafar M, Jusuf EC, Syamsuddin S, Mappaware NA, Saleng H. Foot Hydrotherapy: Non-pharmacology Treatment for Reducing Anxiety in Third Trimester Pregnancy. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: This research aims to examine the effect of foot hydrotherapy as one of non-pharmacological therapies for reducing anxiety of pregnancy.
Method: The reported study employed Quasi Experimental method by using two Group pretest-posttest design with comparison group. It involved 57 respondents who were recruited using consecutive sampling technique. Hamilton Anxiety Rating Scale (HARS) questionnaire was used to measure the respondents’ anxiety. For bivariate analysis, the data were tested using paired samples t-test and Independent T-test
Result. The results of data analysis indicated that before the treatment, the anxiety values in the two groups were almost the same (21±2.3 dan 22.07±1.99). After the treatment in the intervention group, the anxiety value decreased while in the control group, the anxiety score was increased on the third day after the pretest measurement Data analysis which was conducted with Independent Sample t-test revealed that foot hydrotherapy using warm water reduced the anxiety level of pregnant women in the third trimester (p = 0,000).
Conclusion: Giving foot hydrotherapy is effective for reducing anxiety in pregnant women. Therefore, the non-pharmacological therapy can be socialized and applied given to the public (society), especially pregnant women
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19
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Caparros-Gonzalez RA, Lynn F, Alderdice F, Peralta-Ramirez MI. Cortisol levels versus self-report stress measures during pregnancy as predictors of adverse infant outcomes: a systematic review. Stress 2022; 25:189-212. [PMID: 35435113 DOI: 10.1080/10253890.2022.2059348] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Systematically review existing evidence to (1) identify the association between self-report stress and cortisol levels measured during pregnancy; and, (2) assess their association with adverse infant outcomes to determine which is the better predictor. A systematic review was conducted in accordance with PRISMA guidelines. Search terms focused on pregnancy, psychological stress and cortisol. Nine electronic databases were searched, in addition to reference lists of relevant papers. Eligibility criteria consisted of studies that included measurement of self-reported psychological stress, cortisol and assessed their associations with any infant-related outcome. Further limits included studies published in English or Spanish with human female participants. A meta-regression was not feasible due to differences in study samples, measurement tools employed, types of cortisol assessed and outcomes reported. A narrative synthesis was provided. 28 studies were eligible for inclusion. Convergent validity between self-report measures and cortisol was reported by three studies (range r = 0.12-0.41). Higher levels of self-report stress were significantly associated with intrauterine growth restriction (fetal biparietal diameter, low fetal head circumference, abdominal circumference), low gestational age at birth, low anthropometric measures (birth length, head circumference, length of the neonate), poor infant neurodevelopment (cognitive development) and potentially pathogenic gut microbiota (Clostridiaceae Clostridium, Haemophilus) in six studies. Higher cortisol levels were significantly associated with intrauterine growth restriction (fetal biparietal diameter, low fetal head circumference, abdominal circumference), low gestational age at birth, low infant birth weight, poor infant neurodevelopment (attention scores on the Network Neurobehavioral Scale) and low levels of potentially protective gut microbiota (Lactobacillus, Slackia and Actinobaculum) in 13 studies. Of the studies that assessed which type of measure was a better predictor of infant outcomes (n = 6), there was agreement that cortisol levels were statistically better at predicting adverse outcomes than self-reported stress. Self-report stress measures appear to be modest predictors of adverse infant outcomes in comparison to cortisol. A number of methodological limitations need to be addressed in future studies to help understand the relationship between cortisol and self-reported stress and how they are related to adverse infant outcomes.
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Affiliation(s)
- Rafael A Caparros-Gonzalez
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Fiona Lynn
- Medical Biology Center, School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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20
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Sanjuan PM, Fokas K, Tonigan JS, Henry MC, Christian K, Rodriguez A, Larsen J, Yonke N, Leeman L. Prenatal maternal posttraumatic stress disorder as a risk factor for adverse birth weight and gestational age outcomes: A systematic review and meta-analysis. J Affect Disord 2021; 295:530-540. [PMID: 34509068 PMCID: PMC10481878 DOI: 10.1016/j.jad.2021.08.079] [Citation(s) in RCA: 13] [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] [Received: 02/09/2021] [Revised: 07/29/2021] [Accepted: 08/25/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although not routinely assessed, prenatal posttraumatic stress disorder (PTSD) is associated with poor maternal mental health and mother-infant bonding. Prenatal PTSD may also be associated with birth weight and gestational age outcomes, but this remains unclear. This systematic review and meta-analysis investigated the association of prenatal PTSD with risk of low birth weight (LBW) or preterm birth (PTB) (dichotomous medically-defined cut-offs) or with birth weight (BW) or gestational age (GA) (continuous variables). METHODS A comprehensive literature search was conducted in Web of Science, MedLine, PubMed, and PsychInfo. Data were collected and processed according to Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Study quality was assessed with the Newcastle-Ottowa Quality Assessment Scale. Pooled effect sizes were estimated with random-effects models (correlation for continuous and odds ratios for dichotomous outcomes). RESULTS Sixteen studies with 51,470 participants (prenatal PTSD 8%) were included in 4 meta-analyses. Maternal prenatal PTSD was associated with higher risks of LBW (OR = 1.96; 95% CI, 1.26, 3.03; P = .003), PTB (OR = 1.42; 95% CI, 1.16, 1.73; P = .001), and reduced GA (r = -0.04; 95% CI, -0.06, -0.01; P = .002). LIMITATIONS Different designs across studies, variety of PTSD assessment practices, and a small pool of studies were noted. CONCLUSIONS Findings suggest prenatal PTSD presents increased risks of LBW, PTB, and reduced GA. Evidence of physical harm to neonates from prenatal PTSD provides a powerful rationale to increase prenatal PTSD screening and identify effective prenatal interventions to improve maternal and child outcomes.
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Affiliation(s)
- Pilar M Sanjuan
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, United States; Department of Family and Community Medicine, University of New Mexico School of Medicine, United States.
| | - Kathryn Fokas
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, United States
| | - J Scott Tonigan
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, United States
| | - Melissa C Henry
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, United States
| | - Korinna Christian
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, United States; Department of Family and Community Medicine, University of New Mexico School of Medicine, United States
| | - Andrea Rodriguez
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, United States
| | - Jessica Larsen
- University of New Mexico School of Medicine, United States
| | - Nicole Yonke
- Department of Family and Community Medicine, University of New Mexico School of Medicine, United States
| | - Lawrence Leeman
- Department of Family and Community Medicine, University of New Mexico School of Medicine, United States; Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, United States
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21
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Bedaso A, Adams J, Peng W, Sibbritt D. The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reprod Health 2021; 18:162. [PMID: 34321040 PMCID: PMC8320195 DOI: 10.1186/s12978-021-01209-5] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 07/19/2021] [Indexed: 01/11/2023] Open
Abstract
Background Pregnancy is a time of profound physical and emotional change as well as an increased risk of mental illness. While strengthening social support is a common recommendation to reduce such mental health risk, no systematic review or meta-analysis has yet examined the relationship between social support and mental problems during pregnancy. Methods The PRISMA checklist was used as a guide to systematically review relevant peer-reviewed literature reporting primary data analyses. PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database searches were conducted to retrieve research articles published between the years 2000 to 2019. The Newcastle–Ottawa Scale tool was used for quality appraisal and the meta-analysis was conducted using STATA. The Q and the I2 statistics were used to evaluate heterogeneity. A random-effects model was used to pool estimates. Publication bias was assessed using a funnel plot and Egger’s regression test and adjusted using trim and Fill analysis. Result From the identified 3760 articles, 67 articles with 64,449 pregnant women were part of the current systematic review and meta-analysis. From the total 67 articles, 22 and 45 articles included in the narrative analysis and meta-analysis, respectively. From the total articles included in the narrative analysis, 20 articles reported a significant relationship between low social support and the risk of developing mental health problems (i.e. depression, anxiety, and self-harm) during pregnancy. After adjusting for publication bias, based on the results of the random-effect model, the pooled odds ratio (POR) of low social support was AOR: 1.18 (95% CI: 1.01, 1.41) for studies examining the relationship between low social support and antenatal depression and AOR: 1.97 (95% CI: 1.34, 2.92) for studies examining the relationship between low social support and antenatal anxiety. Conclusion Low social support shows significant associations with the risk of depression, anxiety, and self-harm during pregnancy. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01209-5. Pregnancy is a significant event for reproductive-age women. It is supplemented by hormonal changes and can represent a time of increased risk for the occurrence of mental illness like depression, anxiety and self-harm. Providing good social support for the pregnant mother reduce this risk and prevent pregnancy complication and adverse birth outcome. However, no systematic review and/or meta-analysis has explored the associations between social support and mental illness (depression, anxiety, self-harm) among pregnant women. Therefore, this systematic review and meta-analysis aimed to examine the association between social support and mental illness (anxiety, depression, and self-harm) during pregnancy. The review identified 67 relevant articles with 64,449 pregnant women, from PubMed, Psych Info, MIDIRS, SCOPUS, and CINAHL database. Of the total 67 articles, 22 articles included in the narrative review and 45 articles included in the meta-analysis. Among studies included in the narrative synthesis, a majority of them reported significant positive associations between low social support and antenatal depression, antenatal anxiety and self-harm during pregnancy. Further, the pooled estimates of the meta-analysis show that low social support had a significant positive association with antenatal depression (AOR: 1.18 (95% CI: 1.01, 1.41)) and antenatal anxiety (AOR: 1.97 (95% CI: 1.34, 2.92)). Therefore, maternal health professionals need to have discussions with pregnant women regarding the level and source of social support they receive. Maternal health professionals may also need to consider encouraging the social network of pregnant women to improve social support being given. Policy-makers and those working on maternity care should consider the development of targeted social support programs with a view to helping reduce mental health problems amongst pregnant women.
