Prenatal Psychological Distress Research Articles

Prenatal paternal depression, anxiety, and somatic symptom burden in different risk samples: an explorative study

PurposeGrowing evidence implies that transition to parenthood triggers symptoms of mental burden not only in women but likewise in men, especially in high-risk pregnancies. This is the first study that examined and compared the prevalence rates of depression, anxiety, and somatic symptom burden of expectant fathers who face different risk situations during pregnancy.MethodsPrevalence rates of paternal depression (Edinburgh postnatal depression scale), anxiety (generalized anxiety disorder seven), and somatic symptom burden (somatic symptom scale eight) were examined in two risk samples and one control group in the third trimester of their partners’ pregnancy: risk sample I (n = 41) consist of expectant fathers whose partners were prenatally hospitalized due to medical complications; risk sample II (n = 52) are fathers whose partners were prenatally mentally distressed; and control group (n = 70) are those non-risk pregnancies.ResultsOn a purely descriptive level, the data display a trend of higher symptom burden of depression, anxiety, and somatic symptoms in the two risk samples, indicating that expectant fathers, whose pregnant partners were hospitalized or suffered prenatal depression, were more prenatally distressed. Exploratory testing of group differences revealed an almost three times higher prevalence rate of anxiety in fathers whose partner was hospitalized (12.2%) compared to those non-risks (4.3%).ConclusionResults underline the need for screening implementations for paternal prenatal psychological distress, as well as specific prevention and treatment programs, especially for fathers in risk situations, such as their pregnant partners’ prenatal hospitalization.The study was registered with the German clinical trials register (DRKS00020131) on 2019/12/09.

Maternal prenatal psychological distress and vitamin intake with children's neurocognitive development.

Maternal prenatal psychological distress (PPD) is increasingly linked to sub-optimal child neurodevelopment. Daily intake of prenatal vitamin during pre-conception and early pregnancy may ameliorate the effects of PPD on cognition in the offspring. PPD was assessed in early (12-16 weeks) and late (28-32 weeks) gestation in the Ontario Birth Study. Prenatal vitamin supplement intake information was collected in early gestation. Child cognition at 4 years was assessed using the NIH Toolbox. Poisson regression was used to investigate associations between PPD and/or prenatal vitamin intake and child cognition. Four hundred and eighteen mother-child dyads were assessed. Moderate-severe PPD experienced during early gestation was associated with reduced cognition (adjusted incidence rate ratio (IRRadj) = 3.71, 95% confidence interval (CI): 1.57-8.77, P = 0.003). Daily intake of prenatal vitamins was not associated with cognition (IRRadj = 1.34, 95% CI: 0.73-2.46, P = 0.34). Upon stratification, the experience of mild-severe PPD with daily intake of prenatal vitamins was associated with higher incident rates of suboptimal cognition compared to children of women with daily prenatal vitamin intake without any episode of PPD (IRRadj = 2.88, 95% CI: 1.1-7.4). Moderate-severe PPD in early pregnancy is associated with poor cognition in children and daily intake of prenatal vitamin did not ameliorate this association. Our findings expand on existing literature by highlighting that exposure to prenatal psychological distress (PPD), in moderate-to-severe form, in the early stages of pregnancy, can have detrimental effects on the offspring's cognitive development at 4 years. Overall, prenatal vitamin intake did not ameliorate the effects of PPD. Early screening and treatment of prenatal maternal mental illness is crucial.

