Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T03:55:36.006Z Has data issue: false hasContentIssue false
  • English
  • Français

Maternal antenatal mood and child development: an exploratory study of treatment effects on child outcomes up to 5 years

Published online by Cambridge University Press:  10 October 2018

J. Milgrom ,
C. J. Holt ,
L. S. Bleker ,
C. Holt ,
J. Ross ,
J. Ericksen ,
V. Glover ,
K. J. O’Donnell ,
S. R. de Rooij  and
A. W. Gemmill
J. Milgrom
Affiliation:
Parent-Infant Research Institute, Heidelberg West, Victoria, Australia Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
C. J. Holt
Affiliation:
Parent-Infant Research Institute, Heidelberg West, Victoria, Australia
L. S. Bleker*
Affiliation:
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
C. Holt
Affiliation:
Parent-Infant Research Institute, Heidelberg West, Victoria, Australia
J. Ross
Affiliation:
Parent-Infant Research Institute, Heidelberg West, Victoria, Australia
J. Ericksen
Affiliation:
Parent-Infant Research Institute, Heidelberg West, Victoria, Australia
V. Glover
Affiliation:
Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
K. J. O’Donnell
Affiliation:
Douglas Hospital Research Centre, McGill University, Montreal, Canada Canadian Institute for Advanced Research, Child and Brain Development Program, Toronto, Canada
S. R. de Rooij
Affiliation:
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
A. W. Gemmill
Affiliation:
Parent-Infant Research Institute, Heidelberg West, Victoria, Australia
*
Address for correspondence: L. S. Bleker, Department of Clinical Epidemiology, Bioinformatics and Biostatistics, Amsterdam UMC, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Effective treatment of maternal antenatal depression may ameliorate adverse neurodevelopmental outcomes in offspring. We performed two follow-up rounds of children at age 2 and age 5 whose mothers had received either specialized cognitive-behavioural therapy or routine care for depression while pregnant. Of the original cohort of 54 women, renewed consent was given by 28 women for 2-year follow-up and by 24 women for 5-year follow-up. Child assessments at the 2-year follow-up included the Parenting Stress Index (PSI), Bayley Scales of Infant Development (BSID-III) and the Child Behaviour Checklist (CBCL). The 5-year follow-up included the Wechsler Preschool and Primary Scales of Intelligence (WPPSI-III) and again the CBCL. Treatment during pregnancy showed significant benefits for children’s development at age 2, but not at age 5. At 2 years, intervention effects were found with lower scores on the PSI Total score, Parent Domain and Child domain (d=1.44, 1.47, 0.96 respectively). A non-significant trend favoured the intervention group on most subscales of the CBCL and the BSID-III (most notably motor development: d =0.52). In contrast, at 5-year follow-up, no intervention effects were found. Also, irrespective of treatment allocation, higher depression or anxiety during pregnancy was associated with higher CBCL and lower WPPSI-III scores at 5 years. This is one of the first controlled studies to evaluate the long-term effect of antenatal depression treatment on infant neurodevelopmental outcomes, showing some benefit. Nevertheless, caution should be taken interpreting the results because of a small sample size, and larger studies are warranted.

