Early adversity and psychiatric symptoms \u2013 a prospective study on Ethiopian mothers and their children

Johan Isaksson,Ulf Högberg,Yemane Berhane,Negussie Deyessa

doi:10.1186/s12888-017-1500-2

Abstract

BackgroundMaternal exposure to adversity during the perinatal period has been associated with increased susceptibility for psychiatric symptoms in the offspring. The aim of this study was to investigate a possible developmental effect of maternal perinatal stressors on emotional and behavioural symptoms in the offspring in a developing country.MethodsWe followed an Ethiopian birth cohort (N = 358), assessing intimate partner violence (IPV) and maternal psychiatric symptoms during the perinatal period and at follow-up 10 years later, as a proxy for adversity, and maternal ratings on the Child Behavior Checklist (CBCL) 10 years later as the outcome.ResultsAmong the women, exposure to IPV was common (60.6%) during the perinatal period and predicted IPV (29.9% of the mothers) at follow-up (ρ = 0.132; p = 0.012). There was also an association between maternal psychiatric symptoms at the two time points (ρ = 0.136; p = 0.010) and between maternal symptoms and IPV. Current maternal symptoms of anxiety and depression (β = 0.057; p < 0.001), but not during the perinatal period, were associated with child CBCL-scores.ConclusionOur findings do not support the hypothesis that early adversity increase susceptibility for psychiatric symptoms. However, the findings emphasize the public health problem of IPV in this population, adding to the women’s mental health problem.

Highlights

Maternal exposure to adversity during the perinatal period has been associated with increased susceptibility for psychiatric symptoms in the offspring
Maternal anxiety during pregnancy has been shown to predict child symptoms of anxiety at preadolescence in a sample of 178 mother-child pairs in the USA, independently of obstetric risk factors, socioeconomic status and current maternal wellbeing [12]; of attention problems measured at five years of age and anxiety measured up to adolescents in a study of almost 4000 pairs in Australia, adjusting for possible perinatal confounders [13]; and of behavioural and emotional problems, adjusting for psychosocial and obstetric risk, as measured with the strengths and difficulties questionnaire in children up to the age of 13 using a large English cohort of nearly 8000 pairs [14]
Regarding intimate partner violence (IPV), 60.6% (N = 217) of the women had been exposed to severe partner violence during the last year (22.9% had been exposed to both physical and sexual violence) at baseline

Summary

Introduction

Maternal exposure to adversity during the perinatal period has been associated with increased susceptibility for psychiatric symptoms in the offspring. More long-term health outcomes of the offspring have been investigated, applying a “foetal programming theory” or a “developmental origins of health and disease hypothesis” on behavioural and emotional development of the child, including psychiatric symptoms during childhood and adolescence [3, 5,6,7,8,9,10] A recent publication, including a sample of 119 motherchild pairs in the USA, reported an association between IPV during pregnancy and internalizing and externalizing symptoms in the offspring at 10 years of age [16], even after adjusting for maternal distress and later maternal exposure to IPV These studies support the notion that maternal psychiatric symptoms and mental disorder during the antenatal period have long-term effect on the offspring’s development, which the authors contribute to a possible programming mechanism influencing the foetal nervous system

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