Psychosocial Impact of COVID-19: Health Impact and Clinical Findings

Besides its high mortality rates, COVID-19 disease has dramatic psychosocial and psychological effects worldwide. There are significant reports of mental issues, panic attacks, anxiety, depression, and financial difficulties, and the effects continue to persist months after recovery [1]. The disease itself multipliedgic by many other problems like post-traumatic stress disorder, depression, change in behaviors. All these have a significant impact on their lives [1]. It also has adverse effects on pregnancy. COVID-19 has affected the mother as well as the child’s health. There are many panic and anxiety issues. Many deaths were not even reported. Coronavirus pandemic has led to many health and mental illnesses. Many lockdowns led to financial difficulties and problems in the present and future.
 Long-term neuropsychiatric effects may be caused by more than only the massive psychological trauma suffered during the outbreak.
 Poor developmental outcomes in offspring have been associated with prenatal psychological distress, including abnormalities in brain development 4, 7, and worse socio-emotional and cognitive development.
 This article tends to define the psychosocial (psychosocial remove) impact of COVID-19 on students, health workers, pregnant women, how their lives and mental health are affected worldwide. COVID-19 affected the workplace. Stress throughout pregnancy and early life has been linked to cancer lately. It has affected many lives in agricultural areas, economic-financial losses. Current reports put forward feasible passing on vertical coronavirus, although longitudinal studies offspring are needed. The paternal infection on the offspring and generational upshot can be contemplated.

Maternal prenatal psychological distress associates with offspring early-life wheezing - FinnBrain Birth Cohort.

BackgroundExposure to prenatal maternal psychological distress may contribute to the development of childhood atopic disorders. Little is known about the importance of distress severity and its duration for the risk. Our aim was to investigate how chronic maternal depressive and anxiety symptoms across gestation influence the risk of wheezing and eczema at child age 24 months.MethodsThe study population was drawn from the FinnBrain Birth Cohort Study, including 1305 mother‐infant dyads followed across gestation until the child age of 24 months when the outcomes were mother‐reported wheezing ever and doctor‐diagnosed eczema. To investigate the risk of wheezing phenotypes, wheezing with and without eczema was separated. Maternal distress was assessed with the Edinburgh Postnatal Depression Scale for depressive and the Symptom Checklist‐90 for anxiety symptoms three times during pregnancy, and the chronicity was demonstrated using symptom trajectories composed by latent growth mixture modeling.ResultsOf the children, 219/1305 (17%) had wheezing ever and 285/1276 (22%) had eczema. Risk of wheezing ever was elevated with maternal consistently high depressive symptoms (adjusted odds ratio 2.74; 95% confidence interval 1.37–5.50) or moderate and increasing anxiety symptoms (1.94; 1.06–3.54, respectively). Similarly, wheezing without eczema was associated with consistently high depressive (3.60; 1.63–7.94, respectively) and moderate and increasing anxiety symptoms (2.43; 1.21–4.91, respectively).ConclusionsMaternal chronic psychological distress across gestation was associated with toddler wheezing and especially wheezing without other atopic features (eczema). This finding supports the theory of intrauterine programming effect by maternal psychological distress on offspring immune system and respiratory morbidity.

Age and sex differences in the cortisol stress reactivity and recovery among infants exposed to prenatal psychological distress

BackgroundAltered hypothalamic-pituitary-adrenal axis (HPA) functioning is one of the potential mechanisms bridging exposure to maternal prenatal psychological distress (PPD) and later risk for offspring psychiatric illness. Research on infant cortisol stress reactivity, on scarcely studied recovery and their associations with maternal PPD is needed to clarify these mechanisms. Knowledge on sex differences in prospective settings is largely lacking. We aimed at filling these gaps by building upon our previous report showing that exposure to maternal prenatal depressive and anxiety symptoms associates with slower cortisol recovery among 10-week-old female infants. MethodsIn all, 363, 205 and 263 infants at 10 weeks, six and 14 months of age from the FinnBrain Birth Cohort Study participated in a stress test comprising of venipuncture and nasopharynx sampling. Five saliva cortisol samples were collected during each visit to measure cortisol reactivity and recovery. PPD was assessed from maternal self-reports for depressive, anxiety and pregnancy-related anxiety symptoms at gestational weeks 14, 24 and 34. ResultsAn 11% enhanced recovery among 14-month-old females was associated with higher depressive and anxiety symptoms (95% CI=1–23%) and pregnancy-related anxiety symptoms (2–21%). No alterations in the female cortisol reactivity or male cortisol stress responses were observed. ConclusionsThe opposite directions in the associations between the PPD exposure and infant cortisol recovery among 10-week-old and 14-month-old females suggest sex- and age-dependent associations between HPA axis functioning and PPD exposure among healthy infants. Follow-up is needed to characterize the impact of this altered negative feedback mechanism on later health.

