ArticleLiterature Review

Prenatal depression effects on the fetus and newborn: A review

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Abstract

A review of research on prenatal depression effects on the fetus and newborn suggests that they experience prenatal, perinatal and postnatal complications. Fetal activity is elevated, prenatal growth is delayed, and prematurity and low birthweight occur more often. Newborns of depressed mothers then show a biochemical/physiological profile that mimics their mothers' prenatal biochemical/physiological profile including elevated cortisol, lower levels of dopamine and serotonin, greater relative right frontal EEG activation and lower vagal tone. Elevated prenatal maternal cortisol is the strongest predictor of these neonatal outcomes. Moderate pressure massage can alleviate these effects including reducing prematurity.

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... Η ανασκόπηση της έρευνας δείχνει ότι η κατάθλιψη κατά την κύηση μειώνει την κινητικότητα του εμβρύου (Dieter et al., 2001. Field et al., 2006. Stuart-Parrigon & Stuart, 2014, συντελεί στη γέννηση λιποβαρών βρεφών, λόγω της αυξημένης συγκέντρωσης κυρίως της κορτιζόλης, αλλά και της νορεπινεφρίνης (Halbreich, 2005. Field et al., 2006. Grote et al. 2010. Ibanez et al., 2012. Stuart-Parrigon & Stuart, 2014. Επίσης, τα καταθλιπτικά συμπτώματα κατά την κύηση έχουν συνδεθεί με αυξημ ...
... Η ανασκόπηση της έρευνας δείχνει ότι η κατάθλιψη κατά την κύηση μειώνει την κινητικότητα του εμβρύου (Dieter et al., 2001. Field et al., 2006. Stuart-Parrigon & Stuart, 2014, συντελεί στη γέννηση λιποβαρών βρεφών, λόγω της αυξημένης συγκέντρωσης κυρίως της κορτιζόλης, αλλά και της νορεπινεφρίνης (Halbreich, 2005. Field et al., 2006. Grote et al. 2010. Ibanez et al., 2012. Stuart-Parrigon & Stuart, 2014. Επίσης, τα καταθλιπτικά συμπτώματα κατά την κύηση έχουν συνδεθεί με αυξημένο κίνδυνο πρόωρου τοκετού (Halbreich, 2005. Grote et al., 2010. Field, 2011. Fransson et al., 2011. Ibanez et al., 2012. Stuart-Parrigon & Stuart, 2014.Ανάλογες είναι και οι επιπτώσεις του ά ...
... Stuart-Parrigon & Stuart, 2014.Ανάλογες είναι και οι επιπτώσεις του άγχους κατά την κύηση, δεδομένης και της συχνής συννοσηρότητας καταθλιπτικών και αγχωδών διαταραχών (Field, 2004). Τα έμβρυα των γυναικών με υψηλότερα επίπεδα κορτιζόλης είχαν μικρότερη εγκεφαλική, κοιλιακή, αμφιβρεγματική περίμετρο και χαμηλότερο βάρος (Field et al., 2006. Field, 2011. ...
... La depresión antenatal se relaciona con un pobre autocuidado materno, una nutrición inadecuada, parto prematuro, anormalidades placentarias, con resultados obstétricos adversos como bajo peso al nacer, morbilidad y mortalidad tanto para la madre como para el feto [11][12][13] . No tratarla tiene repercusiones adversas a corto y largo plazos, ésta afecta la funcionalidad de la madre, su capacidad para obtener atención prenatal y evitar comportamientos no saludables, factores que a su vez pueden complicar el embarazo 3 . ...
... No tratarla tiene repercusiones adversas a corto y largo plazos, ésta afecta la funcionalidad de la madre, su capacidad para obtener atención prenatal y evitar comportamientos no saludables, factores que a su vez pueden complicar el embarazo 3 . La depresión antenatal, cuando se prolonga al periodo puerperal, implica una menor posibilidad para responder a las necesidades fisiológicas y afectivas del hijo, interacciones maternoinfantiles desadaptadas que pueden tener como consecuencia el maltrato o negligencia, asi como un pobre desarrollo cognitivo 13,14 . ...
... Para el feto, la depresión materna incrementa el ritmo cardiaco y la reactividad fisiológica, al tiempo que el crecimiento es menor; una vez nacido, se ha encontrado que su afecto es mayormente negativo y este afecto puede perdurar a lo largo de la infancia; el desarrollo mental, motor y emocional de los niños con madres deprimidas durante el embarazo es también menor en comparación con niños con madres sin depresión antenatal; esta anomalía materna logra, en el largo plazo, afectar la estabilidad emocional en los años de la infancia 13,15 . ...
... Detrimental consequences are wide-ranging, with associated impacts encompassing poor maternal self-care (Stewart, 2011), obstetric and birthing complications (Chung, Lau, Yip, Chiu, & Lee, 2001;Grote et al., 2010), reduced maternal-infant bonding (Hayes, Goodman, & Carlson, 2013), and postnatal depression (Milgrom, Gemmill, Bilszta, Hayes, Barnett, Brooks, Ericksen, Ellwood, & Buist, 2008). Affected offspring in addition display disrupted physiological, social and emotional development (Deave, Heron, Evans, & Emond, 2008;Diego et al., 2004;Field et al., 2006), as well as a life-long propensity to mental health vulnerability (Epstein et al, 2014;Pawlby, Hay, Sharp, Waters, & O'Keane, 2009). Conventional therapeutic approaches for the management of symptoms include psychotherapies for mild to moderate cases, and psychotherapy combined with psychotropic medication for moderate to severe depression (Austin, Highet, & Group, 2017). ...
... Behavioural consequences also described encompass externalising behaviours, such as attention deficit hyperactivity disorder (ADHD) (Field, 2011), to anti-social (Field, 2011;Stein et al., 2014 ), and criminal activities (Mäki et al., 2003). With respect to developmental milestones, language, cognition (Epstein et al., 2014), motor (Field, Diego, & Hernandez-Reif, 2006;Goodman, Rouse, Long, Ji, & Brand, 2011;Hanley & Oberlander, 2014), emotional and social functioning (Field et al., 2006;Stein et al., 2014) are reportedly all disrupted, with overall developmental delays (Deave, Heron, Evans, & Emond, 2008;Field, 2011) in the order of 9% (Deave et al., 2008) being seen. ...
... Behavioural consequences also described encompass externalising behaviours, such as attention deficit hyperactivity disorder (ADHD) (Field, 2011), to anti-social (Field, 2011;Stein et al., 2014 ), and criminal activities (Mäki et al., 2003). With respect to developmental milestones, language, cognition (Epstein et al., 2014), motor (Field, Diego, & Hernandez-Reif, 2006;Goodman, Rouse, Long, Ji, & Brand, 2011;Hanley & Oberlander, 2014), emotional and social functioning (Field et al., 2006;Stein et al., 2014) are reportedly all disrupted, with overall developmental delays (Deave, Heron, Evans, & Emond, 2008;Field, 2011) in the order of 9% (Deave et al., 2008) being seen. ...
Thesis
A mixed-methods study evaluating the effects of acupuncture as an adjunct intervention for antenatal depression.
... There are many studies [10,14,21,23,33,35,49] on the relationship between prenatal depression and childbirth. Most of these studies are statistic-based, for example, they use standard mathematical tools like v 2 test, independent t-test, Mann-Whitney etc., to calculate the persistence between prenatal depression symptoms and birth [10,35]. ...
... With this measurement, statistical-based studies [14,23,49] revealed that there exists a close relationship between prenatal depression and abnormal births (such as premature birth, birth defects and etc.). Following the same trend, researchers [10,21] dig deeper and use the prenatal depression symptoms of pregnant women to predict the delivery of pregnant women. ...
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Obstetric studies had long revealed that the human female mental state, although subjective, has a nonlinear relation to the gestation, which could eventually leads to eugenics characteristics. Due to the difference of regions, there are differences between the data, people want to analyze the correlation between the survey data of different regions. Traditional obstetric studies explore health information on understanding and predicting this psychological state. However, most traditional research is based on statistical methods that exploring the correlation between numbers. This type of method lacks an understanding of the natural semantics of obstetric data, so it is prone to problems such as deviation or missing data (such as missing geospatial information) in data analysis. To tackle this problem, we study the use of a generic graph representation on gynecology and obstetric surveys with geospatial features, and propose a bipartite approach, or Geo-SPS, to mine the semantic relationship between low quality health information data. Our solution highlights our unconventional adaptation of novel graph theory from computational physics into biomedical ontology, that carefully maps semantic objects into a bipartite graph. With this tool, Geo-SPS provides a unique approach to semantic similarity metrics. The method supports fast and understandable processing of mixed textual data under different geographic spaces in a graph convolutional neural network. We further evaluate and validate the feasibility of Geo-SPS using a case study on obstetric surveys and health information data from over 3000 pregnant women in three different places from China. Results show that Geo-SPS can effectively represent prenatal mental state from this mixed data set, with an accurate classification on birth defects.
... Weight-for-Height Weight-for-Age Z-Score Z-Score Z-Score which also emphasize the health threat induced by the last two trimester exposure to negative shocks [40][41][42][43]. ...
... Our study adds to this literature by exploiting drought as an adverse in-utero shock to evaluate the persistent effects of prenatal conditions. Furthermore, our findings are in accordance with studies emphasizing the importance of second and third trimester exposure to child outcomes [40][41][42]. ...
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This paper investigates the extent to which in-utero exposure to droughts influences the health outcomes of Bangladeshi children in early childhood. Exploiting the plausibly exogenous deviations of rainfall from the location-specific norms, we find that deficient rainfall during the prenatal period is harmful to child health. Specifically, in-utero exposure to droughts decreases the height-for-age, weight-for-height, and weight-for-age z-scores by 0.10, 0.11, and 0.11 standard deviations among children under five years old, respectively. Our heterogeneity analyses reveal that the adverse health setbacks fall disproportionately on children of disadvantaged backgrounds. Exploring the differential effects by trimesters of exposure, we further show that experiencing droughts during the second and the third trimesters leaves injurious effects on early childhood health.
... It seems that the relationships between gestational alterations of a psychological and emotional nature (depression, changes in self-esteem, anxiety, stress, insecurity, etc.) and physiological parameters (longer deliveries and more instrumental labors, altered birth weights, etc.) have been scientifically confirmed (Field et al., 2006;Rahman et al., 2007;Grote et al., 2010). This negative association extends beyond the gestational period, causing postnatal complications for both mothers and offspring (Hammond and Crozier, 2007;Deave et al., 2008;Hay et al., 2010;Field, 2011). ...
... Drug treatment during pregnancy is difficult and often questioned due to the possible side effects of antidepressants in the mother and fetus (Hammond and Crozier, 2007). Depression is a difficult complication to control because it is necessary to implement an intervention that avoids the possible negative effects on the fetus and the mother, such as altered brain development (O'Connor et al., 2002;Lee et al., 2007), an increased risk of preterm birth or intrauterine growth restriction (Field et al., 2006;Li et al., 2009;Field, 2011). Notwithstanding the aforementioned difficulty, it is clear that it is necessary to establish strategies that prevent the already proven, dangerous, and increasing association between prenatal depression and postpartum depression, which is a more well-known type of depression that involves a series of related complications, such as mother-child bonding difficulties (Wisner et al., 2009), infant feeding difficulties and infant overweight problems (Ertel et al., 2010), low birth weight and long hospital stays. ...
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Background: Prenatal depression is associated with an increased risk of physical, physiological, cardiovascular, and psychological diseases for mothers and future newborns. Prenatal depression and depressive symptoms could have negative effects on the cognitive, emotional, social, and behavioral development of children. Objective: This study aimed to examine the influence of exercise during pregnancy on the prevalence of prenatal depression and depressive symptoms in the scientific literature. Data Sources: A search was carried out examining different online databases up to November 2020. Methods of Study Selection: A systematic review with random effects meta-analysis was performed. Only randomized controlled trials published in English or Spanish with pregnant populations and interventions with exercise programs carried out during pregnancy were included. The scores obtained by the tools that measured the emotional state and depressive symptoms as well as the number and percentage of depressed women of the study groups were analyzed. Tabulation, Integration, and Results: We analyzed 15 studies and found a negative association between moderate exercise during pregnancy and prenatal depression (ES = −0.36, 95% CI = −0.58, −13, I ² = 80.2%, P heterogeneity = 0.001). In addition, the studies also showed that women who were inactive during pregnancy had a 16% higher probability of suffering prenatal depression [RR = 0.84 (95% IC = 0.74, 0.96) I ² = 61.9%, P heterogeneity = 0.010]. Conclusion: Supervised exercise during pregnancy may be useful for the prevention and reduction of prenatal depression and depressive symptoms. Systematic Review Registration: Registered in PROSPERO (Registration No. CRD42020164819).
