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Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective
Abstract
If a mother is stressed or anxious while pregnant her child is more likely to show a range of symptoms such as those of attention deficit hyperactivity disorder, conduct disorder, aggression or anxiety. While there remains some debate about what proportion of these effects are due to the prenatal or the postnatal environment, and the role of genetics, there is good evidence that prenatal stress exposure can increase the risk for later psychopathology. Why should this be? In our evolutionary history it is possible that some increase in these characteristics in some individuals was adaptive in a stressful environment, and that this type of fetal programming prepared the child or group for the environment in which they were going to find themselves. Anxiety may have been associated with increased vigilance, distractible attention with more perception of danger, impulsivity with more exploration, conduct disorder with a willingness to break rules, and aggression with the ability to fight intruders or predators. This adaptation for a future dangerous environment may explain why stress and anxiety, rather than depression, seem to have these programming effects; why there is a dose-response relationship with prenatal stress from moderate to severe and it is not only toxic stress that has consequences; why not all children are affected and why individual children are affected in different ways; and why the outcomes affected can depend on the sex of the offspring. An evolutionary perspective may give a different understanding of children in our society with these symptoms, and suggest new directions for research. For example, there is some evidence that the type of cognitive deficits observed after prenatal stress have specific characteristics; these may be those which were adaptive in a past environment.
... Prequels of stress-related neurodevelopmental phenotypes (Glover, 2011(Glover, , 2015O'Donnell et al., 2009) have been recently identified (i) in the fetus, in terms of decreased hippocampal volume, increased cortical local gyrification and sulcal depth and altered patterns of subcortical-cortical and cortical-cortical functional connectivity at rest (rs-FC) Thomason, Palopoli, et al., 2021;van den Heuvel et al., 2021) and (ii) in the neonate, in terms of both abnormal volumetric growth trajectories of the hippocampus, amygdala and prefrontal cortices, as well as of altered structural (please see Demers et al., 2021 for a detailed review) and functional connectivity by limbic subcortical and cortical structures (particularly between amygdala, hippocampus and temporal, parietal and prefrontal cortices) (Adamson et al., 2018;Lautarescu, Pecheva, et al., 2020;Scheinost et al., 2016Scheinost et al., , 2017Scheinost et al., , 2020. Importantly, these alterations have been associated with the emergence, throughout infancy (Bergman et al., 2007;Blair et al., 2011;Howland et al., 2020) and childhood (Barker et al., 2011;Field, 2017;Howland et al., 2016;Madigan et al., 2018), of behavioral profiles marked by increased impulsivity, negative affectivity and emotional reactivity, internalizing behaviors and anxiety, independent of maternal anxiety and/or depression emerging after childbirth (Demers et al., 2021). ...
... Functional homeostasis between network configurations appears thus to trace back to a more "limbicocentric" equilibrium in order to reach optimal organization, reminiscent of the likely neurobiological underpinnings of phylogenetically older assets of human cognitive and behavioral adaptation (Cavanna et al., 2007;Glover, 2011;Mesulam, 1998;Vilensky et al., 1982). Socio-emotional regulation, increase in group size and complexity of social cooperation represent core assets of current human adaptation to the environment and are critically underlied by cognitive abilities (including cognitive flexibility, semantic abstraction, and perspective creation) which are emergent or reach their peak in our species (Adolphs, 2003;Chang et al., 2013;Park & Moghaddam, 2017;Rapoport, 1990;Sinha et al., 2014). ...
... Socio-emotional regulation, increase in group size and complexity of social cooperation represent core assets of current human adaptation to the environment and are critically underlied by cognitive abilities (including cognitive flexibility, semantic abstraction, and perspective creation) which are emergent or reach their peak in our species (Adolphs, 2003;Chang et al., 2013;Park & Moghaddam, 2017;Rapoport, 1990;Sinha et al., 2014). Attentional deficits, increased impulsivity and emotional dysregulation blooming into internalizing and externalizing behaviors, antisocial behaviors, anxiety, and depression, do all entail (with different manifestations and to varying degrees of severity) impairments in social adaptation abilities and, critically, represent frequently observed cognitive and behavioral neurodevelopmental sequelae in infants, children, and adolescents born from anxious mothers (please see for instance : Bergman et al., 2007;Blair et al., 2011;Buss et al., 2011;Davis & Sandman, 2010;Glover, 2011;Howland et al., 2020;McQuaid et al., 2019;Mennes et al., 2006;O'Connor et al., 2002;Van Den Bergh et al., 2005;Van Den Bergh & Marcoen, 2004). ...
A link between maternal anxiety during pregnancy and adverse socio-emotional outcomes in childhood has been consistently sustained on the very early neurodevelopmental alteration of structural pathways between fetal limbic and cortical brain regions. In this study, we provide follow-up evidence for a feed-forward model linking (i) maternal anxiety, (ii) fetal functional neurodevelopment, (iii) neonatal functional network organization with (iv) socio-emotional neurobehavioral development in early childhood. Namely, we investigate a sample of 16 mother–fetus dyads and show how a maternal state–trait anxiety profile with pregnancy-specific worries can significantly influence functional synchronization patterns between regions of the fetal limbic system (i.e., hippocampus and amygdala) and the neocortex, as assessed through resting-state functional magnetic resonance imaging. Generalization of the findings was supported by leave-one-out cross-validation. We further show how this maternal–fetal cross-talk propagates to functional network topology in the neonate, specifically targeting connector hubs, and further maps onto socio-emotional profiles, assessed through Bayley-III socio-emotional scale in early childhood (i.e., in the 12–24 months range). Based on this evidence, we put forward the hypothesis of a “Maternal-Fetal-Neonatal Anxiety Backbone”, through which neurobiological changes driven by maternal anxiety could trigger a divergence in the establishment of a cognitive–emotional development blueprint, in terms of the nascent functional homeostasis between bottom-up limbic and top-down higher-order neuronal circuitry.
... Maternal stress exposure and mental health problems during pregnancy are well-established risk factors for adverse child development and psychopathology, suggesting that developmental origins of later mental health begin even before birth (Glover, 2011;Van den Bergh et al., 2005. Substantial evidence indicates that stress exposure, maternal anxiety, and depression during pregnancy increase the risk for negative mental health outcomes in offspring across the life span (Betts et al., 2014;Lafortune et al., 2021;O'Donnell et al., 2014;Madigan et al., 2018). ...
... Prenatal stress exposure is associated with increased risk for maternal perinatal mental health symptoms including depression, anxiety, and posttraumatic stress (Brock et al., 2014;Harville et al., 2010;Tees et al., 2010), which are associated with mental health risk in offspring (Chen et al., 2020;Lin et al., 2017). The developing fetus is particularly vulnerable to environmental influences, including maternal psychopathology and exposure to stressful life events (Glover, 2011;Van den Bergh et al., 2005). In utero exposure to maternal psychological distress has long been associated with adverse socioemotional outcomes in offspring (DiPietro et al., 2018;Korja et al., 2017). ...
... In utero exposure to maternal psychological distress has long been associated with adverse socioemotional outcomes in offspring (DiPietro et al., 2018;Korja et al., 2017). Prenatal maternal stress, depression, anxiety, and posttraumatic stress symptoms have been associated with increased risk for infant negative emotional reactivity and lower self-regulation capacity (Bosquet Enlow et al., 2009, 2011Bush et al., 2017;Erickson et al., 2017;Korja et al., 2017) which are both associated with later psychopathology risk (Clauss & Blackford, 2012;De Pauw & Mervielde, 2010;Rapee, 2014;Sayal et al., 2014). Thus, maternal mental health problems that develop following exposure to a stressor in pregnancy may be one psychological mechanism that increases the risk for adverse infant socioemotional outcomes. ...
Prenatal maternal stress and mental health problems are known to increase risk for developmental psychopathology in offspring, yet pathways leading to risk or resiliency are poorly understood. In a quasi-experimental design, we prospectively examined associations between disaster-related prenatal stress, maternal mental health symptoms, and infant temperament outcomes. Mothers who were pregnant during Hurricane Harvey (N = 527) reported on objective hardships (e.g., loss of belongings or income, evacuation, home flooding) related to the storm and subsequent mental health symptoms (anxiety/depression, posttraumatic stress) across time. At a postpartum assessment, mothers reported on their infant's temperament (negative affect, positive affect, orienting/regulatory capacity). Greater objective hardship indirectly predicted higher levels of infant orienting/regulatory capacity through its association with increased maternal posttraumatic stress symptoms. Greater objective hardship also indirectly predicted higher levels of infant negative affect through its association with increased maternal anxiety/depression symptoms across time. Our findings suggest a psychological mechanism linking prenatal stress with specific temperamental characteristics via maternal mental health symptoms. Findings point to the importance of high-quality assessment and mental health services for vulnerable women and young children.
... Among these factors, there is an increasing interest in examining how prenatal stress (e.g. depression, anxiety, stressful life events exposure) can increase the risk for children's behavioural and emotional problems such as aggression, depression and anxiety [12,13]. ...
... Hence, our results emphasise the importance of continuing exanimating earthquakes as environmental stressors for pregnancy since their associations with children's behavioural and emotional outcomes may be larger than for other natural disasters. An evolutionary perspective may help explain these results [13,36]. The concept of predictive adaptive response [13,37] explains that early experiences in utero are a source of information about the environment in which the child will live and that foetal development is an opportunity to adapt to that future environment and have a successful development. ...
... An evolutionary perspective may help explain these results [13,36]. The concept of predictive adaptive response [13,37] explains that early experiences in utero are a source of information about the environment in which the child will live and that foetal development is an opportunity to adapt to that future environment and have a successful development. Therefore, children's emotional reactivity, anxiety/ depression, sleep, attention and aggression problems potentially reflect adaptative behaviours to predicted stressful environments [37]. ...
Purpose: Associations between prenatal earthquake exposure and children's mental health remain unclear. Moreover, there is a paucity of research using quasi-experimental statistical techniques to diminish potential selection bias. Thus, this study aimed to explore the impact of prenatal exposure to the Chilean earthquake of 2010 on children's behavioural and emotional problems between 1½ and 3 years old using propensity score matching.
Methods: Participants included 1549 families from the Encuesta Longitudinal de la Primera Infancia cohort in Chile. Maternal reports using the Child Behaviour Checklist (CBCL) were used to assess behavioural and emotional problems between 1½ and 3 years old. Information on prenatal earthquake exposure was collected via maternal report. The Kernel matching estimator was used to compare the average treatment effects of children who were exposed to the earthquake compared to those who were not.
Results: Five of the seven CBCL outcomes were statistically significant after matching and adjustment for multiple testing, suggesting greater difficulties for exposed children which included emotional reactivity, anxious/depressed, sleep problems, attention problems, and aggression (mean difference of 0.69, 0.87, 0.73, 0.85, 3.51, respectively). The magnitude of the effect was small to medium.
Conclusion: Findings contribute to the potential causal inferences between prenatal earthquake exposure and increased behavioural and emotional problems in early childhood. Results suggest that in utero experiences may have long-term consequences for infants' well-being, supporting the need for specific interventions in pregnancy after natural disasters.
... Fetal programming theory (FPT; Barker, 2004;Glover, 2011;Glover et al., 2018) is an important framework to understand the impact of maternal prenatal depressive symptoms on infant development. FPT argues that exposure to an adverse prenatal event (e.g., maternal prenatal depressive symptoms) may lead to a reprogrammation of the fetus and to long-term consequences on infant development and health (Barker, 2004;Glover, 2011), namely the emergence of sleep problems. ...
... Fetal programming theory (FPT; Barker, 2004;Glover, 2011;Glover et al., 2018) is an important framework to understand the impact of maternal prenatal depressive symptoms on infant development. FPT argues that exposure to an adverse prenatal event (e.g., maternal prenatal depressive symptoms) may lead to a reprogrammation of the fetus and to long-term consequences on infant development and health (Barker, 2004;Glover, 2011), namely the emergence of sleep problems. The biological changes occurring in embryotic and fetal environments related to depressive symptoms may negatively interfere with infant development throughout the lifespan, particularly when occurring in sensitive stages of fetal development (Barker, 2004;Glover, 2011;Gustafsson et al., 2018). ...
... FPT argues that exposure to an adverse prenatal event (e.g., maternal prenatal depressive symptoms) may lead to a reprogrammation of the fetus and to long-term consequences on infant development and health (Barker, 2004;Glover, 2011), namely the emergence of sleep problems. The biological changes occurring in embryotic and fetal environments related to depressive symptoms may negatively interfere with infant development throughout the lifespan, particularly when occurring in sensitive stages of fetal development (Barker, 2004;Glover, 2011;Gustafsson et al., 2018). Sex differences in fetal programming are reported, with boys and girls presenting different outcomes after exposure to a prenatal adverse environment (DiPietro & Voegtline, 2017;Sandman et al., 2013;Sutherland & Brunwasser, 2018). ...
Objectives:
We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex.
Methods:
The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems.
Results:
While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex.
Conclusions:
Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.