Maternal caregiving ameliorates the consequences of prenatal maternal psychological distress on child development.

Children exposed to prenatal maternal psychological distress are at elevated risk for a range of adverse outcomes; however, it remains poorly understood whether postnatal influences can ameliorate impairments related to prenatal distress. The current study evaluated if sensitivematernal care during the first postnatal year could mitigate child cognitive and emotional impairments associated with prenatal psychological distress. Prenatal maternal psychological distress was assessed via self-reports of anxiety, depression, and perceived stress for 136 mothers at five prenatal and four postpartum time points. Quality of maternal care (sensitivity to nondistress, positive regard, and intrusiveness reverse-scored) were assessed during a mother-child play interaction at 6 and 12 months. Child cognitive function and negative emotionality were assessed at 2 years, using The Bayley Scales and the Early Childhood Behavior Questionnaire. Elevated prenatal distress was associated with poorer child cognitive function and elevated negative emotionality. Children exposed to elevated prenatal maternal distress did not, however, display these outcomes if they received high-quality caregiving. Specifically, maternal care moderated the relation between prenatal psychological distress and child cognitive function and negative emotionality. This association remained after consideration of postnatal maternal psychological distress and relevant covariates. Sensitive maternal care was associated with altered offspring developmental trajectories, supporting child resilience following prenatal distress exposure.

Feelings about pregnancy and mother-infant bonding as predictors of persistent psychological distress in the perinatal period: The Japan Environment and Children's Study

Feelings about pregnancy and mother-infant bonding are associated with maternal mental health before and after childbirth. The current study examined factors associated with persistent distress at 12 months after childbirth among mothers with psychological distress in the first trimester, using data from the Japan Environment and Children's Study (JECS). Feelings about pregnancy were assessed using a questionnaire in the first trimester, and maternal mental health was assessed using the Kessler 6 (K6) in the first trimester and at 12 months after childbirth. In addition, mother-infant bonding was assessed using the Mother-to-Infant Bonding Scale Japanese version (MIBS-J) at 12 months after childbirth, and 5 items from the MIBS-J at one and six months after childbirth. Among the 97,415 mothers registered in the JECS, 24,324 mothers with psychological distress (K6 ≥ 5) in the first trimester were included in this analysis. The relationships between persistence of psychological distress at 12 months after childbirth with feelings about pregnancy and mother-infant bonding were analyzed. Both maternal negative feelings about pregnancy in the first trimester and mother-infant bonding after childbirth were significantly associated with persistent psychological distress at 12 months after childbirth (β = 0.02, p = 0.001 and β = 0.35, p < 0.001, respectively). The indirect effect of feelings about pregnancy on persistent distress through mother-infant bonding was also observed (β = 0.06, p < 0.001). These findings indicate that mother-infant bonding after childbirth may be important for improving the mental health of mothers with prenatal psychological distress.

Uptrend in Distress and Psychiatric Symptomatology in Pregnant Women During the Coronavirus Disease 2019 Pandemic

(Acta Obstet Gynecol Scand. 2020;99:848–855) It is well established that psychological distress in pregnancy is associated with a range of negative outcomes, including delivery at an earlier gestational age, lower neonatal birthweight, and poor maternal psychosocial functioning. Expectant mothers of all social classes and educational levels can experience antenatal psychological distress, and the COVID-19 pandemic has introduced additional stress to people around the world. Most obstetric research on COVID-19 has focused on respiratory issues rather than mental health implications. This study aimed to provide data on any increase in prenatal psychological distress symptoms caused by the COVID-19 pandemic. As a secondary objective, the study aimed to identify which subgroup of women would be particularly vulnerable.