... Infant and youth relationships with the attachment figure have been associated with HPA axis functioning following maltreatment (Van Voorhees & Scarpa, 2004) and in response to acute stress (Gunnar, 2000;Nachmias, Gunnar, Mangelsdorf, Parritz, & Buss, 1996), which may influence onset of internalizing symptoms (Gunnar, 2000). Relatedly, parental psychopathology may influence a range of infant and youth outcomes, including physical growth, cognitive and emotional development, and alterations in physiological reactivity (Bush et al., 2020;Field, Diego, & Hernandez-Reif, 2006), immune system (Meyer, Yee, & Feldon, 2007;O'Donnell, O'Connor, & Glover, 2009), and brain function (Field et al., 2006;Field, Fox, Pickens, & Nawrocki, 1995;Lin et al., 2017;Pine, 2007;Posner et al., 2016;Rifkin-Graboi et al., 2013), which may subsequently increase internalizing risk as the child ages. These data also extend to the prenatal periodwhen the mother is distressed, the placenta releases corticotropinreleasing hormone, which may exacerbate effects of stress for the mother (King, Smith, & Nicholson, 2001;Weinstock, 2001) and the fetus to affect fetal development (Girard & Sebire, 2016). ...
... Infant and youth relationships with the attachment figure have been associated with HPA axis functioning following maltreatment (Van Voorhees & Scarpa, 2004) and in response to acute stress (Gunnar, 2000;Nachmias, Gunnar, Mangelsdorf, Parritz, & Buss, 1996), which may influence onset of internalizing symptoms (Gunnar, 2000). Relatedly, parental psychopathology may influence a range of infant and youth outcomes, including physical growth, cognitive and emotional development, and alterations in physiological reactivity (Bush et al., 2020;Field, Diego, & Hernandez-Reif, 2006), immune system (Meyer, Yee, & Feldon, 2007;O'Donnell, O'Connor, & Glover, 2009), and brain function (Field et al., 2006;Field, Fox, Pickens, & Nawrocki, 1995;Lin et al., 2017;Pine, 2007;Posner et al., 2016;Rifkin-Graboi et al., 2013), which may subsequently increase internalizing risk as the child ages. These data also extend to the prenatal periodwhen the mother is distressed, the placenta releases corticotropinreleasing hormone, which may exacerbate effects of stress for the mother (King, Smith, & Nicholson, 2001;Weinstock, 2001) and the fetus to affect fetal development (Girard & Sebire, 2016). ...
Article
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In the last decade, an abundance of research has utilized the National Institute of Mental Health (NIMH) research domain criteria (RDoC) framework to examine mechanisms underlying anxiety and depression in youth. However, relatively little work has examined how these mechanistic intrapersonal processes intersect with context during childhood and adolescence. The current paper covers reviews and meta-analyses that have linked RDoC-relevant constructs to ecological systems in internalizing problems in youth. Specifically, cognitive, biological, and affective factors within the RDoC framework were examined. Based on these reviews and some of the original empirical research they cover, we highlight the integral role of ecological factors to the RDoC framework in predicting onset and maintenance of internalizing problems in youth. Specific recommendations are provided for researchers using the RDoC framework to inform future research integrating ecological systems and development. We advocate for future research and research funding to focus on better integration of the environment and development into the RDoC framework.
... Perinatal anxiety, mania, and psychosis further increase the prevalence and burden. The myriad consequences of undertreated perinatal mental illness are well documented, including impaired fetal development, impaired maternal-fetal bonding, and difficulties for offspring later in life (Bansil et al. 2010;Field et al. 2006;Beebe et al. 2008;Glover et al. 2010;Murray et al. 2003). Perinatal illness also has the potential to be associated with mortality; suicides account for 1 in 5 perinatal deaths (Lindahl et al. 2005), and postpartum psychosis is associated with up to a 4.5% risk of infanticide (Brockington 2017). ...
Article
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In this review, we aim to summarize research findings and marketplace apps for women with perinatal mood disorders with the goal of informing clinicians and patients about current risks and benefits, as well as proposing clinical implementation advice and a harmonized agenda for both academic and industry advancement in this space. Multiple searches were run of academic databases in 2018–2020, examining literature on mobile apps for peripartum mental health. Multiple searches were also run of the iOS and Android app stores in 2019 and 2020, looking at apps for peripartum mental health. Results were compared within the academic dataset as well within the commercial app dataset; the two datasets were also examined for overlap. The academic search results were notable for small sample sizes and heterogeneous endpoints. The app store search results were notable for apps of generally poor quality (as assessed by a modified Silberg scale). Very few of the mHealth interventions studied in the academic literature were available in the app store; very few of the apps from the commercial stores were supported by academic literature. The disconnect between academically developed apps and commercially available apps highlights the need for better collaboration between academia and industry. More collaboration between the two approaches may benefit both app developers and patients in this demographic moving forwards. Additionally, we present a set of practice guidelines for mHealth in perinatal psychiatry based on the trends identified in this review.
... Field et al. (26) reported that depressed mother-infant dyads expressed less positive emotions and spent more time in negative behavioural states. A meta-analysis by Goodman et al. (27) also found an association with negative child affectivity and maternal depression. ...
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Background: Infants in lower middle income countries are often exposed to early adversities which may lead to suboptimal caregiving environments and place them at risk of not achieving their developmental potential. Synchrony and positive engagement in the mother-infant relationship plays a critical role in buffering the impact of early adversity. Shared Pleasure (SP) is considered a marker of high intensity positive interaction and may hold a promise of improving developmental outcomes.Methods: This study was part of a prospective observational study of mothers with and without mental illness in South Africa. Dyadic videos were assessed for SP and infant withdrawal (using the Alarm Distress Baby Scale) at 6 months. Infant developmental outcomes were assessed using the Bayley's Scales for Infant and Toddler Development, third edition at 18 months.Results: Ninety-one dyads were assessed for SP. The occurrence of SP was low (20%). There was no significant association with an EPDS measure of maternal depression (p = 0.571) and SP moments. Infant withdrawal was high (72%) and associated with male infant gender (p = 0.025). There was a significant association between the occurrence of SP and a lower score of infant withdrawal (estimate = −1.29; SE = 0.4; p = 0.0002). The number of SP moments at 6 months was significantly associated with motor (estimate = 2.4; SE = 0.9; p = 0.007) and marginally significant with cognitive scores (estimate = 1.9; SE = 1.0; p = 0.052) at 18 months. Regression modelling differential outcomes showed a greater improvement in cognitive scores at 18 months in infants with an SP moment compared to those without an SP moment [SP average difference (AD) = 7.4 (2.4), no SP AD = 10.4 (1.2); p = 0.012]. Infants without an SP moment experienced a larger decrease in motor scores at 18 months compared to those with an SP moment [SP AD = −3 (3.0); no SP AD = −10.6 (1.5), p = 0.027].Conclusion: While the occurrence of SP in this sample was low and the rates of infant withdrawal were high, there were promising results suggesting early positive SP interactions may contribute to improvements in subsequent developmental outcomes.
... This is important given that approximately 40% of mothers of children with ADHD have a history of major depression, making them 2-3 times more likely to be depressed than women in the general population (Chronis-Tuscano et al., 2003;Kessler et al., 2006). Furthermore, prenatal depression is consistently linked to shorter gestation and lower birth weight, which are both common risk factors of ADHD (Field et al., 2006;Field, 2011). The available literature suggests that maternal depressive symptoms during pregnancy can negatively shape the offspring's attention system and increase the risk of comorbidity in those children who already have a diagnosis of ADHD (Chronis-Tuscano et al., 2010;Van Batenburg Eddes et al., 2013). ...
Article
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Background : Few studies have explored the complex gene-by-prenatal environment-by-early postnatal environment interactions that underlie the development of attentional competence. Here, we examined if variation in dopamine-related genes interacts with prenatal adversity to influence toddler attentional competence and whether this influence is buffered by early positive maternal behavior. Methods : From the Maternal Adversity, Vulnerability and Neurodevelopment cohort, 134 participants (197 when imputing missing data) had information on prenatal adversity (prenatal stressful life events, prenatal maternal depressive symptoms, and birth weight), five dopamine-related genes ( DAT1, DRD4, DRD2, COMT, BDNF ), observed maternal parenting behavior at 6 months and parent-rated toddler attentional competence at 18 and 24 months. The Latent Environmental and Genetic Interaction (LEGIT) approach was used to examine genes-by-prenatal environment-by-postnatal environment interactions while controlling for sociodemographic factors and postnatal depression. Results : Our hypothesis of a three-way interaction between prenatal adversity, dopamine-related genes, and early maternal parenting behavior was not confirmed. However, consistent two-way interactions emerged between prenatal adversity and dopamine-related genes; prenatal adversity and maternal parenting behavior, and dopamine-related genes and maternal parenting behavior in relation to toddler attentional competence. Significant interaction effects were driven by the DAT1, COMT , and BDNF genotypes; prenatal stressful life events; maternal sensitivity, tactile stimulation, vocalization, and infant-related activities. Conclusions : Multiple dopamine-related genes affected toddler attentional competence and they did so in interaction with prenatal adversity and the early rearing environment, separately. Effects were already visible in young children. Several aspects of early maternal parenting have been identified as potential targets for intervention.
... Low infant PE predicts behavioral inhibition in early childhood (23), and by middle childhood, low PE is associated with later depression (24)(25)(26)(27)(28)(29) and externalizing behavior problems (30). Mood disorders and emotional instability in caregivers impact NE development in infants (31)(32)(33)(34)(35) and may disrupt emotional regulation development (36)(37)(38)(39)(40). Similarly, low caregiver positive affect (41)(42)(43) and high negative affect and emotional instability (44)(45)(46) are associated with lower infant PE, primarily smiling and laughter. ...
... Low psychological wellbeing and prenatal maternal stress are associated with numerous adverse outcomes, such as fetal growth restriction, LBW and increased risk for preterm delivery (Alder et al., 2007;Lopez Bernal, 2007). Some studies have also shown that maternal stress and anxiety may be associated with increased arterial blood pressure and pre-eclampsia as well as decreased uterine blood flow (Field et al., 2006;Hern andez-Valencia et al., 2007). In addition, women with high anxiety, stress or depressive symptoms during pregnancy are more likely to experience mood disorders in the post-partum period, which carries negative consequences on infant development (Schetter & Tanner, 2012). ...
Article
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Although a number of international diet and lifestyle guidelines during pregnancy (DLGP) exist in the literature, contextualization to low‐ and middle‐income settings is less common. The aim of this study was to present the Lebanese DLGP and to describe the process followed for their development. A mixed‐method approach was used including a review and synthesis of existing international DLGP and a consensus building nominal group technique (NGT) with a multidisciplinary group of experts (n = 11). During the meeting, participants identified the themes of the guidelines, formulated the wording of each themes' guideline and translated the guidelines to the Arabic language. Consensus was defined as an agreement of 80%. Reviewing the literature, a list of 17 main topics were found to be common themes for the DLGP. For the Lebanese DLGP, participants in the NGT meeting selected seven themes from this list: gestational weight gain, diet diversity, hydration, food safety, harmful foods, physical activity and breastfeeding. In addition, the group formulated three themes based on merging/modifying existing themes: supplementation, alcohol and smoking and religious fasting. Two context‐specific new themes emerged: wellbeing and nutrition resilience. For each of the identified themes, the group agreed upon the wording of its guidelines and description. This study is the first from the Eastern Mediterranean Region to develop through consensus building, context and culture‐specific dietary and lifestyle guidelines for pregnant women. Putting maternal nutrition at the heart of tackling malnutrition and its detrimental health outcomes is a core investment for a better maternal and child health.
... Moksliniai tyrimai atskleidė, kad nėščiųjų emocijos, patirtas stresas ir įvairios nėštumo bei gimdymo problemos turi tiesioginį priežastinį tarpusavio ryšį (Field, Diego, Hernandez-Reif, 2006). Ir nors tokia informacija visuomenei nėra paslaptis, tačiau, pasak Lietuvos tyrėjų Rūtos Baltrušaitytės, Ingos Drupienės ir Lino Rovo (Baltrušaitytė, Drupienė, Rovas, 2011, p. 100-106), 66,3 proc. ...
... Studies from south Africa indicates that maternal depression in postnatal period can also adversely affect the infant growth and failure to thrive [27][28]. Recent studies also identified that elevated foetal activity, LBW and prematurity as common consequences of prenatal maternal depression [29]. All these researches suggest that the antenatal and postnatal psychological distress in mother can adversely affect the multiple aspects of child development. ...
Article
The science of Ayurveda strongly states that the mental status of the mother has a strong influence on foetal health. This does not start from the time of conception. Instead from the time of development of the ovum itself all the mental conditions of the mother start affecting the foetal health. In this busy urban life mental health of the mother is given less importance. Most of the women, including pregnant ladies are under stress in present scenario. Hence awareness regarding the impact of the mental status of the mother on the fetus may help the society to prevent the ill effects of maternal stress on the fetus.
... Hayes et al. showed that nonacceptance of emotions leads to a avoidance pattern. Avoidance is generally considered to be a maladaptive emotional strategy that reduces negative emotions in the short run but leads to the development and persistence of anxiety disorders in the long run [18]. Sue et al. also showed that avoidance and lack of emotional clarity are associated with symptoms of depression and anxiety [19]. ...
