ArticlePublisher preview availableLiterature Review

The Relationship Between Perinatal Mental Health and Stress: a Review of the Microbiome

Authors:
Nusiebeh Redpath
Nusiebeh Redpath
Nusiebeh Redpath
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Hannah Rackers at Child Trends
Hannah Rackers
Mary C. Kimmel
Mary C. Kimmel
Mary C. Kimmel
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Read publisher preview
Download citation
To read the full-text of this research, you can request a copy directly from the authors.

Abstract and Figures

Purpose of Review Our current understanding of the underlying mechanisms and etiologies of perinatal mood and anxiety disorders (PMADs) is not clearly identified. The relationship of stress-induced adaptations (i.e., the hypothalamic-pituitary-adrenal (HPA) axis, the autonomic nervous system (ANS), the immune system) and the microbiota are potential contributors to psychopathology exhibited in women during pregnancy and postpartum and should be investigated. Recent Findings The stress response activates the HPA axis and dysregulates the ANS, leading to the inhibition of the parasympathetic system. Sustained high levels of cortisol, reduced heart variability, and modulated immune responses increase the vulnerability to PMAD. Bidirectional communication between the nervous system and the microbiota is an important factor to alter host homeostasis and development of PMAD. Summary Future research in the relationship between the psychoneuroimmune system, the gut microbiota, and PMAD has the potential to be integrated in clinical practice to improve screening, diagnosis, and treatment.
Figures - available from: Current Psychiatry Reports
This content is subject to copyright. Terms and conditions apply.
A preview of this full-text is provided by Springer Nature.
Learn more
Content available from Current Psychiatry Reports
This content is subject to copyright. Terms and conditions apply.
REPRODUCTIVE PSYCHIATRY AND WOMEN'S HEALTH (CN EPPERSON AND L HANTSOO, SECTION
EDITORS)
The Relationship Between Perinatal Mental Health and Stress: a Review
of the Microbiome
Nusiebeh Redpath
1
&Hannah S. Rackers
2
&Mary C. Kimmel
2
Published online: 2 March 2019
#Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
Purpose of Review Our current understanding of the underlying mechanisms and etiologies of perinatal mood and anxiety
disorders (PMADs) is not clearly identified. The relationship of stress-induced adaptations (i.e., the hypothalamic-pituitary-
adrenal (HPA) axis, the autonomic nervous system (ANS), the immune system) and the microbiota are potential contributors to
psychopathology exhibited in women during pregnancy and postpartum and should be investigated.
Recent Findings The stress response activates the HPA axis and dysregulates the ANS, leading to the inhibition of the parasym-
pathetic system. Sustained high levels of cortisol, reduced heart variability, and modulated immune responses increase the
vulnerability to PMAD. Bidirectional communication between the nervous system and the microbiota is an important factor to
alter host homeostasis and development of PMAD.
Summary Future research in the relationship between the psychoneuroimmune system, the gut microbiota, and PMAD has the
potential to be integrated in clinical practice to improve screening, diagnosis, and treatment.
Keywords Heart rate variability .Psychosocial stress .Depression .Anxiety .Pregnancy .Microbiota
Introduction
Stress is a state in which an individual’s homeostasis is threat-
ened by perceived or real adverse physical or psychological
conditions [1]. The perinatal period encompassing pregnancy,
parturition, and postdelivery is innately stressful. A healthy
pregnancy demonstrates resilience and adaption to physiolog-
ical, psychological, and social demands of the perinatal period
and maintenance of maternal well-being beyond the postpar-
tum period. Perinatal mood and anxiety disorders (PMADs),
occurring in 10–20% of women, may result when a woman is
unable to successfully adjust to stressors whether due to
physiologic factors or exposure to severe or chronic external
stressors [2,3]. The burden of disease from perinatal mental
illness is shared by all communities of the world. The non-
psychotic PMADs are among the most common morbidities
during pregnancy and postpartum period [4]. In current prac-
tice, the diagnosis of PMAD is defined by syndromic criteria,
thus highly dependent on a clinician’s assessment and results
of screening scales. The intensity and severity of depressive or
anxiety-associated symptoms can change throughout the
course of pregnancy and postpartum period [5,6]. Adding to
the complexity of diagnosis, normative physiological changes
exhibited in pregnancy often reflect symptoms of depression
(i.e., fatigue, appetite changes, sleep deprivation). Anxiety
and/or depression can be missed or inaccurately diagnosed
[7•]. Furthermore, an individual’s presentation may not fully
meet the symptomology criteria or reach the diagnosticthresh-
old of screening tools. Similarly, some women may underre-
port symptoms due to stigma and worry regarding how they
are perceived as parents [8]. PMADs remain at risk of being
undiagnosed, underdiagnosed, and untreated, which increase
the risk of poor health outcomes in mother and child.