... Prenatal stress may shape infants' emotion dynamics to maximize survival and fitness by enabling infants to readily scan and explore their environments, cuing the infants to threat and danger cues, and programming the infants to draw on internal resources rather than caregiver support (for reviews, see Glover, 2011;Monk et al., 2019). From an evolutionary perspective, greater threat sensitivity, as well as increased distractibility and exploration of novel (e.g., nonmaternal) environments, could be a successful adaptation to a stressful environment presaged by prenatal stress (Glover, 2011;Monk et al., 2019). ...
... Prenatal stress may shape infants' emotion dynamics to maximize survival and fitness by enabling infants to readily scan and explore their environments, cuing the infants to threat and danger cues, and programming the infants to draw on internal resources rather than caregiver support (for reviews, see Glover, 2011;Monk et al., 2019). From an evolutionary perspective, greater threat sensitivity, as well as increased distractibility and exploration of novel (e.g., nonmaternal) environments, could be a successful adaptation to a stressful environment presaged by prenatal stress (Glover, 2011;Monk et al., 2019). Among neonates, elevated maternal prenatal stress is associated with heightened physiological and behavioral reactivity to stress as well as slower behavioral recovery from a mild stressor (the heel-stick procedure) 24 hr after birth (Davis et al., 2011). ...
... Moment-to-moment emotion dynamics that unfold during an interaction may shed light on the subtle ways that infants have been programmed to adjust their behavior to autonomously meet their momentary needs, while maintaining heightened vigilance to threat cues and more exploration. Though programmed emotion dynamics may help promote survival during stressful moments, over time these dynamics may compromise children's psychological adjustment (Glover, 2011;Monk et al., 2019). ...
Fetal adaptations to prenatal maternal stress may confer high risk for childhood behavior problems, potentially operating via dynamic fluctuations in infants’ emotions during mother–infant interactions. These fluctuations over time may give rise to behavior problems. Among a sample of 210 low-income mothers of Mexican origin and their 24-week-old infants, dynamic structural equation modeling was used to examine whether within-infant second-by-second emotion processes were predicted by maternal prenatal stress and predicted behavior problems at 36 and 54 months. The mean level around which infant negative affect fluctuated was related to prenatal stress, but not to childhood behavior problems. The volatility in infant negative affect, reflecting greater ebb and flow in infant negative affect during playful interaction, was predicted by prenatal stress and predicted enduring behavior problems in childhood. Results highlight a potential child-driven pathway linking prenatal exposure with childhood behavior problems via infant negative emotional volatility.
... Psychosocial stress during pregnancy is a known risk factor for altered neurodevelopment and risk for psychiatric disorders in later life. 1 In addition, psychosocial stress is also related to higher susceptibility to contracting infections and generally lower quality of physical health. [2][3][4] Examining the effects of maternal prenatal psychosocial stress and infection on infant outcomes is particularly timely in the context of the COVID-19 pandemic. ...
... 25 These cortical connections are thus vulnerable to shaping by environmental signals even before birth. 1 Increasing evidence shows associations between prenatal stress and phenotypic alterations in infant attentional processing using both maternal report measures 26,27 and measurement of infant looking behavior. 28,29 Recent findings point to inflammatory processes as one mechanistic pathway through which maternal prenatal stress may impact fetal development. ...
Background:
The COVID-19 pandemic dramatically altered the psychosocial environment of pregnant women and new mothers. In addition, prenatal infection is a known risk factor for altered fetal development. Here we examine joint effects of maternal psychosocial stress and COVID-19 infection during pregnancy on infant attention at 6 months postpartum.
Method:
One-hundred and sixty-seven pregnant mothers and infants (40% non-White; n = 71 females) were recruited in New York City (n = 50 COVID+, n = 117 COVID-). Infants' attentional processing was assessed at 6 months, and socioemotional function and neurodevelopmental risk were evaluated at 12 months.
Results:
Maternal psychosocial stress and COVID-19 infection during pregnancy jointly predicted infant attention at 6 months. In mothers reporting positive COVID-19 infection, higher prenatal psychosocial stress was associated with lower infant attention at 6 months. Exploratory analyses indicated that infant attention in turn predicted socioemotional function and neurodevelopmental risk at 12 months.
Conclusions:
These data suggest that maternal psychosocial stress and COVID-19 infection during pregnancy may have joint effects on infant attention at 6 months. This work adds to a growing literature on the effects of the COVID-19 pandemic on infant development, and may point to maternal psychosocial stress as an important target for intervention.
Impact:
This study found that elevated maternal psychosocial stress and COVID-19 infection during pregnancy jointly predicted lower infant attention scores at 6 months, which is a known marker of risk for neurodevelopmental disorder. In turn, infant attention predicted socioemotional function and risk for neurodevelopmental disorder at 12 months. These data suggest that maternal psychosocial stress may modulate the effects of gestational infection on neurodevelopment and highlight malleable targets for intervention.
... Adverse maternal experiences early in a child's life can have pervasive effects across the domains of cognition, emotion, and behavior (Glover, 2011;Monk et al., 2012;Adamson et al., 2018;Van den Bergh et al., 2020). It is possible that early life experiences bias the allocation of resources toward neural systems that are critical for effective adaptation within the given environmental context (Chelini et al., 2022). ...
... As posited by proponents of the prenatal programming hypothesis, the in-utero environment provides cues to the fetus about its expected postnatal environment (Pluess and Belsky, 2011). Upon exposure to adverse prenatal conditions, fetal brain development can calibrate in a manner that supports optimal functioning within an expected adverse postnatal environment (Glover, 2011;Pluess and Belsky, 2011). ...
Introduction:
Environmental perturbations during critical periods can have pervasive, organizational effects on neurodevelopment. To date, the literature examining the long-term impact of early life adversity has largely investigated structural and functional imaging data outcomes independently. However, emerging research points to a relationship between functional connectivity and the brain's underlying structural architecture. For instance, functional connectivity can be mediated by the presence of direct or indirect anatomical pathways. Such evidence warrants the use of structural and functional imaging in tandem to study network maturation. Accordingly, this study examines the impact of poor maternal mental health and socioeconomic context during the perinatal period on network connectivity in middle childhood using an anatomically weighted functional connectivity (awFC) approach. awFC is a statistical model that identifies neural networks by incorporating information from both structural and functional imaging data.
Methods:
Resting-state fMRI and DTI scans were acquired from children aged 7-9 years old.
Results:
Our results indicate that maternal adversity during the perinatal period can affect offspring's resting-state network connectivity during middle childhood. Specifically, in comparison to controls, children of mothers who had poor perinatal maternal mental health and/or low socioeconomic status exhibited greater awFC in the ventral attention network.
Discussion:
These group differences were discussed in terms of the role this network plays in attention processing and maturational changes that may accompany the consolidation of a more adult-like functional cortical organization. Furthermore, our results suggest that there is value in using an awFC approach as it may be more sensitive in highlighting connectivity differences in developmental networks associated with higher-order cognitive and emotional processing, as compared to stand-alone FC or SC analyses.
... The Predictive Adaptive Response (PAR) model suggests that the developing organism makes adjustment based on predictions of the postnatal environment [3][4][5]. A maternal depression among the prenatal period, for example, leads the fetus to habituate and to "adjust" the trajectory of her/his development during the first year of life [6,7]. The fetal environment is modulated by the placenta, which integrates and transduces information from the maternal environment to the fetal developmental program rapidly adapting to changes through epigenetic mechanisms [8] that respond to internal (hereditary) and external (environmental and social) signals. ...
... Some included papers have explored the mechanisms underlying alterations in the maternal environment, such as stress, anxiety, maternal depression, serotonergic antidepressant use, and their effects on child development [74,[76][77][78]. The increased fetal exposure to cortisol showed an effect on pre-and postnatal brain development [7]. Inadequate or excessive levels of glucocorticoids can cause abnormalities in neuronal and glial structure and function. ...
Background:
The fetal environment is modulated by the placenta, which integrates and transduces information from the maternal environment to the fetal developmental program and adapts rapidly to changes through epigenetic mechanisms that respond to internal (hereditary) and external (environmental and social) signals. Consequently, the fetus corrects the trajectory of own development. During the last trimester of gestation, plasticity shapes the fetal brain, and prematurity can alter the typical developmental trajectories. In this period, prevention through activity-inducing (e.g., music stimulation) interventions are currently tested. The purpose of this review is to describe the potentialities of music exposure on fetus, and on preterm newborns in the Neonatal Intensive Care Unit evaluating its influence on neurobehavioral development.
Methods:
Databases were searched from 2010 to 2022 for studies investigating mechanisms of placental epigenetic regulation and effects of music exposure on the fetus and pre-term neonates.
Results:
In this case, 28 selected papers were distributed into three research lines: studies on placental epigenetic regulation (13 papers), experimental studies of music stimulation on fetus or newborns (6 papers), and clinical studies on premature babies (9 papers). Placental epigenetic changes of the genes involved in the cortisol and serotonin response resulted associated with different neurobehavioral phenotypes in newborns. Prenatal music stimulation had positive effects on fetus, newborn, and pregnant mother while post-natal exposure affected the neurodevelopment of the preterm infants and parental interaction.
Conclusions:
The results testify the relevance of environmental stimuli for brain development during the pre- and perinatal periods and the beneficial effects of musical stimulation that can handle the fetal programming and the main neurobehavioral disorders.
... Sustained prenatal psychological distress increases the risk of postpartum depression (Robertson et al., 2004), prenatal illness and infection (Coussons-Read, 2013), miscarriage, preterm birth, and reduced birthweight (Accortt, Cheadle, & Schetter, 2015;Grigoriadis et al., 2018;Qu et al., 2017;Rondó et al., 2003;Stein et al., 2014). Furthermore, there is considerable evidence demonstrating that children of mothers who experience greater symptoms of depression, anxiety, and stress during the prenatal period are themselves at a greater risk of adverse neurodevelopmental outcomes, including emotional and behavioural problems (Glover, 2011;MacKinnon et al., 2018;Stein et al., 2014;Talge et al., 2007;Van den Bergh et al., 2005;Van den Bergh et al., 2018;Van den Bergh et al., 2020), and are at higher risk for later mental health problems, such as anxiety and attention deficit hyperactivity disorder (Glover, 2011;Van den Bergh & Marcoen, 2004). ...
... Sustained prenatal psychological distress increases the risk of postpartum depression (Robertson et al., 2004), prenatal illness and infection (Coussons-Read, 2013), miscarriage, preterm birth, and reduced birthweight (Accortt, Cheadle, & Schetter, 2015;Grigoriadis et al., 2018;Qu et al., 2017;Rondó et al., 2003;Stein et al., 2014). Furthermore, there is considerable evidence demonstrating that children of mothers who experience greater symptoms of depression, anxiety, and stress during the prenatal period are themselves at a greater risk of adverse neurodevelopmental outcomes, including emotional and behavioural problems (Glover, 2011;MacKinnon et al., 2018;Stein et al., 2014;Talge et al., 2007;Van den Bergh et al., 2005;Van den Bergh et al., 2018;Van den Bergh et al., 2020), and are at higher risk for later mental health problems, such as anxiety and attention deficit hyperactivity disorder (Glover, 2011;Van den Bergh & Marcoen, 2004). ...
Introduction: Social capital is important for good mental health and the quality of close relationships is one key indicator of social capital. Examining the association between relationship quality and mental health may be particularly important during pregnancy as mental health concerns during this period pose significant risk to families. The COVID-19 pandemic has contributed to increased mental health problems among pregnant individuals. The resulting lockdown protocols of the pandemic have also disrupted larger social networks and couples spent more time together in the context of ongoing chronic stress, highlighting the particular importance of romantic relationship quality. This study explored longitudinal associations between relationship satisfaction, depression, and anxiety among pregnant individuals during the first wave of the COVID-19 pandemic. Methods: Pregnant individuals (n = 1842) from the Pregnancy During the Pandemic Study were surveyed monthly (April-July 2020). Depression, anxiety symptoms, and relationship satisfaction were self-reported. Cross-lagged panel models were conducted to examine bidirectional associations between relationship satisfaction and mental health symptoms over time. Results: Relationship satisfaction was significantly correlated with depression and anxiety at all time points. Longitudinally, relationship satisfaction predicted later depression and anxiety symptoms, but depression and anxiety symptoms did not predict later relationship satisfaction. Discussion: This study suggests that poor relationship satisfaction was linked to subsequent elevations in prenatal depressive and anxiety symptoms during the COVID-19 pandemic. Relationship enhancement interventions during pregnancy may be a means of improving the mental health of pregnant individuals, and interrupting transgenerational transmission, during times of prolonged psychological distress.
... Similar to psychiatric conditions [36,62,72,77,89] such as depression [13,96], psychosis [26], and disruptive behavior disorders [57,90], suicidality is a life course problem [22]. Vulnerability to suicide is partly established very early in development and may amplify the effects of acute risk factors for suicide during adolescence or adulthood. ...
... For example, in the context of heightened plasticity, psychological and physiological responses to adversity may prove adaptive (protective) in the short-term but ultimately be pathologic later in adulthood [37]. Reponses to altered fetal growth and early socioeconomic and emotional adversity could include changes in immune, neuroendocrine, epigenetic, and neural systems that impact neurodevelopment [15,27,36,72,77,99]. From a life-history perspective, early life exposures may have an enduring impact on suicide risk because they may alter the pace of major life transitions, increase risk taking, and reduce future orientation, all of which may be implicated in the etiology of suicidal behaviors [106]. ...