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Background: Emotion regulation is an important meta-diagnosis construct and one of the common core and underlying dimensions of emotional disorders. Emotion regulation models are divided into two general categories of interpersonal and interpersonal models. Purpose: This study aimed to compare interpersonal and intrapersonal models of emotion regulation in predicting depression and anxiety syndromes in Tehran universities students. Method and material: The method of this study was cross-sectional. The statistical population of this study was all students of public universities in Tehran. Sampling was done using multi-stage cluster and the subjects were evaluated using Emotion Regulation Strategies Questionnaire, Interpersonal Emotion Regulation Questionnaire, Short Difficulty in Emotion Regulation Questionnaire and SCL-25 Questionnaire. Results: Findings showed that intrapersonal and interpersonal emotion regulation strategies have a significant role in explaining depression and anxiety syndrome. Between the two interpersonal and interpersonal emotion regulation models, the interpersonal emotion regulation model had a stronger and more significant effect on prediction of depression and anxiety syndrome (P <0.01). Conclusion: Both intrapersonal and interpersonal emotion regulation models have role in explanation of depression and anxiety syndromes and can be effective in predicting and treating emotional disorders.
... Our analyses indicate that parental distress is related to mild and moderate stunting, but not severe stunting. A previous study suggested that maternal stress and/or depression may affect disturbance of the hypothalamic-pituitary-adrenal (HPA) axis thereby exerting physiological effects during intrauterine growth [42]. This mechanism affects fetal weight which is mediated by prenatal cortisol and norepinephrine levels. ...
Article
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Background: Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting. Methods: We used data from the Indonesia National Health Survey 2013, including 46,315 children 6-59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire (SRQ20), with height-for-age z score (HAZ), stunting, and behavioral and other risk factors for stunting. Results: Maternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.086 (95% CI -0.17, -0.00), 0.11 (95% CI -0.24, -0.02) and 0.19 (95% CI -0.37, -0.00) HAZ-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ <-1) by 33% (95% CI 1.17,1.50) and 37% (95% CI 1.18,1.60), and the risk of moderate stunting (HAZ <-2) by 25% (95% CI 1.10,1.43) and 28% (95% CI 1.08,1.51]), respectively. Parental stress increased the risk of moderate stunting by 40% (95% CI 1.06,1.85). Amongst specific groups of risk factors, the proportion of HAZ-score lost was associated with socioeconomic factors (30.3%) including, low wealth, low maternal occupational status, low maternal education, rural residence, and low paternal occupational status; physiological factors (15.5%) including low maternal height, low maternal mid-upper arm circumference, being male, low paternal height; behavioral factors (8.9%) including open garbage disposal, paternal smoking, not using iodized salt; and experiencing at least one infectious diseases episode (1.1%). Conclusions: Maternal, paternal and parental stress were associated with reduced linear growth of children. These findings highlight the complex etiology of stunting and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents must be pursued as part of a comprehensive strategy to enhance child growth and development, i.e. improved caretaker capacity, integrated community development, improved parenting skills, as well as reduced gender discrimination, and domestic violence.
... Stunted offspring observed by survey respondents may be due to the same pathophysiological processes that are suspected to contribute to premature births in humans [16]. These may include the cytotoxic effects of inhalation of oxygen-free radicals [78], or the disruption of fetal-maternal circulation [79], which have been shown to result in low birth weights and other poor birth outcomes [80]. A recent study reported miscarriage in Rhesus macaques naturally exposed to wildfire smoke, further supporting the need to expand research of these reproductive impacts of smoke on animals [54]. ...
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Wildfires are increasing in frequency and severity across the Western United States. However, there is limited information available on the impacts these fires are having on the livelihood of livestock producers and their animals. This work presents the results of a survey evaluating the direct and indirect impacts of the 2020 wildfire season on beef cattle, dairy cattle, sheep, and goat, producers in California, Oregon, and Nevada. Seventy completed surveys were collected between May and July 2021. While dairy producers reported no direct impacts from the fires, beef, sheep, and goat producers were impacted by evacuations and pasture lost to fires. Only beef producers reported losses due to burns and burn-associated deaths or euthanasia. Dairy, beef, sheep, and goat producers observed reduced conception, poor weight gain, and drops in milk production. All but dairy producers also observed pneumonia. Lower birthweights, increased abortion rates, and unexplained deaths were reported in beef cattle, sheep, and goats. This work documents the wide-ranging impacts of wildfires on livestock producers and highlights the need for additional work defining the health impacts of fire and smoke exposure in livestock, as well as the policy changes needed to support producers experiencing direct and indirect losses.
... Children of mothers with mental health issues are also two to three times more likely to develop adjustment problems than children of mothers without mental health issues (8). Even as infants, children of depressed mothers are fussier, less responsive to facial and vocal expressions, more inactive, and have elevated levels of stress hormones compared to infants whose mothers are not depressed (9,10). Literature has also shown that poor mental health is associated with a lack of engaged parenting (7,11,12), which may explain why perinatal mental health disorders in caregivers are often associated with developmental delays among infants and young children (11,13,14). ...
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Background: Perinatal mental health is important for the well-being of the mother and child, so the relatively high prevalence of perinatal mental health problems in developing settings poses a pressing concern. However, most studies in these settings focus on the demographic factors associated with mental health problems, with very few examing social factors. Hence, this study examines the prevalence of the depressive, anxiety and stress symptoms among pregnant women and new mothers in rural China, and the associations between these mental health problems and social factors, including decision-making power, family conflicts, and social support. Methods: Cross-sectional data were collected from 1,027 women in their second trimester of pregnancy to 6 months postpartum in four low-income rural counties in Sichuan Province, China. Women were surveyed on symptoms of mental health problems using the Depression, Anxiety, and Stress Scale (DASS-21) and social risk factors. Multivariate logistic regression analyses were conducted to examine social risk factors associated with maternal mental health problems, with results reported as odds ratios (OR) and 95% confidence intervals (CI). Results: Among all respondents, 13% showed symptoms of depression, 18% showed symptoms of anxiety, 9% showed symptoms of stress, and 23% showed symptoms of any mental health problem. Decision-making power was negatively associated with showing symptoms of depression (OR = 0.71, CI: 0.60–0.83, p < 0.001) and stress (OR = 0.76, CI: 0.63–0.90, p = 0.002). Family conflict was positively associated with depression (OR = 1.53, CI: 1.30–1.81, p < 0.001), anxiety (OR = 1.34, CI: 1.15–1.56, p < 0.001), and stress (OR = 1.68, CI: 1.41–2.00, p < 0.001). In addition, social support was negatively associated with depression (OR = 0.56, CI: 0.46–0.69, p < 0.001), anxiety (OR = 0.76, CI: 0.63–0.91, p = 0.002), and stress (OR = 0.66, CI: 0.53–0.84, p < 0.001). Subgroup analyses revealed that more social risk factors were associated with symptoms of anxiety and stress among new mothers compared to pregnant women. Conclusion: Perinatal mental health problems are relatively prevalent among rural women in China and are strongly associated with social risk factors. Policies and programs should therefore promote individual coping methods, as well as target family and community members to improve the social conditions contributing to mental health problems among rural women.
... We also know that maternal depression negatively affects her quality of life, her relationship with her child, and the development of infants (38,39). Depressed mothers appear to have less positive and more negative interactions with their babies (40), and are more likely to have children with difficult temperaments (41). Also, women with poorer mental health report more infant night awakenings and bed-time distress, and appear more bothered by these behaviors (15,42). ...
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Introduction: Infant sleep difficulties are often a challenge for new parents and may be related to maternal mood. Aim: The aim of this study was to investigate whether the presence of reported infant sleep difficulties at the 6th week and at the 12th month postpartum is associated with maternal psychological well-being and the presence of a mental health disorder in the perinatal period or with other perinatal factors. Methods: It is a retrospective longitudinal study, examining a sample of 622 women who attended a 12-month innovative psychosocial intervention. Data were obtained through the EPDS and PHQ-9 psychometric tools, and the completion of a health history. Statistical analyses included Spearman rank correlation coefficients and Chi-square tests. Results: Reported infant sleep difficulties at the 6th week postpartum were associated with a) increased maternal scores on psychometric tools (EPDS and PHQ-9) during pregnancy and at the 6th week postpartum, b) the presence of pathological maternal mental health symptoms in the perinatal period (p =.034), c) high maternal educational level (p <.001), and d) reported maternal breastfeeding difficulties at the 6th week postpartum (p =.031). Reported infant sleep difficulties at the 12th month postpartum were associated with a) increased maternal scores on the EPDS at the 6th week after birth (p =.030), and at the 6th (p =.031) and the 12th month (p =.006) postpartum, b) reported infant sleep difficulties (p <.001) and frequent infant awakenings in the puperperium (p <.001), d) maternal fatigue at the 6th week postpartum (p <.001), e) infant gastro-esophageal reflux problems (p <.001), and f) high maternal educational level (p =.001). Conclusions: This study demonstrates a positive relationship between infant sleep difficulties at the 6th week and at the 12th months postpartum, with poor maternal mental health in the perinatal period.
... A genetically transmitted risk from fathers to the children may also explain some of the association between fathers' prenatal psychological distress and children's increase in hitting [26]. Further, psychological distress in expecting fathers may have an impact on the mental health of their pregnant partners, and therefore indirectly have negative effect on children's outcomes through an impact on the mothers [27]. This is in accordance with the review by Tremblay et al. [3] stating that there are interrelated biopsychosocial 'channels' involved in the development of physical aggressive behaviour. ...
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The aim of the study was to examine the association between fathers’ prenatal psychological distress and children’s aggressive behaviour in terms of hitting others, and how children’s age, gender and temperament affect this association. The study is based on data from 20,155 fathers and mothers from the Norwegian Mother, Father and Child Cohort Study (MoBa). Fathers and mothers completed questionnaires at 17 or 18 weeks of gestation and mothers at children’s age 18 months, and 3 and 5 years. Fathers’ prenatal psychological distress was assessed by the 5-item Symptom Checklist (SCL-5), and children’s temperament by 12 items from the Emotionality Activity Sociability (EAS) Temperament Survey. Increasing prenatal psychological distress in fathers was associated with an increase of hitting from 18 months to 3 years of age in boys. Children’s temperament did not affect the association between fathers’ prenatal psychological distress and children’s aggressive behaviour.
... The present study demonstrates that the right frontal asymmetry in EEG patterns remains dominant in infants whose mothers are depressed but only for those who are bottle-fed as early as 3 months of age. The plasticity of the infant brain is, we expect, vulnerable to environmental interactions and appears to be negatively affected by the presence of maternal depression [100] and the lack of stable breastfeeding patterns and more optimally affected in I-BFD toward more left frontal EEG, like their nondepressed peers. ...
Article
Background: While numerous studies have demonstrated maternal depression's influence on infant brain development, few studies have examined the changes that occur as a consequence of co-occurring experiential factors that affect quality of mother and infant affectionate touch as well as infant temperament and neurophysiological systems. The aim of the study was to examine the interactive effects of maternal depression and breastfeeding on mother and infant affectionate touch and infant temperament and cortical maturation patterns across early development. Methods: 113 mothers and their infants participated when infants were 1 and 3 months of age. Questionnaires to assess maternal depressive symptoms, feeding, and temperament were completed. Tonic EEG patterns (asymmetry and left and right activity) were collected and the dyads were video-recorded during feeding to assess mother and infant affectionate touch patterns. Results: Data analysis showed that EEG activity and mother-infant affectionate touch differed as a function of mood and feeding method. Notably, only infants of depressed mothers that bottle-fed showed right frontal EEG asymmetry and attenuated change in the left frontal region across 3 months. Breastfeeding positively impacted affectionate touch behaviors and was associated with increased left and decreased right frontal EEG activation even for depressed groups. Furthermore, a model incorporating physiology, maternal depression, touch, temperament, and feeding indicated significant prediction for infant affectionate touch (with breastfeeding and affectively positive temperament demonstrating the strongest prediction). Con-clusion: The findings suggest that breastfeeding and the infant's positive temperament influence mother-infant affectionate touch patterns and result in neuroprotective outcomes for infants, even those exposed to maternal depression within early development.
... Prospective studies show that if a pregnant woman is depressed, anxious, or stressed during pregnancy, the baby is more likely to experience a number of adverse neurodevelopmental outcomes, including an increased risk of emotional, behavioral, and cognitive problems [13]. Pregnancy-specific stress has been associated with an increased risk of miscarriage, premature birth, low birth weight, and cesarean delivery [4,[14][15][16][17][18]. ...