Research has identified sociodemographic, psychological,
and biological risk factors contributing to the manifestation of
This article is part of the Topical Collection on Reproductive Psychiatry
and Women’s Health
*Mary C. Kimmel
mary_kimmel@med.unc.edu
1
Department of Maternal and Child Health, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill, Chapel
Hill, NC, USA
2
Department of Psychiatry, School of Medicine, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
Current Psychiatry Reports (2019) 21: 18
https://doi.org/10.1007/s11920-019-0998-z
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... The perception of parenting as more overwhelming and stressful tends to be higher during the perinatal period compared to other times of motherhood [45], and there is evidence that it is more salient in vulnerable groups of mothers, for example, those with lower educational levels due to less access to expert support and other reliable sources to respond to difficult parenting situations [46]. In addition, it has been found that high levels of maternal parenting stress are associated with a greater risk of mental health difficulties [47][48][49][50] and exacerbate maternal psychopathological symptoms [51]. Based on these considerations, it is possible to hypothesize a mediation of parental stress in the relation between socioemotional development difficulties and maternal perinatal mental health. ...
... Secondly, responding to these demands may be more complicated for these mothers, given the scarcity of educational, economic, and support resources that they experience during the perinatal period. Finally, the greater biological, psychological, and social vulnerability of this period may increase parental stress [47]. Additionally, it can be posited that socioeconomic vulnerability may increase the risk of the emergence of mental health issues during the perinatal period, particularly in the context of the challenges associated with motherhood. ...
Maternal Stress Mediates Association of Infant Socioemotional Development with Perinatal Mental Health in Socioeconomically Vulnerable Peruvian Settings
Article
Full-text available
Increased maternal mental health during the perinatal period has been widely associated with a variety of positive outcomes for both mothers and infants. However, no studies in Peru have yet focused on studying maternal mental health and related psychological variables during this stage. Thus, the aim of this study was to test a model to associate a mother’s parental stress with infant socioemotional difficulties and maternal mental health. The sample included 988 mothers of infants aged 6 to 18 months from Peru, all from socioeconomically vulnerable settings. The findings showed that infant socioemotional difficulties were associated with poorer maternal mental health through the mother’s parental stress (χ²(7) = 28.89, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.03). These results provide a better understanding of the key elements associated with maternal mental health during the perinatal period in Peru and offer valuable insights for developing interventions and support strategies for socioeconomically vulnerable mothers and their young children.
View
... It is worth noting that Th17 cells in the blood and IL-17A, which have long been reported to be regulated by the gut microbiota, are positively associated with postpartum depression Min et al., 2022). The hypothalamic-pituitary-adrenal (HPA) axis, which refers to the feedback network between the hypothalamus, pituitary, and adrenal glands, has been reported to participate in the crosstalk between gut microbiota and postpartum depression by regulating cortisol secretion (Redpath et al., 2019). Disturbed gut microbiota has been associated with lower cortisol levels, which has been reported in depression patients, and an association with chronic postpartum depression has also been demonstrated (Seth et al., 2016). ...