Suicide prevention efforts generally target acute precipitants of suicide, though accumulating evidence suggests that vulnerability to suicide is partly established early in life before acute precipitants can be identified. The aim of this systematic review was to synthesize evidence on early life vulnerability to suicide beginning in the prenatal period and extending through age 12. We searched PubMed, Embase, PsycNet, Web of Science, Scopus, Social Services Abstracts, and Sociological Abstracts for prospective studies published through January 2021 that investigated early life risk factors for suicide mortality. The search yielded 13,237 studies; 54 of these studies met our inclusion criteria. Evidence consistently supported the link between sociodemographic (e.g., young maternal age at birth, low parental education, and higher birth order), obstetric (e.g., low birth weight), parental (e.g., exposure to parental death by external causes), and child developmental factors (e.g., exposure to emotional adversity) and higher risk of suicide death. Among studies that also examined suicide attempt, there was a similar profile of risk factors. We discuss a range of potential pathways implicated in these associations and suggest that additional research be conducted to better understand how early life factors could interact with acute precipitants and increase vulnerability to suicide.
... Este tipo de programación fetal prepara al niño para el entorno en que se van a encontrar ellos mismos. Esta adaptación lo hace mucho más pronto a reaccionar, ser más vigilante, distraído en su atención con mayor percepción de peligro, impulsivo con mayor exploración, tener desórdenes de conducta con deseo de romper las reglas, y agresivo para luchar contra intrusos (16) . Suelen ser niños más susceptibles a llorar, a estresarse, a sentir ansiedad. ...
La manera en que el feto se desarrolla en el útero depende del estado de la madre, de su alimentación, de su entorno y también de sus emociones. Estudios realizados en animales de laboratorio demuestran que el estrés prenatal ocasiona serias perturbaciones en el desarrollo del SNC, particularmente del eje hipotálamo adrenal (HPA); en la respuesta hormonal al estrés. Diferentes estudios, incluyendo varios experimentos naturales, han encontrado una asociación significativa entre ansiedad o estrés materno antenatal y diferentes problemas cognitivos, conductuales, de lenguaje y emocionales en los hijos. Entre los factores de riesgo para presentar alteraciones psicológicas durante el embarazo se encuentran una historia personal o familiar de enfermedades psiquiátricas o uso de drogas, historia personal pasada de abuso sexual, físico o emocional, y una historia pasada de depresión, el cual es el factor que más fuertemente predice síntomas depresivos antenatales. El estrés y la ansiedad materna pueden afectar al feto durante todo el embarazo pero lo hacen de manera distinta de acuerdo a la etapa de gestación en que se encuentra y de qué áreas del cerebro se están desarrollando. Por ello es tan necesario investigar y desarrollar programas de prevención, de intervención y de apoyo para reducir los niveles de estrés, ansiedad o depresión durante el embarazo y prevenir sus efectos adversos en una proporción clínicamente significativa de niños.
... Essa população vivencia um ciclo gravídico-puerperal, marcado por inúmeras mudanças físicas, psíquicas e sociais, tornando gestantes e puérperas mais vulneráveis ao sofrimento psíquico, como o estresse. Estudos mostram que o tipo e a intensidade do estresse na gestação têm impacto no desenvolvimento fetal, com consequências para o desenvolvimento do bebê (Charil, Laplante, Vaillancourt & King, 2010;Glover, 2011;Franke et al, 2017) e também para a mãe, aumentando as chances de depressão pós-parto (Rodrigues & Schiavo, 2011;Arrais & Araujo, 2017;Kliemann, Böing & Crepaldi, 2017). ...
A pandemia da COVID-19 resultou em grande estresse, especialmente para populações mais vulneráveis, como mulheres grávidas e no pós-parto. Devido ao isolamento social, durante o início do período pandêmico, as redes sociais tornaram-se recursos importantes para informar e promover saúde e bem-estar. O objetivo deste estudo é apresentar uma proposta psicoeducativa de intervenção positiva na forma de posts para o Instagram e sua validade de conteúdo para o enfrentamento do estresse provocado pela pandemia por gestantes e puérperas no ano de 2020. A validade de conteúdo foi avaliada por 64 juízas, que analisaram 29 posts adotando uma escala Likert de 5 pontos para validar linguagem, relevância, pertinência e apresentação da proposta. Observou-se coeficientes de validade de conteúdo acima do ponto de corte (≥ 0.80) para todos os critérios, o que indica a adequação da proposta para enfrentar os estressores da pandemia pela população alvo. Dessa forma, confirmou-se a possibilidade de utilização das mídias sociais visando o aumento no acesso a materiais de qualidade que promovem a democratização do cuidado à saúde mental.
... La depresión durante el embarazo genera efectos adversos a nivel biológico y psicológico en el bebé (Glover, 2011), como menor crecimiento y bajo peso al nacer (Accortt et al., 2015), partos prematuros o posmaduros (Straub et al., 2012), consecuencias negativas en el desarrollo general (Agnafors et al., 2013;Pilowsky et al., 2008;Podestá et al., 2013) y un mayor riesgo en el infante de presentar depresión a lo largo de la vida (Fox & Borelli, 2015;Leis et al., 2014). En el contexto carcelario, las investigaciones muestran que la sintomatología depresiva materna puede aumentar una vez cumplida la condena y finalizado el encarcelamiento (Dolan et al., 2013), lo que hace necesario revisar el efecto en los hijos e hijas y las necesidades específicas de este grupo para apoyar su salud mental y una adecuada reinserción social y familiar. ...
... La depresión durante el embarazo genera efectos adversos a nivel biológico y psicológico en el bebé (Glover, 2011), como menor crecimiento y bajo peso al nacer (Accortt et al., 2015), partos prematuros o posmaduros (Straub et al., 2012), consecuencias negativas en el desarrollo general (Agnafors et al., 2013;Pilowsky et al., 2008;Podestá et al., 2013) y un mayor riesgo en el infante de presentar depresión a lo largo de la vida (Fox & Borelli, 2015;Leis et al., 2014). En el contexto carcelario, las investigaciones muestran que la sintomatología depresiva materna puede aumentar una vez cumplida la condena y finalizado el encarcelamiento (Dolan et al., 2013), lo que hace necesario revisar el efecto en los hijos e hijas y las necesidades específicas de este grupo para apoyar su salud mental y una adecuada reinserción social y familiar. ...
De acuerdo con el Programa de Naciones Unidas para el Desarrollo, en América Latina, alrededor de 1.5 millones de personas se encuentran privadas de su libertad, lo que la coloca como una de las regiones con mayor sobrepoblación en prisiones del mundo. Ante este panorama, el objetivo de esta obra es coadyuvar a la reflexión y puesta en acción de prácticas e intervenciones que promuevan la adaptación y reintegración social de esta población. Bajo este marco, las y los autores analizan lo que implica la privación de la libertad, desde distintas disciplinas como Psicología, Derecho, Ciencias Políticas y Trabajo Social. Esta variedad de perspectivas permite que la condición de perder la libertad se estudie en procesos específicos, tales como: maternidad, atención a la salud mental, vínculos familiares, educación en centros penitenciarios, sexualidad, consumo de sustancias, distinciones de la privación de libertad en centros penitenciarios para mujeres, experiencias de víctimas del crimen organizado y vivencias de adolescentes en conflicto con la ley. Se espera que el esfuerzo cristalizado en esta obra, contribuya a sensibilizar a más profesionales y se involucren en intervenciones dirigidas a atender a esta población vulnerable.
http://www.librosoa.unam.mx/handle/123456789/3650
... La depresión durante el embarazo genera efectos adversos a nivel biológico y psicológico en el bebé (Glover, 2011), como menor crecimiento y bajo peso al nacer (Accortt et al., 2015), partos prematuros o posmaduros (Straub et al., 2012), consecuencias negativas en el desarrollo general (Agnafors et al., 2013;Pilowsky et al., 2008;Podestá et al., 2013) y un mayor riesgo en el infante de presentar depresión a lo largo de la vida (Fox & Borelli, 2015;Leis et al., 2014). En el contexto carcelario, las investigaciones muestran que la sintomatología depresiva materna puede aumentar una vez cumplida la condena y finalizado el encarcelamiento (Dolan et al., 2013), lo que hace necesario revisar el efecto en los hijos e hijas y las necesidades específicas de este grupo para apoyar su salud mental y una adecuada reinserción social y familiar. ...
Los factores familiares, sociales y criminológicos serán la base principal para que el diseño del instrumento de evaluación en Trabajo Social propuesto en este trabajo, se convierta en una herramienta útil para la impartición y ejecución de justicia, en específico, en el campo de la reinserción social y reeducación de las personas privadas de su libertad por el delito de robo.
... These distinct research literatures share a common notion that mothers' adverse experiences can influence offspring development (Roubinov et al., 2021). However, the former focuses on biopsychosocial mechanisms underlying associations between maternal pre-conception adversity and offspring development (Bowers & Yehuda, 2016;Scorza et al., 2018) whereas the latter explores how in utero stress exposure affects fetal development (Glover, 2011). Despite evidence that a woman's exposures to adversity prior to adulthood and while pregnant are each associated with offspring outcomes, few studies have tested these associations simultaneously, and no studies have tested the simultaneous effects of these variables on childbirth and newborn neurobehavioral outcomes. ...
Separate literatures have demonstrated that mothers' experiences with trauma during childhood or pregnancy are associated with maternal prenatal health risks, adverse childbirth outcomes, and offspring internalizing and externalizing disorders. These literatures largely align with the intergenerational transmission or fetal programming frameworks, respectively. However, few studies have tested the effects of maternal childhood and prenatal trauma simultaneously on mothers' and infants' health outcomes, and no studies have examined these effects on newborn neurobehavioral outcomes. Thus, in the present study, we examined how the developmental timing of pregnant women's traumatic life experiences associated with their physical health and psychopathology (Aim 1) as well as their newborns' birth and neurodevelopmental outcomes (Aim 2; for pre-registered aims and hypotheses, see https://osf.io/ygnre/?view_only=cbe17d0ac7f24af5a4d3e37e24eebead). One hundred and fifty-two 3rd trimester pregnant women (Mage = 29 years; 17.1% Hispanic/Latina) completed measures of trauma history and psychopathology. Then, 24-48 h after birth, trained clinicians conducted newborn neurobehavioral exams (n = 118 newborns; 52.6% female). Results indicated that lifetime traumatic experiences associated with multiple prenatal maternal health outcomes, including depression, anxiety, emotion dysregulation, and pregnancy complications. Pregnant women's experiences with childhood trauma, but not adulthood or prenatal trauma, predicted higher neurobehavioral attention scores among female newborns. Our discussion highlights the importance of considering the developmental timing of maternal trauma on perinatal outcomes and contextualizes our findings within the intergenerational transmission and fetal programming literatures. DATA AVAILABILITY: Data pertaining to R01MH119070 (MPIs Crowell & Conradt) and that support these findings are uploaded to the NIMH repository.
... For the mother, there is a high risk for the onset of psychological distress, including depression, state anxiety, and pregnancy-related anxiety [1][2][3]. Poor maternal mental health can result in downstream consequences for fetal development and infant health, including preterm birth, low-birth weight, cognitive developmental deficits, and lifelong non-communicable chronic disease risk [4][5][6][7][8][9][10][11][12][13]. Thus, investigating maternal mental health during pregnancy can have intergenerational public health implications. ...
Latina women living in the USA experience disproportionately higher rates of psychological distress compared to their non-Latina White counterparts. Poor maternal mental health during pregnancy can contribute to intergenerational mental health disparities. Through this pathway, mothers' experiences, environments, and exposures (henceforth "exposures") during pregnancy become biologically embodied and can negatively affect the fetus and life-long developmental trajectories of her child. One of the exposures that can affect mother-offspring dyads is the neighborhood. With the goal of integrating anthropological and sociological theories to explain mental health disparities among pregnant Latina women, we explored how perceptions of neighbor attitudes may influence mental health during pregnancy. We analyzed self-reported responses from 239 pregnant Latina women in Southern California (131 foreign-born, 108 US-born) on their mental health and perceived attitudes of their neighbors using multiple linear regression models. Among foreign-born Latina women, living in neighborhoods with more favorable views of Latinos was associated with lower depression scores (pooled β = - .70, SE = .29, p = .019) and lower pregnancy-related anxiety scores (pooled β = - .11, SE = .05, p = .021), but greater state anxiety scores (pooled β = .09, SE = .04, p = .021). Among US-born women, there were no associations between neighbor attitudes and mental health. Overall, results suggest that social environments are correlated with mental health and that foreign-born and US-born Latinas have varied mental health experiences in the USA. Our findings highlight the importance of improving aspects of neighborhood cohesion as part of maternal-fetal care management.