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Affiliation(s)
- Asres Bedaso
- College of Medicine and Health Sciences, School of Nursing, Hawassa University, Hawassa, Ethiopia. .,Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Jon Adams
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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22
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Bedaso A, Adams J, Peng W, Sibbritt D. Prevalence and determinants of low social support during pregnancy among Australian women: a community-based cross-sectional study. Reprod Health 2021; 18:158. [PMID: 34315486 PMCID: PMC8314443 DOI: 10.1186/s12978-021-01210-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 07/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background Pregnancy is a time for women in which the need for social support is crucial. Social support reduces stressors and improves the emotional and physical well-being of pregnant women. Women receiving low social support during pregnancy are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women. Methods Data were obtained from the 1973–1978 cohort of Australian Longitudinal Study on Women’s Health (ALSWH) and those who report being pregnant (n = 493) were included in the current analyses. Social support was assessed using Medical Outcomes Study Social Support index (MOSS). A logistic regression model was applied to identify determinants of low social support, separately for each MOSS domain. Result The study found that 7.1% (n = 35) of pregnant women reported low social support. Significant determinants of low emotional support were non-partnered (AOR = 4.4, 95% CI: 1.27, 14.99), difficulty managing on available income (AOR = 3.1, 95% CI: 1.18, 8.32), experiencing depressive symptoms (AOR = 8.5, 95% CI: 3.29, 22.27) and anxiety symptoms (AOR = 2.9, 95% CI: 1.26, 7.03). Significant determinants of low affectionate support were suffering from depressive symptoms (AOR = 5.3, 95% CI: 1.59, 17.99), having anxiety symptoms (AOR: 6.9, 95% CI: 2.21, 22.11) and being moderately/very stressed (AOR: 3, 95% CI: 1.17, 7.89). Significant determinants of low tangible support were difficulty managing available income (AOR = 3, 95% CI: 1.29, 6.95), and being depressed (AOR = 2.8, 95% CI: 1.48, 5.34). Conclusion The study revealed that 7.1% of pregnant women reported low social support. Having a mental health problems, being stressed, being from low socio-economic status and being non-partnered were significant determinants of low social support during pregnancy. Maternal health professionals and policymakers can use this information to screen pregnant women at risk of receiving low social support and improve the level of support being provided. Providing strong social support improves emotional and physical well-being, strengthens social relationships, promotes health, and enhances the stress coping ability of pregnant women. However, pregnant women receiving low social support are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women. Data were obtained from Survey 6 of the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH) (n = 493, pregnant women aged 34–39 years). This cohort is one of ALSWH ongoing community-based study focusing on the health of women in Australia. Social support provided for a pregnant woman was the outcome variable, assessed using the 19-item Medical Outcomes Study Social Support index (MOSS). The prevalence of low social support in each domain was calculated for each of the independent variables. A logistic regression model, using a backward stepwise elimination approach, was employed to identify determinants of low social support. In the final model, the strength of association measured by adjusted odds ratios (AOR) with 95% confidence intervals. The significance level was set at p < 0.05. From the total participant pregnant women, 7.1% of them reported low social support. Significant determinants of low social support among pregnant Australian women were, having a mental illness, being stressed and/or being from low socio-economic status and being non-partnered. Maternal health professionals can use this information to screen pregnant women at risk of receiving low social support as well as develop policy to help enhance the social support being given and the psychological wellbeing being of pregnant women.
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Affiliation(s)
- Asres Bedaso
- College of Medicine and Health Sciences, Faculty of Health, School of Nursing, Hawassa University, Hawassa, Ethiopia. .,Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Jon Adams
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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23
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Kemppinen L, Mattila M, Ekholm E, Pallasmaa N, Törmä A, Varakas L, Mäkikallio K. Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections. J Perinat Med 2021; 49:431-438. [PMID: 33554586 DOI: 10.1515/jpm-2020-0379] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 12/02/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Gestational IDA has been linked to adverse maternal and neonatal outcomes, but the impact of iron supplementation on outcome measures remains unclear. Our objective was to assess the effects of gestational IDA on pregnancy outcomes and compare outcomes in pregnancies treated with either oral or intravenous iron supplementation. METHODS We evaluated maternal and neonatal outcomes in 215 pregnancies complicated with gestational IDA (Hb<100 g/L) and delivered in our tertiary unit between January 2016 and October 2018. All pregnancies from the same period served as a reference group (n=11,545). 163 anemic mothers received oral iron supplementation, and 52 mothers received intravenous iron supplementation. RESULTS Gestational IDA was associated with an increased risk of preterm birth (10.2% vs. 6.1%, p=0.009) and fetal growth restriction (FGR) (1.9% vs. 0.3%, p=0.006). The gestational IDA group that received intravenous iron supplementation had a greater increase in Hb levels compared to those who received oral medication (18.0 g/L vs. 10.0 g/L, p<0.001), but no statistically significant differences in maternal and neonatal outcomes were detected. CONCLUSIONS Compared to the reference group, prematurity, FGR, postpartum infections, and extended hospital stays were more common among mothers with gestational IDA, causing an additional burden on the families and the healthcare system.
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Affiliation(s)
- Lotta Kemppinen
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Mirjami Mattila
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Eeva Ekholm
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Nanneli Pallasmaa
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Ari Törmä
- University of Turku, Turku, Finland.,Department of Clinical Laboratory, Turku University Hospital, Turku, Finland
| | - Leila Varakas
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Kaarin Mäkikallio
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
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24
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Crovetto F, Crispi F, Borras R, Paules C, Casas R, Martín-Asuero A, Arranz A, Vieta E, Estruch R, Gratacós E. Mediterranean diet, Mindfulness-Based Stress Reduction and usual care during pregnancy for reducing fetal growth restriction and adverse perinatal outcomes: IMPACT BCN (Improving Mothers for a better PrenAtal Care Trial BarCeloNa): a study protocol for a randomized controlled trial. Trials 2021; 22:362. [PMID: 34030703 PMCID: PMC8147060 DOI: 10.1186/s13063-021-05309-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Fetal growth restriction (FGR) affects 7-10% of all pregnancies resulting in a higher risk of perinatal morbidity and mortality, long-term disabilities, and cognitive impairment. Due to its multifactorial etiology, changes in maternal lifestyle, including suboptimal maternal diet and stress, have increasingly been associated with its prevalence. We present a protocol for the Improving Mothers for a better PrenAtal Care Trial Barcelona (IMPACT BCN), which evaluates two different maternal lifestyle strategies (improved nutrition by promoting Mediterranean diet and stress reduction program based on mindfulness techniques) on perinatal outcomes. The primary objective is to reduce the prevalence of FGR. Secondary aims are to reduce adverse perinatal outcomes and to improve neurodevelopment and cardiovascular profile in children at 2 years of age. METHODS A randomized parallel, open-blind, single-center trial following a 1:1:1 ratio will select and randomize high-risk singleton pregnancies for FGR (N=1218), according to the criteria of the Royal College of Obstetricians and Gynaecologists (19.0-23.6 weeks' gestation), into three arms: Mediterranean diet, mindfulness-based stress reduction program, and usual care without any intervention. Compliance to the interventions will be randomly tested in 30% of participants with specific biomarkers. Maternal socio-demographic, clinical data, biological samples, and lifestyle questionnaires will be collected at enrollment and at the end of the interventions (34.0-36.6 weeks' gestation), together with a fetoplacental ultrasound and magnetic resonance. Fetoplacental biological samples and perinatal outcomes will be recorded at delivery. Postnatal follow-up is planned up to 2 years of corrected age including neurodevelopmental tests and cardiovascular assessment. Intention-to-treat and population per-protocol analysis will be performed. DISCUSSION This is the first randomized study evaluating the impact of maternal lifestyle interventions during pregnancy on perinatal outcomes. The maternal lifestyle interventions (Mediterranean diet and mindfulness-based stress reduction program) are supported by scientific evidence, and their compliance will be evaluated with several biomarkers. TRIAL REGISTRATION ClinicalTrials.gov NCT03166332 . Registered on April 19, 2017.