Unraveling the role of the gut microbiome in pregnancy disorders: insights and implications
Article
Full-text available
  • Mar 2025
The gut microbiota is the collective term for the microorganisms that reside in the human gut. In recent years, advances in sequencing technology and bioinformatics gradually revealed the role of gut microbiota in human health. Dramatic changes in the gut microbiota occur during pregnancy due to hormonal and dietary changes, and these changes have been associated with certain gestational diseases such as preeclampsia (PE) and gestational diabetes mellitus (GDM). Modulation of gut microbiota has also been proposed as a potential treatment for these gestational diseases. The present article aims to review current reports on the association between gut microbiota and gestational diseases, explore possible mechanisms, and discuss the potential of probiotics in gestational diseases. Uncovering the link between gut microbiota and gestational diseases could lead to a new therapeutic approach.
View
The impact of perinatal maternal stress on the maternal and infant gut and human milk microbiomes: A scoping review
Article
Full-text available
Background Perinatal maternal stress, which includes both psychological and physiological stress experienced by healthy women during pregnancy and the postpartum period, is becoming increasingly prevalent. Infant early exposure to adverse environments such as perinatal stress has been shown to increase the long-term risk to metabolic, immunologic and neurobehavioral disorders. Evidence suggests that the human microbiome facilitates the transmission of maternal factors to infants via the vaginal, gut, and human milk microbiomes. The colonization of aberrant microorganisms in the mother’s microbiome, influenced by the microbiome-brain-gut axis, may be transferred to infants during a critical early developmental period. This transfer may predispose infants to a more inflammatory-prone microbiome which is associated with dysregulated metabolic process leading to adverse health outcomes. Given the prevalence and potential impact of perinatal stress on maternal and infant health, with no systematic mapping or review of the data to date, the aim of this scoping review is to gather evidence on the relationship between perinatal maternal stress, and the human milk, maternal, and infant gut microbiomes. Methods This is an exploratory mapping scoping review, guided by the Joanna Briggs Institute’s methodology along with use of the Prisma Scr reporting guideline. A comprehensive search was conducted using the following databases, CINAHL Complete; MEDLINE; PsycINFO, Web of Science and Scopus with a protocol registered with Open Science Framework DOI 10.17605/OSF.IO/5SRMV. Results After screening 1145 papers there were 7 paper that met the inclusion criteria. Statistically significant associations were found in five of the studies which identify higher abundance of potentially pathogenic bacteria such as Erwinia, Serratia, T mayombie, Bacteroides with higher maternal stress, and lower levels of stress linked to potentially beneficial bacteria such Lactococcus, Lactobacillus, Akkermansia. However, one study presents conflicting results where it was reported that higher maternal stress was linked to the prevalence of more beneficial bacteria. Conclusion This review suggests that maternal stress does have an impact on the alteration of abundance and diversity of influential bacteria in the gut microbiome, however, it can affect colonisation in different ways. These bacterial changes have the capacity to influence long term health and disease. The review analyses data collection tools and methods, offers potential reasons for these findings as well as suggestions for future research.
View
Depressive symptoms and heart rate variability in perinatal women: A narrative review
Article
  • Jan 2025
  • JPN J NURS SCI
Aim This study aims to review research on heart rate variability and psychiatric symptoms in perinatal women and explains how heart rate variability can be useful in preventing depressive symptoms in perinatal women. Methods Data were collected from PubMed, CINAHL, PsycINFO, and Google Scholar. The literature search encompassed articles published until July 2024, with the inclusion criteria targeting studies on women within 1 year postpartum, starting from the gestation period. Further, articles exploring this population that discussed the relationship between anxiety, depression, stress, and heart rate variability were selected. The exclusion criterion was studies that confirmed a correlation between stressors and heart rate variability. Results We identified 36 relevant articles. The results demonstrated that, since 2022, research has been conducted using smartwatches, smartphones, and so on. The effectiveness of using heart rate variability has been confirmed, particularly in studies linking it to depression. However, some studies lacked controls during measurements. Intervention studies demonstrated the effectiveness of heart rate variability biofeedback. Conclusions This is the first review to investigate the relationship between psychiatric symptoms and heart rate variability in perinatal women. Understanding and using the characteristics of heart rate variability may lead to the detection of psychiatric symptoms in perinatal women and to self‐care among women.