... Worldwide the societal burden of mental health problems is increasing (Vigo et al., 2016). Although early stage prevention is more cost-efficient than treatment (Bauer et al., 2016), prenatal origins of mental health problems that are often preventable remain understudied (Browne et al., 2020;Glover, 2011;Monk et al., 2019;van den Heuvel, 2022). In a UK-based study, it has been estimated that perinatal anxiety and depression combined costs the society about £8500 per woman giving birth. ...
Background
The connectome, constituting a unique fingerprint of a person’s brain, may be influenced by its prenatal environment, potentially affecting later-life resilience and mental health.
Methods
We conducted a prospective resting-state functional Magnetic Resonance Imaging study in 28-year-old offspring (N = 49) of mothers whose anxiety was monitored during pregnancy. Two offspring anxiety subgroups were defined: “High anxiety” (n = 13) group versus “low-to-medium anxiety” (n = 36) group, based on maternal self-reported state anxiety at 12–22 weeks of gestation. To predict resting-state functional connectivity of 32 by 32 ROIs, maternal state anxiety during pregnancy was included as a predictor in general linear models for both ROI-to-ROI and graph theoretical metrics. Sex, birth weight and postnatal anxiety were included as covariates.
Results
Higher maternal anxiety was associated with weaker functional connectivity of medial prefrontal cortex with left inferior frontal gyrus (t = 3.45, pFDR < 0.05). Moreover, network-based statistics (NBS) confirmed our finding and revealed an additional association of weaker connectivity between left lateral prefontal cortex with left somatosensory motor gyrus in the offspring. While our results showed a general pattern of lower functional connectivity in adults prenatally exposed to maternal anxiety, we did not observe significant differences in global brain networks between groups.
Conclusions
Weaker (medial) prefrontal cortex functional connectivity in the high anxiety adult offspring group suggests a long-term negative impact of prenatal exposure to high maternal anxiety, extending into adulthood. To prevent mental health problems at population level, universal primary prevention strategies should aim at lowering maternal anxiety during pregnancy.
... According to this hypothesis, exposure to certain stimulus during critical periods of vulnerability in early life (i.e., fertility treatments, and labour complications) may permanently affect the structure, physiology and metabolism of specific physiological systems (e.g., inflammatory response, neuroendocrine system of stress regulation) [9]. During the prenatal period, certain agents (e.g., hormones, nutrients, contaminants) that cross the placenta may prepare the fetuses to that the child will be exposed to after birth [10,11]. Indeed, there are accumulative evidence supporting the influence of maternal perinatal conditions on the offspring's health in both short and long term [12,13]. ...
Objectives
Asthma is a common chronic and burdensome disease which typically begins in childhood. The aim of this study was to assess perinatal and obstetric factors which may increase the risk of developing asthma in the offspring.
Methods
Data from five consecutive waves (n=7,073 children, from birth to 15 years old) from a nationally-representative birth cohort of people born in the United Kingdom between 2000 and 2002, the Millennium Cohort Study (MCS), were used. The Kaplan–Meier survival curve was used to graphically display the risk of developing asthma from early childhood to adolescence. The Z-based Wald test was used to prove significant covariate loading.
Results
Cox regression analyzing the influence of covariates on asthma development risk showed a significant likelihood ratio test, χ2(18)=899.30, p<0.01. A parent with asthma (OR=2.02, p<0.01), a younger maternal age at delivery (OR=0.98, p<0.05), and the use of assisted reproductive technology (OR=1.43, p<0.05) were associated with an increased risk of developing asthma in the offspring.
Conclusions
Perinatal factors (a younger maternal age, assisted reproductive technology) and a parental factor (a parent with asthma) increased the risk for developing asthma in the offspring.
Keywords: assisted reproductive technology; asthma; delivery; perinatal factors; pregnancy
... In addition, several works show the effects of disturbing stimuli such as stress or drug abuse during the gestational period, especially on offspring. [54][55][56][57][58][59][60] However, the effects of possible beneficial stimuli like EE during the gestational period have been scarcely studied. Here, we will describe the most salient studies that show the effects of gestational EE on maternal and offspring physiology and behavior, and future directions (Figure 3). ...
Environmental enrichment is a widely used experimental manipulation that physically, cognitively and socially stimulates individuals. It has a great variety of long-term effects at neuroanatomical, neurochemical, and behavioral level; however, the influence of parental environmental enrichment during gestation and pregestation on the development of the offspring and on the mother's behavior has been poorly explored. This article presents a review of the literature from the year 2000 about the effects of maternal and paternal environmental enrichment on the behavioral, endocrine, and neural systems of offspring and parents. Relevant research terms were searched for on the biomedical databases, PubMed, Medline, ScienceDirect, and Google Scholar. The data suggest that paternal/maternal environmental enrichment can profoundly affect the developmental trajectories of offspring through putative epigenetic mechanisms. Environmental enrichment presents as a promising therapeutic tool for human health interventions, especially to counteract the deleterious effects of impoverished and adverse growing conditions.
... 40 Psychological distress during pregnancy is a serious problem that has been associated with adverse maternal and perinatal outcomes, poor maternal psychosocial functioning, breastfeeding and parental difficulties, and poorer socioemotional and cognitive development of the offspring. [41][42][43][44][45][46] Although traditional in-person perinatal education courses offer the opportunity to interact with the trainer and other women, the main focus of these classes is to provide practical knowledge about healthy habits during pregnancy, childbirth preparation, and information about breastfeeding and care of the newborn. 47 Contrary to the person-centered format of the Godmother Project, conventional maternal education classes are usually not designed to attend the specific needs of the participants but rather deliver information and messages that the educators believe are important. ...
Background:
The COVID-19 pandemic increased maternal distress and demand for social support and educational services, while restriction measures decreased the availability of these services.
Project description:
The Godmother Project, a person-centered, WhatsApp-based support and health education initiative, was created after all in-person perinatal educational activities offered at 3 Brazilian hospitals were canceled in 2020. The project was developed in response to pregnant/postpartum women who called the hospitals with questions for health care professionals (HCPs). Health education nurses teamed up with staff from the communication department to design a project to (1) provide a direct communication channel between women and HCPs to answer health-related questions, (2) offer reliable virtual health education material, (3) identify women in need of additional assessment/referrals, (4) offer each woman continuous support from a specific nurse educator (Godmother), and (5) offer a virtual forum where women going through similar experiences could interact.
Project development and rollout:
The project provides direct communication between WhatsApp groups of 25-30 pregnant/postpartum women and a Godmother. It also offers access to a virtual library of educational materials prepared in response to women's needs/demands. The project, which began in July 2020 with 1 WhatsApp group of 5 women and 1 Godmother, currently has 305 groups, 6,942 active participants, and 4 Godmothers. Enrollments and WhatsApp groups continued to increase despite reestablishment of in-person educational activities in 2022. The vast majority of 232 participants surveyed in December 2021 were very satisfied with the project, the Godmothers, and the educational materials.
Conclusions:
Our findings suggest that WhatsApp groups of pregnant/postpartum women led by dedicated nurse educators can be an important tool to educate and support women during the perinatal period. This type of initiative may be especially important in contexts of physical distancing requirements or situations where social support is unavailable.
... Prenatal maternal depression is associated with attenuated levels of dopamine and serotonin, as well as elevated cortisol and norepinephrine levels (Lundy et al., 1999), which can cause limited transport of oxygen and nutrients to the fetus (Teixeira et al., 1999). This may contribute to premature birth, low birthweight, and increased rates of attentional, emotional, and behavioral problems later on (Glover, 2011;O'Connor et al., 2014). ...
... Moreover, although it does not mediate the effect on child outcome, postpartum maternal mental health was also longitudinally associated with the psychological stress of the prenatal pandemic period, potentially highlighting the lasting costs to maternal health of pandemic-imposed changes in the perinatal period. Taken together, these processes could reflect a cascade of underlying mechanisms involving epigenetic, inflammatory, and/or endocrine pathways in which stress-based alterations in maternal biology and social functioningpartially induced by the pandemiccould transit to the fetus and newborn by altering the prenatal environment (Glover, 2011;Van den Bergh et al., 2017) and putting parenting behaviors at risk in a very sensitive time window (Huizink et al., 2017;Stein et al., 2014). ...
For mother-infant health especially, the pandemic has brought multiple stressors inside a susceptible psychobiological system. We study the longitudinal associations between maternal prenatal and postpartum: (a) COVID-19 stressful events exposure, (b) pandemic psychological stress, and (c) mental health and infants' negative affect. A sample of 643 Italian pregnant women completed a web-based survey from April 8th to May 4th, 2020 and a follow-up at 6 months after delivery. Maternal assessment covered prenatal and postpartum measures for: COVID-19 stressful events exposure, pandemic psychological stress, mental health symptoms (i.e., depression, anxiety, posttraumatic stress disorder) and postpartum, social support and report of infants' negative affect. Maternal mental health symptoms during pregnancy, at the peak of pandemic, is longitudinally associated with infant negative affect, with postpartum mental health mediating this association. Also, maternal COVID-19 stressful events exposure in postpartum is associated with negative affect at 6 months mediated by postpartum mental health symptoms. Maternal pandemic psychological stress during pregnancy predicted mental health symptoms in postpartum. The study supports the association between pandemic-related maternal health across pregnancy and postpartum and offspring's development (i.e., negative affect). It also puts the spotlight on mental health risk in women experiencing lockdown during pregnancy, especially when feeling high psychological stress in pregnancy or when directly exposed to COVID-19 stressful events postpartum.
... Apart from the physical health risks identified, HG experiences can affect maternal psychological health (Simpson et al. 2001) including suicidal thoughts and depression (Poursharif et al., 2008;Glover, Bergman & O'Connor, 2008) and anxiety (King, Chambers, & O'Donnell, 2010;Glover, Bergman, & O'Connor, 2008, Glover, 2011O'Connor et al., 2022) and can be long lasting with women reporting acute stress and post-traumatic stress symptoms 12 months after birth (Meltzer-Brody et al. 2017;Kjeldgaard et al. 2019). These long-term effects of maternal anxiety, depression and stress during pregnancy are seen in their offspring's later psychopathology (Glover, O'Donnell, & Fisher, 2018). ...
Research indicates a higher prevalence of attention deficits in children exposed to HG in utero compared to controls with some claiming that the deficit is due to prenatal effects of malnutrition in HG mothers and others that it is due to maternal mental health after birth. The current study examines the effect of hyperemesis gravidarum (HG) diagnosis during pregnancy on infant attention controlling for maternal stress, depression anxiety and attachment. Thirty-eight infants mean age 4 months were videotaped with their mothers (19 mothers with a hyperemesis diagnosis and 19 controls) during play with a soft toy and looking at a picture book. Infant attention was operationalized as gaze direction towards the play activity, mother, and 'distracted' (indicated by looking away from play or mother). Mothers completed stress, depression, anxiety, and attachment questionnaires. HG exposed infants attended for significantly less time during play with a book or soft toy compared to controls. Maternal stress, depression, anxiety, and attachment did not differ in HG mothers and controls. Infant ability to attend to the toy, book, mother or being distracted did not relate to maternal postnatal attachment, or mental health. These results suggest that the prenatal environment, especially exposure to HG might be associated with reduced infant attention abilities independent of maternal postnatal health.
... As other disasters have shown, adverse circumstances lead to significant increases in stress, depression, and anxiety symptoms in pregnant women, which could have secondary psychological, cognitive, and motor effects on their prenatally exposed infants (Field, 2011;Madigan et al., 2018). Some studies have even suggested that exposure to adverse circumstances in early childhood could predict >30% of psychiatric disorders a posteriori (Green et al., 2010) and is causally associated with structural and functional changes in the nervous system that could affect the child's behavior and, thus, favor the development of a mental disorder (Babenko, Kovalchuk, & Metz, 2015;Glover, 2011;Qiu et al., 2015). Therefore, the aim of this study is to analyze the relationships of prenatal anxiety and depression and exposure to the COVID-19 pandemic with the offspring socioemotional development, controlling for postnatal anxiety and depression. ...
The COVID-19 pandemic context may predispose mothers to increased maternal psychopathology, which may be associated with offspring socioemotional development. The aim of this study is to analyze the relationships between prenatal anxiety and depression and exposure to the COVID-19 pandemic with offspring socioemotional development, controlling for postnatal anxiety and depression. A total of 105 mother-child dyads were assessed in pre- and postnatal periods. Questionnaires were used to assess the impact of the pandemic, indicators of psychopathology, and the socioemotional development of the offspring. Results suggest that negative pandemic experiences are indirectly associated with offspring socioemotional development via prenatal maternal anxiety symptomatology and after controlling for postnatal anxiety and depression. These indicators predispose to emotional deficits and increase the risks of psychopathological and neurodevelopmental disorders. It is important to adopt health policies that provide timely assessment of development in early childhood to reduce the risks associated with these deficits.
... It has been further suggested that prenatal stress exposure appears to accelerate the development of these regions, particularly the amygdala, as a means of allowing more rapid detection of incoming danger and threat (Lautarescu et al., 2020). Our results are consistent with the evolutional model of stress that suggests the exaggeration of automatic fear detection programmed prenatally to better prepare for the likely at stake environment postnatally (Glover, 2011). ...