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Affiliation(s)
- Francesca Crovetto
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Fàtima Crispi
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain.
| | - Roger Borras
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Cardiovascular Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Cristina Paules
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rosa Casas
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Angela Arranz
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Hospital Clinic, Neuroscience Institute, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Eduard Gratacós
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
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25
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Sex Differences in Placental Protein Expression and Efficiency in a Rat Model of Fetal Programming Induced by Maternal Undernutrition. Int J Mol Sci 2020; 22:ijms22010237. [PMID: 33379399 PMCID: PMC7795805 DOI: 10.3390/ijms22010237] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 12/30/2022] Open
Abstract
Fetal undernutrition programs cardiometabolic diseases, with higher susceptibility in males. The mechanisms implicated are not fully understood and may be related to sex differences in placental adaptation. To evaluate this hypothesis, we investigated placental oxidative balance, vascularization, glucocorticoid barrier, and fetal growth in rats exposed to 50% global nutrient restriction from gestation day 11 (MUN, n = 8) and controls (n = 8). At gestation day 20 (G20), we analyzed maternal, placental, and fetal weights; oxidative damage, antioxidants, corticosterone, and PlGF (placental growth factor, spectrophotometry); and VEGF (vascular endothelial growth factor), 11β-HSD2, p22phox, XO, SOD1, SOD2, SOD3, catalase, and UCP2 expression (Western blot). Compared with controls, MUN dams exhibited lower weight and plasma proteins and higher corticosterone and catalase without oxidative damage. Control male fetuses were larger than female fetuses. MUN males had higher plasma corticosterone and were smaller than control males, but had similar weight than MUN females. MUN male placenta showed higher XO and lower 11β-HSD2, VEGF, SOD2, catalase, UCP2, and feto-placental ratio than controls. MUN females had similar feto-placental ratio and plasma corticosterone than controls. Female placenta expressed lower XO, 11β-HSD2, and SOD3; similar VEGF, SOD1, SOD2, and UCP2; and higher catalase than controls, being 11β-HSD2 and VEGF higher compared to MUN males. Male placenta has worse adaptation to undernutrition with lower efficiency, associated with oxidative disbalance and reduced vascularization and glucocorticoid barrier. Glucocorticoids and low nutrients may both contribute to programming in MUN males.
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26
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L. Aubuchon-Endsley N, E. Swann-Thomsen H, Douthit N. Maternal Prenatal Cortisol and Breastfeeding Predict Infant Growth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218233. [PMID: 33171766 PMCID: PMC7664389 DOI: 10.3390/ijerph17218233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/17/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022]
Abstract
Fetal/infant growth affects adult obesity and morbidities/mortality and has been associated with prenatal exposure to cortisol. Bidirectional relations between maternal stress and breastfeeding suggest that they interact to influence offspring growth. No models have tested this hypothesis, particularly regarding longer-term offspring outcomes. We used a subset of the IDAHO Mom Study (n = 19-95) to examine associations among maternal prenatal cortisol (cortisol awakening response (CAR) and area under the curve), and standardized weight-for-length (WLZ) and length-for-age (LAZ) z-scores from birth-18 months, and main and interactive effects of prenatal cortisol and breastfeeding on infant growth from birth-6 months. CAR was negatively associated with LAZ at birth (r = -0.247, p = 0.039) but positively associated at 13-14 months (r = 0.378, p = 0.033), suggesting infant catch-up growth with lower birth weights, likely related to elevated cortisol exposure, continues beyond early infancy. A negative correlation between breastfeeding and 10-month WLZ (r = -0.344, p = 0.037) and LAZ (r = -0.468, p = 0.005) suggests that breastfeeding assists in managing infant growth. WLZ and LAZ increased from birth to 6 months (ps < 0.01), though this was unrelated to interactions between prenatal cortisol and breastfeeding (i.e., no significant moderation), suggesting that other factors played a role, which should be further investigated. Findings add to our understanding of the predictors of infant growth.
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Affiliation(s)
- Nicki L. Aubuchon-Endsley
- Department of Psychology, Idaho State University, Pocatello, ID 83209, USA
- Correspondence: ; Tel.: +1-208-282-2574
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27
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Franke K, Van den Bergh BRH, de Rooij SR, Kroegel N, Nathanielsz PW, Rakers F, Roseboom TJ, Witte OW, Schwab M. Effects of maternal stress and nutrient restriction during gestation on offspring neuroanatomy in humans. Neurosci Biobehav Rev 2020; 117:5-25. [PMID: 32001273 PMCID: PMC8207653 DOI: 10.1016/j.neubiorev.2020.01.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 01/06/2023]
Abstract
Cognitive and mental health are major determinants of quality of life, allowing integration into society at all ages. Human epidemiological and animal studies indicate that in addition to genetic factors and lifestyle, prenatal environmental influences may program neuropsychiatric disorders in later life. While several human studies have examined the effects of prenatal stress and nutrient restriction on brain function and mental health in later life, potentially mediating effects of prenatal stress and nutrient restriction on offspring neuroanatomy in humans have been studied only in recent years. Based on neuroimaging and anatomical data, we comprehensively review the studies in this emerging field. We relate prenatal environmental influences to neuroanatomical abnormalities in the offspring, measured in utero and throughout life. We also assess the relationship between neuroanatomical abnormalities and cognitive and mental disorders. Timing- and gender-specific effects are considered, if reported. Our review provides evidence for adverse effects of an unfavorable prenatal environment on structural brain development that may contribute to the risk for cognitive, behavioral and mental health problems throughout life.
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Affiliation(s)
- Katja Franke
- Department of Neurology, Jena University Hospital, Jena, Germany.
| | - Bea R H Van den Bergh
- Research Group on Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Department for Welfare, Public Health and Family, Flemish Government, Brussels, Belgium
| | - Susanne R de Rooij
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands
| | - Nasim Kroegel
- Department of Neurology, Jena University Hospital, Jena, Germany; acatech - National Academy of Science and Engineering, Berlin, Germany
| | - Peter W Nathanielsz
- Texas Pregnancy & Life Course Health Research Center, Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, United States; Dept. of Animal Science, University of Wyoming, Laramie, WY, United States
| | - Florian Rakers
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Tessa J Roseboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands
| | - Otto W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Matthias Schwab
- Department of Neurology, Jena University Hospital, Jena, Germany
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28
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Prenatal stress and epigenetics. Neurosci Biobehav Rev 2020; 117:198-210. [DOI: 10.1016/j.neubiorev.2017.05.016] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 12/22/2022]
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29
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Schneider MO, Hübner T, Pretscher J, Goecke TW, Schwitulla J, Häberle L, Kornhuber J, Ekici AB, Beckmann MW, Fasching PA, Schwenke E. Genetic variants in the glucocorticoid pathway genes and birth weight. Arch Gynecol Obstet 2020; 303:427-434. [PMID: 32886236 DOI: 10.1007/s00404-020-05761-6] [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: 02/20/2020] [Accepted: 08/24/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE The aim of this study was to examine associations between single nucleotide polymorphisms (SNPs) that tag genetic variation in the glucocorticoid pathways (particularly in maternal genes FKBP5, NR3C1, and CRHR1) and birth weight. METHODS The Franconian Maternal Health Evaluation Study (FRAMES) recruited healthy pregnant women prospectively for the assessment of maternal and fetal health. Germline DNA was collected from 375 pregnant women. Nine SNPs in the above-mentioned genes were genotyped. After reconstruction of haplotypes for each gene, a linear regression model was applied to the data to describe the association between haplotypes and birth weight. RESULTS Female sex in the newborn (compared to male) was associated with lower birth weight, whereas a later week of gestation, higher body mass index pre-pregnancy, and higher parity were associated with higher birth weight. No association with birthweight was shown for the haplotypes of the selected SNPs. CONCLUSIONS In this cohort of healthy unselected pregnant women, the analyzed candidate haplotypes in FKBP5, NR3C1, and CRHR1 did not show any association with birth weight. This might be in line with several other studies that have found no influence of fetal polymorphisms in the glucocorticoid receptor gene or triggers of the maternal HPA axis such as stress and psychosocial problems on birth weight. However, the small sample size in this study and the lack of consideration of individual risk factors and levels of stress in this cohort needs to be taken into account when interpreting the results.