Keywords

antenatal anxietyantenatal depressionchild neurodevelopmentcognitive-behavioural therapyintervention
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 10 , Issue 2 , April 2019 , pp. 221 - 231
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2018. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Glover, V. Maternal depression, anxiety and stress during pregnancy and child outcome: what needs to be done. Best Pract Res Clin Obstet Gynaecol. 2014; 28, 25–35.Google Scholar
2. Woody, CA, Ferrari, AJ, Siskind, DJ, et al. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017; 219, 86–92.Google Scholar
3. Gavin, NI, Gaynes, BN, Lohr, KN, et al. Perinatal depression. Obstet Gynecol. 2005; 106(5, Part 1), 1071–1083.Google Scholar
4. Dennis, C-L, Falah-Hassani, K, Shiri, R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017; 210, 315–323.Google Scholar
5. Bauer, A, Parsonage, M, Knapp, M. et al. The costs of perinatal mental health problems. Retrieved 27 March 2018 from http://eprints.lse.ac.uk/59885/1/__lse.ac.uk_storage_LIBRARY_Secondary_libfile_shared_repository_Content_Bauer%2C%20M_Bauer_Costs_perinatal_ mental_2014_Bauer_Costs_perinatal_mental_2014_author.pdf.Google Scholar
6. O’Donnell, K, O’Connor, TG, Glover, V. Prenatal stress and neurodevelopment of the child: focus on the HPA axis and role of the placenta. Dev Neurosci. 2009; 31(4), 285–292.Google Scholar
7. Schuurmans, C, Kurrasch, D. Neurodevelopmental consequences of maternal distress: What do we really know? Clin Genet. 2013; 83, 108–117.Google Scholar
8. Weinstock, M. The long-term behavioural consequences of prenatal stress. Neurosci Biobehav Rev. 2008; 32, 1073–1086.Google Scholar
9. Netsi, E, Evans, J, Wulff, K, et al. Infant outcomes following treatment of antenatal depression: findings from a pilot randomized controlled trial. J Affect Disord. 2015; 188, 252–256.Google Scholar
10. O’Connor, TG, Heron, J, Golding, J. et al. ALSPAC Study Team. Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. J Child Psychol Psychiatry. 2003; 44(7), 1025–1036.Google Scholar
11. Van Batenburg-Eddes, T, Brion, MJ, Henrichs, J, et al. Parental depressive and anxiety symptoms during pregnancy and attention problems in children: a cross-cohort consistency study. J Child Psychol Psychiatry. 2013; 54, 591–600.Google Scholar
12. Barker, ED, Jaffee, SR, Uher, R, et al. The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. Depress Anxiety. 2011; 28, 696–702.Google Scholar
13. O’Donnell, KJ, Glover, V, Barker, ED, et al. The persisting effect of maternal mood in pregnancy on childhood psychopathology. Dev Psychopathol. 2014; 26, 393–403.Google Scholar
14. Van den Bergh, BRH, Marcoen, A. High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8- and 9-year-olds. Child Dev. 2004; 75, 1085–1097.Google Scholar
15. Bergman, K, Sarkar, P, O’connor, TG, et al. Maternal stress during pregnancy predicts cognitive ability and fearfulness in infancy. J Am Acad Child Adolesc Psychiatry. 2007; 46, 1454–1463.Google Scholar
16. Huizink, AC, Robles de Medina, PG, Mulder, EJH, et al. Stress during pregnancy is associated with developmental outcome in infancy. J Child Psychol Psychiatry. 2003; 44, 810–818.Google Scholar
17. Blakeley, PM, Capron, LE, Jensen, AB, et al. Maternal prenatal symptoms of depression and down regulation of placental monoamine oxidase A expression. J Psychosom Res. 2013; 75, 341–345.Google Scholar
18. de Weerth, C, Buitelaar, JK, Mulder, EJH. Prenatal programming of behavior, physiology and cognition. Neurosci Biobehav Rev. 2005; 29, 207–208.Google Scholar
19. Mehta, D, Klengel, T, Conneely, KN, et al. Childhood maltreatment is associated with distinct genomic and epigenetic profiles in posttraumatic stress disorder. Proc Natl Acad Sci. 2013; 110, 8302–8307.Google Scholar
20. Mairesse, J, Lesage, J, Breton, C, et al. Maternal stress alters endocrine function of the feto-placental unit in rats. Am J Physiol Metab. 2007; 292, E1526–E1533.Google Scholar
21. O’Donnell, KJ, Bugge Jensen, A, Freeman, L, et al. Maternal prenatal anxiety and downregulation of placental 11β-HSD2. Psychoneuroendocrinology. 2012; 37, 818–826.Google Scholar
22. Uno, H, Eisele, S, Sakai, A, et al. Neurotoxicity of glucocorticoids in the primate brain. Horm Behav. 1994; 28, 336–348.Google Scholar
23. Coe, CL, Lubach, GR. Developmental consequences of antenatal dexamethasone treatment in nonhuman primates. Neurosci Biobehav Rev. 2005; 29, 227–235.Google Scholar