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Pregnancy is characterized by changes in neuroendocrine, cardiovascular, and immune function. For this reason, pregnancy itself is perceived as a psychological “stress test”. Research to date has focused on stress exposure. The aim of the study was to evaluate the influence of associated factors on the level of stress experienced by pregnant patients. We conducted a prospective study that included 215 pregnant women in the third trimester of pregnancy, hospitalized in the Obstetrics and Gynecology Clinic II in Târgu-Mureș, between December 2019 and December 2021, who were evaluated by the ABS II scale. All patients included in the study filled in a questionnaire that included 76 questions/items, in which all the data necessary for the study were recorded. The results obtained from the study showed that pregnant women in urban areas (53.49%) are more vulnerable than those in rural areas (46.51%), being influenced by social and professional stressors, social determinants playing a critical role in pregnancy and in the newborn. Patients who have had an imminent abortion in their current pregnancy have a significantly higher score of irrationality than those with normal pregnancy, which shows that their emotional state can negatively influence the phenomenon of irrationality. There is a statistically significant association between pregnancy type I (normal pregnancy or imminent pregnancy) and irrationality class (p = 0.0001; RR: 2.150, CI (95%): 1.154–4.007). In the case of women with desired pregnancies, the risk of developing irrationality class IV–V is 4.739 times higher, with the association being statistically significant (p < 0.0001; RR 4.739; CI (95%): 2.144–10.476). The analysis of the obtained results demonstrates the importance of contributing factors and identifies the possibility of stress disorders, occurring in the last trimester of pregnancy, disorders that can have direct effects on maternal and fetal health. We consider it extremely important to carry out evaluations throughout the pregnancy. At the same time, it is necessary to introduce a screening program to provide psychological counseling in the prenatal care of expectant mothers.
... A lack of quality antidepressant safety data during pregnancy poses a complex clinical challenge for obstetrical providers. While conclusive data is not available to support the absolute safety of antidepressant medication during pregnancy [37], untreated maternal depression/anxiety has serious known consequences, including substance use [38][39][40]. ...
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Purpose of review To provide a narrative summary of the epidemiology of prenatal cannabis use, the known reasons for use, the effects of in utero cannabis exposure on offspring neurodevelopment and impact on mother-infant attachment. Recent findings Compelling evidence from human imaging studies suggest that in utero cannabis exposure disrupts early brain development and has long-term behavioral consequences for the offspring. Maternal postpartum cannabis use may diminish the maternal-infant bonding process and quality of caregiving. Summary The combination of increasing trends in prenatal cannabis use, low perceived risk, and increasing potency pose a serious challenge for the clinical and public health communities. Additional research is needed to understand the consequences of in utero exposure as well as postnatal maternal impacts that diminish the quality of caregiving. Most importantly, clinical cessation programs are needed to support women who enter pregnancy with cannabis dependency.
... With the pregnancy and the birth of a child, mothers face important physiological, psychological, and social challenges and, for some, these periods may entail substantial emotional pain and distress (Staneva et al., 2015). Depression affects 7-25% of women during the antenatal period (Gavin et al., 2005;Field et al., 2006;Dubber et al., 2015;Staneva et al., 2015), and 11-20% of women during the postpartum period, making postpartum depression (PPD) the most prevalent clinical condition after childbirth and an important public health problem (de Tychey et al., 2005). Also, it is estimated that 30-50% of cases will last 6 months or more and 25% of mothers will continue to be depressed 1 year later (National Institute for Health and Care Excellence, 2003). ...
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Introduction History of depression symptoms, including before and during pregnancy, has been identified as an important risk factor for postpartum depression (PPD) symptoms. This condition has also been associated with diverse implications, namely, on the quality of mother–infant bonding. Moreover, the role of self-criticism on PPD has been recently found in several studies. However, the link between these factors has not been explored yet. Furthermore, anxiety symptoms in postpartum has been less studied. Methods This study analyzed whether the history of depression symptoms predicted mother–infant bonding, via self-criticism and PPD symptoms. The same model was repeated with a history of anxiety and postpartum anxiety symptoms. A total of 550 mothers of infants <24 months old participated in this cross-sectional study and answered an online survey. Results Through a parallel–serial mediation model, the results show that in a first step, self-criticism dimensions of inadequate-self, hated-self, and reassuring-self, and in a second step, PPD symptoms, mediate the relationship between the history of depression symptoms and mother–infant bonding. However, the relationship between the history of anxiety symptoms and bonding is not mediated by all the considered chain of mediators, being only mediated by one of the self-criticism dimensions, inadequate self. Conclusions The current study confirmed the association of history of both depression and anxiety with mother–infant bonding. While in the case of history of anxiety symptoms, the relation was only mediated by inadequate self-dimension of self-criticism, in the case of history of depression symptoms, the relation was mediated by self-criticism and postpartum depressive symptoms. The buffering effect of reassuring-self on bonding and negative affect was also evidenced. Psychological and preventive interventions should address this evidence to target interventions for mother–infant bonding problems in accordance with previous and actual current maternal risk factors.
... PND is both emotionally and physically debilitating like major depression, with additional risks related to the pregnancy and birth, such as PTB, low birth weight, pre-eclampsia and placental abnormalities. [8][9][10] Moreover, it is associated with retained maternal weight postpartum, 11 decreased breast feeding, 12-14 poor maternal sleep 15 and poor perinatal quality of life. 16 PND can also compromise the critical mother-infant bond, as it affects the mother's caregiving abilities and adaptation to the maternal role, 16 17 and has a long-term impact on the child's cognitive, emotional and behavioural development. ...
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Introduction: Perinatal complications, such as perinatal depression and preterm birth, are major causes of morbidity and mortality for the mother and the child. Prediction of high risk can allow for early delivery of existing interventions for prevention. This ongoing study aims to use digital phenotyping data from the Mom2B smartphone application to develop models to predict women at high risk for mental and somatic complications. Methods and analysis: All Swedish-speaking women over 18 years, who are either pregnant or within 3 months postpartum are eligible to participate by downloading the Mom2B smartphone app. We aim to recruit at least 5000 participants with completed outcome measures. Throughout the pregnancy and within the first year postpartum, both active and passive data are collected via the app in an effort to establish a participant's digital phenotype. Active data collection consists of surveys related to participant background information, mental and physical health, lifestyle, and social circumstances, as well as voice recordings. Participants' general smartphone activity, geographical movement patterns, social media activity and cognitive patterns can be estimated through passive data collection from smartphone sensors and activity logs. The outcomes will be measured using surveys, such as the Edinburgh Postnatal Depression Scale, and through linkage to national registers, from where information on registered clinical diagnoses and received care, including prescribed medication, can be obtained. Advanced machine learning and deep learning techniques will be applied to these multimodal data in order to develop accurate algorithms for the prediction of perinatal depression and preterm birth. In this way, earlier intervention may be possible. Ethics and dissemination: Ethical approval has been obtained from the Swedish Ethical Review Authority (dnr: 2019/01170, with amendments), and the project fully fulfils the General Data Protection Regulation (GDPR) requirements. All participants provide consent to participate and can withdraw their participation at any time. Results from this project will be disseminated in international peer-reviewed journals and presented in relevant conferences.
... Perinatal depression is associated with adverse outcomes for the mother, her newborn, motherinfant relationship, and intimate partner relationship (Field et al., 2006;Jarde et al., 2016;Slomian et al., 2019;Zelkowitz & Milet, 2001). It is common, with overall pooled prevalence of 11.9% (95% CI 11.4-12.5) ...
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Purpose: To compare the characteristics of depression-related symptoms identified by individual EPDS items in women who screened positive and negative, and to describe the occurrence of thoughts of self-harm in these women. Methods: Based on a Chinese cohort of 1,112 women, scores on each EPDS item were analyzed at 7 time points from the first trimester to 6 weeks postpartum. Scores greater than 0 indicated the presence of symptoms, and higher scores indicated more severe symptoms. We defined the most frequent, serious and important symptoms for screening-positive and screening-negative groups as the item with the highest proportion of respondents scoring 1 or higher, highest proportion scoring 3, and highest average score, respectively. Results: In screened positive women the most frequent symptom was feeling sad or miserable, and the most serious and important symptoms were both sleeping problems. Among those screened negative, self-blame was the most frequent, serious and important item. For women who screened positive in the first trimester, only self-blame and feeling overwhelmed showed stability over time. Symptoms in women screened negative were relatively stable. Four in ten women who had self-harm thoughts were screened negative. Conclusion: Women who screened positive in EPDS differed from those screened negative in the characteristics in depressive symptoms. Intervention strategies focusing on the most frequent, serious and important symptoms (such as sadness and insomnia) may be worthwhile. Health practitioners should be trained to respond to a positive response to thoughts of self-harm, regardless of whether the women are screened positive or negative.
... Perinatal dönemde düzenli görüşmeler ile depresyon tanılanmalı ve tedavi edilmelidir(175). ACOG tüm gebelerin perinatal dönemde standardize edilmiş ölçüm araçları ile anksiyete ve depresyon belirtileri yönünden değerlendirilmesini önermektedir.Perinatal depresyon geçiren kadınlarda istenmeyen birtakım obstetrik komplikasyonlar meydana gelmektedir, örneğin; fetal gelişim geriliği, preterm eylem, DDA (Düşük Doğum Ağırlığı) ve yenidoğan yoğun bakım ünitesine kabülü gerektirecek durumlardır(177)(178)(179). Perinatal depresyon geçiren kadınlarda bedensel uyum ve kişisel bakım ile ilgili fonksiyonel bozukluklar meydana gelmektedir(180,181). Düşük ve orta gelirli ülkelerde antenatal depresyon ile ilişkili olarak perinatal komplikasyon riski artmaktadır(182)(183)(184). ...
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THE COMPARISON OF HEALTH PRACTICES IN PLANNED AND UNPLANNED PREGNANCIES ABSTRACT Aim: The aim of this study was compare health practices in planned and unplanned pregnancies. Materials and Methods: The study is descriptive. The research sample consist of a total of 230 pregnant women with planned and unplanned pregnancy. The data were collected using the Introductory Information Form, Health Practices Questionnaire-II (HPQ-II), and the BECK Depression Inventory Forms. Statistical analysis was done in SPSS-21 program. Student’s t test and Mann Whitney U tests were performed acording to normality analysis. In categorical data; Chi-square and Fisher Exact test were applied, Pearson’s correlation coefficients were calculated in continuous variables. Results: A statisitically significant difference was found between the socio-demographic characteristics of pregnant women in the group of planned pregnancies and unplanned pregnancies. In the study no statisticaly significant difference was found between the planned and unplanned pregnancies group pregnant health practices in pregnancy scale total score average (p=0,058). In the study, it was determined that the mean scores of health practices during pregnancies grop (127,10±12,03) were higher. No statistically significant difference was found between planned and unplanned pregnancies group between the BECK depression scale mean scores (p=0,425). When planned and unplanned pregnancies are evaluated separately, there is a negative correlation between BECK and HPQ-II scores (p=0.006, r=0.179). As the BECK score increases, the total scores of the HPQ-II scale decrease. Conclusion: The total scores of health practices during pregancy in pregnant women with planned pregnancy are higher than those with unplanned pregnancy. In maintaining maternal and fetal health; It is an important factor to determine the health practices of women during pregnancy starting from the preconceptional period, to plan pregnancies, to question negative health behaviors. Key Words: Depression, Health Practices During Pregnancy, Planned Pregnancy and Unplanned Pregnancy
... Increased levels of discomfort and multiple somatic complaints such as headache, nausea, stomach pain, shortness of breath, gastrointestinal problems, palpitations, dizziness, and sexual dysfunction, could also be manifestations of unrecognized depression often leading to unwarranted diagnostic procedures and medical interventions [18]. Global functional impairment, pre-eclampsia, increased risk of postnatal depression and ultimately poor pregnancy outcomes have all been associated with untreated maternal depression [19]. ...
... Previous literature also emphasises that these symptoms may have detrimental effects on the foetus and newborn. [3][4][5][6] There is substantial literature showing that exercise serves as a commendable solution to ease, if not totally eradicate, several health concerns during pregnancy. However, there are few studies about the amount and type of exercise appropriate for pregnant women. ...
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A structured exercise programme was designed that incorporates motion-based video games to decrease anxiety and depression among pregnant women. A pilot study determined its viability. Methods: A 2-group pre-post-test experiment was done on 16 pregnant women who met study criteria. Eight underwent the structured exercise programme twice a week for a month (intervention), and eight did not (control). The State Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS) were adapted and used to determine participants' anxiety and depression scores, respectively. Results: Significant improvement in the participants' mean anxiety 48.50 to 42.88 (p=0.029) and depression 11.50 to 7.63 (p=0.022) scores were found after the exercise programme. No changes were noted in the control group, HADS (p=0.196) and STAI (p=0.714) confirming the strength of the scores of the experimental group. Conclusion: The results suggest the exercise programme can be a valid approach to decrease anxiety and depression among pregnant women. We recommend replication of this study to other geographical areas with more samples to establish generalizability.
... It has been hypothesized that air pollutants such as those released during wildfire events have the potential to reach and cross the placental barrier, disrupting fetal-maternal circulation and directly impacting the growing fetus (Malley et al., 2017;Proietti et al., 2013;Siddiqui et al., 2008;Slama et al., 2008). Wildfire exposures during pregnancy have also been associated with increased rates of stress and depression (Belleville et al., 2019) that can potentially lead to poor birth outcomes such as preterm birth (PTB), fetal growth retardation, and low birth weight (Field et al., 2006). However, the exact physiological pathways between maternal wildfire exposure and adverse birth outcomes remain to be elucidated. ...