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Affiliation(s)
- Michael O Schneider
- Department of Gynecology and Obstetrics, Erlangen University Perinatal Center, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany.
| | - Theresa Hübner
- Department of Gynecology and Obstetrics, Erlangen University Perinatal Center, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
- Department of Gynecology and Obstetrics, Würzburg University Hospital, Würzburg, Germany
| | - Jutta Pretscher
- Department of Gynecology and Obstetrics, Erlangen University Perinatal Center, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Tamme W Goecke
- Department of Gynecology and Obstetrics, Erlangen University Perinatal Center, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
- Department of Obstetrics, RoMed Clinic Rosenheim, Rosenheim, Germany
| | - Judith Schwitulla
- Biostatistics Unit, Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Lothar Häberle
- Biostatistics Unit, Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Arif B Ekici
- Institute of Human Genetics, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Perinatal Center, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Perinatal Center, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Eva Schwenke
- Department of Gynecology and Obstetrics, Erlangen University Perinatal Center, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
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Haft SL, Zhou Q, Stephens M, Alkon A. Culture and stress biology in immigrant youth from the prenatal period to adolescence: A systematic review. Dev Psychobiol 2020; 63:391-408. [PMID: 32643148 DOI: 10.1002/dev.22009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/15/2020] [Accepted: 06/04/2020] [Indexed: 11/09/2022]
Abstract
Immigration patterns over the last two decades have changed the demographic composition of the United States; children are growing up in an increasingly multicultural environment. Immigrant youth may face culture-related stressors and leverage culture-related strengths across development that may influence their mental and physical health. Responses to early life stressors may differ across children at the level of stress biology, which can affect how they handle cultural challenges. However, there is limited research on culture and stress biology, which may be a mediator or moderator of culture's effects on immigrant youth. The aim of the present article is to systematically review research that examines the roles of both culture and stress biology from the prenatal period to adolescence in immigrant youth. Specifically, we review articles that examine how stress-sensitive biological systems (hypothalamic pituitary adrenal axis and the autonomic nervous system) and culture-related constructs have been modeled together in immigrant youth. Based on these findings, we note remaining questions and recommendations for future research in integrating measures of cultural processes and stress biology in children.
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Affiliation(s)
- Stephanie L Haft
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Qing Zhou
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Michelle Stephens
- School of Nursing, Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Abbey Alkon
- School of Nursing, Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, USA
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31
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Montazeri M, Mirghafourvand M, Esmaeilpour K, Mohammad-Alizadeh-Charandabi S, Amiri P. Effects of journal therapy counseling with anxious pregnant women on their infants' sleep quality: a randomized controlled clinical trial. BMC Pediatr 2020; 20:229. [PMID: 32423396 PMCID: PMC7236485 DOI: 10.1186/s12887-020-02132-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep is especially important for infants, since it stimulates the development of neural connections in their brains. Psychological stress such as anxiety could affect sleep quality. This study investigated the effects of journal therapy counseling sessions on the infants' sleep quality based on mothers' perception (primary outcome), maternal anxiety, infants' anthropometric and developmental parameters, and the frequency of exclusive breastfeeding (secondary outcomes). METHODS A total of 70 healthy women with gestational age of 28-31 weeks participated in this randomized controlled trial. The participants were randomly allocated into intervention and control groups using randomized block design. Three in-person journal therapy sessions and three telephone counseling sessions (2 between in-person sessions and 1 one month postpartum) were provided to those in the intervention group, while the control group only received routine care. The Infant Sleep Questionnaire (ISQ), Exclusive Breastfeeding Checklist, and Infant Anthropometric Parameters Checklist were completed at two and four months postpartum. The Beck Anxiety Inventory (BAI) was completed during pregnancy, at the end of the intervention, and at two and four months postpartum, and the Ages and Stages Questionnaire (ASQ) was completed at 4 months postpartum. Data were analyzed using chi-square, independent t-test, ANCOVA and repeated measure ANOVA. RESULTS There was no significant difference between the two groups in demographic characteristics and baseline anxiety scores. The mean sleep quality score in infants two months of age (MD: -4.2; 95%CI: - 1.1 to - 7.2; P = 0.007) and four months of age (MD: -5.5; 95%CI: - 8.4 to - 2.7; P < 0.001) was significantly lower in the intervention group than that of those in the control group. Based on the repeated measure ANOVA results, the mean postpartum anxiety score of mothers in the intervention group was significantly lower than that of those in the control group (AMD: -7.7; 95%CI: - 5.5 to - 10.1; P < 0.001). There was no significant difference between the two groups regarding other outcomes including the frequency of exclusive breastfeeding, and anthropometric and developmental parameters (P > 0.05). CONCLUSION Journal therapy can decrease mothers' anxiety and improve the infants' sleep quality based on their perception. However, further studies are required before drawing any definitive conclusion. TRIAL REGISTRATION NUMBER Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N45. Date of registration: August 11, 2018. URL: https://en.irct.ir/trial/33211.
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Affiliation(s)
- Maryam Montazeri
- Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Centre, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | | | | | - Paria Amiri
- School of Nursing and Midwifery, Tabriz University of Medical Science, Tabriz, Iran
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Do developmental and temperamental characteristics mediate the association between preterm birth and the quality of mother-child interaction? Infant Behav Dev 2020; 58:101421. [PMID: 32135402 DOI: 10.1016/j.infbeh.2020.101421] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 12/05/2019] [Accepted: 01/18/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The current study aims to evaluate the association between preterm birth and the quality of mother-child interaction of very preterm-, moderate preterm-, and full-term-born children at 18 and 36 months and to determine whether developmental and behavioral characteristics mediate the association between preterm birth and the quality of mother-child interaction. METHOD Participants included 110 preterm-born children and 39 full-term-born children assessed at ages 18 and 36 months. Mother-child free play interactions, the Mullen Scales of Early Learning, the Infant Behavior Questionnaire, and the Early Childhood Behavior Questionnaire were administered. RESULTS Significant associations between preterm birth and the quality of mother-child interaction were found at 18 and 36 months. The mother-child interaction quality was less optimal for the preterm-born children compared with the full-term-born children, mainly so for the very preterm-born children. Unlike behavioral characteristics, cognitive development was found to mediate the association between the gestational age-based group and the quality of mother-child interaction. CONCLUSIONS Intervention programs for preterm-born children and their families, should consider maternal and children's behaviors during mother-child interactions, in addition to cognitive, language, motor and emotional regulation abilities, and particularly so with very preterm-born children, who exhibit slower cognitive development.