Introduction
Prenatal maternal stress (PNMS), including exposure to natural disasters, has been shown to serve as a risk factor for future child psychopathology and suboptimal brain development, particularly among brain regions shown to be sensitive to stress and trauma exposure. However, statistical approaches deployed in most studies are usually constrained by a limited number of variables for the sake of statistical power. Explainable machine learning, on the other hand, enables the study of high data dimension and offers novel insights into the prominent subset of behavioral phenotypes and brain regions most susceptible to PNMS. In the present study, we aimed to identify the most important child neurobehavioral and brain features associated with in utero exposure to Superstorm Sandy (SS).
Methods
By leveraging an explainable machine learning technique, the Shapley additive explanations method, we tested the marginal feature effect on SS exposures and examined the individual variable effects on disaster exposure.
Results
Results show that certain brain regions are especially sensitive to in utero exposure to SS. Specifically, in utero SS exposure was associated with larger gray matter volume (GMV) in the right caudate, right hippocampus, and left amygdala and smaller GMV in the right parahippocampal gyrus. Additionally, higher aggression scores at age 5 distinctly correlated with SS exposure.
Discussion
These findings suggest in utero SS exposure may be associated with greater aggression and suboptimal developmental alterations among various limbic and basal ganglia brain regions.
... Pregnant women must be able to adapt to pregnancy. Anxiety is one of the factors that can cause the ability to adapt in pregnancy is not achieved optimally (Glover, 2011). Changes in body physiology in the third trimester of pregnancy and fear of facing labor often exacerbate anxiety in pregnant women. ...
Background: Severe and prolonged anxiety can cause mental disorders. Physiological changes and preparation for labor in the third trimester of pregnancy can trigger increased anxiety in pregnant women. One of the interventions to reduce anxiety in third-trimester pregnant women is yoga exercise. Purpose: The primary purpose of this study was to determine how much influence yoga exercise can reduce anxiety in third-trimester pregnant women.Methods: This research is quantitative research with a pure experimental research design with pre and post-test control group design techniques. the number of respondents was 30 and divided into two groups. 15 respondents in the intervention group and 15 respondents in the control group. Data collection using yoga practice protocol and perinatal anxiety screening scale questionnaire. The instrument was used after passing the validity and reliability test. Bivariate analysis was carried out using the homogeneity test, normality test, and Wilcoxon non-parametric distribution test. Results: By this study, it is known that the yoga exercise intervention reduced the level of anxiety in the intervention group. P-value 0.00 (<0.05) indicates that the yoga exercise intervention affects reducing anxiety in third-trimester pregnant women.Conclusion: Health workers need to make innovative interventions that can improve the mental health of pregnant women, for example, by activating the pregnant women's class program.
... Individuals who start to adapt to a stressful environment as early in life as in the in utero period may have a significant benefit in later life in terms of better cognitive or physical capabilities. However, there is no definite evidence to show an association between the type, amount or timing of pre-natal stress exposure and enhanced neurodevelopment, nor whether enhanced performance in one area of development is associated with inferior performance in others [13]. ...
The concept of the early life developmental origins of health and disease (DOHaD) in adults has stimulated a new approach to understanding disease trajectories, with major public health implications. Indeed, the principle of the 'lifecourse of disease' now influences health policies internationally. Environmental influences during pregnancy and early life that affect lifelong health are well documented, but there is a new focus on the preconception period and the significance of paternal health on the fetus. This fully revised second edition highlights scientific and clinical advances in the field, exploring new understanding of mechanisms such as epigenetics and the increasingly recognised role of external influences, including pollution. The book is structured logically, covering environment, clinical outcomes, mechanisms of DOHaD, interventions throughout the lifespan and finally implications for public health and policy. Clinicians and scientists alike will improve their understanding of the developmental origins of health and disease with this essential text.
... Our findings support the fetal origins hypothesis. From a developmental perspective, the brain's structure and function can be influenced by events in gestation [34]. For example, maternal infections were associated with schizophrenia in the offspring in adulthood [35]. ...
Preliminary evidence indicates that natural disasters are associated with an increased risk for schizophrenia. With few longitudinal studies on earthquakes, this retrospective cohort study examined exposure to the 1976 Tangshan earthquake and the subsequent risk of schizophrenia. Population counts and visits to all nine psychiatric hospitals in Tangshan city were collected. We created three cohort groups by earthquake exposure: infant (August 1972 to July 1976 births), fetal (August 1976 to May 1977 births), and unexposed (June 1977 to May 1981 births). The cumulative incidence of schizophrenia in each cohort was calculated by dividing the number of schizophrenia patients by total births in the corresponding period. Altogether, 6424 schizophrenia patients were identified, with 2786 in the infant group, 663 in the fetal group, and 2975 in the unexposed group. The crude cumulative incidence of schizophrenia in the infant, fetal and unexposed groups were 7.64 (95% confidence interval [CI] = 7.36–7.92), 9.07 (95% CI = 8.38–9.76), and 7.40 (95% CI = 7.13–7.66) per thousand population respectively. Adjusted for mortality, the corresponding figures were 7.73 (95% CI = 7.44–8.01), 9.30 (95% CI = 8.60–10.01) and 7.44 (95% CI = 7.18–7.71) per thousand population respectively. The mortality-adjusted risk ratio (aRR) was 1.25 (95% CI = 1.15–1.36) between fetal and unexposed groups ( χ ² = 27.31, P < 0.001). Males exposed as infants did not differ from the unexposed in cumulative schizophrenia incidence. People with fetal exposure to the 1976 earthquake had 25% higher risk of developing schizophrenia compared to unexposed counterparts.
... transient mood disturbance, personality-based or trait anxiety, clinical diagnoses of anxiety disorder etc. These experiences of anxiety are generally measured by self-report questionnaire, which are associated with measurable effects on the infant in utero and with later emotional, cognitive, and behavioural effects on the infant/child (Glover, 2011;Talge, Neal, & Glover, 2007) even after controlling the effects for obstetric complications, depression, and complications in the postnatal period (Van Den Bergh, Mulder, Mennes, & Glover, 2005). Although the effect of prenatal maternal anxiety on foetal development does not occur in each case but the behavioural/emotional problems can be attributed from 10-15% in the population (Glover, 2015). ...
The present study aims to examine the relationship between spirituality and anxiety during 2nd and 3rd trimesters of pregnancy, the relationship between spirituality and antenatal outcomes viz., gestational age, infant weight and apgar score of 1 and 5 minutes and the relationship between anxiety during 2nd and 3rd trimesters of pregnancy and antenatal outcomes. The study was conducted on a sample of 100 pregnant women of age range between 20-35 years during 2nd and 3rd trimester of their pregnancy who were recruited in Department of Obstetrics and Gynecology of Institute of Medical Sciences Banaras Hindu University, Varanasi. The study follows a correlational design. Spirituality and anxiety have been treated as independent variables, and antenatal outcomes have been treated as dependent variables. Spirituality was measured by using The Daily Spiritual Experiences Scale (Underwood, 2002) and the Hindi adaptation of the scale was done to use in Indian context (Cronbach alpha 0.79). Anxiety was assessed by using State, Trait and Free-floating Anxiety Inventory (Rastogi and Tripathi, 1986). The indices of internal consistency for both state and trait scale is 0.93 and 0.89 respectively. The data was analyzed with correlational analysis and hierarchical regression. The results indicated that spirituality is significantly negatively correlated with anxiety during pregnancy and positively correlated with antenatal outcomes in pregnant women. The results also revealed that anxiety during pregnancy is negatively correlated with antenatal outcomes. Thus, it can be concluded that women with high level of spirituality were more likely to have less anxiety and healthy antenatal outcomes.
Objectives
The objective is to to explore the longitudinal change trajectories of postpartum stress and its related factors.
Design
A longitudinal study with follow-ups from 42 days to 6 months after delivery.
Settings and participants
A total of 406 postpartum women were recruited at baseline (42 days after delivery) from 6 hospitals in Nantong, Jiangsu Province, China, and followed up at 3 and 6 months. After the follow-ups, 358 postpartum women were retained for further analysis.
Methods
Postpartum stress was evaluated using the Maternal Postpartum Stress Scale (MPSS) at baseline (42 days) and 3 and 6 months after delivery. MPSS has three dimensions, such as: personal needs and fatigue, infant nurturing and body changes and sexuality. Postpartum depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the short-form Depression, Anxiety and Stress Scale, respectively. The MPSS scores were normalised using a rank-based inverse normal transformation.
Results
Postpartum stress decreased significantly after 3 months, and postpartum stress reduced further after 6 months. Additionally, the scores for all three dimensions reduced after 6 months, while infant nurturing reduced after both 3 and 6 months. Older age (β=0.028, p=0.049), higher education level (β=0.153, p=0.005) and higher body mass index (BMI) (β=0.027, p=0.008) of the postpartum women were significantly associated with higher postpartum stress levels in corresponding dimensions at 42 days. Older age was also associated with higher postpartum stress at 3 (β=0.030, p=0.033) and 6 months (β=0.050, p<0.001) in the dimension of personal needs and fatigue. Postpartum stress levels were significantly higher in women with depression or anxiety symptoms.
Conclusions
Postpartum stress continuously declined from 42 days to 6 months after delivery. Postpartum women with older age, higher education levels, higher BMI and anxiety or depression symptoms should be the target population for early intervention.
This systematic review examines the impact of parental preconception adversity on offspring mental health among African Americans (AAs) and Native Americans (NAs), two populations that have experienced historical trauma and currently experience ethnic/racial mental health disparities in the United States. PsycINFO, PubMed, CINAHL, Scopus, and Web of Science were searched for studies that included at least two generations of AAs or NAs from the same family, measured parental preconception adversity and their offspring’s mental health, and examined the association between these variables. Over 3,200 articles were screened, and 18 articles representing 13 unique studies were included in this review. Among the studies with samples that included AAs ( n = 12, 92%), 10 (83%) reported a significant association between parental preconception adversity and adverse offspring mental health. The only study with a sample of NAs ( n = 1, 8%) also reported a significant association between these variables. Although the literature suggests that parental preconception adversity is associated with offspring mental health among AAs and NAs, it must be interpreted in the context of the small number of studies on this topic and the less-than-ideal samples utilized—just one study included a sample of NAs and several studies ( n = 6, 46%) used multi-ethnic/racial samples without testing for ethnic/racial disparities in their results. A more rigorous body of literature on this topic is needed as it may help explain an important factor underlying ethnic/racial mental health disparities, with important implications for interventions and policy.
Prenatal maternal stress (PNMS)—characterized by exposure to stress, anxiety, depression, or intimate partner violence—has been linked to biological alterations in infants, including disruptions to their intestinal microbiota, which have long‐term implications for children's developmental outcomes. Significant research has been done examining the effects of PNMS on the microbiome in animals, but less is known about these effects in human research. The current systematic review aimed to synthesize current findings on the association between PNMS and mother and infant microbiomes. Medline, Embase, PsycInfo, Web of Science, and Eric databases were searched through to February 2022. A total of eight studies ( n = 2219 infants, 2202 mothers) were included in the qualitative synthesis. Findings provided promising evidence of the role that PNMS plays in altering the microbial composition, diversity, and gut immunity in mothers and infants. Notably, majority of included studies found that higher PNMS was linked to increases in genera from the phylum Proteobacteria . The factors influencing these effects are explored including nutrition, birth mode, and parenting behaviors. Potential interventions to mitigate the adverse effects of PNMS are discussed, along with recommendations for future studies with longitudinal designs to better understand the appropriate type and timing of interventions needed to promote “healthy” maternal and infant microbial functioning.
Purpose: There are conflicting data about the effects of fetal echocardiography (fECHO) on the psychiatric symptoms of the mother and cardiac evaluation of the fetus. Methods: This study included 119 pregnant women who evaluated using fECHO as the study group and 65 healthy pregnant women who evaluated using ultrasonography for routine screening as the control group. All participants filled out State and Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) before assessment. Results: Mitral flow velocity, Tricuspid flow velocity, Aorta flow velocity (AFV), Pulmonary artery flow velocity, Fetal heart rate (FHR) was evaluated by fECHO. STAI-S, STAI-T and PSS scores of women who evaluated by using fECHO were higher than the control group. In fECHO group, AFV values of pregnant women with high STAI-S scores were higher than those with low STAI-S scores. FHR was higher in pregnant women with low STAI-T scores compared to pregnant women with high STAI-T scores. Correlation analyses showed that STAI-S scores and AFV values and number of pregnancies were positively correlated. FHR was found to be negatively correlated with STAI-S, STAI-T and PSS scores. Conclusion: fECHO can cause anxiety and stress in pregnant women and may have negative effects on fetal cardiac evaluation.
Objective:
The study aims to examine the association between depressiveness in mothers on infant obesity and stunting at one year of age.
Methods:
We enrolled 4829 pregnant women, followed them up at public health facilities in Bengaluru for one year after birth. We collected information on women's sociodemographic characteristics, obstetric history, depressive symptoms during pregnancy and delivery within 48 h. We took infant anthropometric measurements at birth and one year. We used chi-square tests, and calculated an unadjusted odds ratio using univariate logistic regression. We used multivariate logistic regression to examine the association between maternal depressiveness, childhood adiposity, and stunting.