Article
Background: Maternal wildfire exposure (e.g., smoke, stress) has been associated with poor birth outcomes with effects potentially mediated through air pollution and psychosocial stress. Despite the recent hike in the intensity and frequency of wildfires in some regions of the world, a critical appraisal of the evidence on the association between maternal wildfire exposure and adverse birth outcomes has not yet been undertaken. We conducted a systematic review that evaluated the scientific evidence on the association between wildfire exposure during pregnancy and the risk of adverse birth outcomes. Methods: Comprehensive searches in nine bibliographic databases were conducted from database inception up to June 2020. Observational epidemiological studies that evaluated associations between exposure to wildfire during pregnancy and adverse birth outcomes were eligible for inclusion. Studies were assessed using the National Toxicology Program's Office of Health Assessment and Translation (NTP OHAT) risk of bias tool and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Screening of retrieved articles, data extraction, and risk of bias assessment were performed by two independent reviewers. Study results were synthesized descriptively. Results: Eight epidemiological studies conducted in four countries and involving 1,702,252 births were included in the review. The exposure to wildfire during pregnancy was assessed in individual studies by measurement of PM2.5 (n = 2), PM10 (n = 1), Total Ozone Mapping Spectrometer (TOMS)aerosol index (n = 1), heat spots (n = 1), and by proximity of maternal residence to wildfire-affected areas (n = 3). There is some evidence indicating that maternal wildfire exposure associates with birth weight reduction (n = 7) and preterm birth (n = 4), particularly when exposure to wildfire smoke occurred in late pregnancy. The association between wildfire exposure and small for gestational age (n = 2) and infant mortality (n = 1) was inconclusive. Conclusion: Current evidence suggests that maternal exposure to wildfire during late pregnancy is linked to reduced birth weight and preterm birth. Well-designed comprehensive studies are needed to better understand the perinatal effects of wildfires.
Chapter
During the transitional age period between adolescence and adulthood, youth are engaged in the developmental tasks of moving toward self-sufficiency, pursuing education and employment, and negotiating intimate relationships. For a variety of reasons, transitional age youth are vulnerable to risky sexual behaviors that could lead to unintended pregnancy. This chapter gives an overview of reproductive health and unintended pregnancy, the risk factors for unintended pregnancy, negative outcomes of pregnancy, contraception options, and mental health in pregnancy. In addition, particularly vulnerable groups to the transitional age period and pregnancy will be discussed, including those with intellectual disability, autism spectrum disorder, and lesbian, gay, bisexual, transgender, and questioning (LGBTQ) population. Finally, we make recommendations about policy changes that could help reduce unintended pregnancy.
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Background Behavioral research indicates that caregiver mood disorders and emotional instability in the early months following childbirth are associated with lower infant positive (PE) and higher negative emotionality (NE), but the neural mechanisms remain understudied. Methods Using resting state functional connectivity (rs-FC) as a measure of the functional architecture of the early infant brain, we aimed to determine the extent to which connectivity between the amygdala, a key region supporting emotional learning and perception, and large-scale neural networks mediated the association between caregiver mood and anxiety and early infant NE and PE. Two samples of infants (first sample: n=58; second sample: n=31) aged 3-months underwent an MRI scan during natural sleep. Results During infancy, greater rs-FC between the amygdala and the salience network, and, to a lesser extent, lower amygdala-and executive control network rs-FC, mediated the effect of greater caregiver postpartum depression and trait anxiety on reducing infant smiling (p<0.05, FWE). Furthermore, results from the first sample were replicated in the second, independent sample, to a greater extent for caregiver depression than for caregiver anxiety. Conclusions We provide evidence of early objective neural markers that can help identify those infants who are more likely to be at risk from, versus those who might be protected against, the deleterious effects of caregiver depression and anxiety and reduced PE.
Chapter
Pregnancy is a sensitive period during which women are at risk of experiencing stress and mental health issues. It is known that higher levels of depressive symptoms are generally observed during pregnancy relative to the postpartum period. The occurrence of depressive symptoms in pregnant women may influence the development of her unborn child by affecting its epigenome which undergoes erasure and reprogramming during fetal development. Epigenetics studies examine molecular changes in gene expression that do not depend on the DNA sequence itself. The literature on prenatal exposure to maternal depression and related epigenetics alterations is a relatively new field of interest where studies have been performed mainly during the last decade. Studies have reported epigenetics alterations in offspring exposed to prenatal maternal depression. The results of these studies highlight the importance of early epigenetic programming in fetuses exposed to adversity in early life providing biomarkers of exposure and disease susceptibility.
Chapter
Stress response plays pivotal roles in physiological process, including reproduction and embryonic development. It’s long been acknowledged that stress stimulates the activation of both hormone and immune system resulting in disorders of maternal immune function and infertility. However, the stress types, biological alterations, clinical outcomes, and the potential underlying mechanisms remain largely unclear. Recent studies suggest that more stress factors and relative mechanisms are identified to be involved in female reproductive immune response stimulation, and they may lead to immune dysregulations that negatively influence maternal health. In this part, we focus on the outcomes or mechanisms of common stress factors which affect female immune response before and during pregnancy.
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The common occurrence of trauma-related mental illnesses in transitional age youth (TAY) deserves special focus both in terms of context and treatment options. This chapter will discuss the prevalence and consequences of trauma in TAY, which can range from brief acute reactions to chronic disabling conditions. Considerations for psychotherapeutic and pharmacological interventions for this age group will be discussed. Treatments generally involve psychotherapy, and there are a number of evidence-based ones to choose from, though most originated for use with adolescents or adults. Further research is needed to determine adaptability for TAY. Pharmacologic options can support patients through symptom targeting and remission, particularly in combination with psychotherapy. Finally, special considerations and challenges in trauma intervention with this age group will be discussed.
Article
Background Maternal prenatal depression is a significant public health issue associated with mental disorders of offspring. This study aimed to determine if maternal prenatal depressive symptoms are associated with changes in neonatal behaviors and brain function at the resting state. Methods A total of 204 pregnant women were recruited during the third trimester and were evaluated by Edinburgh Postpartum Depression Scale (EPDS). The mother-infant pairs were divided into the depressed group (n = 75) and control group (n = 129) based on the EPDS, using a cut-off value of 10. Cortisol levels in the cord blood and maternal blood collected on admission for delivery were measured. On day three of life, all study newborns were evaluated by the Neonatal Behavior Assessment Scale (NBAS) and 165 infants were evaluated by resting-state functional near-infrared spectroscopy (rs-fNIRS). To minimize the influences of potential bias on the rs-fNIRS results, we used a binary logistic regression model to carry out propensity score matching between the depressed group and the control group. Rs-fNIRS data from 21 pairs of propensity score-matched newborns were used for analysis. The associations between maternal EPDS scores, neonatal NBAS scores, and cortisol levels were analyzed using linear regressions and the mediation analysis models. Results Compared to the control group, the newborns in the depressed group had lower scores in the social-interaction and autonomic system dimensions of NBAS (P < 0.01). Maternal and umbilical cord plasma cortisol levels in the depressed group were higher (P < 0.01) than in the control group. However, only umbilical cord plasma cortisol played a negative mediating role in the relationship between maternal EPDS and NBAS in the social-interaction and autonomic system (β med = -0.054 [-0.115,-0.018] and -0.052 [-0.105,-0.019]. Proportional mediation was 13.57% and 12.33 for social-interaction and autonomic systems, respectively. The newborns in the depressed group showed decreases in the strength of rs-fNIRS functional connections, primarily the connectivity of the left frontal-parietal and temporal-parietal regions. However, infants in the depressed and control groups showed no differences in topological characteristics of the brain network, including standardized clustering coefficient, characteristic path length, small-world property, global efficiency, and local efficiency (P > 0.05). The social-interaction Z-scores had positive correlations with functional connectivity strength of left prefrontal cortex-left parietal lobe (r = 0.57, p < 0.01),prefrontal cortex-left parietal lobe - left temporal lobe (r = 0.593, p < 0.01) and left parietal lobe - left temporal lobe (r = 0.498, p < 0.01). Autonomic system Z-scores were also significantly positive correlation with prefrontal cortex-left parietal lobe (r = 0.509, p < 0.01),prefrontal cortex-left parietal lobe - left temporal lobe (r = 0.464, p < 0.01), left parietal lobe - left temporal lobe (r = 0.381, p < 0.05), and right temporal lobe and left temporal lobe (r = 0.310, p < 0.05). Conclusion This study shows that maternal prenatal depression may affect the development of neonatal social-interaction and autonomic system and the strength of neonatal brain functional connectivity. The fetal cortisol may play a role in behavioral development in infants exposed to maternal prenatal depression. Our findings highlight the importance of prenatal screening for maternal depression and early postnatal behavioral evaluation that provide the opportunity for early diagnosis and intervention to improve neurodevelopmental outcomes.
Chapter
When left untreated, perinatal mood and anxiety disorders (PMADs) are associated with increased risk for numerous adverse effects for the mother, the infant, and the mother-infant dyad. The significant risks of untreated symptoms must be weighed against the risks of treatment options in pregnancy and lactation. It is paramount that providers and patients understand the risk of not treating during pregnancy, as the symptoms themselves can lead to great harm. This chapter will review the correlated risks of untreated symptoms in detail, as well as the impact on lactation and breastfeeding. Lastly, the economic impact of untreated PMADs will be addressed.
Article
Objectives We investigated the association between maternal depression trajectories from pregnancy until 2 years postpartum, and problematic internet use in children at nine years of age. Methods A total of 1132 mother-child pairs from the Panel Korea Study for Children were used. Maternal depression was assessed repeatedly using the Kessler scale (K-scale) (during pregnancy, and at 6, 12, and 24 months of age). Problematic internet use was assessed in children 9 years old using the K-scale. The children's behavioral problems were assessed using the Child Behavior Checklist at nine years old. Latent profile analysis was used to identify the group trajectories of maternal depression. We compared the severity of problematic internet use of the children according to the maternal depression trajectories. We also identified behavioral problems in children with problematic internet use in each maternal depression trajectory. Results Trajectory analysis identified three group trajectories of maternal depression: no symptoms (n = 478), mild symptoms (n = 534), and moderate symptoms (n = 120). The mild and moderate maternal depression trajectory groups were more associated with high-risk internet use in 9-year-old children compared to the non-depressed group. In children with high-risk internet use, more severe behavioral problems were reported when their mothers had depression. Conclusion Maternal depression up to two years after childbirth affected problematic internet use in middle childhood.
Article
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Background: Prenatal exposure to serotonin reuptake inhibitor (SRI) antidepressants increases risk for adverse neurodevelopmental outcomes, yet little is known about whether effects are present before birth. In relation to maternal SRI pharmacokinetics, this study investigated chronic and acute effects of prenatal SRI exposure on third-trimester fetal heart rate variability (HRV), while evaluating confounding effects of maternal depressed mood. Methods: At 36-weeks' gestation, cardiotocograph measures of fetal HR and HRV were obtained from 148 pregnant women [four groups: SRI-Depressed ( n = 31), SRI-Non-Depressed ( n = 18), Depressed (unmedicated; n = 42), and Control ( n = 57)] before, and ~5-h after, typical SRI dose. Maternal plasma drug concentrations were quantified at baseline (pre-dose) and four time-points post-dose. Mixed effects modeling investigated group differences between baseline/pre-dose and post-dose fetal HR outcomes. Post hoc analyses investigated sex differences and dose-dependent SRI effects. Results: Maternal SRI plasma concentrations were lowest during the baseline/pre-dose fetal assessment (trough) and increased to a peak at the post-dose assessment; concentration-time curves varied widely between individuals. No group differences in fetal HR or HRV were observed at baseline/pre-dose; however, following maternal SRI dose, short-term HRV decreased in both SRI-exposed fetal groups. In the SRI-Depressed group, these post-dose decreases were displayed by male fetuses, but not females. Further, episodes of high HRV decreased post-dose relative to baseline, but only among SRI-Non-Depressed group fetuses. Higher maternal SRI doses also predicted a greater number of fetal HR decelerations. Fetuses exposed to unmedicated maternal depressed mood did not differ from Controls. Conclusions: Prenatal SRI exposure had acute post-dose effects on fetal HRV in late gestation, which differed depending on maternal mood response to SRI pharmacotherapy. Importantly, fetal SRI effects were sex-specific among mothers with persistent depressive symptoms, as only male fetuses displayed acute HRV decreases. At trough (pre-dose), chronic fetal SRI effects were not identified; however, concurrent changes in maternal SRI plasma levels suggest that fetal drug exposure is inconsistent. Acute SRI-related changes in fetal HRV may reflect a pharmacologic mechanism, a transient impairment in autonomic functioning, or an early adaption to altered serotonergic signaling, which may differ between males and females. Replication is needed to determine significance with postnatal development.
Article
This paper investigates the extent to which in utero exposure to temperature shocks affects birth weight outcomes in Vietnam. Exploiting the variations across districts and conception timing within districts, we show that a one standard deviation increase in temperature relative to the local norm (approximately 0.52°C) during the first trimester of pregnancy reduces the child's weight at birth by 67 g or 2.2 percent. Our heterogeneity analysis suggests that infants living in rural areas, born to poor and low‐educated mothers are especially vulnerable to temperature shocks.
