Over the last few years, there has been an increasing number of articles focusing on perinatal anxiety. Recent studies indicate that anxiety during pregnancy and the postpartum period is common and may occur independently of perinatal depression, although anxiety and depressive symptoms frequently appear together during the perinatal period. This week we have several large studies which look at the impact of perinatal anxiety on children’s development.
Polte and colleagues observe that two-year olds who were exposed to maternal anxiety either during pregnancy or the postpartum period are two to four times as likely to exhibit problems in social-emotional development. Mulghal and colleagues reported similar findings in children at three years of age, observing higher rates of problems in communication and social-personal domains in the children of mothers with persistently high levels of anxiety.
Ruta Nonacs, MD PhD
Polte C, Junge C, von Soest T, Seidler A, Eberhard-Gran M, Garthus-Niegel S.
Matern Child Health J. 2019 Jan 4.
5.6% of the 2-year-olds showed problems in their social-emotional behavior. These problems were more common in children exposed to maternal anxiety during pregnancy (Odds Ratio [OR]?=?2.48, 95% CI 1.55-4.92) or during the postpartum period (OR 3.32, 95% CI 1.43-7.74), but was most strongly associated with exposure to maternal anxiety both during pregnancy and the postpartum period (OR 3.98, 95% CI 1.85-8.56).
Mughal MK, Giallo R, Arnold PD, Kehler H, Bright K, Benzies K, Wajid A, Kingston D. J Affect Disord. 2018 Dec 27;248:1-12.
At age three years, 5.2% of children were at risk communication delay; 12.7% for gross motor delay; 15.4% for fine motor delay; 11.2 for problem solving delay; and 5.6% for personal-social delay on ASQ-3 domains. Multivariable analysis showed children born to mothers with persistent high anxiety symptoms from pregnancy to 3-years postpartum had an increased risk of delays in communication and personal-social domains.
Cauli G, Iapichino E, Rucci P, Quartieri Bollani M, Marconi AM, Bassi M, Gala C. J Affect Disord. 2018 Dec 18;246:148-156.
A multidisciplinary psychosocial intervention (MPI) was offered to women at high risk for perinatal depression. The MPI had positive effects on women with depressive or anxiety symptoms during pregnancy, that however did not exceed significantly those observed in women who refused the intervention.
Disordered personality traits and psychiatric morbidity in pregnancy: a population-based study.
Crowley G, Molyneaux E, Nath S, Trevillion K, Moran P, Howard LM. Arch Womens Ment Health. 2019 Jan 5.
Women with disordered personality traits experienced higher rates of anxiety disorders (31.4%) and depressive disorders (17.6%) during pregnancy.
The HPA Axis During the Perinatal Period: Implications for Perinatal Depression.
Dickens MJ, Pawluski JL. Endocrinology. 2018 Nov 1;159(11):3737-3746.
Selective serotonin reuptake inhibitor effects on neural biomarkers of perinatal depression.
Pawluski JL, Brain U, Hammond GL, Oberlander TF. Arch Womens Ment Health. 2018 Dec 1.
S100 calcium binding protein B (S100B) could be a unique biomarker to determine the efficacy of SSRIs during gestation.
Huybrechts KF, Hernández-Díaz S, Straub L, Gray KJ, Zhu Y, Patorno E, Desai RJ, Mogun H, Bateman BT. JAMA. 2018 Dec 18;320(23):2429-2437.
Among offspring of mothers enrolled in Medicaid, first-trimester exposure to ondansetron was not associated with cardiac malformations or congenital malformations overall after accounting for measured confounders but was associated with a small increased risk of oral clefts.
Godier-McBard LR, Ibbitson L, Hooks C, Fossey M. J R Army Med Corps. 2019 Jan 5.
US literature suggests that military spouses are particularly at risk of perinatal mental health problems during deployment of their serving partner and highlights the protective nature of social support during this time.
Course of ante- and postnatal depressive symptoms related to mothers’ HPA axis regulation.
Laurent H, Goodman SH, Stowe ZN, Halperin M, Khan F, Wright D, Nelson BW, Newport DJ, Ritchie JC, Monk C, Knight B. J Abnorm Psychol. 2018 May;127(4):404-416.
For high-risk mothers, a trajectory of worsening depression may both follow from and give rise to neuroendocrine stress hyperactivation.
Treatment of postpartum psychosis in a mother-baby unit: do both mother and baby benefit?
Hill R, Law D, Yelland C, Sved Williams A. Australas Psychiatry. 2019 Jan 21
In 25 dyads. While a minority of infants showed developmental concerns, appropriate development was noted in most.
Brown HK, Dennis CL, Kurdyak P, Vigod SN. Br J Psychiatry. 2018 Dec 20:1-8.
Women with schizophrenia had higher abortion rates than women without schizophrenia in all age groups (15.5-17.5 v. 12.8-13.6 per 1000 women). The following factors were associated with higher rates of abortion: younger age (less than 25 years; adjusted relative risk (aRR), 1.84), multiparity (aRR 2.17), comorbid non-psychotic mental illness (aRR 2.15) and substance misuse disorders (aRR 1.85).
Factors associated with a positive depression screen after a miscarriage.
Mutiso SK, Murage A, Mwaniki AM. BMC Psychiatry. 2019 Jan 7;19(1):8. Free Article
Factors associated with depressive symptoms after miscarriage include younger age, low education level, an older gestational age at miscarriage, being single, an assisted mode of conception and prior miscarriage.
Monteiro F, Fonseca A, Pereira M, Alves S, Canavarro MC.
J Affect Disord. 2018 Dec 26;246:522-529.
In a group of women at increased risk for PPD, women who did not experience depression or anxiety symptoms reported significantly higher levels of psychological flexibility, nonjudgmental appraisal of thought content and self-compassion than women who experienced postpartum depression and/or anxiety symptoms.
Zhang H, Shao S, Su Q, Yao D, Sun H, Ding D, Dang S, Wang S, Zhu Z, Li H. J Affect Disord. 2018 Oct 1;238:526-533.
The scores of irritability were higher in newborns born to mothers with perinatal anxiety than those born to mothers without anxiety. Lower serum prolactin and serotonin and higher serum cortisol were found in the newborns in the anxiety group.