Results:
We found that the prevalence of depressiveness was 31.8% in mothers who delivered in public health facilities in Bengaluru. Infants born to mothers with depressiveness at birth had 3.9 times higher odds of having larger waist circumference than infants born to mothers with no depressiveness (AOR: 3.96, 95% Confidence Interval: 1.24,12.58) and 1.9 times higher odds of having a larger sum of skinfold thickness (AOR: 1.99, 95% CI: 1.18,3.38). Additionally, we found that infants born to mothers with depressiveness at birth had 1.7 times higher odds of stunting than infants born to mothers with no depressiveness (AOR: 1.72; 95%CI: 1.22,2.43) after adjusting for confounders.
Conclusion:
Our study highlights a high prevalence of depressiveness among mothers seeking antenatal care at a public hospital is associated with an increased risk of infant adiposity and stunting at one year. Further research is needed to understand the underlying mechanisms and identify effective interventions.
For a long time it was assumed that the risk for diseases such as coronary heart disease (CHD) or insulin resistance, for example, develops from the genetic potential of the parents and is amplified by environmental influences such as an unfavorable lifestyle. This view has been completely overturned in the last two decades by the concept of fetal programming. The concept implies that a stimulus or insult during a sensitive period of fetal development produces permanent changes in structure, physiology, and metabolism, determining later risk for chronic diseases such as CHD and insulin resistance, as well as allergies, an impaired stress response, and many others in adulthood. The concept of Fetal Origins of Adult Disease (FOAD) was introduced by the British epidemiologist David Barker more than 20 years ago and has been the subject of intensive research ever since. The current research approaches aim to identify the biological mechanisms by which a prenatal stimulus or insult alters fetal development, the time lag between prenatal stimulus/insult and later disease, and the multiple factors that contribute to disease risk throughout the lifespan.
Early life environments program developmental processes that determine later life disease risk and resiliency. To understand how early life circumstances shape health trajectories, it is critical to consider how environmental adversity and enrichment interact with constitutional factors, such as one’s genetic makeup, to produce lasting changes to the structure and function of biological systems. In this chapter, we illustrate how pre- and postnatal environments influence neurodevelopmental disorder emergence and trajectories, with a focus on Attention Deficit Hyperactivity Disorder (ADHD). We present evidence that prenatal exposure to nutritional insufficiency, altered maternal metabolic states, or excessive maternal stress and mental health challenges can make a child more susceptible to developing ADHD. We also explore how postnatal environmental enrichment may mitigate the consequences of adverse prenatal exposures and optimize developmental trajectories. Lastly, we present approaches for exploring gene-by-environment interactions, which have the potential to help identify those who are especially susceptible to adverse environments, as well as those who may benefit from enriched environments. The work highlighted supports a developmental approach for understanding the emergence of neurodevelopmental disorders, as well as evidence of continued susceptibility and resilience across the lifespan. Additionally, this work describes spaces where early intervention could modify long-term trajectories.
This chapter presents important points regarding early traumatic experiences. The pioneers of trauma research and their approach to searching for childhood burdens and their consequences are briefly mentioned. Furthermore, specific questionnaires and the first large epidemiological studies are named. Depending on the time point of the child’s exposure, different functions of the brain and the body periphery are sustainably influenced. The frequency of child abuse is shown. Compensatory positive factors against trauma experiences are illuminated from different perspectives (resilience, parallel benevolent experiences, sensitivity of the affected person, genetic and epigenetic variables, “steeling factors”). The influence of early traumatic experiences can be passed on from generation to generation (transmission). Finally, the chapter presents some findings from evolutionary psychology, which embed the complex of early traumatic experiences in a larger whole. The chapter is the preparation for Chap. 3 and 4 in order to be able to better classify the multiple trauma consequences presented there.
This is a comprehensive, up-to-date and evidence-based review of women's mental health. It starts by considering the social and cultural contexts of women's lives today before addressing how developmental aspects pertain to mental health, exploring biological, evolutionary and psychosocial parameters. The heart of the book contains a series of chapters with a clinical emphasis. These aim to elucidate causal mechanisms for gender differences in mental disorder considering hormonal and environmental influences. The therapeutic implications of gender are then addressed in some detail, with a focus on inter-partner and other forms of violence, substance misuse, personality disorder and post-traumatic stress disorder. The book concludes with a detailed section considering psychosis and its sequelae in women and their families. The book's scope is intended to be broad, and it is aimed at a clinical audience including psychiatrists and general physicians, as well as mental health nurses, psychologists, social workers and occupational therapists.
Evolutionary psychiatry attempts to explain and examine the development and prevalence of psychiatric disorders through the lens of evolutionary and adaptationist theories. In this edited volume, leading international evolutionary scholars present a variety of Darwinian perspectives that will encourage readers to consider 'why' as well as 'how' mental disorders arise. Using insights from comparative animal evolution, ethology, anthropology, culture, philosophy and other humanities, evolutionary thinking helps us to re-evaluate psychiatric epidemiology, genetics, biochemistry and psychology. It seeks explanations for persistent heritable traits shaped by selection and other evolutionary processes, and reviews traits and disorders using phylogenetic history and insights from the neurosciences as well as the effects of the modern environment. By bridging the gap between social and biological approaches to psychiatry, and encouraging bringing the evolutionary perspective into mainstream psychiatry, this book will help to inspire new avenues of research into the causation and treatment of mental disorders.
Background
Prenatal maternal stress is increasingly recognized as a risk factor for offspring mental health challenges. DNA methylation may be a mechanism, but few studies directly tested mediation. These few integrative studies are reviewed along with studies from three research areas: prenatal maternal stress and child mental health, prenatal maternal stress and child DNA methylation, and child mental health and DNA methylation.
Methods
We conducted a narrative review of articles in each research area and the few published integrative studies to evaluate the state of knowledge.
Results
Prenatal maternal stress was related to greater offspring internalizing and externalizing symptoms and to greater offspring peripheral DNA methylation of the NR3C1 gene. Youth mental health problems were also related to NR3C1 hypermethylation while epigenome-wide studies identified genes involved in nervous system development. Integrative studies focused on infant outcomes and did not detect significant mediation by DNA methylation though methodological considerations may partially explain these null results.
Limitations
Operationalization of prenatal maternal stress and child mental health varied greatly. The few published integrative studies did not report conclusive evidence of mediation by DNA methylation.
Conclusions
DNA methylation likely mediates the association between prenatal maternal stress and child mental health. This conclusion still needs to be tested in a larger number of integrative studies. Key empirical and statistical considerations for future research are discussed. Understanding the consequences of prenatal maternal stress and its pathways of influence will help prevention and intervention efforts and ultimately promote well-being for both mothers and children.
Evolutionary psychiatry attempts to explain and examine the development and prevalence of psychiatric disorders through the lens of evolutionary and adaptationist theories. In this edited volume, leading international evolutionary scholars present a variety of Darwinian perspectives that will encourage readers to consider 'why' as well as 'how' mental disorders arise. Using insights from comparative animal evolution, ethology, anthropology, culture, philosophy and other humanities, evolutionary thinking helps us to re-evaluate psychiatric epidemiology, genetics, biochemistry and psychology. It seeks explanations for persistent heritable traits shaped by selection and other evolutionary processes, and reviews traits and disorders using phylogenetic history and insights from the neurosciences as well as the effects of the modern environment. By bridging the gap between social and biological approaches to psychiatry, and encouraging bringing the evolutionary perspective into mainstream psychiatry, this book will help to inspire new avenues of research into the causation and treatment of mental disorders.
Poverty undeniably negatively impacts cognitive development, yet effects vary across children as a function of associated risk factors. Indeed, adverse childhood experiences may influence development in both risk and promotive ways. For example, unpredictability (i.e., variability of stressors and living conditions) may promote children’s divergent thinking by providing opportunities to develop cognitive flexibility. This longitudinal study of 250 children (50% female, 46% Latinx) evaluated relations between poverty from birth to age 4 and children’s divergent thinking at age 8 as moderated by residential mobility and gender. The results revealed stark gender differences. Boys followed a traditional cumulative risk model wherein residential mobility exacerbated negative effects of poverty on divergent thinking. However, for girls, poverty was not associated with worse divergent thinking at higher levels of residential mobility, demonstrating its protective role. These findings highlight the need for nuanced models of early childhood risk to clarify individual differences in cognitive development.
The authors investigated the association between maternal psychological and fetal neurobehavioral functioning. Data were provided by 52 maternal-fetal pairs at 24, 30, and 36 weeks gestation. The relations between maternal measures and fetal heart rate, variability, and motor activity were statistically modeled. Fetuses of women who were more affectively intense, appraised their lives as more stressful, and reported more frequent pregnancy-specific hassles were more active across gestation. Fetuses of women who perceived their pregnancy to be more intensely and frequently uplifting and had positive emotional valence toward pregnancy were less active. Associations with fetal heart-rate measures were detected at 36 weeks gestation. These data provide evidence for proximal effects of maternal psychological functioning on fetal neurobehavior.
This article reviews the evolutionary origins and functions of the capacity for anxiety, and relevant clinical and research issues. Normal anxiety is an emotion that helps organisms defend against a wide variety of threats. There is a general capacity for normal defensive arousal, and subtypes of normal anxiety protect against particular kinds of threats. These normal subtypes correspond somewhat to mild forms of various anxiety disorders. Anxiety disorders arise from dysregulation of normal defensive responses, raising the possibility of a hypophobic disorder (too little anxiety). If a drug were discovered that abolished all defensive anxiety, it could do harm as well as good. Factors that have shaped anxiety-regulation mechanisms can explain prepotent and prepared tendencies to associate anxiety more quickly with certain cues than with others. These tendencies lead to excess fear of largely archaic dangers, like snakes, and too little fear of new threats, like cars. An understanding of the evolutionary origins, functions, and mechanisms of anxiety suggests new questions about anxiety disorders.
Like humans engaged in risky activities, group members of some animal societies take turns acting as sentinels. Explanations
of the evolution of sentinel behavior have frequently relied on kin selection or reciprocal altruism, but recent models suggest
that guarding may be an individual's optimal activity once its stomach is full if no other animal is on guard. This paper
provides support for this last explanation by showing that, in groups of meerkats (Suricata suricatta), animals guard from safe sites, and solitary individuals as well as group members spend part of their time on guard. Though
individuals seldom take successive guarding bouts, there is no regular rota, and the provision of food increases contributions
to guarding and reduces the latency between bouts by the same individual.
Problems with language and symptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood and adolescence are often strongly linked to low scholastic performance. Early recognition of children who are at increased risk is necessary. Our objective was to determine whether mixed-handedness, which is associated with atypical cerebral laterality, is associated with language, scholastic, and ADHD symptoms in childhood and adolescence.
Prospective data come from the Northern Finland Birth Cohort 1986, a longitudinal, population-based birth cohort with assessments when children were 7 to 8 and 16 years of age (N = 7871). Teacher, parent, and/or adolescent reports were used to assess language difficulties, scholastic performance, and mental health, including ADHD symptoms.
Mixed-handed children, relative to right-handed, had approximately a twofold increase in odds of having difficulties with language and scholastic performance at the age of 8 years. Eight years later, as 16-year-olds, adolescents had twofold increase in odds concerning difficulties in school with language and with ADHD symptoms. Mixed-handed children were more likely to have scores indicating probable psychiatric disturbance, including ADHD symptoms. As adolescents, mixed-handed children with previous behavioral problems were at considerably higher risk for scoring within the range of probable ADHD-inattention or ADHD-combined case. Mixed-handedness was associated with greater symptom severity in children and adolescents (P = .01) concerning psychiatric disturbance and ADHD inattention but not ADHD hyperactivity.
The results indicate that mixed-handed children have a greater likelihood of having language, scholastic, and mental health problems in childhood and that these persist into adolescence. Thus, these results suggest that mixed-handedness, particularly in the presence of difficulties, could aid in the recognition of children who are at risk for stable problems. Additional research is needed to understand the connections between neural substrates related to atypical cerebral asymmetry, mixed-handedness, and mental health problems including ADHD symptoms.
"Barker's hypothesis" emerged almost 25 years ago from epidemiological studies of birth and death records that revealed a high geographic correlation between rates of infant mortality and certain classes of later adult deaths as well as an association between birthweight and rates of adult death from ischemic heart disease. These observations led to a theory that undernutrition during gestation was an important early origin of adult cardiac and metabolic disorders due to fetal programming that permanently shaped the body's structure, function, and metabolism and contributed to adult disease. This theory stimulated interest in the fetal origins of adult disorders, which expanded and coalesced approximately 5 years ago with the formation of an international society for developmental origins of health and disease (DOHaD). Here we review a few examples of the many emergent themes of the DOHaD approach, including theoretical advances related to predictive adaptive responses of the fetus to a broad range of environmental cues, empirical observations of effects of overnutrition and stress during pregnancy on outcomes in childhood and adulthood, and potential epigenetic mechanisms that may underlie these observations and theory. Next, we discuss the relevance of the DOHaD approach to reproductive medicine. Finally, we consider the next steps that might be taken to apply, evaluate, and extend the DOHaD approach.