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MacGinty RP, Kariuki SM, Barnett W, Wedderburn CJ, Hardy A, Hoffman N, Newton CR, Zar HJ, Donald KA, Stein DJ. Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort. Compr Psychiatry 2020; 96:152128. [PMID: 31715335 PMCID: PMC6945113 DOI: 10.1016/j.comppsych.2019.152128] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Antenatal maternal psychological distress is common in low and middle-income countries (LMIC), but there is a dearth of research on its effect on birth and developmental outcomes in these settings, particularly in Sub-Saharan Africa. This study set out to identify risk factors for antenatal maternal psychological distress and determine whether antenatal maternal psychological distress was associated with infant birth and developmental outcomes, using data from the Drakenstein Child Health Study (DCHS), a birth cohort study in South Africa. METHODS Pregnant women were enrolled in the DCHS from primary care antenatal clinics. Antenatal maternal psychological distress was measured using the Self-Reporting Questionnaire 20-item (SRQ-20). A range of psychosocial measures, including maternal childhood trauma, depression, and posttraumatic stress disorder (PTSD) were administered. Birth outcomes, including premature birth, weight-for-age z-score and head circumference-for-age z-score, were measured using revised Fenton growth charts. The Bayley III Scales of Infant and Toddler Development was administered at 6 months of age to assess infant development outcomes, including cognitive, language, and motor domains in a subset of n=231. Associations of maternal antenatal psychological distress with psychosocial measures, and with infant birth and developmental outcomes were examined using linear regression models. RESULTS 961 women were included in this analysis, with 197 (21%) reporting scores indicating the presence of psychological distress. Antenatal psychological distress was associated with maternal childhood trauma, antenatal depression, and PTSD, and inversely associated with partner support. No association was observed between antenatal maternal psychological distress and preterm birth or early developmental outcomes, but antenatal maternal psychological distress was associated with a smaller head circumference at birth (coefficient=-0.30, 95% CI: -0.49; -0.10). CONCLUSION Antenatal maternal psychological distress is common in LMIC settings and was found to be associated with key psychosocial measures during pregnancy, as well as with adverse birth outcomes, in our study population. These associations highlight the potential value of screening for antenatal maternal psychological distress as well as of developing targeted interventions.
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Affiliation(s)
- R P MacGinty
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa.
| | - S M Kariuki
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, UK
| | - W Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa
| | - C J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - A Hardy
- Statistical Consulting Service, Department of Statistical Science, University of Cape Town, South Africa
| | - N Hoffman
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
| | - C R Newton
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, UK
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa
| | - K A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - D J Stein
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk & Resilience in Mental Disorders, South Africa
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Petrullo L, Hinde K, Lu A. Steroid hormone concentrations in milk predict sex-specific offspring growth in a nonhuman primate. Am J Hum Biol 2019; 31:e23315. [PMID: 31468643 DOI: 10.1002/ajhb.23315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/09/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES In humans and other mammals, maternal hormones are transferred to offspring during lactation via milk and may regulate postnatal development, including the pace of early growth. Here, we used a nonhuman primate model to test the hypotheses that milk cortisol and dehydroepiandrosterone-sulfate (DHEAS) concentrations reflect maternal characteristics, and that changes in these hormones across lactation are associated with early postnatal growth rates. METHODS Demographic information, morphometrics, and milk samples were collected from rhesus macaque mothers and their infants at the California National Primate Research Center in Davis, California. Using linear models, we examined the relationship between maternal traits and milk hormone concentrations (N = 104 females) and explored the effect of milk hormones on the rate of offspring growth (N = 72 mother-infant dyads), controlling for available milk energy. RESULTS Contrary to previous studies, we found that milk cortisol concentrations were categorically higher in multiparous females than in primiparous females. However, milk DHEAS concentrations decreased with maternal parity. Neither milk cortisol nor DHEAS were related to maternal rank. Finally, changes in milk hormones predicted offspring growth in a sex-specific and temporal manner: increases in cortisol from peak to late lactation predicted faster female growth, and increases in DHEAS concentrations from early to peak and peak to late lactation predicted faster male growth. CONCLUSIONS Our findings shed light on how hormonal components of milk have sex-specific effects on offspring growth during early postnatal life with varying temporal windows of sensitivity.
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Affiliation(s)
- Lauren Petrullo
- Interdepartmental Doctoral Program in Anthropological Sciences, Stony Brook University, Stony Brook, New York
| | - Katie Hinde
- Center for Evolution and Medicine, Arizona State University, Tempe, Arizona.,School for Human Evolution and Social Change, Arizona State University, Tempe, Arizona.,Brain, Mind, and Behavior Unit, California National Primate Research Center, Davis, California
| | - Amy Lu
- Department of Anthropology, Stony Brook University, Stony Brook, New York
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Song M, Wang L, Zhao XC, Li N, Wang R, Gao YY, Yu LL, An CX, Wang XY. The prevalence and risk of DSM-IV axis I disorder in adults with early-life earthquake stress: A cross-sectional study. Int J Dev Neurosci 2019; 76:65-71. [PMID: 31229525 DOI: 10.1016/j.ijdevneu.2019.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/22/2019] [Accepted: 06/18/2019] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Tangshan earthquake which had a magnitude of 7.8 killed approximately 250,000 people in China in 1976. In the present study, we sought to determine the prevalence and risks of mental disorders in adults who experienced earthquake as an infant or in the prenatal period. METHODS This cross-sectional cohort study recruited participants based on the urban resident registry of Tangshan, Hebei province, 2013 using a multistage stratified cluster sampling method with selection probabilities proportional to size. We recruited subjects who were born between July 29, 1975 and April 28, 1978 that was one year before and 1.9 years after the occurrence of Tangshan Earthquake, respectively. Current psychiatric diagnoses and lifetime psychiatric diagnoses were obtained through the Structured Clinical Interview for DSM-IV Axis I Disorders Patient Research Version. Unconditional logistic regression analysis was performed to analyze risk factors of mental disorders. RESULTS Totally1380 subjects were included with 392 subjects exposed to the earthquake in the fetal period, 399 subjects who experienced the earthquake during their infancy, and 589 subjects who had no exposure to the earthquake. Twenty-one (2.7%; current 1.9%) subjects exposed to earthquake were diagnosed with major depressive disorderversus 2.3% (current 1.5%) in the non-exposure group. Five (0.6%; current 0.6%) subjects with exposure to earthquake had bipolar disorder versus 0.9% in the non-exposure group.Thirteen (1.6%; current 1.6%) subjects with exposure to earthquake had schizophreniaversus 0.2% in the non-exposure group (P=0.006). Furthermore, 5.2% (current 3.7%) subjects with exposure to earthquake had anxiety disorders versus 5.7% (current 3.9%) in the non-exposure group. Moreover, 8.1% (current 7.0%)subjects with exposure to earthquake had alcohol use disorders versus 7.1% (current 5.3%) in the non-exposure group. Furthermore, the prevalence of schizophrenia of the prenatal exposure group (2.3%) was significantly higher than the other two groups (χ2 = 10.273, P = 0.006); however, no statistically significant difference was found in the current and lifetime prevalence of other DSM-IV axis I disorders among the three groups (P > 0.05). Our multivariate regression analysis showed that prenatal earthquake stress exposure was not a significant risk of any of the lifetime or current DSD-IV axis I disorders. CONCLUSION Adults who were exposed to earthquake in the prenatal period had a significantly higher rate of schizophrenia than those who were not exposed or who experienced earthquake in their infancy. No statistically significant difference was found in the current and lifetime prevalence of other DSM-IV axis I disorders between those exposed and those not exposed to earthquake. Furthermore, prenatal earthquake stress exposure was not a significant risk of any of the lifetime or current DSD-IV axis I disorders.
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Affiliation(s)
- Mei Song
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
| | - Lan Wang
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
| | - Xiao-Chuan Zhao
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
| | - Na Li
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
| | - Ran Wang
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
| | - Yuan-Yuan Gao
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
| | - Lu-Lu Yu
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
| | - Cui-Xia An
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
| | - Xue-Yi Wang
- Department of Psychiatry, First Hospital of Hebei Medical University, Mental Health Institute of the Hebei Medical University, Shijiazhuang, China
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Jones NA, Sloan A. Neurohormones and temperament interact during infant development. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2017.0159. [PMID: 29483344 DOI: 10.1098/rstb.2017.0159] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2017] [Indexed: 12/14/2022] Open
Abstract
The infant's psycho-physiological regulatory system begins to develop prenatally and continues to mature during the postnatal period. Temperament is a construct comprising tonic individual differences in dispositional physiological and behavioural reactions as well as an evolving ability to regulate to environmental conditions. Theoretical models and research have shown that neurohormonal and -physiological factors contribute to individual development and impact infant behaviours as well as the developing regulatory system. Moreover, prenatal maternal risks such as stress and depression are thought to programme fetal regulatory tendencies and that influences neural and behavioural functioning in infancy. The purpose of this review is to examine the theories and research that link infant temperament to neurohormonal and -physiological development in typically developing infants and in those exposed to environmental risk. Research has demonstrated associations between individual variation in physiological stress responses and regulation (measured with cortisol). Moreover, studies have noted an association with physiological regulation and socio-emotional interaction (as measured by the touch-oxytocin link) that may buffer emotional dysregulation. The interaction between individual differences in temperamental tendencies, neurohormonal and -physiological patterns will be discussed by presenting data from studies that have shown that infant neurohormonal and -physiological functioning sets an important trajectory for the development of the individual.This article is part of the theme issue 'Diverse perspectives on diversity: multi-disciplinary approaches to taxonomies of individual differences'.