24. Babenko, O, Kovalchuk, I, Metz, GAS. Stress-induced perinatal and transgenerational epigenetic programming of brain development and mental health. Neurosci Biobehav Rev. 2015; 48, 70–91.Google Scholar
25. Qiu, A, Anh, TT, Li, Y, et al. Prenatal maternal depression alters amygdala functional connectivity in 6-month-old infants. Transl Psychiatry. 2015; 5, e508–e508.Google Scholar
26. Qiu, A, Tuan, TA, Ong, ML, et al. COMT haplotypes modulate associations of antenatal maternal anxiety and neonatal cortical morphology. Am J Psychiatry. 2015; 172, 163–172.Google Scholar
27. Oberlander, TF, Weinberg, J, Papsdorf, M, et al. Prenatal exposure to maternal depression, neonatal methylation of human glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses. Epigenetics. 2008; 3, 97–106.Google Scholar
28. Milgrom, J, Holt, C, Holt, CJ, et al. Feasibility study and pilot randomised trial of an antenatal depression treatment with infant follow-up. Arch Womens Ment Health. 2015; 18, 717–730.Google Scholar
29. First, MB, Spitzer, RL, Gibbon, M. Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition (SCID-I/P, Version 2.0). 1996. Am Psychiatr Press Inc: Washington, DC.Google Scholar
30. Beck, AT, Steer, RA, Brown, GK. BDI-II Manual,. 1996. The Psychological Corporation, San Antonio: TX.Google Scholar
31. Milgrom, J, Ericksen, J, Negri, L, et al. Screening for postnatal depression in routine primary care: properties of the Edinburgh Postnatal Depression Scale in an Australian sample. Aust New Zeal J Psychiatry. 2005; 39, 833–839.Google Scholar
32. Beck AT, Epstein, N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988; 56, 893–897.Google Scholar
33. Bayley, N. Bayley Scales of Infant Development, 3rd edn, 2005. Pearson PsychCorp: San Antonio, TX.Google Scholar
34. Abidin, RR. Parenting Stress Index, 4th edn, 2012. PAR, Lutz: FL.Google Scholar
35. Achenbach, TM. Integrative Guide for the 1991 CBCL/4-18, YSR, and TRF Profiles. 1991. University of Vermont: Burlington, VT.Google Scholar
36. Wechsler, D. The Wechsler Preschool and Primary Scale of Intelligence, 3rd edn, 2002; TX Psychol Corp: San Antonio, TX.Google Scholar
37. Cohen, J. A power primer. Psychol Bull. 1992; 112, 155–159.Google Scholar
38. Talge, NM, Neal, C, Glover, V, Early stress, translational research and prevention science network: fetal and neonatal experience on child and adolescent mental health. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why?. J Child Psychol Psychiatry. 2007; 48, 245–261.Google Scholar
39. Laplante, DP, Barr, RG, Brunet, A, et al. Stress during pregnancy affects general intellectual and language functioning in human toddlers. Pediatr Res. 2004; 56, 400–410.Google Scholar
40. Ford, T, Vostanis, P, Meltzer, H, et al. Psychiatric disorder among British children looked after by local authorities: comparison with children living in private households. Br J Psychiatry. 2007; 190, 319–325.Google Scholar
41. Rodriguez, A, Bohlin, G. Are maternal smoking and stress during pregnancy related to ADHD symptoms in children? J Child Psychol Psychiatry. 2005; 46, 246–254.Google Scholar
42. Khashan, AS, Abel, KM, McNamee, R, et al. Higher risk of offspring schizophrenia following antenatal maternal exposure to severe adverse life events. Arch Gen Psychiatry. 2008; 65, 146–152.Google Scholar
43. Bleker, LS, Roseboom, TJ, Vrijkotte, TG, et al. Determinants of cortisol during pregnancy – the ABCD cohort. Psychoneuroendocrinology. 2017; 83–, 172–181.Google Scholar
44. Voegtline, KM, Costigan, KA, Kivlighan, KT, et al. Concurrent levels of maternal salivary cortisol are unrelated to self-reported psychological measures in low-risk pregnant women. Arch Womens Ment Health. 2013; 16, 101–108.Google Scholar
45. Cao-Lei, L, de Rooij, SR, King, S, et al. Prenatal stress and epigenetics. Neurosci Biobehav Rev. 2017; pii, S0149-7634(16)30726-6. doi:10.1016/j.neubiorev.2017.05.016.Google Scholar
46. Palma-Gudiel, H, Córdova-Palomera, A, Eixarch, E, et al. Maternal psychosocial stress during pregnancy alters the epigenetic signature of the glucocorticoid receptor gene promoter in their offspring: a meta-analysis. Epigenetics. 2015; 10, 893–902.Google Scholar
47. Prins, JR, Eskandar, S, Eggen, BJL, et al. Microglia, the missing link in maternal immune activation and fetal neurodevelopment; and a possible link in preeclampsia and disturbed neurodevelopment? J Reprod Immunol. 2018; 126, 18–22.Google Scholar