Human milk metabolome is associated with symptoms of maternal psychological distress and milk cortisol

The composition of human milk is subject to considerable variation, but the effects of maternal stress are largely unknown. We studied differences in human milk metabolome between Finnish mothers (n = 120, secretors) with symptoms of prenatal symptoms of psychological distress and milk cortisol concentrations. Human milk samples acquired at 2.5 months postpartum were analyzed using targeted 1H NMR metabolomics. Self-reported scores for depression (EPDS), overall anxiety (SCL-90), and pregnancy-related anxiety (PRAQ) were used to evaluate psychological distress. Prenatal psychological distress was positively associated with concentrations of short-chain fatty acids, caprate, and hypoxanthine (q < 0.0012). Milk cortisol was positively associated with lactate concentration (q < 0.05). Changes in the human milk metabolome were shown to be associated with maternal psychological distress and concentration of milk cortisol in a dissimilarly, suggesting alterations in bacterial and energy metabolism of the mother, respectively.

Fathers\u2019 Mental Health and Children\u2019s Aggressive Behaviour A Study Based on Data from the Norwegian Mother, Father and Child Cohort Study (MoBa)

The aim of the study was to examine the association between fathers’ prenatal psychological distress and children’s aggressive behaviour in terms of hitting others, and how children’s age, gender and temperament affect this association. The study is based on data from 20,155 fathers and mothers from the Norwegian Mother, Father and Child Cohort Study (MoBa). Fathers and mothers completed questionnaires at 17 or 18 weeks of gestation and mothers at children’s age 18 months, and 3 and 5 years. Fathers’ prenatal psychological distress was assessed by the 5-item Symptom Checklist (SCL-5), and children’s temperament by 12 items from the Emotionality Activity Sociability (EAS) Temperament Survey. Increasing prenatal psychological distress in fathers was associated with an increase of hitting from 18 months to 3 years of age in boys. Children’s temperament did not affect the association between fathers’ prenatal psychological distress and children’s aggressive behaviour.

The association of maternal-fetal attachment with smoking and smoking cessation during pregnancy in The FinnBrain Birth Cohort Study

BackgroundSmoking in pregnancy constitutes a preventable risk factor for fetal/child development and maternal-fetal attachment (MFA) seems to contain a momentum that can break the chain of adverse outcomes by promoting maternal prenatal health practices. This study aimed to explore the association of MFA with smoking at any time during pregnancy and smoking cessation in early pregnancy, and the modifying role of MFA on the expected effects of education and prenatal psychological distress (PPD) on prenatal smoking behavior.MethodsThe pregnant women (n = 3766) participated in the The FinnBrain Birth Cohort Study in Finland between December 2011 and April 2015. The binary outcomes, smoking at any time during pregnancy and smoking cessation in early pregnancy, were obtained from self-reports at gestational weeks (gwks) 14 and 34 and The Finnish Medical Birth Register. MFA was assessed with the Maternal-Fetal Attachment Scale (MFAS) at gwks 24 and 34. Logistic regression analyses were used to determine the association between MFA and maternal prenatal smoking behavior.FindingsThe prevalence of smoking was 16.5%, and 58.1% of the smokers quit smoking during pregnancy. The independent associations of total MFA scores with prenatal smoking behavior were not established (aOR = 1.00-1.02, multiplicity adjusted p > 0.05). A higher score in the altruistic subscale of MFA, Giving of self, associated with a higher probability of smoking cessation (24 gwks: aOR = 1.13, 95% CI [1.04, 1.24], p = 0.007, multiplicity adjusted p = 0.062; 34 gwks: aOR = 1.17, 95% CI [1.07, 1.29], p < 0.001, multiplicity adjusted p = 0.008). The modifying effect of MFA on the observed associations between PPD and smoking in pregnancy and between maternal education and smoking in pregnancy / smoking cessation in early pregnancy was not demonstrated.ConclusionsThe altruistic dimension of maternal-fetal attachment associates with an increased probability of smoking cessation during pregnancy and therefore strengthening altruistic maternal-fetal attachment may constitute a promising novel approach for interventions aiming at promoting smoking cessation during pregnancy.