Article
Background: Prevention of perinatal depression beginning from the antenatal period is essential. Therefore, this study aimed to investigate the effectiveness of recently developed internet-delivered cognitive behavioral therapy (iCBT) for preventing the onset of a major depressive episode (MDE) in the third trimester and at 3 months postpartum. Methods: This is a two-arm, parallel-group, general-information controlled, randomized controlled trial. Participants were 5017 pregnant women at 16-20 weeks' gestation without MDE at baseline. They were randomly assigned to an iCBT (intervention; n = 2509) or general-information (control; n = 2508) group, stratified by psychological distress at baseline. The primary outcomes were the numbers of new MDE onsets, measured using the World Health Organization Composite International Diagnostic Interview 3.0, at 32 weeks' gestation and at 3 months postpartum. Results: New MDE onset was reported by 59 participants (2.35%) in the intervention group and 73 (2.91%) in the control group during follow-up. Compared with the control group, the hazard ratio (HR) of MDE in the intervention group was 0.85 (95% CI 0.61-1.20), which was not significantly different. Among participants who scored between 5 and 8 on K6 at baseline, 10 (1.37%) in the intervention group reported new onset of MDE, compared with 28 (3.81%) in the control group, and the HR of MDE was 0.38 (95%CI 0.19-0.79). Conclusions: No intervention effect was found for iCBT in preventing new onset of perinatal MDE. iCBT might prevent perinatal depression only among pregnant women with subthreshold depressive symptoms. Trial registration: UMIN000038190.
Article
Purpose: Perinatal depression affects upwards of one in seven women and is associated with significant negative maternal and child consequences. Despite this, it remains under-detected and under-treated. We sought to identify clinician practices, self-efficacy, and remaining barriers to comprehensively addressing perinatal depression care. Materials and Methods: Surveys were administered to obstetric clinicians in Massachusetts that queried frequency of depression screening and Likert questions about subsequent depression management. Results: Approximately 79.0% of clinicians approached completed the survey. Whereas most clinicians (93.5%) screened for perinatal depression at 6 weeks postpartum, fewer clinicians (66.1%) screened during pregnancy. Most reported they were comfortable providing support to their patients (98.4%), but fewer endorsed being able to treat them on their own (43.0%). Most noted an ability to treat with antidepressants (77.9%); however, fewer endorsed adequate access to nonmedication treatment (45.5%). Conclusions: The majority of surveyed clinicians screen for depression consistent with guidelines. However, efforts are focused on the postpartum period, despite literature citing two-thirds of patients experiencing onset before or during pregnancy. Respondents indicated an ability to treat with medication management, while noting greater challenge with referral. These findings describe the challenges of interdisciplinary coordination as a barrier to comprehensive perinatal mental health care. Clinical Trial Registration Number: NCT02760004.
Article
Background: Improved knowledge of causal and protective factors is crucial for Postpartum depression (PPD) prevention and management. Aims: To investigate the relationship between adverse childhood experience (ACE), perceived social support and PPD in a middle-income non-Western country, and to investigate which type of ACE and which sources of social support were associated with PPD. Methods: The study was cross-sectional study and conducted in a one center from Turkey during March-June 2019. Women up to 1-week postpartum were included in the study. The Edinburgh Postpartum Depression Scale (EPDS), a validated ACE questionnaire, and the Multidimensional Scale of Perceived Social Support were completed. Results: Nine hundred women took part in the study. The proportion identified with PPD and ACE were 10% and 8.8%, respectively. In bivariate analysis, having previous PPD, unwanted pregnancy, insufficient antenatal care, low family income, history of ACE, and perception of low social support were associated with PPD (p < 0.05). Family support was perceived as beneficial, in both women with no history or ≥2 instances of ACE. However, perceived support from friends and/or a special person was lowest in the ≥2 ACE group (p < 0.05). In logistic regression, unwanted pregnancy, emotional abuse, and neglect, incarceration of a household member, and poor special person support were factors significantly associated with developing PPD (p = 0.005). Conclusions: Emotional abuse, neglect, household dysfunction, and perceived poor support from a special person were risk factors for PPD. A history of maternal childhood trauma and poor social support might indicate the need for early PPD interventions.
Article
Background: Before the Affordable Care Act (ACA), most women who gained pregnancy-related Medicaid were not eligible for Medicaid as parents postpartum. The ACA aimed to expand health insurance coverage, in part, by expanding Medicaid; introducing mandates; reforming regulations; and establishing exchanges with federal subsidies. Federal subsidies offer a means to coverage for individuals with income at 100%-400% of the federal poverty level who do not qualify for Medicaid. Objective: The objective of this study was to identify the effects of the ACA's non-Medicaid provisions on women's postpartum insurance coverage and depressive symptoms in nonexpansion states with low parental Medicaid thresholds. Participants: Women with incomes at 100%-400% of the federal poverty level who had prenatal insurance and completed the Pregnancy Risk Assessment Monitoring System (2012-2015). Setting: Five non-Medicaid expansion states with Medicaid parental eligibility thresholds below the federal poverty level. Design: Interrupted time-series analyses were conducted to examine changes between pre-ACA (January 2012-November 2013) and post-ACA (December 2013-December 2015) trends for self-reported loss of postpartum insurance and symptoms of postpartum depression. Results: The sample included 9,472 women. Results showed significant post-ACA improvements where the: (1) trend for loss of postpartum insurance reversed (change of -0.26 percentage points per month, P=0.047) and (2) level of postpartum depressive symptoms decreased (change of -3.5 percentage points, P=0.042). Conclusions: In these 5 states, the ACA's non-Medicaid provisions were associated with large increases in retention of postpartum insurance and reductions in postpartum depressive symptoms, although depressive symptoms findings are sensitive to model specification.
Article
Pregnant women struggling with emotion dysregulation may be more likely to engage in a wide range of health risk behaviors. This protocol describes a study on intergenerational transmission of emotion dysregulation from the third trimester of pregnancy to 18 months postpartum. Biobehavioral markers of emotion dysregulation are typically measured in laboratory settings which was prohibited by many universities during the COVID-19 pandemic. We describe how markers of emotion dysregulation (e.g. maternal, fetal, and infant heart rate variability) are collected remotely. We detail how data collection can be augmented to reach diverse populations who may not otherwise participate in laboratory-based research.
Article
Perinatal depression carries significant levels of disability for both women and their infants, but there is a large treatment gap for this condition in low and middle-income countries (LMICs). To address this gap, task-sharing using community health workers (CHWs) to provide psychosocial interventions for perinatal depression is increasingly common. Many of these interventions have shown significant positive effects on maternal mood, however not all have done so. This study used data from a task-shared psychosocial intervention for perinatal depression in Cape Town, South Africa, the ‘Africa Focus on Intervention Research for Mental Health’ (AFFIRM-SA) randomised controlled trial (RCT). It aimed to examine the processes that occurred within the delivery of the counselling intervention, and to use these findings to provide recommendations for psychosocial task sharing in LMICs. A grounded theory analysis was conducted of 234 counselling session transcripts of 39 randomly selected participants from the RCT. This revealed that participants provided examples of elements they perceived to be therapeutically effective, and that these aligned with ‘common elements’ of therapy. However the effectiveness of the intervention was compromised by the negative influence of participants’ socio-economic context, and by counselling strategies that did not align with what was intended in the counselling manual. Recommendations for future research and practice include conducting participatory formative research, using an iterative and responsive research design informed by implementation science, including contextually appropriate strategies in interventions such as addressing social determinants of mental health, conducting intensive training and supervision, adopting a staged approach to distinguishing and managing depression including the use of support groups, and using common elements of therapy as the basis for psychosocial interventions.
Article
Purpose: To reveal the effect of intermittent kangaroo care on maternal attachment, postpartum depression of mothers with preterm infants. Methods: The study was conducted as a single centre randomised controlled study with sixty mothers whose newborns were hospitalised in the NICU due to prematurity. The data were collected by the questionnaire form, Edinburgh Postnatal Depression Scale (EPDS) and the Maternal Attachment Inventory (MAI). 'Intermittent kangaroo care' was applied for 30 minutes once a day for 10 days to the experimental group. Women were completed the EPDS and the MAI in postpartum 30-40th days. Results: The median of the total score of EPDS in the experimental group was 7, and in the control group was 9 (p > 0.05). The median of the total score of MAI in the experimental group was 99, and in the control group was 97 (p <0.05) and it was determined that the effect size of the difference between the groups was medium (1-β: 0.65, Cohen's d: 0.532). Conclusion: It was determined that mothers who received intermittent kangaroo care had higher scores that can be interpreted as higher maternal attachment than others and the postpartum depression scores did not differ between experimental and control group.
Article
Prenatal intrauterine exposures and postnatal caregiving environments may both shape the development of infant parasympathetic nervous system (PNS) activity. However, the relative contributions of prenatal and postnatal influences on infant respiratory sinus arrhythmia (RSA)-an index of PNS functioning-are relatively unknown. We examined whether prenatal and postnatal maternal emotion dysregulation, a transdiagnostic construct that spans mental health diagnoses, were independently related to infant RSA trajectories during a social stressor, the still-face paradigm. Our sample included 104 mothers and their 7-month-old infants. Maternal emotion dysregulation was measured with the Difficulties in Emotion Regulation Scale during the 3rd trimester of pregnancy and again at a 7-month postpartum laboratory visit. Infant RSA was recorded during the still-face paradigm. Only postnatal maternal emotion dysregulation was associated with infant RSA. Specifically, high postnatal emotion dysregulation was associated with a blunted (i.e., dampened reactivity and recovery) infant RSA response profile. Infant sex did not moderate the associations between maternal emotion dysregulation and infant RSA. Findings suggest that postnatal interventions to promote effective maternal emotion regulation may reduce risk for infants' dysregulated psychophysiological stress responses.
Article
Background: A woman is highly vulnerable to anxiety and stress during her pregnancy causing negative effect in somatic and psychological forms like Intrauterine growth restriction, low birth weight and preterm birth in child. Maternal anxiety not only leads to adverse effect on pregnancy outcome but also decreases maternal competence in childcare. Aims/Objectives: To determine the prevalence of antenatal anxiety among women attending Ashok Nagar UHC and identify the associated risk factors. Methodology: A cross sectional study was done for 3 months in 320 antenatal women attending antenatal clinic at Ashok Nagar UHC. Data collection was done using a pre designed and pre tested questionnaire. Results: The prevalence of antenatal anxiety was 31.2%. Among them 30% had mild to moderate anxiety and only 1.2% had severe anxiety. Prevalence of anxiety was higher in younger women and with lower literacy status. Conclusion: Antenatal anxiety is of major public health importance but its effect on mother is not considered to be a serious issue in the society. There is a need for regular antenatal screening, assessment and treatment of antenatal anxiety.
Article
Objective: To determine the association between insufficient sleep in the prenatal period and postpartum depression (PPD), and whether changes in sleep patterns during pregnancy increase the risk of PPD. Methods: A prospective cohort study was conducted between March 2013 and November 2017. Participants completed a sleep questionnaire pre-pregnancy and at 12, 24 and 36 gestational weeks (GW). Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS) at 4 weeks postpartum, and the cut-off score for PPD was 10 or more. Results: Of 2512 participants, 410 (16.3%) were identified as having PPD. Only insufficient sleep at 36 GW was significantly associated with PPD after adjusting for confounding factors (odds ratio 1.79, 95% confidence interval 1.40-2.27, P < 0.001). Both Group 1 (change from sufficient to insufficient) and Group 3 (sustained insufficient) demonstrated a significant risk of PPD at all starting time-points in the multivariate analysis, but no significant association was evident between Group 2 (change from insufficient to sufficient) and PPD. Conclusion: Insufficient sleep at 36 GW was associated with a significant risk of developing PPD. Additionally, regardless of whether women had sufficient sleep, a shift towards worsening sleep at 36 GW was highly associated with PPD.
Article
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The questions addressed in this study were whether prenatal depression effects on the foetus and neonate varied by ethnicity and socio-economic status. Eighty-six depressed pregnant women were compared by ethnic group, Hispanic and African-American, and by socio-economic status (upper/lower) on prenatal and neonatal outcome variables. The Hispanic mothers were older, had a higher SES and had higher prenatal norepinephrine levels. Their foetuses were also more active. At the neonatal period they had higher anger scores, but also higher serotonin levels, and their infants had higher dopamine and lower cortisol levels and they spent less time in deep and indeterminate sleep. The comparison by middle/lower socio-economic status revealed that the middle SES group was older, had more social support and showed less depressed affect but had higher norepinephrine levels prenatally. At the postnatal period the middle SES mothers had lower depression, anxiety and anger scores and lower norepinephrine levels. Their infants also had lower norepinephrine levels, fewer postnatal complications and were less excitable on the Neonatal Behaviour Assessment Scale.