The aim of the present study was to examine the association between prenatal psychosocial stress exposure and subsequent prefrontal cortex-dependent working memory performance in human adults. Working memory performance was assessed using an item-recognition task under 10 mg hydrocortisone (cortisol) and placebo conditions in a sample of 32 healthy young women (mean age = 25 +/- 4.34 years) whose mothers experienced a major negative life event during their pregnancy (Prenatal Stress, PS group), and in a comparison group of 27 healthy young women (mean age = 24 +/- 3.4 years). The two groups did not differ in the placebo condition, however, subjects in the PS group showed longer reaction times after hydrocortisone administration compared with subjects in the comparison group (p = .02). These findings provide support for an association between prenatal stress exposure and the potential modulatory effect of cortisol on working memory performance in young adults, which may reflect compromised development of the prefrontal cortex in prenatal life.
Recent human studies have shown that a wide variety of prenatal stressors, from anxiety and partner relationship problems, to natural disasters, increase the risk for a diverse range of adverse neurodevelopmental outcomes in the child. These include impaired cognitive development and behavioral problems, autism and schizophrenia. However, many questions remain about the underlying processes. Much of the research, based on animal studies, has focussed on the maternal HPA axis, with mixed results. Maternal stress or anxiety during pregnancy has been found to be weakly associated with raised maternal cortisol, if at all. The placenta may be a more promising programming vector, because it controls fetal exposure to the maternal environment. Animal studies indicate that prenatal stress can affect the activity of the placental barrier enzyme 11-betaHSD2, which metabolises cortisol. We review the evidence for a similar mechanism in humans and how maternal stress may cause other changes in the placenta which affect fetal neurodevelopment.
Exposure to prenatal stress is associated with later adverse health and adjustment outcomes. This is generally presumed to arise through early environmentally mediated programming effects on the foetus. However, associations could arise through factors that influence mothers' characteristics and behaviour during pregnancy which are inherited by offspring.
A 'prenatal cross-fostering' design where pregnant mothers are related or unrelated to their child as a result of in vitro fertilization (IVF) was used to disentangle maternally inherited and environmental influences. If links between prenatal stress and offspring outcome are environmental, association should be observed in unrelated as well as related mother-child pairs. Offspring birth weight and gestational age as well as mental health were the outcomes assessed.
Associations between prenatal stress and offspring birth weight, gestational age and antisocial behaviour were seen in both related and unrelated mother-offspring pairs, consistent with there being environmental links. The association between prenatal stress and offspring anxiety in related and unrelated groups appeared to be due to current maternal anxiety/depression rather than prenatal stress. In contrast, the link between prenatal stress and offspring attention deficit hyperactivity disorder was only present in related mother-offspring pairs and therefore was attributable to inherited factors.
Genetically informative designs can be helpful in testing whether inherited factors contribute to the association between environmental risk factors and health outcomes. These results suggest that associations between prenatal stress and offspring outcomes could arise from inherited factors and post-natal environmental factors in addition to causal prenatal risk effects.
Human aggression is viewed from four explanatory perspectives, derived from the ethological tradition. The first consists of its adaptive value, which can be seen throughout the animal kingdom, involving resource competition and protection of the self and offspring, which has been viewed from a cost-benefit perspective. The second concerns the phylogenetic origin of aggression, which in humans involves brain mechanisms that are associated with anger and inhibition, the emotional expression of anger, and how aggressive actions are manifest. The third concerns the origin of aggression in development and its subsequent modification through experience. An evolutionary approach to development yields conclusions that are contrary to the influential social learning perspective, notably that physical aggression occurs early in life, and its subsequent development is characterized by learned inhibition. The fourth explanation concerns the motivational mechanisms controlling aggression: approached from an evolutionary background, these mechanisms range from the inflexible reflex-like responses to those incorporating rational decision-making.
Dermatoglyphic asymmetry of fingertip ridge counts is more frequent in schizophrenia patients than normal controls, and may reflect disruptions in fetal development during Weeks 14-22 when fingerprints develop. However, there are no data in humans linking specific adverse events at specific times to dermatoglyphic asymmetries. Our objective was to determine whether prenatal exposure to a natural disaster (1998 Quebec ice storm) during Weeks 14-22 would result in increased dermatoglyphic asymmetry in children, and to determine the roles of maternal objective stress exposure, subjective stress reaction, and postdisaster cortisol. Ridge counts for homologous fingers were scored for 77 children (20 target exposed [Weeks 14-22] and 57 nontarget exposed [exposed during other gestation weeks]). Children in the target group had more than 0.50 SD greater asymmetry than the nontarget group. Within the target group, children whose mothers had high subjective ice storm stress had significantly greater asymmetry than those with lower stress mothers, and maternal postdisaster cortisol had a significant negative correlation with the children's dermatoglyphic asymmetry (r = -.56). Prenatal maternal stress during the period of fingerprint development results in greater dermatoglyphic asymmetry in their children, especially in the face of greater maternal distress.
Maternal care influences hypothalamic-pituitary-adrenal (HPA) function in the rat through epigenetic programming of glucocorticoid receptor expression. In humans, childhood abuse alters HPA stress responses and increases the risk of suicide. We examined epigenetic differences in a neuron-specific glucocorticoid receptor (NR3C1) promoter between postmortem hippocampus obtained from suicide victims with a history of childhood abuse and those from either suicide victims with no childhood abuse or controls. We found decreased levels of glucocorticoid receptor mRNA, as well as mRNA transcripts bearing the glucocorticoid receptor 1F splice variant and increased cytosine methylation of an NR3C1 promoter. Patch-methylated NR3C1 promoter constructs that mimicked the methylation state in samples from abused suicide victims showed decreased NGFI-A transcription factor binding and NGFI-A-inducible gene transcription. These findings translate previous results from rat to humans and suggest a common effect of parental care on the epigenetic regulation of hippocampal glucocorticoid receptor expression.
Emotions research is now routinely grounded in evolution, but explicit evolutionary analyses of emotions remain rare. This article considers the implications of natural selection for several classic questions about emotions and emotional disorders. Emotions are special modes of operation shaped by natural selection. They adjust multiple response parameters in ways that have increased fitness in adaptively challenging situations that recurred over the course of evolution. They are valenced because selection shapes special processes for situations that have influenced fitness in the past. In situations that decrease fitness, negative emotions are useful and positive emotions are harmful. Selection has partially differentiated subtypes of emotions from generic precursor states to deal with specialized situations. This has resulted in untidy emotions that blur into each other on dozens of dimensions, rendering the quest for simple categorically distinct emotions futile. Selection has shaped flexible mechanisms that control the expression of emotions on the basis of an individual's appraisal of the meaning of events for his or her ability to reach personal goals. The prevalence of emotional disorders can be attributed to several evolutionary factors.
The current study sought to determine whether prenatal 3,4-methylenedioxy-N-methamphetamine (MDMA) exposure from E14-20 in the rat resulted in behavioral sequelae in adult offspring. Prenatal MDMA exposure results in increased dopaminergic fiber density in the prefrontal cortex, striatum and nucleus accumbens of young rats. Since these areas are critical in response to novelty, reward, attention and locomotor activity, we hypothesized that prenatal MDMA exposure would produce significant changes in the performance of tasks that examine such behaviors in adult rats. Adult rats prenatally exposed to MDMA exhibited greater activity and spent more time in the center during a novel open field test as compared to controls. This increased activity was not reflected in normal home cage activity. Prenatal exposure to MDMA did not affect feeding or food reward. It did not alter cocaine self-administration behaviors, nor did it have an effect on the locomotor response to amphetamine challenge. Finally, while prenatal MDMA did not affect performance in the radial arm maze or the Morris water maze (MWM), these animals demonstrated altered performance in a cued MWM paradigm. Prenatal MDMA exposure resulted in perseverative attendance to a hanging cue when the platform in the MWM was removed as compared to controls. Together, these data demonstrate that prenatal exposure to MDMA results in a behavioral phenotype in adult rats characterized by reduced anxiety, a heightened response to novelty, and "hyperattentiveness" to environmental cues during spatial learning.
Postpartum depression (PPD) is considered a major public health problem that conveys risk to mothers and offspring. Yet PPD typically occurs in the context of a lifelong episodic illness, and its putative effects might derive from the child's exposure to other episodes, in pregnancy or later childhood. The aim of the study is to test two hypotheses: (1) that the effects of PPD on adolescent outcomes are partly explained by antepartum depression (APD) and (2) that the effects of APD and PPD are both explained by later exposure to the mother's depression.
A random sample of 178 antenatal patients was drawn from two general medical practices in South London; 171 gave birth to live infants, and 150 (88%) were assessed at 3 months post partum, with 121 of their offspring (81%) assessed for emotional disorders (ED), disruptive behaviour disorders (DBD) and IQ, at 11 and 16 years of age.
When APD and subsequent episodes of depression were taken into account, PPD had a significant effect on adolescent IQ, especially for boys, but did not predict psychopathology. ED and DBD in adolescence were predicted by the extent of exposure to maternal depression after 3 months post partum; a significant effect of APD on ED in girls was accounted for by later exposure to the mother's illness. Mothers' symptoms of anxiety, smoking and alcohol use in pregnancy did not predict adolescent outcomes, once maternal depression was taken into account.
Some effects attributed to mothers' mental health problems in pregnancy or post partum may be mediated by cumulative exposure to maternal illness, probably reflecting genetic influence and gene-environment correlation. However, PPD has a direct effect on cognition. Clinicians should endeavour to identify women with depression in pregnancy (31% of this sample) and help them to manage their lifelong illness.
Prenatal stress is associated with an increased vulnerability to neurodevelopmental disorders, including autism and schizophrenia. To determine the critical time window when fetal antecedents may induce a disease predisposition, we examined behavioral responses in offspring exposed to stress during early, mid, and late gestation. We found that male offspring exposed to stress early in gestation displayed maladaptive behavioral stress responsivity, anhedonia, and an increased sensitivity to selective serotonin reuptake inhibitor treatment. Long-term alterations in central corticotropin-releasing factor (CRF) and glucocorticoid receptor (GR) expression, as well as increased hypothalamic-pituitary-adrenal (HPA) axis responsivity, were present in these mice and likely contributed to an elevated stress sensitivity. Changes in CRF and GR gene methylation correlated with altered gene expression, providing important evidence of epigenetic programming during early prenatal stress. In addition, we found the core mechanism underlying male vulnerability may involve sex-specific placenta responsivity, where stress early in pregnancy significantly increased expression of PPARalpha (peroxisome proliferator-activated receptor alpha), IGFBP-1 (insulin-like growth factor binding protein 1), HIF3alpha (hypoxia-inducible factor 3a), and GLUT4 (glucose transporter 4) in male placentas but not females. Examination of placental epigenetic machinery revealed basal sex differences, providing further evidence that sex-specific programming begins very early in pregnancy, and may contribute to the timing and vulnerability of the developing fetus to maternal perturbations. Overall, these results indicate that stress experience early in pregnancy may contribute to male neurodevelopmental disorders through impacts on placental function and fetal development.
Current knowledge about early plasticity and children's responsiveness to environmental modifications as well as the atheoretical nature of current nosological systems necessitate alternative models to explain the phenomena of childhood behavioral and emotional disturbances. Evolutionary biology provides one such framework. It organizes data from the behavioral and cognitive sciences and parallels similar efforts in other areas of medicine and biology. Through an evolutionary biological lens, some mental disorders are better viewed as an adaptive response to early pathogenic environments and/or reflect the optimization of brain function to some environments at the cost of poorer response to the demands of other environments. As an example, the authors examine attention-deficit/hyperactivity disorder (ADHD) in relation to evolutionary theories of psychology and biology and clarify the potentially adaptive nature of characteristics of inattention, impulsivity, and motoric hyperactivity, depending on the nature of child's environments. Reframing ADHD characteristics according to evolutionary theory has important treatment implications for clinicians and offers researchers opportunities for novel scientific discoveries.
Low birthweight is now known to be associated with increased rates of coronary heart disease and the related disorders stroke, hypertension and non-insulin dependent diabetes. These associations have been extensively replicated in studies in different countries and are not the result of confounding variables. They extend across the normal range of birthweight and depend on lower birthweights in relation to the duration of gestation rather than the effects of premature birth. The associations are thought to be consequences of developmental plasticity, the phenomenon by which one genotype can give rise to a range of different physiological or morphological states in response to different environmental conditions during development. Recent observations have shown that impaired growth in infancy and rapid childhood weight gain exacerbate the effects of impaired prenatal growth. A new vision of optimal early human development is emerging which takes account of both short and long-term outcomes.
