Effects of mothers’ prenatal psychiatric status and postnatal caregiving on infant biobehavioral regulation: Can prenatal programming be modified?

Department of Psychology, Columbia University, 1190 Amsterdam Ave MC 5501, New York, NY 10027, USA.
Early Human Development (Impact Factor: 1.79). 05/2008; 84(4):249-56. DOI: 10.1016/j.earlhumdev.2007.06.004
Source: PubMed


Animal research suggests that antenatal stress exposure and postnatal rearing style act in concert to shape offspring biobehavioral outcomes. However, the combination of these maternally-mediated influences has not been studied in human infants.
To examine antenatal psychiatric status and maternal sensitivity in relation to 4-month-olds' autonomic regulation, HPA-axis functioning, and behavior.
Prospective study of 47 pregnant women recruited from an urban hospital who completed questionnaire measures of anxiety and depression and underwent a psychiatric interview in the 2nd trimester. At 4 months postpartum, women again completed mood questionnaires and the mother-infant dyads participated in a 10-minute free-play session evaluated for maternal sensitivity.
Baseline infant salivary cortisol and electrocardiogram (EKG) collected at the start of the 4-month sessions. Infant responsiveness and maternal report of temperament also were evaluated.
Maternal sensitivity, but not antenatal psychiatric diagnosis, predicted greater levels of infant high frequency heart rate variability, after controlling for birth weight and age. Maternal sensitivity, but not psychiatric status, also predicted infant responsiveness. Maternal sensitivity modulated the effects of psychiatric illness on infant cortisol such that cortisol was low regardless of sensitivity for children of healthy women yet higher if the infant had insensitive versus sensitive caregiving when the mother had had an antenatal diagnosis.
Biobehavioral adaptation, even that initiated in utero, is influenced by interactions with the social world. These findings support the compatibility of fetal programming and social-context models of infant biobehavioral development and have promising implications for pre and postnatal clinical intervention.

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Available from: Catherine Monk, May 18, 2015
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    • "Depressed mothers often display lower sensitivity (Kim et al., 2011), more negativity and anger (Maughan et al., 2007; Pratt et al., 2015), increased intrusiveness (Murray et al., 2010), difficulties in maintaining physical proximity (Feldman and Eidelman, 2003; Feldman et al., 2004), and inconsistent, unpredictable parenting (Jameson et al., 1997; Leadbeater et al., 1996). These maternal behaviors have been associated with altered child CT patterns (Blair et al., 2008; Feldman et al., 2009; Hastings et al., 2011; Kaplan et al., 2008), suggesting that compromised parenting may be a key factor in the child's psychosocial maladjustment, possibly via its effect on HPA dysregulation. This notion is consistent with research in animal models, which showed that maternal proximity and the species-typical maternal behavior exert a regulatory impact on the pup's stress response by organizing glucocorticoids receptor densities in the hippocampus (Weaver et al., 2004). "
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    ABSTRACT: Maternal depression across the first years of life negatively impacts children's development. One pathway of vulnerability may involve functioning of the hypothalamic-pituitary-adrenal (HPA) axis. We utilize a community cohort of 1983 women with no comorbid risk repeatedly assessed for depression from birth to six years to form two groups; chronically depressed (N=40) and non-depressed (N=91) women. At six years, mother and child underwent psychiatric diagnosis, child salivary cortisol (CT) was assessed three times during a home-visit, mother-child interaction was videotaped, and child empathy was coded from behavioral paradigms. Latent Growth curve Model using Structural Equation Modeling (SEM) estimated the links between maternal depression and mother's negative parenting and three child outcomes; psychopathology, social withdrawal, and empathy as related to child CT baseline and variability. Depressed mothers displayed more negative parenting and their children showed more Axis-I psychopathology and social withdrawal. SEM analysis revealed that maternal depression was associated with reduced CT variability, which predicted higher child psychopathology and social withdrawal. Whereas all children exhibited similar initial levels of CT, children of controls reduced CT levels over time while children of depressed mothers maintained high, non-flexible levels. Mother negativity was related to lower initial CT levels, which predicted decreased empathy. Findings suggest that chronic maternal depression may compromise children's social-emotional adjustment by diminishing HPA-system flexibility as well as limiting the mother's capacity to provide attuned and predictable caregiving.
    Full-text · Article · Nov 2015 · Psychoneuroendocrinology
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    • "Dal punto di vista clinico la flessibilità dello strumento lo rende adattabile a pressoché qualsiasi situazione, rendendo più agevole la valutazione dello sviluppo affettivo relazionale del bambino nell'interazione con le figure di riferimento (Biringen et al., 2014). Fino ad ora lo strumento è stato impiegato in numerosi gruppi clinici e valutato in relazione alla psicopatologia dell'adulto (De Palo, Simonelli, Capra, & Porreca, 2014; Fonseca, Silva, & Otta, 2010; Kaplan et al., 2008; Porreca, Simonelli, De Palo, & Capra, 2014; Swanson et al., 2000; Trapolini, Ungerer, & McMahon, 2008; Trupe, 2010; Vliegen, Luyten, & Biringen, 2009) o a quella del bambino (Atzaba-Poria et al., 2010; Gueron-Sela, Atzaba-Poria, Meiri, & Yerushalmi, 2011; Wiefel et al., 2005). Il fatto che si tratti di una procedura non particolarmente stressante aggira inoltre il rischio che il compito richiesto vada a penalizzare la performance del soggetto, come invece accade per altre procedure sperimentali. "

    Full-text · Article · Jul 2015
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    • "Several studies propose that these alterations in the hypothalamic– pituitary–adrenal (HPA) axis (Gitau et al., 1998; Kaplan et al., 2008; O'Donnell et al., 2009) and alterations in placental enzymes (Gluckman et al., 1999) caused by environmental stress may affect the neurodevelopment of the foetus (Coe et al., 2003) and have significant later effects on the child (Talge et al., 2007) Walker and Diforio's (1997) neural diathesis stress model of schizophrenia incorporates prenatal factors and the augmentation of dopamine and dopamine receptor synthesis by the HPA axis (Walker and Diforio, 1997). Longitudinal studies are required to examine effects of prenatal stressors on risk of schizophrenia whilst minimizing recall bias, but are rarely feasible given the incidence of this disorder. "
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    ABSTRACT: International studies indicate that the median prevalence of psychotic experiences in children is 7%. It has been proposed that environmental stress during pregnancy may affect the neurodevelopment of the foetus and lead to a vulnerability in the child to later stressors and psychopathology. AIM In this study we explore the relationship between environmental stress during pregnancy and psychotic experiences in children in the general population at 12years. METHODS We analysed a birth cohort of 5038 children from the Avon Longitudinal Study of Parents and Children. Environmental stress was measured as life event exposure. Data on life events were collected on women during their pregnancy, whilst psychotic experiences in the offspring were assessed at age 12. RESULTS There was a weak association between maternal exposure to life events and psychotic experiences at twelve years (crude OR 1.10 95% CI 1.02-1.18) per quartile of life event score. This association was not reduced after adjustment for socio-economic status, family history of schizophrenia, maternal education or birth weight but after adjustment for maternal anxiety and depression and smoking in early pregnancy there was no longer any evidence for an association (OR 1.01 95% CI 0.93-1.10). CONCLUSION This study provides some evidence to suggest that stressful life events may affect child psychotic experiences through effects on maternal psychopathology, and possibly physiology, during pregnancy.
    Full-text · Article · Dec 2013 · Schizophrenia Research
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