Article
The vasoactive effects of corticotropin-releasing hormone (CRH) in the human fetal-placental circulation in vitro have been investigated. Single lobules of term placentae were bilaterally perfused with constant flows of Krebs' solution (maternal and fetal, 5 ml/min, 95% O2, 5% CO2, 37 degrees C, pH 7.3) and changes in fetal-placental arterial perfusion pressure measured. Effects of human (hCRH) and ovine (oCRH) CRH were examined during submaximal vasoconstriction (100-120 mmHg) of the fetal-placental vasculature induced by prostaglandin F2 alpha (PGF2 alpha), (0.7-2 mumol/L). During infusion of hCRH or oCRH (24-7000 pmol/L) a concentration-dependent vasodilatation was observed. Human CRH and oCRH were equipotent as vasodilator agents (regression analysis; P > 0.05; n = 5). The vasodilator response curves to human and ovine CRH were compared to prostacyclin (PGI2) (1.2-1180 nmol/L). Human and oCRH were 53 times more potent than PGI2 (regression analysis, P < 0.05; n = 5). These results indicate that CRH ha...
Article
Sixty-three infants of mothers with depressive symptoms were compared on physiology and behavior to infants of nonsymptomatic mothers. The newborns of depressive mothers had greater relative right frontal EEC asymmetry (due to reduced left hemisphere activation), lower vagal tone, and less optimal scores on the Brazelton, suggesting that maternal depressive symptoms during pregnancy may be contributing to newborn neurobehavioral functioning.
Conference Paper
The brain circuitry underlying emotion includes several territories of the prefrontal cortex (PFC), the amygdala, hippocampus, anterior cingulate, and related structures. In general, the PFC represents emotion in the absence of immediately present incentives and thus plays a crucial role in the anticipation of the future affective consequences of action, as well as in the persistence of emotion following the offset of an elicitor. The functions of the other structures in this circuit are also considered. Individual differences in this circuitry are reviewed with an emphasis on asymmetry within the PFC and activation of the amygdala as 2 key components of affective style. These individual differences are related to both behavioral and biological variables associated with affective style and emotion regulation. Plasticity in this circuitry and its implications for transforming emotion and cultivating positive affect and resilience are considered.
Article
The purpose of this study was to examine the relation between maternal depressive symptoms and spontaneous preterm birth. From 1991 to 1993, pregnant, African-American women were prospectively enrolled at four hospital-based clinics in Baltimore, Maryland, that serve low-income areas of the city. The Center for Epidemiologic Studies Depression (CES-D) Scale was used to assess depressive symptoms. Multiple logistic regression analysis estimated the independent contribution of maternal depressive symptoms to spontaneous preterm birth, controlling for behavioral, clinical, and demographic variables. Among the 1,399 women in the sample, 117 (8.4%) had a spontaneous preterm delivery. Spontaneous preterm birth occurred among 12.7% of those with a CES-D score in the upper 10th percentile and among 8.0% of those with a lower score (relative risk = 1.59). The adjusted odds ratio for an elevated CES-D score was 1.96 (95% confidence interval: 1.04, 3.72); hence, maternal depressive symptoms in this sample of African-American women were independently associated with spontaneous preterm birth. Effective treatment of depression in pregnant women could ultimately result in a reduction of spontaneous preterm births.
Article
BACKGROUND: Unexplained miscarriage is speculated to be due to a Th1/Th2 cytokine imbalance at the feto–maternal interface and immunological functions are known to be under the influence of various psychological factors. Indeed, the psycho–neuro–immuno–endocrine network has been proposed to contribute to miscarriage. To assess whether psychological disorders might induce spontaneous abortion we carried out a prospective study to determine if any psychological parameter influenced risk in those patients with a history of recurrent miscarriages. METHODS: A prospective study was carried out on 61 patients with a history of two consecutive first-trimester miscarriages. A battery of self-report questionnaires including Symptom Checklist-90 Revised and the NEO Five Factor Index and semi-structured interviews were conducted before a subsequent pregnancy. We investigated whether or not these parameters predicted subsequent miscarriages. RESULTS: Ten (22.2%) of the 45 patients who conceived miscarried again. Baseline depressive symptoms influenced subsequent miscarriage (P = 0.004). This statistically significant effect remained when we corrected with Bonfferoni adjustment (P = 0.036). CONCLUSIONS: A high depression scale is associated with a high miscarriage rate in those patients suffering recurrent miscarriage.
Article
Examined facial expressions in 84 3-mo-old infants of mothers classified as depressed, nondepressed, or low scoring on the Beck Depression Inventory. Mother–infant dyads were videotaped during a 3-min face-to-face interaction, and the videotapes were coded by using the AFFEX facial expression coding system. Infants of both depressed and low-scoring mothers showed significantly more sadness and anger expressions and fewer interest expressions than infants of nondepressed mothers. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Brain electrical activity (electroencephalogram; EEG) was recorded from left and right frontal (F) and parietal (P) scalp regions (F3, F4, P3, and P4, referenced to the central vertex site, Cz) in a sample of depressed and nondepressed mothers and their 3–6-month-old infants. A greater number of depressed mothers and their infants vs. nondepressed mothers and their infants displayed right frontal EEG asymmetry. These data indicate that the depressed affect exhibited by infants of depressed mothers is associated with a pattern of brain electrical activity similar to that found in inhibited infants and children and in chronically depressed adults. Further research is required to determine whether the EEG pattern is a marker of current or chronic mood state. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
24 women (mean age 24 yrs) who had received ultrasound examinations and psychological interviews during the 3rd trimester of pregnancy were subsequently divided into a group of 12 Ss who had reported pregnancy problems (marital difficulties and ambivalence about the child) and another group of 12 Ss who had not. Ss were then observed at 3–5 mo postpartum in interactions with their infants and were given the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Nowicki-Strickland Internal–External Control Scale for Adults, measures of mothers' and infants' temperament, and a maternal developmental expectations and childrearing attitudes scale. The mothers who had experienced pregnancy problems were more depressed, anxious, and externalizing postpartum and expressed more punitive childrearing attitudes. These depressed mothers and their infants showed less optimal interaction behaviors. Results suggest that postpartum depression can be predicted from a simple set of questions regarding the mother's negative feelings about her marriage and her expectant child during the prenatal period. (19 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
24 depressed and 24 nondepressed mothers (mean age 27.2 yrs) were videotaped in 3 face-to-face interactions with their 3-mo-old infants to investigate whether infants of depressed Ss, who became depressed postpartum, would behave like infants of nondepressed Ss, who were invited to "look depressed." For the 1st interaction, Ss were asked to play with their infants; for the 2nd interaction, Ss were instructed to look and act depressed with their infants; and for the 3rd interaction, Ss were again asked to play with their infants (reunion). The videotapes were then coded by a naive research assistant. Results show that infants of nondepressed Ss exhibited more frequent positive facial expressions; less frequent negative facial expressions; and more frequent vocalizations, protests, and wary looks than infants of depressed Ss. Activity level and heart rate were higher for infants of nondepressed Ss than infants of depressed Ss. Data suggest that infants are able to detect the affective qualities of their mothers' displays and appropriately modify their affective displays in response. Findings also suggest that depression or depressed affect emerges in infants as a function of early interactions with their depressed mothers. (16 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Emotional reactivity and expressivity in infants have been previously correlated with vagal tone. This study investigated vagal tone of 3- and 6-month-old infants of depressed mothers. Vagal tone did not differ for infants of depressed versus nondepressed mothers at 3 months, but lower vagal tone was noted in infants of depressed versus nondepressed mothers at 6 months. The developmental increase in vagal tone that occurred between 3 and 6 months for infants of nondepressed mothers did not occur for infants of depressed mothers. Correlation analyses suggested that higher vagal tone at 6 months was related to more vocalizations and more optimal neurological scores.
Article
Literature is reviewed demonstrating the impact of maternal depression on early infant interactions and development. Infants of depressed mothers (a) develop a depressed mood style as early as 3 months; (b) this mood generalizes to interactions with nondepressed women; (c) it persists over the first year if the mother's depression persists; and (d) it affects growth and Bayley developmental scores by the end of the first year. Other data are reviewed on individual differences including maternal depression styles of withdrawal and intrusion, negative behavior matching, and distorted perceptions of behavior. Finally, genetic, intrauterine, and extrauterine environment effects are discussed and interventions are suggested for altering the mother's depressed behavior and distorted perceptions. The review concludes that a developmental psychopathology perspective is needed to better understand the development of early depression.
Article
Mothers classified as ‘depressed’, ‘non-depressed’ or ‘low scoring’ on the Beck Depression Inventory and their 3-month-old infants were videotaped during 3-minute face-to-face play interactions. Infants' facial expressions were coded using the AFFEX facial expression coding system and their EKG was recorded during the interactions to assess the relationship between cardiac measures and facial expressivity. Infants of both ‘depressed’ and ‘low scoring’ mothers showed significantly more sad and anger expressions and fewer interest expressions than infants of nondepressed mothers. Cardiac vagal tone, (quantified from the amplitude of respiratory sinus arrhythmia) was correlated with infants' joy and interest expressions and with self-comfort behaviours in the non-depressed and low scoring groups, but not in the depressed group. The results suggest that matermal depression affects infants' affective state and appearance as well as their biobehavioural emotional regulation systems.
Article
Eighty-three newborns (M GA = 37 weeks) were assigned to depressed (N = 47) and nondepressed mother (N = 36) groups based on Beck Depression Inventory (BDI) scores. The Brazelton Neonatal Assessment Scale was administered to the infants within 24 hours after birth. Infants of depressed mothers demonstrated poorer performance on the orientation cluster. Further analysis of the orientation cluster items revealed inferior orientation to the inanimate stimuli. Infants of depressed mothers also showed less motor tone and activity and more irritability and less robustness and endurance (unavailability, lethargy, and stress behaviors) during the examination.83 nouveaux-nés (M GA = 37 semaines) ont été assignés á des groupes de mères déprimées (N = 47) et de meres non-dtprimkes (N = 36), groupes à partir de scores D'Inventaire de Dépression Beck (Beck Depression Inventory). L'Echelle d'Evaluation Néonatale Brazelton a été administrée aux nourrissons dans les 24 heures près la naissance. Les nourrissons de méres déprimées se sont avérés moins per-formants pour ce qui est de la mesure d'orientation. Des analyses plus poussées des mesures d'orientation groupées ont révélé une orientation moindre aux stimuli inanimés. Les nourrissons de mères déprimées manifestaient également moins de tonicité et d'activité motrices, plus d'irritabilité, moins de robustesse et d'endurance (comportements de retrait et de stress et comportement léthargique) durant l'examen.
Article
Ninety-two mothers were recruited at a prenatal ultrasound clinic at which time they were given the CES-D for depression and the State-Trait Anxiety Inventory, and their urines were assayed for cortisol, norepinephrine, epinephrine, dopamine, and serotonin. At the neonatal period the mothers and neonates were assessed on frontal EEG asymmetry. Correlation analyses revealed the following: (1) the mothers’ frontal asymmetry was negatively related to prenatal depression (CES-D) symptoms, negatively related to prenatal norepinephrine levels and positively related to prenatal serotonin levels; (2) the frontal asymmetry of the newborn was positively correlated with the mothers’ frontal asymmetry and negatively correlated with the mothers’ prenatal depression (CES-D) symptoms and negatively correlated with the mothers’ prenatal state anxiety scores. The neonates’ EEG frontal asymmetry was also, like the mother's, negatively related to prenatal maternal norepinephrine and positively related to prenatal maternal serotonin.
Article
Objective To measure the plasma levels of corticotrophin-releasing hormone and corticotrophin-releasing hormone binding protein in normal pregnancy and in pregnancies complicated by pre-eclampsia. Setting John Radcliffe Hospital, Oxford and St Thomas's Hospital, London. Subjects One hundred and twenty pregnant women sampled prospectively throughout gestation, of whom 91 experienced a normal pregnancy and eight developed pre-eclampsia; in a second study, 10 women with severe pre-eclampsia, presenting at a range of gestational ages, were sampled once and compared with appropriately matched normal pregnant women. Main outcome measure Plasma levels of corticotrophin-releasing hormone determined by immunoradiometric assay. Plasma levels of corticotrophin-releasing hormone binding protein measured by direct radioimmunoassay. Results In the prospective study, plasma samples from women with pre-eclampsia exhibited higher (390.2 versus 292.7 pmol/l at 36 weeks) levels of corticotrophin-releasing hormone and significantly lower (5.24 versus 8.14 nmol/l at 36 weeks, P 0.002) levels of corticotrophin-releasing hormone binding protein than normal controls. In the second, single time point study a significant elevation in CRH (P < 0.002) and reduction in CRH-BP (P < 0.001) was found in pre-eclamptic pregnancies compared with controls. Conclusions In human pregnancies complicated by pre-eclampsia there is an elevated level of corticotrophin releasing hormone whilst there is less corticotrophin-releasing hormone binding protein; therefore there is a net increase in free potentially bioactive hormone which may play a role in the pathology of the disease.