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Affiliation(s)
- Nancy Aaron Jones
- Department of Psychology and Behavioral Neuroscience, Florida Atlantic University, John D. MacArthur Campus, 5353 Parkside Drive, Jupiter, FL, USA
| | - Aliza Sloan
- Department of Psychology and Behavioral Neuroscience, Florida Atlantic University, John D. MacArthur Campus, 5353 Parkside Drive, Jupiter, FL, USA
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Orta OR, Tworoger SS, Terry KL, Coull BA, Gelaye B, Kirschbaum C, Sanchez SE, Williams MA. Stress and hair cortisol concentrations from preconception to the third trimester. Stress 2019; 22:60-69. [PMID: 30585520 PMCID: PMC6453704 DOI: 10.1080/10253890.2018.1504917] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Stress is an important and modifiable determinant of health, and its association with hair cortisol concentrations (HCC) during pregnancy remains unclear. We selected a random sample of 97 participants from a cohort of pregnant participants attending prenatal clinics in Lima, Peru. Each provided a hair sample at enrollment (mean gestational age = 13.1 weeks) and again at full-term delivery. Hair samples were segmented to reflect HCC in preconception and each trimester. At enrollment, measures of stress included: difficulty accessing basic goods, educational attainment, exposure to violence, fair or poor general health, perceived stress, and symptoms of depression, general anxiety, and post-traumatic stress disorder. Linear mixed models evaluated the association between each stress measure and absolute and relative changes in HCC. Pearson correlation coefficients (r) assessed correlations between HCC and continuous stress scores. Educational attainment of ≤12 years was associated with higher HCC in preconception and the 1st trimester, and general anxiety with lower preconception HCC. When modeling HCC patterns across the 4 hair segments, an educational attainment of ≤12 years was associated with higher HCC, high perceived stress with lower HCC, and general anxiety with steeper increases in HCC (group by time p value = .02). Only preconception HCC and GAD scores correlated (r = -0.22, p = .04). We observed few associations between stress and HCC. However, those that were seen were generally restricted to the preconception and 1st trimester. Further investigations into the association between stress and changes in HCC across pregnancy are warranted, and should include the preconception where possible.
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Affiliation(s)
- Olivia R. Orta
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Corresponding author email and postal address: 677 Huntington Ave, Harvard T.H. Chan School of Public Health, Room Kresge 500, Harvard University, Boston, Massachusetts 02115
| | - Shelley S. Tworoger
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Kathryn L. Terry
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Brent A. Coull
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bizu Gelaye
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Abstract
BACKGROUND Anxiety disorders and self-reported symptoms are highly prevalent in pregnancy. Despite their negative impact on maternal and child outcomes, uncertainty remains regarding which symptoms can be considered accurate indicators of antenatal anxiety.AimsTo examine and synthesise the evidence in relation to the psychometric properties and content of self-report scales used to detect anxiety symptoms in pregnant women. METHOD A systematic search was carried out and the methodological quality of all included studies was assessed. Only those achieving a rating of good or excellent were considered in a synthesis of the best available evidence. RESULTS Several anxiety symptoms and domains were identified as promising for screening for general antenatal anxiety and pregnancy-related anxiety, including elevated levels of worry, symptoms of panic, fear of childbirth and excessive worries about the baby's health. CONCLUSIONS This review contributes to the existing knowledge by identifying a number of anxiety symptoms that can be considered psychometrically robust indicators of antenatal anxiety.Declaration of interestNone.
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Affiliation(s)
- Andrea Sinesi
- Nursing, Midwifery and Allied Health Professions Research Unit,University of Stirling,UK
| | - Margaret Maxwell
- Professor of Health Services and Mental Health Research and Director, Nursing, Midwifery and Allied Health Professions Research Unit,University of Stirling,UK
| | - Ronan O'Carroll
- Professor of Psychology, Department of Psychology,University of Stirling,UK
| | - Helen Cheyne
- Professor of Maternal and Child Health and Deputy Director, Nursing, Midwifery and Allied Health Professions Research Unit,University of Stirling,UK
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Fallon B, Filippelli J, Joh-Carnella N, Milne E, Carradine J. Promoting Protective Factors in Environments of Risk for Young Children: An Organizing Framework for Practice, Policy, and Research. GENDER AND THE GENOME 2018. [DOI: 10.1177/2470289718820843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Early childhood is an important developmental period, which lays the foundation for future learning, behaviour, physical and mental health and gene expression. The most vulnerable children in society are often referred to and receive services from the child welfare system because of a concern of abuse and neglect and/or a poor developmental trajectory. This paper presents an organizing framework for how the child welfare system, in concert with allied partners, can support interventions for young children and families by acknowledging its crucial role in improving their development and well-being. The framework is informed by research amassed from numerous disciplines, including child welfare, development, neuroscience, neurobiology and epigenetics. Although the notions of protection and well-being are central considerations in child welfare legislation in Ontario, Canada, the operationalization of wellbeing has proven challenging in child welfare practice, policy and research. The framework proposes ten key indicators and priorities for identifying and promoting optimal child development. Findings from the 2013 cycle of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013), the only provincial source of aggregated child welfare investigation data, are presented to articulate the divide between the environmental context of a population of at-risk children and the conditions that both protect children and increase the likelihood that they will thrive in adulthood. This paper argues there are different points of entry and intervention across sectors and provides a foundation for further discussion on how to promote well-being for society's most vulnerable children.
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Affiliation(s)
- Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Joanne Filippelli
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | | | - Elizabeth Milne
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Jessica Carradine
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Luecken LJ, Crnic KA, Gonzales NA, Winstone LK, Somers JA. Mother-infant dyadic dysregulation and postpartum depressive symptoms in low-income Mexican-origin women. Biol Psychol 2018; 147:107614. [PMID: 30391479 DOI: 10.1016/j.biopsycho.2018.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/06/2023]
Abstract
The current study evaluated a mechanistic pathway by which prenatal stress increases the risk of postpartum depressive (PPD) symptoms via observed dyadic emotional, behavioral, and attentional dysregulation and associated cortisol responses during mother-infant interactions. METHODS Participants included 322 low-income Mexican American mother-infant dyads. Depressive symptoms, economic hardship, and negative life events were assessed at a prenatal visit. Dysregulation in dyadic (mother-infant) interactions and cortisol responses to mother-infant interaction were evaluated at 12 weeks after the birth. Twenty-four weeks after the birth, PPD symptoms were predicted from prenatal stress (negative life events and economic hardship) and prenatal depressive symptoms, mediated through dyadic dysregulation and maternal and infant cortisol responses. RESULTS More negative life events in the prenatal period predicted more dyadic dysregulation at 12 weeks postpartum. Dyadic dysregulation and economic hardship predicted elevated 12-week infant cortisol total response and reactivity, and higher total infant cortisol response predicted higher maternal PPD symptoms at 24 weeks. Maternal cortisol response was not associated with dyadic dysregulation, either form of prenatal stress, or PPD symptoms. CONCLUSION The results indicate the salience of early psychosocial processes and mother-infant relationship challenges for subsequent maternal affective well-being.
