Emotional Stress During Pregnancy – Associations With Maternal Anxiety Disorders, Infant Cortisol Reactivity, and Mother–Child Interaction at Pre-school Age

Abstract

There is growing evidence that even milder forms of maternal stress or anxiety during pregnancy affect the fetus causing possible long-term consequences for infant and child development. The mechanisms through which prenatal maternal stress may affect the unborn are not yet entirely clarified. Due to limited self-regulatory skills after birth, infants depend on sensitive behavior of their parents to regulate affective states and physiological arousal. Dyadic affect regulation has been linked to various developmental patterns up to adolescence and thereby represents a key element of early social relationships. Aim of the study was to evaluate possible long-term consequences of emotional stress during pregnancy and postpartum anxiety disorders, as well as infant postpartum cortisol reactivity on mother–child-interaction at pre-school age. The sample comprised of N = 63 mother–infant dyads at study entry, n = 28 diagnosed with postpartum anxiety disorders according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), n = 35 were healthy controls. Mothers were interviewed with the Structured Clinical Interview for DSM-IV Disorders at an average infant age of M = 4.1 months and filled out a questionnaire regarding emotional stress during pregnancy. Further, they were videotaped during the Face-to-Face-Still-Face paradigm (FFSF), a widely used mild socio-emotional stressor for infants. To determine infant stress-reactivity, infant salivary cortisol was collected before, immediately after and 20 min after the FFSF. Missing values were estimated by multiple imputations. At the age of M = 5.3 years, mother-child-interaction was re-assessed in a follow-up sample of n = 30 dyads via a free-play situation. Moreover, dimensional measures for anxiety were assessed. Mothers in the clinical group reported significantly higher stress scores than the control group. Infant stress reactivity in the early postpartum period and maternal anxiety symptoms at the 5-year follow-up assessment were significantly associated with dyadic interaction quality at pre-school age. Even though maternal stress during pregnancy did not directly predict mother–child interaction quality at pre-school age, it was significantly correlated with infant cortisol reactivity during postpartum period. Nevertheless, caution should be taken when interpreting the results considering the small sample size.

The Little Professor and the Virus: Scaffolding Children’s Meaning Making During the COVID-19 Emergency

“…Increased prevalence of post-traumatic stress symptoms was reported in survivals of the SARS epidemic (10) and preliminary evidence of similar psychological effects are also emerging for the Covid-19 emergency (11). Notably, the stress perceived by parents may widely affect parenting behaviors (12) and the quality of parent-child interaction (13,14). Neuroscientific (15) and epigenetic (16) evidence suggests that these stress-related parenting effects may have profound intergenerational consequences for children's emotional and cognitive development (17)(18)(19).…”

Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal

“…The mother’s intense emotions, feelings, and stress are associated with the health outcomes of the infant [ 23 ]. In this context, availability, accessibility, and affordability of quality newborn health care services are key to maternal positive mental health, newborn survival, growth, and development of infants [ 24 ].…”

An exercise program throughout pregnancy: Barakat model

“…This aspect is possibly the most important. The process of pregnancy and childbirth modifies (and puts at risk) the entire female body in all domains (physical, psychological, and emotional) (Mottola, 2016; Zietlow, Nonnenmacher, Reck, Ditzen, & Muller, 2019). Therefore, the scheduling of sessions and physical activities should depend on the different needs, complexities and requirements of the individuals during the pregnancy process (Barakat et al, 2019).…”

“…However, when mild exercises (without excessive overload) are performed, supine is a very suitable position as long as the duration of the exercise does not extend beyond 2–3 min and an alternation with tasks to the lying on side position is applied, always starting from the left side. In this sense, many studies have shown that in healthy pregnant women, exercise in the supine position in series that do not exceed 2–3 min does not represent a risk for the aforementioned supine‐hypotensive syndrome (Barakat et al, 2017; Barakat et al, 2018; Vargas‐Terrones et al, 2019; Zietlow et al, 2019). Likewise, the use of the modified supine position in which the support of the lumbar area is not compromised is recommended (Figures 9 and 10), which in theory can significantly reduce the risk of supine‐hypotensive syndrome. Side position : Side position is a suitable and relevant exercise option during pregnancy, not only due to the large number of applications derived from it, but also because it is an excellent alternative for the decompression of the inferior cava vein (i.e., inferior vena cava) and the consequent maintenance of venous return.…”

“…However, when mild exercises (without excessive overload) are performed, supine is a very suitable position as long as the duration of the exercise does not extend beyond 2-3 min and an alternation with tasks to the lying on side position is applied, always starting from the left side. In this sense, many studies have shown that in healthy pregnant women, exercise in the supine position in series that do not F I G U R E 8 Inferior cava vein compression by gravid uterus F I G U R E 9 The use of the modified supine position in which the support of the lumbar area is not compromised is recommended F I G U R E 1 0 The use of the modified supine position in which the support of the lumbar area is not compromised is recommended exceed 2-3 min does not represent a risk for the aforementioned supine-hypotensive syndrome (Barakat et al, 2017;Barakat et al, 2018;Vargas-Terrones et al, 2019;Zietlow et al, 2019). Likewise, the use of the modified supine position in which the support of the lumbar area is not compromised is recommended (Figures 9 and 10), which in theory can significantly reduce the risk of supinehypotensive syndrome.…”