View
View
Maternal Prenatal Stress and the Offspring Gut Microbiome: A Cross-Species Systematic Review
Article
  • Dec 2024
  • DEV PSYCHOBIOL
The prenatal period is a critical developmental juncture with enduring effects on offspring health trajectories. An individual's gut microbiome is associated with health and developmental outcomes across the lifespan. Prenatal stress can disrupt an infant's microbiome, thereby increasing susceptibility to adverse outcomes. This cross-species systematic review investigates whether maternal prenatal stress affects the offspring's gut microbiome. The study analyzes 19 empirical, peer-reviewed research articles, including humans, rodents, and non-human primates, that included prenatal stress as a primary independent variable and offspring gut microbiome characteristics as an outcome variable. Prenatal stress appeared to correlate with differences in beta diversity and specific microbial taxa, but not alpha diversity. Prenatal stress is positively correlated with Proteobacteria, Bacteroidaceae, Lachnospiraceae, Prevotellaceae, Bacteroides, and Serratia. Negative correlations were observed for Actinobacteria, Enterobacteriaceae, Streptococcaceae, Bifidobacteria, Eggerthella, Parabacteroides, and Streptococcus. Evidence for the direction of association between prenatal stress and Lactobacillus was mixed. The synthesis of findings was limited by differences in study design, operationalization and timing of prenatal stress, timing of infant microbiome sampling, and microbiome analysis methods.
View
Adverse Childhood Experiences and Perinatal Mental Health: A Review of Progress and Future Directions
Article
Full-text available
  • Nov 2024
  • Curr Psychiatr Rep
Purpose of Review This review includes recent literature on adverse childhood experiences (ACEs) and perinatal mental health. We summarize key findings, including meta-analytic reviews and emerging data on broad risks for psychopathology, mechanistic pathways, protective factors, and ACEs screening within clinical care contexts. Recent Findings ACEs are associated with small to moderate risks for perinatal depression and anxiety. There is increasing evidence ACEs are also associated with other mental health concerns and transdiagnostic symptoms during pregnancy and postpartum. Possible mechanistic factors include a range of biological and psychosocial variables. Unique effects of benevolent childhood experiences (BCEs) on perinatal mental health are also notable. Summary Continued emphasis on associations between ACEs and perinatal mental health concerns beyond depression and anxiety is needed. More empirical attention to mechanistic and protective factors, including benevolent childhood experiences, is also warranted. Although ACEs screening in clinical settings may be feasible and acceptable, implementation should occur within a healing centered engagement framework.
View
View
The impact of perinatal maternal stress on the maternal and infant gut and human milk microbiomes: A scoping review protocol
Article
Full-text available
Objective The objective of this scoping review is to review the research evidence regarding the impact of perinatal maternal stress on the maternal and infant gut and human milk microbiomes. Introduction Perinatal stress which refers to psychological stress experienced by individuals during pregnancy and the postpartum period is emerging as a public health concern. Early exposure of infants to perinatal maternal stress can potentially lead to metabolic, immune, and neurobehavioral disorders that extend into adulthood. The role of the gut and human milk microbiome in the microbiome-gut-brain axis as a mechanism of stress transfer has been previously reported. A transfer of colonised aberrant microbiota from mother to infant is proposed to predispose the infant to a pro- inflammatory microbiome with dysregulated metabolic process thereby initiating early risk of chronic diseases. The interplay of perinatal maternal stress and its relationship to the maternal and infant gut and human milk microbiome requires further systematic examination in the literature. Inclusion criteria This scoping review is an exploratory mapping review which will focus on the population of mothers and infants with the exploration of the key concepts of maternal stress and its impact on the maternal and infant gut and human milk microbiome in the context of the perinatal period. It will focus on the pregnancy and the post-natal period up to 6 months with infants who are exclusively breastfed. Methods This study will be guided by the Joanna Briggs Institute’s (JBI) methodology for scoping reviews along with use of the Prisma Scr reporting guideline. A comprehensive search will be conducted using the following databases, CINAHL Complete; MEDLINE; PsycINFO, Web of Science and Scopus. A search strategy with pre-defined inclusion and exclusion criteria will be used to retrieve peer reviewed data published in English from 2014 to present. Screening will involve a three-step process with screening tool checklists. Results will be presented in tabular and narrative summaries, covering thematic concepts and their relationships. This protocol is registered with Open Science Framework DOI 10.17605/OSF.IO/5SRMV.