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Affiliation(s)
- Linda J Luecken
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States.
| | - Keith A Crnic
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States
| | - Nancy A Gonzales
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States
| | - Laura K Winstone
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States
| | - Jennifer A Somers
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, United States
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Gartstein MA, Skinner MK. Prenatal influences on temperament development: The role of environmental epigenetics. Dev Psychopathol 2018; 30:1269-1303. [PMID: 29229018 PMCID: PMC5997513 DOI: 10.1017/s0954579417001730] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This review summarizes current knowledge and outlines future directions relevant to questions concerning environmental epigenetics and the processes that contribute to temperament development. Links between prenatal adversity, epigenetic programming, and early manifestations of temperament are important in their own right, also informing our understanding of biological foundations for social-emotional development. In addition, infant temperament attributes represent key etiological factors in the onset of developmental psychopathology, and studies elucidating their prenatal foundations expand our understanding of developmental origins of health and disease. Prenatal adversity can take many forms, and this overview is focused on the environmental effects of stress, toxicants, substance use/psychotropic medication, and nutrition. Dysregulation associated with attention-deficit/hyperactivity-disruptive disorders was noted in the context of maternal substance use and toxicant exposures during gestation, as well as stress. Although these links can be made based on the existing literature, currently few studies directly connect environmental influences, epigenetic programming, and changes in brain development/behavior. The chain of events starting with environmental inputs and resulting in alterations to gene expression, physiology, and behavior of the organism is driven by epigenetics. Epigenetics provides the molecular mechanism of how environmental factors impact development and subsequent health and disease, including early brain and temperament development.
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Affiliation(s)
- Maria A. Gartstein
- Department of Psychology, Washington State University, Pullman, WA-99164-4820, USA
| | - Michael K. Skinner
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA-99164-4236, USA
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Cabeza de Baca T, Wojcicki JM, Epel ES, Adler NE. Lack of partner impacts newborn health through maternal depression: A pilot study of low-income immigrant Latina women. Midwifery 2018; 64:63-68. [PMID: 29990627 PMCID: PMC6084475 DOI: 10.1016/j.midw.2018.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/23/2018] [Accepted: 05/30/2018] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Latina women have a high burden of depression and other mental health issues, particularly in the perinatal period. Suboptimal maternal mental health can have adverse developmental and physiological impacts on child growth. The present study examines the impact of unplanned pregnancy and pregnancy relationship status on prenatal maternal depression in a sample of low-income Latina women. We hypothesized that the association between these prenatal stressors and newborn health would be mediated through prenatal depression. METHOD The present study included a sample 201 Latina mothers and their children recruited from prenatal clinics during their second or third trimesters. Depression symptomology, relationship status were collected prenatally. At birth, several indices of newborn health were examined, including head circumference percentile and birthweight. Finally, planned pregnancy status was retrospectively collected when the child was between 1 and 2 years old. RESULTS Structural equation modelling revealed that single women, compared to partnered women, had higher levels of depression. Higher levels of depression, in turn, predicted poorer newborn health. Unplanned pregnancy was not significantly associated with newborn health. DISCUSSION These results suggest that relationship status may be an important screening question for medical examiners to ask to pregnant Latina women during prenatal visits. These results are consistent with past research investigating the effects of maternal mental health on adverse birth outcomes that propose that stressful early environments shape developmental trajectories.
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Affiliation(s)
- Tomás Cabeza de Baca
- Division of Cardiology, Department of Medicine, University of California, San Francisco, 400 Parnassus Ave, Room AC-16, Box 0369, San Francisco, CA 94143, USA.
| | - Janet M Wojcicki
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California, San Francisco, 550 16th Street, San Francisco CA 94158, USA.
| | - Elissa S Epel
- Department of Psychiatry, University of California, San Francisco, USA
| | - Nancy E Adler
- Center for Health and Community, Department of Psychiatry, University of California, San Francisco, USA
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Lima SAM, El Dib RP, Rodrigues MRK, Ferraz GAR, Molina AC, Neto CAP, de Lima MAF, Rudge MVC. Is the risk of low birth weight or preterm labor greater when maternal stress is experienced during pregnancy? A systematic review and meta-analysis of cohort studies. PLoS One 2018; 13:e0200594. [PMID: 30048456 PMCID: PMC6061976 DOI: 10.1371/journal.pone.0200594] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 07/01/2018] [Indexed: 12/23/2022] Open
Abstract
Antenatal stress is linked to fetal risks that increase the chances of neonatal complications and reduction of child cognitive ability. Therefore, we aimed to evaluate if maternal stress affects fetal, neonatal or child development. The following databases were searched: MEDLINE (1966 to May 2016), Embase (1980 to May 2016), LILACS (1982 to May 2016) and CENTRAL (1972 to May 2016). Observational studies published in English and Portuguese were included whether there was any relationship between fetal and neonatal outcome, such as birth weight, preterm labor, child development with pregnant women that were subjected to any stress type during at least one month of follow-up. Two independent reviewers screened eligible articles, extracted data and assessed the risk of bias. Thus, 8 cohort studies with about 8,271 pregnant women and 1,081,151 children proved eligible. Results suggested a significant association between antenatal stress exposure and increasing rates of low birth weight (Odds ratio (OR) 1.68 [95% Confidential Interval (CI) 1.19, 2.38]). However, there was no statistically significance difference between non-exposed and exposed groups related to preterm labor (OR 1.98 [95% CI 0.91 to 4.31]; I2 = 68%, p = 0.04). Although, results were inconsistent with primary analysis suggesting a significant association between antenatal stress exposure and the occurrence of higher rates of preterm birth (OR 1.42 [95% CI 1.05 to 1.91]; I2 = 68%, p = 0.04) in the sensitivity analysis. Furthermore, the current review has suggested that stress perceived during antenatal negatively influences fetal life and child development. Yet, further studies are necessary with adequate sample size and longer follow-up time to confirm our findings.
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Affiliation(s)
| | - Regina Paolucci El Dib
- Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, UNESP, São José dos Campos, Brazil
| | - Meline Rossetto Kron Rodrigues
- Nursing Department of Gynecology and Obstetrics, Universidade Estadual Paulista (Unesp) Botucatu Medical School, UNESP, Botucatu, Brazil
| | - Guilherme Augusto Rago Ferraz
- Nursing Department of Gynecology and Obstetrics, Universidade Estadual Paulista (Unesp) Botucatu Medical School, UNESP, Botucatu, Brazil
| | | | | | | | - Marilza Vieira Cunha Rudge
- Nursing Department of Gynecology and Obstetrics, Universidade Estadual Paulista (Unesp) Botucatu Medical School, UNESP, Botucatu, Brazil
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Cattane N, Richetto J, Cattaneo A. Prenatal exposure to environmental insults and enhanced risk of developing Schizophrenia and Autism Spectrum Disorder: focus on biological pathways and epigenetic mechanisms. Neurosci Biobehav Rev 2018; 117:253-278. [PMID: 29981347 DOI: 10.1016/j.neubiorev.2018.07.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/11/2018] [Accepted: 07/01/2018] [Indexed: 12/15/2022]
Abstract
When considering neurodevelopmental disorders (NDDs), Schizophrenia (SZ) and Autism Spectrum Disorder (ASD) are considered to be among the most severe in term of prevalence, morbidity and impact on the society. Similar features and overlapping symptoms have been observed at multiple levels, suggesting common pathophysiological bases. Indeed, recent genome-wide association studies (GWAS) and epidemiological data report shared vulnerability genes and environmental triggers across the two disorders. In this review, we will discuss the possible biological mechanisms, including glutamatergic and GABAergic neurotransmissions, inflammatory signals and oxidative stress related systems, which are targeted by adverse environmental exposures and that have been associated with the development of SZ and ASD. We will also discuss the emerging role of the gut microbiome as possible interplay between environment, immune system and brain development. Finally, we will describe the involvement of epigenetic mechanisms in the maintenance of long-lasting effects of adverse environments early in life. This will allow us to better understand the pathophysiology of these NDDs, and also to identify novel targets for future treatment strategies.
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Affiliation(s)
- Nadia Cattane
- Biological Psychiatry Unit, IRCCS Fatebenefratelli San Giovanni di Dio, via Pilastroni 4, Brescia, Italy
| | - Juliet Richetto
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Fatebenefratelli San Giovanni di Dio, via Pilastroni 4, Brescia, Italy; Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, 125 Coldharbour Lane, SE5 9NU, London, UK.