Sex differences in the associations between maternal prenatal distress and infant cortisol reactivity and recovery

Previous research suggests that maternal prenatal psychological distress (PPD) is related to altered cortisol reactivity in the exposed child. There are indications for the sex differences in vulnerability for prenatal adversities that depend on the exposure and child outcome. Still, it is not known whether the association between maternal PPD and infant cortisol stress response is moderated by sex. In addition, the recovery phase of the cortisol stress response has not been given as much attention as reactivity. Our aim was to study the sex differences in the associations between self-reported maternal prenatal depressive-, anxiety- and pregnancy-related anxiety symptoms through gestational weeks 14, 24 and 34 and the saliva cortisol reactivity to and recovery from the acute stress among 10-week-old infants. The study population comprised of 363 mother-infant pairs from the FinnBrain Birth Cohort Study. We found evidence for sex-dependent associations between PPD exposure and infant cortisol response. A less steep recovery slope (-10 % per one SD increase in PPD [95 % CI = -18 to -2 %] and -8 % [-16 to 0 %] depending on the exposure) and a possibly less steep reactivity slope (-14 % [95 % CI = -25 to 0 %] and -10 % [-21 to 3 %]) were associated with higher PPD exposure in females. Of the PPD measures, the strongly intercorrelated, and thus combined, depressive and anxiety symptom score provided the most robust prediction of infant cortisol recovery. Our results demonstrate sexually dimorphic alterations in the functioning of the infant hypothalamus-pituitary-adrenal axis and especially in the functioning of the negative feedback loop of the axis after prenatal PPD exposure among healthy babies.

Maternal psychological distress during and after pregnancy and atopic dermatitis in children

Abstract Background Previous studies reported the association between maternal psychological distress (PD) during or after pregnancy and atopic dermatitis in children. However, studies examining the association from both pre- and post-natal aspects are limited. Methods We analysed data from 6,366 mother-child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Mothers were categorised into four groups of PD (K6 scores ≥5) during early pregnancy and one year after delivery; no PD in both periods, prenatal PD only, postnatal PD only, and PD in both periods. Mothers reported on their children's atopic dermatitis at age two using the International Study of Asthma and Allergies in Childhood (ISAAC). Multivariate logistic regression analysis was conducted to examine the association between maternal PD and atopic dermatitis in children adjusting for maternal age at delivery, maternal education, maternal smoking during early pregnancy, maternal history of atopic diseases, paternal history of atopic diseases, preterm birth, parity, and child's sex. Results The study population included 51.9% without PD in both periods, 14.6% with prenatal PD only, 14.0% with postnatal PD only, and 19.4% with PD in both periods. The prevalence of atopic dermatitis in children at age two was 18.8%. Mothers with postnatal PD only and mothers with PD in both periods had higher risks of children's atopic dermatitis compared with mothers without PD in both periods; the adjusted odds ratios (95% confidence intervals) were 1.37 (1.14-1.65) and 1.38 (1.17-1.63), respectively. The corresponding odds ratio (95% confidence interval) of mothers with prenatal PD only was 1.08 (0.89-1.31). Conclusions Postnatal PD was associated with an increased risk of atopic dermatitis in children. This finding suggests the importance for monitoring mental health among postpartum women. Key messages Postnatal PD has significant effects on atopic dermatitis in children. This study is a first study to examine the association between maternal PD and children’s atopic dermatitis in Japan. Improvements of postnatal care including social support might be effective in preventing atopic dermatitis in children.