How often has anyone said after reading a textbook, “Wow, what a great read!”? That is what I just did. Peter Gluckman, along with Alan Beedle and Mark Hanson, have written a wonderful introduction to the principles of evolutionary biology and defined ways in which these principles can be applied to understanding human disease. I would recommend the first part of the book, “Fundamentals of Evolutionary Biology” (150 pp) to any reader, whether medical professional or layperson, interested in a clear, concise, complete, yet eminently readable introduction to modern evolutionary theory. The authors not only manage to give the reader a sense of how human beings are inextricably linked to their evolutionary past—hairless apes, as it were—but also provide examples of traits, such as menstruation, menopause, having unusually fat infants and an unusually short intestinal tract, needing vitamins C and D, that are unique to humans and a few of their ape relatives, and how these create exciting medical puzzles for evolutionary biologists to explain and physicians to treat.
Animal studies suggest that psychological factors may interfere with the development of brain asymmetry during gestation. We evaluated whether psychological exposure in pregnancy was associated with mixed-handedness in the offspring. In a follow-up design study, 824 Danish-speaking women with singleton pregnancies provided information on psychological distress and the occurrence of life events in the early second and third trimesters of pregnancy. Handedness of the children was based on maternal reports when the children were 3 years of age. Among the 419 males and 405 females, 7% and 5% respectively were mixed-handed whereas mixed-handedness was found in 3% of the parents. Psychological distress in the third trimester as well as higher levels of stressful life events were related to a higher prevalence of mixed-handedness in the offspring. About 16% of the women reported more than one life event in the third trimester of pregnancy and among the offspring of these women 11% were mixed-handed (odds ratio=2.3; 95% confidence interval 1.2 to 4.4). Women who at the same time reported a high level of distress and stressful life events, had a three- to four-fold higher prevalence of mixed-handedness in their offspring.
We review a significant body of evidence from independent prospective studies that if a mother is stressed while pregnant, her child is substantially more likely to have emotional or cognitive problems, including an increased risk of attentional deficit/hyperactivity, anxiety, and language delay. These findings are independent of effects due to maternal postnatal depression and anxiety. We still do not know what forms of anxiety or stress are most detrimental, but research suggests that the relationship with the partner can be important in this respect. The magnitude of these effects is clinically significant, as the attributable load of emotional/behavioral problems due to antenatal stress and/or anxiety is approximately 15%. Animal models suggest that activity of the stress-responsive hypothalamic-pituitary-adrenal (HPA) axis and its hormonal end-product cortisol are involved in these effects in both mother and offspring. The fetal environment can be altered if stress in the mother changes her hormonal profile, and in humans, there is a strong correlation between maternal and fetal cortisol levels. However, many problems remain in understanding the mechanisms involved in this interaction. For example, maternal cortisol responses to stress decline over the course of pregnancy, and earlier in pregnancy, the link between maternal and fetal cortisol is less robust. It is possible that the effects of maternal anxiety and stress on the developing fetus and child are moderated by other factors such as a maternal diet (e.g., protein load). It is suggested that extra vigilance or anxiety, readily distracted attention, or a hyper-responsive HPA axis may have been adaptive in a stressful environment during evolution, but exists today at the cost of vulnerability to neurodevelopmental disorders.
Low birthweight is now known to be associated with increased rates of coronary heart disease and the related disorders stroke, hypertension and non-insulin dependent diabetes. These associations have been extensively replicated in studies in different countries and are not the result of confounding variables. They extend across the normal range of birthweight and depend on lower birthweights in relation to the duration of gestation rather than the effects of premature birth. The associations are thought to be consequences of developmental plasticity, the phenomenon by which one genotype can give rise to a range of different physiological or morphological states in response to different environmental conditions during development. Recent observations have shown that impaired growth in infancy and rapid childhood weight gain exacerbate the effects of impaired prenatal growth. A new vision of optimal early human development is emerging which takes account of both short and long-term outcomes.
Human social interaction is rarely guided by pure reason. Instead, in situation in which humans have the option to cooperate, to defect, or to punish non-cooperative behavior of another person, they quite uniformly tend to reciprocate “good” deeds, reject unfair proposals, and try to enforce obedience to social rules and norms in non-cooperative individuals (“free-riders”), even if the punishment incurs costs to the punisher. Abundant research using various game theoretical approaches has examined these apparently irrational human behaviors. This article reviews the evolutionary rationale of how such behavior could have been favored by selection. It explores the cognitive mechanisms required to compute possible scenarios of cooperation, defection, and the detection of cheating. Moreover, the article summarizes recent research developments into individual differences in behavior, which suggest that temperament and character as well as between- and within-sex differences in hormonal status influence behavior in social exchange. Finally, we present an overview over studies that have addressed the question of how neuropsychiatric disorders may alter performance in game theoretical paradigms, and propose how empirical approaches into this fascinating field can advance our understanding of human nature.
Experimental animal studies suggest that early glucocorticoid exposure may have lasting effects on the neurodevelopment of the offspring; animal studies also suggest that this effect may be eliminated by positive postnatal rearing. The relevance of these findings to humans is not known.
We prospectively followed 125 mothers and their normally developing children from pregnancy through 17 months postnatal. Amniotic fluid was obtained at, on average, 17.2 weeks gestation; infants were assessed at an average age of 17 months with the Bayley Scales of Infant Development, and ratings of infant-mother attachment classification were made from the standard Ainsworth Strange Situation assessment.
Prenatal cortisol exposure, indexed by amniotic fluid levels, negatively predicted cognitive ability in the infant, independent of prenatal, obstetric, and socioeconomic factors. This association was moderated by child-mother attachment: in children with an insecure attachment, the correlation was [r(54) = -.47, p < .001]; in contrast, the association was nonexistent in children who had a secure attachment [r(70) = -.05, ns].
These findings mimic experimental animal findings and provide the first direct human evidence that increased cortisol in utero is associated with impaired cognitive development, and that its impact is dependent on the quality of the mother-infant relationship.
There is extensive evidence in rats that prenatal environmental stress (PES) exposure and early postnatal altered maternal care, as a consequence of stress during gestation, can detrimentally affect the brain and behavioral development of the offspring. In order to separate the effect of PES on the fetuses from that on the behavior of the mother, in the present study, we used a cross-fostering procedure in which PES-fetuses were raised by non-stressed mothers and non PES-fetuses were raised by stressed mothers. In Experiment 1, non-stressed mothers showed significantly more maternal behavior than stressed mothers. In Experiment 2, when the female offspring from Experiment 1 reached maturity, they were tested for: (1) induced maternal behavior (MB), (2) plasma levels of corticosterone (Cpd B), progesterone (P), and estradiol (E2), (3) number of accessory olfactory bulb (AOB) mitral cells, and (4) c-fos expression measured in AOB and medial preoptic area (MPOA) neurons. We replicated our previous findings that the PES group reared by their own stressed mothers, when adult, attacked the young, expressed disorganized MB and showed altered Cpd B, P and E2 levels, plus a male-like neuro-morphological pattern in the AOB, by comparison with the non-PES group, reared by their own non-stressed mothers. By contrast, when adult, the PES group reared by non-stressed mothers showed hormonal and morphological neuronal alterations, but they displayed appropriate (full) MB. The non-PES group raised by stressed mothers also showed altered hormone levels, but showed full MB and no morphological neuronal changes. Significant differences in the AOB and MPOA c-fos activity, related to whether or not MB was expressed, were found in the non-PES groups, but not in the PES group reared by non-stressed mothers.
Exposure to stress during critical periods of an organism's maturation can result in permanent behavioral changes and induced hyper-responsive to aversive stimuli as adult. Hippocampus is a plastic and vulnerable brain structure that is susceptible to damage during aging and repeated stress. The present study examines the effect of maternal restraint stress on the level of GAP-43, pGAP-43 and synaptophysin in the hippocampus of rat pups. Prenatal stress (PS) causes a significant increase of GAP-43 and pGAP-43 (p<or=0.001) in the pup's hippocampus during postnatal days 7 and 14, but not at later ages. Up-regulation of GAP-43 and pGAP-43 may alter the pattern of axonal growth and synapses' formation in the pup's brain since the first two postnatal weeks are correlated with peak period of synaptogenesis in the rat brain. We also examined the level of synaptophysin, a synaptic vesicle membrane protein, in the pup's brain. Our finding revealed that, PS causes a significant decrease of synaptophysin in the pup's hippocampus as compared to control (p<or=0.001). These changes are due to the direct effects of maternal stress hormone since repeated injection with corticosterone (CORT, 40 mg/kg) to pregnant rat during gestation days (GDs) 14-21 also gave the same results. Abnormal axonal sprouting and reorganization together with the alterations in synaptic vesicle membrane protein during the critical period of synaptogenesis may lead to a defect in synapse formation and axonal pruning in the hippocampus. These changes may be associated with stress-induced impairment of hippocampal function that occurs in later life of the offspring.
There are several independent prospective studies showing that a wide variety of forms of prenatal stress can have long-term effects on the behavioural and cognitive outcome for the child. Animal studies have shown that prenatal stress, as well as affecting behaviour, can also reprogram the function of the HPA axis in the offspring. However, the effects on the HPA axis are very variable depending on the nature of the stress, its timing in gestation, the genetic strain of the animal, the sex and age of the offspring and whether basal or stimulated HPA axis responses are studied. There are also several recent studies showing long-term effects of prenatal stress on basal cortisol levels, or cortisol responses to stress, in humans. The designs of these studies differ considerably, many are small, and the effects on outcome are also varied. There is little evidence, so far, that altered function of the HPA axis in the child mediates the behavioural or cognitive alterations observed to be associated with prenatal stress.
It is well established in animal models that the prenatal environment can have a major impact on stress axis function throughout life. These changes can predispose to various metabolic, cardiovascular, and neurobiological pathophysiologies. Emerging evidence indicates that the same programming effects occur in humans. It is now becoming clear that the pathophysiological effects are not confined to the first-generation offspring and that there is transgenerational memory of fetal experience that can extend across multiple generations. The complex mechanisms by which transgenerational transmission of stress responsiveness occur are rapidly becoming a focus of investigation. Understanding these fundamental biological processes will allow for development of intervention strategies that prevent or reverse adverse programming of the stress response.
The goal of our study was to characterise the relationships between trait anxiety symptoms of women during their pregnancies and birth outcomes of their offspring using a longitudinal cohort from the Maternal Health Practices and Child Development Project. We used the State‐Trait Personality Index anxiety measure that is based on Spielberger's State‐Trait Anxiety Inventory to measure self‐reported trait anxiety at two gestational assessments (fourth and seventh months, representing the first and second trimesters, respectively) and at a third assessment shortly after delivery (representing the third trimester). Demographic, social, psychological, substance use and medical factors were assessed prenatally, and outcomes of the 763 live, singleton births were determined at delivery.
In regression models, trait anxiety at the second and third trimesters predicted lower birthweight and shorter birth length, controlling for confounders. Anxiety reported at the third trimester predicted shortened gestational age, controlling for confounders. At the first and second trimesters, the relationship of birthweight and birth length to maternal trait anxiety was only significant for severe anxiety. Women whose anxiety reached severe levels for at least two trimesters were significantly more likely to deliver offspring of lower birthweight and shorter birth length than those women who reported severe anxiety at none or only one of the trimesters. Additionally, offspring of women who experienced severe anxiety during all three trimesters had shorter mean gestational age than offspring of women who did not report severe anxiety at any trimester. Women who report chronic, severe trait anxiety are at the highest risk of having shorter gestations and delivering smaller babies.
Because the brain undergoes dramatic changes during fetal development it is vulnerable to environmental insults. There is evidence that maternal stress and anxiety during pregnancy influences birth outcome but there are no studies that have evaluated the influence of stress during human pregnancy on brain morphology. In the current prospective longitudinal study we included 35 women for whom serial data on pregnancy anxiety was available at 19 (+/-0.83), 25 (+/-0.9) and 31 (+/-0.9) weeks gestation. When the offspring from the target pregnancy were between 6 and 9 years of age, their neurodevelopmental stage was assessed by a structural MRI scan. With the application of voxel-based morphometry, we found regional reductions in gray matter density in association with pregnancy anxiety after controlling for total gray matter volume, age, gestational age at birth, handedness and postpartum perceived stress. Specifically, independent of postnatal stress, pregnancy anxiety at 19 weeks gestation was associated with gray matter volume reductions in the prefrontal cortex, the premotor cortex, the medial temporal lobe, the lateral temporal cortex, the postcentral gyrus as well as the cerebellum extending to the middle occipital gyrus and the fusiform gyrus. High pregnancy anxiety at 25 and 31 weeks gestation was not significantly associated with local reductions in gray matter volume.This is the first prospective study to show that a specific temporal pattern of pregnancy anxiety is related to specific changes in brain morphology. Altered gray matter volume in brain regions affected by prenatal maternal anxiety may render the developing individual more vulnerable to neurodevelopmental and psychiatric disorders as well as cognitive and intellectual impairment.
Although postnatal psychologic distress has been widely studied for many years, particularly with a focus on postpartum depression, symptoms of maternal depression, stress, and anxiety are not more common or severe after childbirth than during pregnancy. This paper reviews the newer body of research aimed at identifying the effects of women's antenatal psychologic distress on fetal behavior and child development, and the biologic pathways for this influence. These studies are in line with the growing body of literature supporting the "fetal origins hypothesis" that prenatal environmental exposures--including maternal psychologic state-based alterations in in utero physiology--can have sustained effects across the lifespan.