The Effect of Maternal PTSD Following in Utero Trauma Exposure on Behavior and Temperament in the 9‐Month‐Old Infant

Cornell University, Итак, New York, United States
Annals of the New York Academy of Sciences (Impact Factor: 4.38). 08/2006; 1071(1):454-8. DOI: 10.1196/annals.1364.041
Source: PubMed


In view of evidence of in utero glucocorticoid programming, and our prior observation of lower cortisol levels in 9-month-old infants of mothers with posttraumatic stress disorder (PTSD) compared to mothers without PTSD, we undertook an examination of the effect of in utero maternal stress, as determined by PTSD symptom severity, and maternal cortisol levels on behavioral outcomes in the infant. Methods: Ninety-eight pregnant women directly exposed to the World Trade Center (WTC) collapse on 9/11 provided salivary cortisol samples and completed a PTSD symptom questionnaire and a behavior rating scale to measure infant temperament, including distress to limitations, and response to novelty. Results: Mothers who developed PTSD in response to 9/11 had lower morning and evening salivary cortisol levels, compared to mothers who did not develop PTSD. Maternal morning cortisol levels were inversely related to their rating of infant distress and response to novelty (i.e., loud noises, new foods, unfamiliar people). Also, mothers who had PTSD rated their infants as having greater distress to novelty than did mothers without PTSD (t = 2.77, df = 61, P = 0.007). Conclusion: Longitudinal studies are needed to determine how the association between maternal PTSD symptoms and cortisol levels and infant temperament reflect genetic and/or epigenetic mechanisms of intergenerational transmission.

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Available from: Sarah Brand, Aug 06, 2014
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    • "Several epidemiological studies reported that 10–15% of mothers suffer from a depressive disorder in the postnatal period (Cox et al., 1993; Andersson et al., 2006). Maternal psychiatric disorders during the postnatal period are also associated with numerous adverse outcomes in the offspring, including impaired neonatal growth and development (Weinberg and Tronick, 1998; Brand et al., 2006) poor cognitive development and behavior during childhood and even adolescence (Weinberg and Tronick, 1998; O'Connor et al., 2002; Brand et al., 2006), as well as negative nutritional and health effects (Rahman et al., 2004; Barr et al., 2006). "
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    ABSTRACT: Background The purpose of the study was to assess the validity of the 10-item Edinburgh Postnatal Depression Scale (EPDS) in screening for postnatal depression (PND) in Hungary. Methods Between July 2010 and March 2011, a sample of 266 women attending a routine check-up at 6 weeks post partum completed the newly translated Hungarian version of the EPDS at the Department of Obstetrics and Gynecology, University of Szeged, Hungary and underwent clinical assessments based on the Structured Clinical Interview for DSM-IV disorders (SCID-I). Results Eight (3.0%) of the mothers were diagnosed with major postnatal depression, and 36 (13.5%) with minor depression on the basis of the SCID. Internal consistency of the Hungarian version of the EPDS was satisfactory (Cronbach alpha coefficients ≥0.727). The best cut-off for major depression was 12/13, with a sensitivity of 100.0%, and a specificity of 97.7%. The area under the ROC curve was found significant for combined (major+minor) depression as well and at a cut-off of 7/8 indicated a sensitivity of 72.7% and a specificity of 86.0%. A factor analysis suggested multidimensionality with two factors (anxiety and depression). Conclusions The EPDS showed good validity in the postnatal period in a clinical sample in Hungary.
    Full-text · Article · Aug 2014 · Midwifery
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    • "Grant et al. (2009) 4–8 months Anxiety (trait) 21; 26– 34, 35 Temperament (ITQ-revised) Vaughn et al. (1987) 8 months Daily hassles 15–17, 27–28, 37–38 Mental development (BSID-MDI) Huizink et al. (2002) (2003) 9 months 9/11 Not reported Temperament (IBQ) Brand et al. (2006) 9 months 9/11 28–40 "
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    ABSTRACT: A suboptimal prenatal environment may induce permanent changes in cells, organs and physiology that alter social, emotional and cognitive functioning, and increase the risk of cardiometabolic and mental disorders in subsequent life ("developmental programming"). Although animal studies have provided a wealth of data on programming and its mechanisms, including on the role of stress and its glucocorticoid mediators, empirical evidence of these mechanisms in humans is still scanty. We review the existing human evidence on the effects of prenatal maternal stress, anxiety and depression, glucocorticoids and intake of liquorice (which inhibits the placental barrier to maternal glucocorticoids) on offspring developmental outcomes including, for instance, alterations in psychophysiological and neurocognitive functioning and mental health. This work lays the foundations for biomarker discovery and affords opportunities for prevention and interventions to ameliorate adverse outcomes in humans.
    Full-text · Article · Aug 2011 · Stress (Amsterdam, Netherlands)
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    • "Yehuda and colleagues (Brand et al., 2006; Yehuda et al., 2005; Yehuda & Bierer, 2008) have documented some evidence for this hypothesis, finding lower postnatal cortisol levels among mothers who developed PTSD symptoms during pregnancy in response to the World Trade Center attacks and among their infants. Furthermore, maternal ratings of infant distress to novelty were positively correlated with maternal PTSD symptoms and negatively correlated with maternal morning cortisol levels (Brand et al., 2006; Yehuda et al., 2005), suggesting possible infant behavioral consequences of maternal-fetal HPA axis dysregulation resulting from PTSD. Other studies have demonstrated that traumas do not have to occur during pregnancy to influence offspring HPA programming. "
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    ABSTRACT: The current study examined associations between maternal posttraumatic stress disorder (PTSD) symptoms and infant emotional reactivity and emotion regulation during the first year of life in a primarily low-income, urban, ethnic/racial minority sample of 52 mother-infant dyads. Mothers completed questionnaires assessing their own trauma exposure history and current PTSD and depressive symptoms and their infants' temperament when the infants were 6 months old. Dyads participated in the repeated Still-Face Paradigm (SFP-R) when the infants were 6 months old, and infant affective states were coded for each SFP-R episode. Mothers completed questionnaires assessing infant trauma exposure history and infant current emotional and behavioral symptoms when the infants were 13 months old. Maternal PTSD symptoms predicted infants' emotion regulation at 6 months as assessed by (a) infant ability to recover from distress during the SFP-R and (b) maternal report of infant rate of recovery from distress/arousal in daily life. Maternal PTSD symptoms also predicted maternal report of infant externalizing, internalizing, and dysregulation symptoms at 13 months. Maternal PTSD was not associated with measures of infant emotional reactivity. Neither maternal depressive symptoms nor infant direct exposure to trauma accounted for the associations between maternal PTSD symptoms and infant outcomes. These findings suggest that maternal PTSD is associated with offspring emotion regulation difficulties as early as infancy. Such difficulties may contribute to increased risk of mental health problems among children of mothers with PTSD.
    Full-text · Article · Aug 2011 · Infant behavior & development
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