Maternal prenatal psychological distress and hair cortisol levels associate with infant fecal microbiota composition at 2.5 months of age

BackgroundMaternal prenatal stress associates with infant developmental outcomes, but the mechanisms underlying this association are not fully understood. Alterations in the composition and function of infant intestinal microbiota may mediate some of the observed health effects, a viewpoint that is supported by animal studies along with a small human study showing that exposure to prenatal stress modifies the offspring’s intestinal microbiota. In the current study, we aim to investigate the associations between maternal prenatal psychological distress (PPD) and hair cortisol concentration (HCC) with infant fecal microbiota composition in a large prospective human cohort. MethodsThe study population was drawn from FinnBrain Birth Cohort Study. Maternal PPD was measured with standardized questionnaires (EPDS, SCL, PRAQ-R2, Daily Hassles) three times during pregnancy (n = 398). A measure addressing the chronicity of PPD was composed separately for each questionnaire. HCC was measured from a five cm segment at gestational week 24 (n = 115), thus covering the early and mid-pregnancy. Infant fecal samples were collected at the age of 2.5 months and analyzed with 16S rRNA amplicon sequencing. ResultsMaternal chronic PPD (all symptom measures) showed positive associations (FDR < 0.01) with bacterial genera from phylum Proteobacteria, with potential pathogens, in infants. Further, chronic PPD (SCL, PRAQ-R2, and Daily Hassles negative scale) associated negatively with Akkermansia. HCC associated negatively with Lactobacillus. Neither maternal chronic PPD nor HCC associated with infant fecal microbiota diversity. ConclusionChronic maternal PPD symptoms and elevated HCC associate with alterations in infant intestinal microbiota composition. In keeping with the earlier literature, maternal PPD symptoms were associated with increases in genera fromProteobacteria phylum. Further research is needed to understand how these microbiota changes are linked with later child health outcomes.

Association of prenatal psychological distress and postpartum depression with varying physical activity intensity: Japan Environment and Children\u2019s Study (JECS)

Evidence is mixed on the associations between physical activity during pregnancy and perinatal depression, and it is limited for different physical activity intensities. Data for 92,743 pregnant women from the Japan Environment and Children’s Study were analyzed in this study. Psychological distress during pregnancy was assessed as moderate or severe using the Kessler Psychological Distress Scale (K6 5–12 and ≥13, respectively). Postpartum depression was assessed using the Edinburgh Postpartum Depression Scale (EPDS; cut-off score 9). Women with only light physical activity had significantly lower odds of psychological distress during pregnancy than those with no physical activity (K6 5–12: adjusted odds ratio [AOR] 0.86, 95% confidence interval [95%CI] 0.82, 0.90; K6 ≥ 13: AOR 0.64, 95%CI 0.58, 0.72). Women with a combination of light, moderate and vigorous physical activity had significantly higher odds of psychological distress during pregnancy (K6 5–12: AOR 1.32, 95%CI 1.18, 1.48; K6 ≥ 13: AOR 1.45, 95%CI 1.16, 1.81) and depression after childbirth (EPDS ≥ 9: AOR 1.42, 95%CI 1.24, 1.61). Physical activity intensity should be considered when assessing psychological distress risk during pregnancy and depression risk after delivery. Future research should evaluate specific physical activity programs with optimal intensity for pregnant women to prevent and treat their psychological distress and depression.

Maternal psychological distress and child weight at 24 months: investigating indirect effects through breastfeeding in the All Our Families cohort.