Article
Objective To test whether maternal corticotrophin-releasing hormone levels are elevated in the mid–trimester for those women who subsequently had spontaneous preterm delivery and to assess the clinical utility of the measurement in the prediction of preterm delivery.Design A prospective observational study.Setting Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hong Kong.Population 1047 low risk pregnant women recruited at 15–20 weeks of gestation.Methods Venous samples were assayed for levels of corticotrophin-releasing hormone. The investigators responsible for the laboratory assay were blinded to the obstetric outcome.Main outcome measures Incidence of preterm, term and post-term pregnancies.Results Those who were delivered spontaneously at a preterm gestational age (before 34 weeks) had significantly higher corticotrophin–releasing hormone levels in the mid–trimester, compared with those who were delivered at term or post–term. There was a trend towards lower corticotrophm–releasing hormone levels with more advanced gestational age at delivery. When the measurement of corticotrophin–releasing hormone was used to predict delivery before 34 weeks, the best cut off was 1.9 MoM, which produced a sensitivity of 72.7% and specificity of 78.4%. This translated to a positive predictive value of 3.6%, negative predlctive value of 99.6% and relative risk of 9.4 when the background prevalence of spontaneous preterm delivery before 34 weeks was 1.1%. The likelihood ratio was 3.4.Conclusions Mid-trimester maternal corticotrophin-releasing hormone levels are elevated in pregnancies destined to deliver preterm before 34 weeks. When used alone in a low risk population, the measurement has a low predictive power for preterm delivery. However, the likelihood ratio of 3.4 implies that in high risk populations the test may be considerably more valuable.
Article
OBJECTIVE: Our purpose was to determine whether various measures of poor psychosocial status in pregnancy are associated with spontaneous preterm birth, fetal growth restriction, or low birth weight. STUDY DESIGN: Anxiety, stress, self-esteem, mastery, and depression were assessed at 25 to 29 weeks in 2593 gravid women by use of a 28-item Likert scale. Scores for each psychosocial subscale were determined, and an overall psychosocial score was calculated. Scores were divided into quartiles, and the lowest quartile scores were used to define poor psychosocial status. The percent spontaneous preterm birth, low birth weight, and fetal growth restriction in women with low and high psychosocial scores were compared. Logistic regression analyses provided the odds ratios and 95% confidence intervals. RESULTS: Analyses revealed that stress was significantly associated with spontaneous preterm birth and with low birth weight with odds ratios of 1.16, p = 0.003, and 1.08, p = 0.02, respectively, for each point on the scale. A low score on the combined scale or on any subscale other than stress did not predict spontaneous preterm birth, fetal growth restriction, or low birth weight. After multivariate adjustment was performed for psychosocial status, substance use, and demographic traits, black race was the only variable significantly associated with spontaneous preterm birth, fetal growth restriction, and low birth weight; stress and low education were associated with spontaneous preterm birth and low birth weight. CONCLUSION: Stress was associated with spontaneous preterm birth and low birth weight even after adjustment for maternal demographic and behavioral characteristics. Black race continues to be a significant predictor of spontaneous preterm birth, fetal growth restriction, and low birth weight even after adjustment for stress, substance use, and other demographic factors. (Am J Obstet Gynecol 1996;175:1286-92.)
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Depressed mothers who could be classified as withdrawn or intrusive were compared with nondepressed mothers on their prenatal cortisol and catecholamine levels and on fetal activity and neonatal outcome variables. The data suggested that the withdrawn mothers had lower dopamine levels during pregnancy, and their infants had lower Brazelton scale scores. The infants of withdrawn mothers also had the highest cortisol levels and the lowest dopamine and serotonin levels as well as the most asymmetrical EEG patterns.
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Prenatal mood and biochemistry levels were assessed in women with (N=70) and without (N=70) depressive symptoms during their second trimester of pregnancy. At the neonatal period maternal and neonatal biochemistry, EEG and vagal tone levels were assessed, neonatal behavioral states were observed and the Brazelton neurobehavioral assessment was conducted. The mothers with depressive symptoms had higher prenatal cortisol levels and lower dopamine and serotonin levels. Mothers with depressive symptoms were also more likely to deliver prematurely and have low birthweight babies. The newborns of mothers with depressive symptoms had higher cortisol levels and lower dopamine and serotonin levels, thus mimicking their mothers prenatal levels. On the Brazelton Scale, the newborns of depressed mothers had less optimal habituation, orientation, motor, range of state, autonomic stability and depressed scores. A path analysis was conducted to assess the effects of prenatal depression and the mothers’ prepartum biochemistry on gestational age and birthweight. As predicted in the model proposed, prenatal depression was related to prepartum cortisol and norepinephrine levels, and cortisol levels were in turn negatively related to prematurity, and norepinephrine levels were positively related to low birthweight.
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The facial expressions of 40 newborns of mothers with depressive symptoms (n = 20) and of nondepressive mothers (n = 20) were recorded during the Brazelton Neonatal Behavior Assessment Scale and during the modeling of happy, sad, and surprised faces. Infants of mothers with depressive symptoms demonstrated inferior performance on the orientation cluster of the Brazelton scale and showed fewer interest and more precry expressions during the Brazelton. During the facial expression modeling, they showed less orientation and fewer facial expressions in response to the modeled happy and surprise facial expressions.
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Sixty-three infants of mothers with depressive symptoms were compared on physiology and behavior to infants of nonsymptomatic mothers. The newborns of depressive mothers had greater relative right frontal EEG asymmetry (due to reduced left hemisphere activation), lower vagal tone, and less optimal scores on the Brazelton, suggesting that maternal depressive symptoms during pregnancy may be contributing to newborn neurobehavioral functioning.
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Two styles of mother-infant interactions have been observed in depressed mothers, including an intrusive style (overstimulating behavior) and a withdrawn style (understimulating behavior). To examine how these styles affect infants, we assessed 87 infants and their mothers, who had been assigned to “intrusive” or “withdrawn” profiles, based on their face-to-face interactive behaviors with their 3-month-old infants. Behavioral assessments were made at 3, 6, and 12 months. The results indicated that infants of withdrawn mothers showed less optimal interactive behavior, greater relative right frontal EEG asymmetry (due to decreased left frontal EEG activation and increased right frontal EEG activation), and lower Bayley Mental Scale scores at 1 year. Infants of intrusive mothers had higher catecholamine and dopamine levels, and their EEG patterns showed greater relative left frontal EEG asymmetry (due to increased left frontal EEG activation and decreased right frontal EEG activation).
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Eighty pregnant women were assessed for depression during mid-pregnancy (Mean gestational age = 25.9 weeks) and shortly after delivery in order to assess the effects of the onset and chronicity of maternal depression on neonatal behavior. The women were classified as reporting depressive symptoms: (1) only during the prepartum assessment; (2) only during the postpartum assessment; (3) during both the prepartum and postpartum assessments; or (4) reporting no depressive symptoms at either the prepartum or the postpartum assessment. Neonates born to mothers reporting symptoms of depression at any time point exhibited greater indeterminate sleep than neonates of non-depressed mothers. Neonates born to mothers reporting prenatal depression spent more time fussing and crying and exhibited more stress behaviors than neonates born to non-depressed mothers or neonates born to mothers exhibiting symptoms of depression only during the postpartum assessment. Finally, neonates born to mothers exhibiting symptoms of depression during both the prepartum and postpartum assessments exhibited less optimal Brazelton neurobehavioral assessment scores than neonates of non-depressed mothers or neonates born to mothers who exhibited symptoms of depression during only the prepartum or only during the postpartum assessments. Taken together these findings suggest that neonatal behavior is influenced not just by the presence but also by the timing and duration of maternal depression symptoms.
Article
Sixty-three pregnant women (36 with depression symptoms) were recruited during their last trimester of pregnancy. The depressed mothers had higher cortisol and norepinephrine levels and lower dopamine levels. Their infants subsequently had higher cortisol and norepinephrine levels and lower dopamine levels at the neonatal stage. The neonates of depressed mothers also showed inferior performance on the orientation, reflex, excitability, and withdrawal clusters of the Brazelton Neonatal Behavioral Assessment. Stepwise regression analyses revealed that the depressed mothers' prenatal norepinephrine and dopamine levels significantly predicted the newborns' norepinephrine and dopamine levels and their Brazelton scores, highlighting an early biochemical influence on neonatal outcome.
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Typescript (Photocopy). Thesis (Ph. D.)--Florida Atlantic University, 2004. Includes bibliographical references (leaves 63-80).
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Pharmacological characterization of adrenoceptors mediating smooth muscle contraction was performed in isolated preparations from the human uterine artery. The mixed alpha 1- and alpha 2-adrenergic agonist, noradrenaline (NA) and the selective alpha 1-agonists, phenylephrine and methoxamine, all contracted the smooth muscle preparations in a concentration-dependent manner. The responses were antagonized competitively by the selective alpha 1-antagonist, prazosin, yielding pA2 values for the three agonists (8.33-9.08) typical for an interaction with alpha 1-receptors. The alpha 2-selective receptor agonists, clonidine and BHT 920, did not exert any contractile effects in the isolated uterine arteries, and the alpha 2-adrenergic antagonist, yohimbine, counteracted the contractile effect of NA only at high concentrations. The concentration-response curve for NA was unaffected by the alpha 2-selective antagonists, rauwolscine and idazoxan. The results suggest that the postjunctional contractile receptors in the human uterine artery primarily are of the alpha 1 type, and give no evidence for any substantial involvement of alpha 2-receptors in this important tributary vessel of the human female reproductive tract.
Article
Although the uterine vascular responses to endogenous vasoactive substances have been extensively investigated in pregnant sheep, the fetal umbilical responses to angiotensin II (ANG II) and norepinephrine (NE) have not been well characterized. Twenty-five pregnant ewes between 105 and 115 days of gestation were anesthetized and instrumented for hemodynamic measurements, systemic fetal and maternal intravenous infusions, and local maternal uterine arterial infusions of ANG II and NE. Fetal and maternal arterial pressure and heart rate, maternal uterine blood flow (total of left and right middle uterine arteries), and fetoplacental blood flow (common umbilical artery) were measured during continuous infusions of ANG II or NE. Fetal infusions of ANG II (0.03-1.0 micrograms.min-1.kg estimated fetal body wt-1) increased fetal arterial blood pressure by as much as 44% over base-line values, decreased umbilical blood flow by as much as 63%, and increased umbilical vascular resistance by up to 345%. Fetal infusions of NE (0.1-3 micrograms.min-1.kg-1) increased fetal arterial pressure 42% and increased umbilical vascular resistance by up to 38% but did not significantly alter fetoplacental blood flow. No significant maternal changes were observed during fetal infusions. Maternal infusion of ANG II increased maternal arterial pressure by as much as 59% and significantly increased uterine vascular resistance at the two highest doses but significantly decreased uterine blood flow only at the highest dose (17%; P less than 0.05). Maternal infusions of NE increased arterial pressure by as much as 113%, decreased uterine blood flow by as much as 76%, and increased uterine vascular resistance 3- to 10-fold over the base-line value.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
The levels of immunoreactive CRH are elevated in both maternal and fetal plasma in late gestation and labor, but fall precipitously after parturition. The major source of this peptide is thought to be the placenta. We determined if the placenta and also the amnion, chorion, and decidua produce CRH, whether this material has biological activity, and whether CRH output is modulated by glucocorticoids and progesterone. In an in vitro monolayer culture system CRH was produced by the fetal membranes and decidua. Media immunoreactive CRH concentrations averaged 625 +/- 45 (SE) pg/10(5) cells in amnion, 701 +/- 56 pg/10(5) cells in chorion, and 580 +/- 60 pg/10(5) cells in decidual tissue obtained at cesarean section. This output was similar to that by the placenta (906 +/- 121 pg/10(5) cells). These values increased in tissue obtained after spontaneous labor. A single peak of CRH immunoreactivity eluting at the same position as synthetic human CRH, and possessing biological activity, was found in all tissues. There was a dose-dependent increase in CRH output by all tissue types when cells were maintained in the presence of increasing concentrations of cortisol and dexamethasone. In contrast, increasing concentrations of progesterone decreased CRH output by all tissue types. We conclude that immuno- and biologically active CRH is produced not only in the human placenta, but also in the fetal membranes. CRH output by the placenta/fetal membranes is moderated by steroids, and changes with labor. These findings raise the possibility of a regulatory system similar to that of the hypothalamic pituitary axis, but residing within the placenta and fetal membranes.
Article
The substances stimulating the release of immunoreactive corticotropin-releasing factor from cultured human placental cells were investigated. Monolayer primary cultures of trophoblast cells from pregnant women at term were used. The immunoreactive corticotropin-releasing factor released in the culture medium eluted from high-performance liquid chromatography with the same retention time as human corticotropin-releasing factor. Norepinephrine and acetylcholine increased immunoreactive corticotropin-releasing factor release into the culture medium in a dose-related manner. Epinephrine was partially active, whereas dopamine and serotonin did not induce significant changes of immunoreactive corticotropin-releasing factor release from placental cultures. Angiotensin II, interleukin-1, oxytocin, and arginine-vasopressin also increased placental immunoreactive corticotropin-releasing factor release in a dose-related manner, whereas other peptides (vasoactive intestinal peptide, substance P, somatostatin, atrial natriuretic factor, interleukin-2) were ineffective. These results showed that several neurotransmitters and peptides stimulate the release of immunoreactive corticotropin-releasing factor from placental cells, suggesting their possible involvement in the physiologic regulation of placental immunoreactive corticotropin-releasing factor release during pregnancy and parturition.