View
View
The Interplay Between Nutrition and Stress in Pregnancy: Implications for Fetal Programming of Brain Development
Article
Full-text available
  • Jul 2018
  • BIOL PSYCHIAT
Growing evidence supports an important role for the intrauterine environment in shaping fetal development and subsequent child health and disease risk. The fetal brain is particularly plastic, whereby even subtle changes in structure and function produced by in utero conditions can have long-term implications. Based on the consideration that conditions related to energy substrate and likelihood of survival to reproductive age are particularly salient drivers of fetal programming, maternal nutrition and stress represent the most commonly, but independently, studied factors in this context. However, the effects of maternal nutrition and stress are context dependent and may be moderated by one another. Studies examining the effects of the bidirectional nutrition-stress interplay in pregnancy on fetal programming of brain development are beginning to emerge in the literature. This review incorporates all currently available animal and human studies of this interplay and provides a synthesis and critical discussion of findings. Nine of the 10 studies included here assessed nutrition-stress interactions and offspring neurodevelopmental or brain development outcomes. Despite significant heterogeneity in study design and methodology, two broad patterns of results emerge to suggest that the effects of prenatal stress on various aspects of brain development may be mitigated by 1) higher fat diets or increased intake and/or status of specific dietary fats and 2) higher dietary intake or supplementation of targeted nutrients. The limitations of these studies are discussed, and recommendations are provided for future research to expand on this important area of fetal programming of brain development.
View
Heart and soul: Heart rate variability and major depression
Article
Full-text available
  • Apr 2018
There is a bidirectional relationship between affective disorders and cardiovascular abnormalities, often described as a downward spiral, whereas major depressive disorders (MDD, and anxiety disorders) significantly increase the risk of developing cardiovascular diseases (CVD); CVD are also associated with increased risk of developing MDD (and anxiety disorders). Moreover, the prognosis and progression of CVD is significantly worsened in the presence of MDD. Heart rate variability (HRV) has often been suggested as a potential mediator in this comorbidity. In this review, we discuss HRV alterations in MDD. However, we mainly focus on the direct relationship between HRV alterations and psychiatric symptoms, rather than its relationship with CVD, as this has been reviewed elsewhere. After a general introduction to HRV and how it can be measured, we review how HRV is altered in MDD. We subsequently describe how antidepressant drugs affect HRV, showing that some classes (such as tricyclics) generally worsen HRV, whereas others (most notably selective serotonin reuptake inhibitors) have a more positive influence. We also review the effects of several other treatments, with a special focus on vagal nerve stimulation, finishing with some further considerations and recommendation for further research, both in humans and animals.