Maternal psychological distress in pregnancy has been associated with both breastfeeding duration and child weight at 24months; however, the potential that breastfeeding duration partially mediates the risk of maternal mental health problems during pregnancy on child weight classification has not been examined. The current study investigated this proposed relationship. Data was taken from the All Our Families (AOF) cohort, an ongoing prospective pregnancy cohort located in Calgary, Canada. Psychological distress, defined as clinically significant symptoms of anxiety and depression, was assessed via self-report and measured between 34 and 36weeks of gestation. Breastfeeding duration was assessed in the postpartum by self-report. Child overweight classification was defined as a weight-for-length/height z-score at or above the 97th percentile as per World Health Organization's child growth guidelines. In this sample of 1582 mother-child pairs, there was no direct relationship between psychological distress and child overweight status. Both anxiety (B = - 5.40, p = 0.001) and depression (B = - 6.54, p = 0.008) were associated with decreased weeks breastfeeding. Breastfeeding duration mediated the association between maternal prenatal psychological distress and child overweight status at 24months, for both anxiety (B(SE) = 0.10(0.05), CI 0.03-0.21) and depression (B(SE) = 0.11(0.07), CI 0.01-0.27). Covariates included maternal age, education, ethnicity, income, pre-pregnancy BMI, gestational weight gain, and infant birth weight. The results of this longitudinal cohort analysis support an indirect relationship between maternal psychological distress in pregnancy and the childhood overweight/obesity at 24months old, mediated through breastfeeding duration.

Psychological distress in pregnancy and postpartum

PurposeDepression, stress, and anxiety, termed ‘psychological distress,’ are common in pregnancy and postpartum periods. However, it is unclear whether prenatal psychological distress predicts postpartum psychological distress. We studied the prevalence, comorbidity and associations of maternal depression, stress, and anxiety in the prenatal period in relation to the occurrence of these same measures in the postpartum period. MethodsData originated from the MotherToBaby study of pregnant women residing in the U.S or Canada (2016–2018). Risk ratios and 95% Confidence Intervals using modified-Poisson regression models were used to investigate associations between prenatal psychological distress and postpartum psychological distress. ResultsOf the 288 women in the analysis, 21.2% and 26.7% of women had evidence of prenatal and postnatal psychological distress, respectively. Among those with prenatal psychological distress, 43 (70.5%) also had postpartum psychological distress. Twenty-five (41%) of those with prenatal and 46 (60%) of those with postpartum psychological distress had comorbidity of at least two of the measures. Prenatal measures independently predicted the same postnatal measures; prenatal anxiety also independently predicted postpartum stress. Participants who experienced more types of prenatal psychological distress were at higher risk for postpartum depression, stress, and anxiety. ConclusionDepression, stress, and anxiety are common in pregnant women and often occur together. Prenatal psychological distress measures are associated with postnatal psychological distress measures, with stronger associations among women with more than one type of psychological distress in pregnancy. Interventions during pregnancy may reduce the risk of postpartum psychological distress.

Newborn amygdalar volumes are associated with maternal prenatal psychological distress in a sex-dependent way

Maternal psychological distress during pregnancy (PPD)11prenatal psychosocial distress has been associated with changes in offspring amygdalar and hippocampal volumes. Studies on child amygdalae suggest that sex moderates the vulnerability of fetal brains to prenatal stress. However, this has not yet been observed in these structures in newborns. Newborn studies are crucial, as they minimize the confounding influence of postnatal life.We investigated the effects of maternal prenatal psychological symptoms on newborn amygdalar and hippocampal volumes and their interactions with newborn sex in 123 newborns aged 2–5 weeks (69 males, 54 females). Based on earlier studies, we anticipated small, but statistically significant effects of PPD on the volumes of these structures. Maternal psychological distress was measured at gestational weeks (GW)22gestational weeks 14, 24 and 34 using Symptom Checklist-90 (SCL-90, anxiety scale)33Symptom Checklist-90 and Edinburgh Postnatal Depression Scale (EPDS)44Edinburgh Postnatal Depression Scale questionnaires.Newborn sex was found to moderate the relationship between maternal distress symptoms at GW 24 and the volumes of left and right amygdala. This relationship was negative and significant only in males. No significant main effect or sex-based moderation was found for hippocampal volumes.This newborn study provides evidence for a sex-dependent influence of maternal psychiatric symptoms on amygdalar structural development. This association may be relevant to later psychopathology.

Association of maternal prenatal psychological stressors and distress with maternal and early infant faecal bacterial profile.

