Abstract
We investigated the relationship between maternal history of nightshift work before and shift work during pregnancy and offspring risk of depression and anxiety, among mothers participating in the Nurses Health Study II and in their offspring enrolled in the Growing Up Today Study 2 between 2004 and 2013. Case definitions were based on offspring self-reports of physician/clinician-diagnosed depression and/or anxiety, regular antidepressant use and depressive symptoms assessed using the Center for Epidemiologic Studies Depression Scale. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using generalized estimating equation models. We found no associations between maternal nightshift work before pregnancy or during pregnancy and offspring mental health disorders (e.g., nightshift work before pregnancy: depression (based on physician/clinician diagnosis): ORever nightwork = 1.14; 95% CI, 0.88–1.47; either depression or anxiety: ORever nightwork = 0.93; 95% CI, 0.81–1.08; nightshift work during pregnancy: depression: ORever nightwork = 1.14; 95% CI, 0.68–1.94; depression or anxiety: ORever nightwork =1.17; 95% CI, 0.70–1.98) and no dose-response relationship with longer history of nightshift work (all PTrend >0.10). Stratifying by maternal chronotype revealed a higher risk of depression for offspring whose mothers worked nightshifts before pregnancy and reported being definite morning chronotypes (a proxy for circadian strain) (ORever nightwork = 1.95; 95% CI, 1.17, 3.24 vs. ORever nightwork = 0.93; 95% CI, 0.68, 1.28 for any other chronotype; PInteraction = 0.03). Further studies replicating our findings and refined understanding regarding the interplay of nightshift work and chronotype and its potential influences on offspring mental health are needed.
Highlights
In the United States and worldwide, depression and anxiety are leading causes of morbidity and disability in young people; both negatively impact long-term health and pose a serious public health problem [1,2,3]
The 4044 mothers included in our analyses were, on average, 33.4 (SD 3.6) years old when they delivered their children in this study, while the 4813 children were on average 11.7 (SD 1.2) years old when they started participating in Growing Up Today Study 2 (GUTS2)
Because differences between basic and multivariable adjusted models were small, we focus on the results obtained from fully-adjusted models only (MV models 2 adjusting for the largest set of relevant covariates)
Summary
In the United States and worldwide, depression and anxiety are leading causes of morbidity and disability in young people; both negatively impact long-term health and pose a serious public health problem [1,2,3]. A twelve-month prevalence of any mental illness (including depression and anxiety) of 21.7% was reported in that age group, following diagnostic criteria stated in the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) [6]. While prevalence estimates vary by country possibly due to different screening scales, clinical cut-points, or application of diagnostic criteria, the age-at-onset for most mental disorders is consistently reported with a median in the early- to mid-twenties across countries [7]. Established risk factors for depression and anxiety include individual-level characteristics (e.g., sex, age, psychosocial stress, substance use) and family-level characteristics (e.g., parental education, socio-economic status, family structure, family history) [8]. There is growing evidence that psychiatric disorders may have developmental origins, and maternal exposure may impact offspring mental health via fetal programming [9, 10]. Recent studies suggest that shift working nurses experience epigenetic alterations (e.g., methylation patterns in the promoter region of the serotonin transporter gene) [21, 22], which could contribute to development of depressed mood in offspring [23]
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