View
Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial
Article
Full-text available
  • Sep 2017
Background: Probiotics may help to prevent symptoms of anxiety and depression through several putative mechanisms. Objective: The aim of this study was to evaluate the effect of Lactobacillus rhamnosus HN001 (HN001) given in pregnancy and postpartum on symptoms of maternal depression and anxiety in the postpartum period. This was a secondary outcome, the primary outcome being eczema in the offspring at 12months of age. Design, setting, participants: A randomised, double-blind, placebo-controlled trial of the effect of HN001 on postnatal mood was conducted in 423 women in Auckland and Wellington, New Zealand. Women were recruited at 14-16weeks gestation. Intervention: Women were randomised to receive either placebo or HN001 daily from enrolment until 6months postpartum if breastfeeding. Outcome measures: Modified versions of the Edinburgh Postnatal Depression Scale and State Trait Anxiety Inventory were used to assess symptoms of depression and anxiety postpartum. Trial registration: Australia NZ Clinical Trials Registry: ACTRN12612000196842. Findings: 423 women were recruited between December 2012 and November 2014. 212 women were randomised to HN001 and 211 to placebo. 380 women (89.8%) completed the questionnaire on psychological outcomes, 193 (91.0%) in the treatment group and 187 (88.6%) in the placebo group. Mothers in the probiotic treatment group reported significantly lower depression scores (HN001 mean=7·7 (SD=5·4), placebo 9·0 (6·0); effect size -1·2, (95% CI -2·3, -0·1), p=0·037) and anxiety scores (HN001 12·0 (4·0), placebo 13·0 (4·0); effect size -1·0 (-1·9, -0·2), p=0·014) than those in the placebo group. Rates of clinically relevant anxiety on screening (score>15) were significantly lower in the HN001 treated mothers (OR=0·44 (0·26, 0·73), p=0·002). Interpretation: Women who received HN001 had significantly lower depression and anxiety scores in the postpartum period. This probiotic may be useful for the prevention or treatment of symptoms of depression and anxiety postpartum. Funding source: Health Research Council of New Zealand (11/318) and Fonterra Co-operative Group Ltd.
View
HPA axis reactivity to pharmacologic and psychological stressors in euthymic women with histories of postpartum versus major depression
Article
Full-text available
  • Jun 2017
  • ARCH WOMEN MENT HLTH
It is unclear whether women with a history of postpartum depression (PPD) have residual, abnormal hypothalamic-pituitary-adrenal (HPA) axis reactivity, as has been reported in major depression (MDD). Further unclear is whether the abnormalities in HPA axis reactivity associated with MDD represent a stable, underlying predisposition or a state-dependent phenomenon. This study sought the following: (1) to determine if euthymic postpartum women with a history of depression have an abnormal HPA axis reactivity to pharmacologic and psychological challenges and (2) to compare HPA reactivity in women with histories of PPD versus MDD. As a secondary objective, we wanted to determine the influence of trauma history on HPA axis function. Forty-five parous (12–24 months postpartum), euthymic women with history of MDD (n = 15), PPD (n = 15), and controls (n = 15) completed pharmacologic (dexamethasone/corticotropin-releasing hormone (CRH) test [DEX/CRH]) and psychological (Trier social stress test [TSST]) challenges during the luteal phase. Outcome measures were cortisol and adrenocorticotropic hormone (ACTH) response after DEX/CRH, and blood pressure, heart rate, epinephrine, norepinephrine, and cortisol response during the TSST. All groups had robust cortisol and ACTH response to DEX/CRH and cortisol response to TSST. Groups did not differ significantly in cortisol or ACTH response to DEX/CRH or in blood pressure, heart rate, epinephrine, norepinephrine, or cortisol response to TSST. Cortisol/ACTH ratio did not differ significantly between groups. Trauma history was associated with decreased cortisol response to DEX/CRH in women with histories of MDD, which was not significant after correction (F8,125, p = 0.02, Greenhouse-Geisser corrected p = 0.11). Currently euthymic women with histories of MDD or PPD did not demonstrate residual abnormal stress responsivity following administration of either a pharmacologic or psychological stressor.