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Fan F, Zou Y, Zhang Y, Ma X, Zhang J, Liu C, Li J, Pei M, Jiang Y, Dart AM. The relationship between maternal anxiety and cortisol during pregnancy and birth weight of chinese neonates. BMC Pregnancy Childbirth 2018; 18:265. [PMID: 29945557 PMCID: PMC6020336 DOI: 10.1186/s12884-018-1798-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/30/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To determine the relationship between maternal anxiety and cortisol values and birth weight at various stages of pregnancy. METHODS Two hundred sixteen pregnant Chinese women were assessed for anxiety and depression and had measurement of morning fasting serum cortisol. Women were assessed either in the first (71), second (72) or third (73) trimester. Birth weights of all children were recorded. RESULTS There were significant negative correlations between anxiety level and birth weight of - 0.507 (p < 0.01) and - 0.275 (p < 0.05) in trimesters 1and 2. In trimester 3 the negative relation between anxiety and birth weight of -.209 failed to reach significance (p = 0.070). There was no relation between depression and birth weight in any trimester (p > 0.5 for all). Maternal cortisol was significantly inversely related to birth weight in trimester 1 (r = - 0.322) and with borderline significance in trimester 2 (r = - 0.229). Anxiety score and maternal cortisol were significantly correlated in each trimester (r = 0.551, 0.650, 0.537). When both anxiety score and maternal cortisol were simultaneously included in multiple regression analyses only anxiety score remained significant. CONCLUSION Whilst both maternal anxiety score and maternal cortisol are inversely related to birth weight the associations with anxiety score were more robust perhaps indicating the importance of mechanisms other than, or in addition to, maternal cortisol in mediating the effects of anxiety. The findings indicate the importance of measures to reduce maternal anxiety, particularly of a severe degree, at all stages of pregnancy. TRIAL REGISTRATION The study was approved by the Ethics Committee of the 1st Affiliated Hospital of Xi'an Jiaotong University.
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Affiliation(s)
- Fenling Fan
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Yuliang Zou
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Yushun Zhang
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Xiancang Ma
- Department of Psychology and Psychiatry, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Junbo Zhang
- Department of Cardiovascular Medicine, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Cai Liu
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Jie Li
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Meili Pei
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Yu Jiang
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, 710061 China
| | - Anthony M. Dart
- Department of Cardiovascular Medicine, The Alfred, Baker Heart and Diabetes Institute, Melbourne, Vic 3004 Australia
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Thomas JC, Magel C, Tomfohr-Madsen L, Madigan S, Letourneau N, Campbell TS, Giesbrecht GF. Adverse childhood experiences and HPA axis function in pregnant women. Horm Behav 2018; 102:10-22. [PMID: 29630895 DOI: 10.1016/j.yhbeh.2018.04.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 03/22/2018] [Accepted: 04/03/2018] [Indexed: 01/12/2023]
Affiliation(s)
- Jenna C Thomas
- Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Chantelle Magel
- Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Lianne Tomfohr-Madsen
- Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada; Department of Pediatrics, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Nicole Letourneau
- Alberta Children's Hospital Research Institute, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada; Faculty of Nursing, & Cumming School of Medicine (Pediatrics, Psychiatry & Community Health Sciences), University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada
| | - Gerald F Giesbrecht
- Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada; Department of Pediatrics, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada; Department of Community Health Sciences, University of Calgary, 2500 University Drive N.W., Calgary, AB T2N 1N4, Canada.
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Hernandez-Reif M, Kendrick A, Avery DM. Pregnant women with depressive and anxiety symptoms read, talk, and sing less to their fetuses. J Affect Disord 2018; 229:532-537. [PMID: 29353212 DOI: 10.1016/j.jad.2017.12.108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/30/2017] [Accepted: 12/31/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Maria Hernandez-Reif
- Department of Human Development and Family Studies, College of Human Environmental Sciences, University of Alabama, Box 870160, Tuscaloosa, AL 35487-1060, USA.
| | - April Kendrick
- Child Development Resources, College of Human Environmental Sciences, University of Alabama, Box 870157, Tuscaloosa, AL 35487-0157, USA.
| | - Daniel Mason Avery
- Department of Obstetrics and Gynecology, College of Community Health Sciences, University of Alabama, Box 870374, Tuscaloosa, AL 35487-0326, USA.
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Stoll K, Swift EM, Fairbrother N, Nethery E, Janssen P. A systematic review of nonpharmacological prenatal interventions for pregnancy-specific anxiety and fear of childbirth. Birth 2018; 45:7-18. [PMID: 29057487 DOI: 10.1111/birt.12316] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite a sharp increase in the number of publications that report on treatment options for pregnancy-specific anxiety and fear of childbirth (PSA/FoB), no systematic review of nonpharmacological prenatal interventions for PSA/FoB has been published. Our team addressed this gap, as an important first step in developing guidelines and recommendations for the treatment of women with PSA/FoB. METHODS Two databases (PubMed and Mendeley) were searched, using a combination of 42 search terms. After removing duplicates, two authors independently assessed 208 abstracts. Sixteen studies met eligibility criteria, ie, the article reported on an intervention, educational component, or treatment regime for PSA/FoB during pregnancy, and included a control group. Independent quality assessments resulted in the retention of seven studies. RESULTS Six of seven included studies were randomized controlled trials (RCTs) and one a quasi-experimental study. Five studies received moderate quality ratings and two strong ratings. Five of seven studies reported significant changes in PSA/FoB, as a result of the intervention. Short individual psychotherapeutic interventions (1.5-5 hours) delivered by midwives or obstetricians were effective for women with elevated childbirth fear. Interventions that were effective for pregnant women with a range of different fear/anxiety levels were childbirth education at the hospital (2 hours), prenatal Hatha yoga (8 weeks), and an 8-week prenatal education course (16 hours). CONCLUSIONS Findings from this review can inform the development of treatment approaches to support pregnant women with PSA/FoB.
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Affiliation(s)
- Kathrin Stoll
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Emma Marie Swift
- Department of Nursing, University of Iceland, Reykjavík, Iceland
| | - Nichole Fairbrother
- Department of Psychiatry, University of British Columbia, Island Medical Program, Victoria, Canada
| | - Elizabeth Nethery
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Patricia Janssen
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
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Evaluating Stress during Pregnancy: Do We Have the Right Conceptions and the Correct Tools to Assess It? J Pregnancy 2018; 2018:4857065. [PMID: 29484210 PMCID: PMC5816839 DOI: 10.1155/2018/4857065] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/19/2017] [Indexed: 01/08/2023] Open
Abstract
Gestational stress is believed to increase the risk of pregnancy failure and perinatal and adult morbidity and mortality in both the mother and her child or children. However, some contradictions might arise from methodological issues or even from differences in the philosophical grounds that guide the studies on gestational stress. Biased perspectives could lead us to use and/or design inadequate/incomplete panels of biochemical determinations and/or psychological instruments to diagnose it accurately during pregnancy, a psychoneuroimmune-endocrine state in which allostatic loads may be significant. Here, we review these notions and propose a model to evaluate and diagnose stress during pregnancy.
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Antolic A, Wood CE, Keller-Wood M. Chronic maternal hypercortisolemia in late gestation alters fetal cardiac function at birth. Am J Physiol Regul Integr Comp Physiol 2017; 314:R342-R352. [PMID: 29092858 DOI: 10.1152/ajpregu.00296.2017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Studies in our laboratory have shown that modest chronic increases in maternal cortisol concentrations over the last 0.20 of gestation impair maternal glucose metabolism and increase the incidence of perinatal stillbirth. Previous studies had found that an increase in maternal cortisol concentrations from 115 to 130 days of gestation in sheep increased both proliferation in fetal cardiomyocytes and apoptosis in the fetal cardiac Purkinje fibers. We hypothesized that the adverse effects of excess cortisol may result in defects in cardiac conduction during labor and delivery. In the present study, we infused cortisol (1 mg·kg-1·day-1) into late gestation pregnant ewes and continuously monitored fetal aortic pressure and ECG through labor and delivery. We found that, although the fetuses of cortisol infused ewes had normal late gestation patterns of arterial pressure and heart rate, there was a significant decrease in fetal aortic pressure and heart rate on the day of birth, specifically in the final hour before delivery. Significant changes in the fetal ECG were also apparent on the day of birth, including prolongation of the P wave and P-R interval. We speculate that chronic exposure to glucocorticoids alters cardiac metabolism or ion homeostasis, contributing to cardiac dysfunction, precipitated by active labor and delivery.
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Affiliation(s)
- Andrew Antolic
- Department of Pharmacodynamics, University of Florida , Gainesville, Florida
| | - Charles E Wood
- Department of Physiology and Functional Genomics, University of Florida , Gainesville, Florida
| | - Maureen Keller-Wood
- Department of Pharmacodynamics, University of Florida , Gainesville, Florida
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