Findings from animal studies indicate that the early gut bacteriome is a potential mechanism linking maternal prenatal stress with health trajectories in offspring. However, clinical studies are scarce and the associations of maternal psychological profiles with the early infant faecal bacteriome are unknown. This study aimed to investigate the associations of prenatal stressors and distress with early infant faecal bacterial profiles in a South African birth cohort study. Associations between prenatal symptoms of depression, distress, intimate partner violence (IPV) and posttraumatic stress disorder (PTSD) and faecal bacterial profiles were evaluated in meconium and subsequent stool specimens from 84 mothers and 101 infants at birth, and longitudinally from a subset of 69 and 36 infants at 4-12 and 20-28 weeks of age, respectively, in a South African birth cohort study. Infants born to mothers that were exposed to high levels of IPV had significantly higher proportions of Citrobacter and three unclassified genera, all of which belonging to the family Enterobacteriaceae detected at birth. Proportions of these Enterobacteriaceae remained significantly increased over time (birth to 20-28 weeks of life) in infants born to mothers with high levels of IPV exposure compared to infants from mothers with no/low IPV exposure. Infants born to mothers exposed to IPV also had higher proportions of the genus Weissella at 4-12 weeks compared to infants from mothers with no/low IPV exposure. Faecal specimens from mothers exposed to IPV had higher proportions of the family Lactobacillaceae and lower proportions of Peptostreptococcaceae at birth. Maternal psychological distress was associated with decreased proportions of the family Veillonellaceae in infants at 20-28 weeks and a slower decline in Gammaproteobacteria over time. No changes in beta diversity were apparent for maternal or infant faecal bacterial profiles in relation to any of the prenatal measures for psychological adversities. Maternal lifetime IPV and antenatal psychological distress are associated with altered bacterial profiles in infant and maternal faecal bacteria. These findings may provide insights in the involvement of the gut bacteria linking maternal psychological adversity and the maturing infant brain.

Internet-based interpersonal psychotherapy for stress, anxiety, and depression in prenatal women: study protocol for a pilot randomized controlled trial

BackgroundPsychological distress, defined as depression, anxiety and perceived stress, during pregnancy is common, with 15–25% of women experiencing clinically significant levels of such distress. Despite the far-reaching impact of prenatal psychological distress on mothers and their children, and that women are receptive to screening, few providers routinely screen for prenatal psychological distress and less than one in five women will receive the mental health care that they require. There is a lack of certainty regarding the most effective treatments for prenatal psychological distress. No online interpersonal psychotherapy (IPT) trials have been conducted that focus on improving psychological distress in prenatal women. The purpose of this pilot randomized controlled trial is to evaluate the perspectives of pregnant women on the feasibility and acceptability of online IPT (e-IPT) delivered during pregnancy.MethodsA pilot randomized controlled trial design with repeated measures will evaluate the feasibility and acceptability of e-IPT for pregnant women compared to routine prenatal care. Qualitative interviews with 15–30 individuals in the intervention group will provide further data on the feasibility and acceptability of the intervention. Assessment of feasibility will include the ease of accessing and completing the intervention. Women will also be asked about what barriers there were to starting and completing the e-IPT. Assessment of acceptability will inquire about the perception of women regarding the intervention and its various features. A sample size of 160 consenting pregnant women aged 18 years and older will be enrolled and randomized into the experimental (e-IPT) or control (routine care) condition. The secondary outcome measures include: depression, anxiety and stress symptoms; self-efficacy; self-mastery; self-esteem; relationship quality (spouse, immediate family members); coping; and resilience. All participants will complete the aforementioned measures at baseline during pregnancy (T1), 3 months postrandomization (T2), at 8 months of pregnancy (T3), and 3 months postpartum (T4).DiscussionThe results of this pilot randomized controlled trial will provide data on the feasibility and acceptability of the intervention and identify necessary adaptations. This study will allow for optimization of full trial processes and inform the evaluation strategy, including sample size calculations for the full randomized controlled trial.Trial registrationClinicalTrials.gov, NCT01901796. Registered on 18 December 2014.