View
Inflammatory markers in late pregnancy in association with postpartum depression-A nested case-control study
Article
Full-text available
  • Feb 2017
Recent studies indicate that the immune system adaptation during pregnancy could play a significant role in the pathophysiology of perinatal depression. The aim of this study was to investigate if inflammation markers in a late pregnancy plasma sample can predict the presence of depressive symptoms at eight weeks postpartum. Blood samples from 291 pregnant women (median and IQR for days to delivery, 13 and 7–23 days respectively) comprising 63 individuals with postpartum depressive symptoms, as assessed by the Edinburgh postnatal depression scale (EPDS ≥ 12) and/or the Mini International Neuropsychiatric Interview (M.I.N.I.) and 228 controls were analyzed with an inflammation protein panel using multiplex proximity extension assay technology, comprising of 92 inflammation-associated markers. A summary inflammation variable was also calculated. Logistic regression, LASSO and Elastic net analyses were implemented. Forty markers were lower in late pregnancy among women with depressive symptoms postpartum. The difference remained statistically significant for STAM-BP (or otherwise AMSH), AXIN-1, ADA, ST1A1 and IL-10, after Bonferroni correction. The summary inflammation variable was ranked as the second best variable, following personal history of depression, in predicting depressive symptoms postpartum. The protein-level findings for STAM-BP and ST1A1 were validated in relation to methylation status of loci in the respective genes in a different population, using openly available data. This explorative approach revealed differences in late pregnancy levels of inflammation markers between women presenting with depressive symptoms postpartum and controls, previously not described in the literature. Despite the fact that the results do not support the use of a single inflammation marker in late pregnancy for assessing risk of postpartum depression, the use of STAM-BP or the novel notion of a summary inflammation variable developed in this work might be used in combination with other biological markers in the future.
View
Stress during pregnancy alters temporal and spatial dynamics of the maternal and offspring microbiome in a sex-specific manner
Article
Full-text available
  • Mar 2017
The microbiome is a regulator of host immunity, metabolism, neurodevelopment, and behavior. During early life, bacterial communities within maternal gut and vaginal compartments can have an impact on directing these processes. Maternal stress experience during pregnancy may impact offspring development by altering the temporal and spatial dynamics of the maternal microbiome during pregnancy. To examine the hypothesis that maternal stress disrupts gut and vaginal microbial dynamics during critical prenatal and postnatal windows, we used high-resolution 16S rRNA marker gene sequencing to examine outcomes in our mouse model of early prenatal stress. Consistent with predictions, maternal fecal communities shift across pregnancy, a process that is disrupted by stress. Vaginal bacterial community structure and composition exhibit lasting disruption following stress exposure. Comparison of maternal and offspring microbiota revealed that similarities in bacterial community composition was predicted by a complex interaction between maternal body niche and offspring age and sex. Importantly, early prenatal stress influenced offspring bacterial community assembly in a temporal and sex-specific manner. Taken together, our results demonstrate that early prenatal stress may influence offspring development through converging modifications to gut microbial composition during pregnancy and transmission of dysbiotic vaginal microbiome at birth.
View
Risk Factors of New Onset Anxiety and Anxiety Exacerbation in the Perinatal Period: A Systematic Review and Meta-Analysis
Article
  • Jun 2018
  • J AFFECT DISORDERS
Background: Even though more than 20% of women meet diagnostic criteria for an anxiety disorder during the perinatal period, very little is known about the predictors of these problems. As a result, we systematically reviewed the literature on risk factors for new onset anxiety and maternal anxiety exacerbation in the perinatal period. Methods: PubMed, MEDLINE, PsycINFO, CINAHL, Ovid, ProQuest Portal, and Web of Science were searched for studies assessing risk factors for the development of new onset anxiety or anxiety worsening in women during pregnancy and the postpartum period. Results: 11,759 citations were identified, with 11 studies meeting eligibility criteria. New onset anxiety was assessed in 7 studies, anxiety worsening in 3, and 1 assessed both. Lower educational attainment, living with extended family members, multiparity, a family history of psychiatric disorders, hyperemesis gravidarum, comorbid sleep disorders, and prenatal oxytocin exposure were risk factors for new onset perinatal anxiety, while presence of comorbid psychiatric disorders and prenatal oxytocin were risk factors for anxiety worsening. Limitations: Studies not explicitly stating whether participants had pre-existing anxiety disorders were excluded. As a result, meta-analysis was not possible for several risk factors. Conclusions: Risk factors for new onset anxiety and anxiety worsening during the perinatal period include psychological, social, and biological exposures. Given the lack of studies differentiating women with and without pre-existing anxiety disorders, additional research is required in order to determine whether these factors differ from the non-puerperal population, as well as from each other.
View
Emerging literature in the Microbiota-Brain Axis and Perinatal Mood and Anxiety Disorders
Article
  • May 2018
  • PSYCHONEUROENDOCRINO
Perinatal Mood and Anxiety Disorders (PMAD) are common and can cause significant morbidity and mortality for mother and child. A healthy perinatal period requires significant adaptations; however, systems can become imbalanced resulting in depressive and anxiety symptoms. The interface between the microbiome, the immune system, and the stress system may be a model for understanding mechanisms underlying PMAD. Emerging literature from general populations regarding immune, hormone, and HPA axis changes in relation to the microbiome combined with literature on immune, gonadotropin, and stress systems in the perinatal period provides a background. We systematically investigated literature in the developing field of the microbiome in relation to PMAD. Our inclusion criteria were 1) reporting measure of maternal mood, stress, or anxious or depressed behavior; 2) in the perinatal period, defined as pregnancy through one year postpartum; and 3) reporting measure of maternal microbiome including manipulations of the microbiome through prebiotics, probiotics, or interventions with microbial byproducts. The review identified research studying associations between stress and maternal microbiome; dietary impacts on microbial composition, mood, and stress; and the relationship between the microbiome and the immune system through immunoregulatory mechanisms. Important themes identified include: the importance of studying the maternal microbiome and measures of stress, anxiety, and depression and that multi-hit models will be needed as research strives to determine the effects of multiple mechanisms working in concert.
View
Stress during pregnancy alters temporal and spatial dynamics of the maternal and offspring microbiome in a sex-specific manner
Article
  • Mar 2017
The microbiome is a regulator of host immunity, metabolism, neurodevelopment, and behavior. During early life, bacterial communities within maternal gut and vaginal compartments can have an impact on directing these processes. Maternal stress experience during pregnancy may impact offspring development by altering the temporal and spatial dynamics of the maternal microbiome during pregnancy. To examine the hypothesis that maternal stress disrupts gut and vaginal microbial dynamics during critical prenatal and postnatal windows, we used high-resolution 16S rRNA marker gene sequencing to examine outcomes in our mouse model of early prenatal stress. Consistent with predictions, maternal fecal communities shift across pregnancy, a process that is disrupted by stress. Vaginal bacterial community structure and composition exhibit lasting disruption following stress exposure. Comparison of maternal and offspring microbiota revealed that similarities in bacterial community composition was predicted by a complex interaction between maternal body niche and offspring age and sex. Importantly, early prenatal stress influenced offspring bacterial community assembly in a temporal and sex-specific manner. Taken together, our results demonstrate that early prenatal stress may influence offspring development through converging modifications to gut microbial composition during pregnancy and transmission of dysbiotic vaginal microbiome at birth.
View
Prenatal stress affects placental cytokines and neurotrophins, commensal microbes, and anxiety-like behavior in adult female offspring Abbreviated title: Prenatal stress and microbiome
Article
  • Dec 2016
Recent studies demonstrate that exposure to stress changes the composition of the intestinal microbiota, which is associated with development of stress-induced changes to social behavior, anxiety, and depression. Stress during pregnancy has also been related to the emergence of these disorders; whether commensal microbes are part of a maternal intrauterine environment during prenatal stress is not known. Here, we demonstrate that microbiome changes are manifested in the mother, and also found in female offspring in adulthood, with a correlation between stressed mothers and female offspring. Alterations in the microbiome have been shown to alter immune responses, thus we examined cytokines in utero. IL-1β was increased in placenta and fetal brain from offspring exposed to the prenatal stressor. Because IL-1β has been shown to prevent induction of brain derived neurotrophic factor (BDNF), we examined BDNF and found a reduction in female placenta and adult amygdala, suggesting in utero impact on neurodevelopment extending into adulthood. Furthermore, gastrointestinal microbial communities were different in adult females born from stressed vs. non-stressed pregnancies. Adult female offspring also demonstrated increased anxiety-like behavior and alterations in cognition, suggesting a critical window where stress is able to influence the microbiome and the intrauterine environment in a deleterious manner with lasting behavioral consequences. The microbiome may be a key link between the intrauterine environment and adult behavioral changes.
View