Prenatal Maternal Psychological Distress and Offspring Risk for Recurrent Respiratory Infections

Korhonen, Laura; Karlsson, Linnéa; Scheinin, Noora M.; Korja, Riikka; Tolvanen, Mimmi; Mertsola, Jussi; Peltola, Ville; Karlsson, Hasse

doi:10.1016/j.jpeds.2018.12.050

Cited by 16 publications

(26 citation statements)

References 29 publications

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“…Our smaller cohort size does however limit our analyses with regards to less common stress exposures such as death of a family member. In contrast to other studies of maternal stress and adverse childhood outcomes with shorter followup [8][9][10][11], the associations reported here include a longer follow-up period of childhood and adolescence to age 16 years.…”

Section: Plos Onementioning

confidence: 70%

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Maternal prenatal stress exposure and sex-specific risk of severe infection in offspring

et al. 2021

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Background Maternal stressful life events during pregnancy have been associated with immune dysregulation and increased risk for asthma and atopy in offspring. Few studies have investigated whether prenatal stress is associated with increased overall or specific infectious diseases in childhood, nor explored sex differences. We sought to examine the relationship between the nature and timing of maternal stress in pregnancy and hospitalisation with infection in offspring. Methods Between 1989 and 1992, exposure data on stressful life events were collected from pregnant women (Gen1) in the Raine Study at 18 and 34 weeks’ gestation and linked to statutory state-wide hospital morbidity data. We examined associations between the number, category and timing of maternal prenatal stress events and overall and clinical groups of offspring (Gen2) infection-related hospitalisation until age 16 years, adjusting for maternal age, education, and smoking in pregnancy in addition to the presence of siblings at birth. Results Of 2,141 offspring with complete stress in pregnancy data available, 1,089 had at least one infection-related hospitalisation, with upper respiratory tract infections the most common (n = 556). Each additional stressful life event during pregnancy was associated with increased risk in male offspring for hospitalisation with all infection types. There was little evidence of these associations in girls. Conclusions Increased exposure to stressful life events in utero is associated with sex-specific infection-related hospitalisations in childhood. Prenatal stress may adversely affect early immune development for boys and increase the risk of more severe infections. Mechanistic understanding would inform preventative interventions.

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Section: Plos Onementioning

confidence: 70%

“…Prenatal maternal stress is correlated with specific early life infections in offspring [8][9][10][11], but longitudinal data through childhood and adolescence are scarce. Maternal bereavement during pregnancy is associated with increased overall and infection-specific mortality in offspring into middle age [12].…”

Section: Introductionmentioning

confidence: 99%

Maternal prenatal stress exposure and sex-specific risk of severe infection in offspring

et al. 2021

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“…Pregnancy-induced symptoms fluctuate across gestational weeks [ 1 , 2 ]. These symp-toms cause significant distress that impacts daily functioning, interferes with work per-formance and impairs the quality of life of both pregnant women and their families [ 3 , 4 , 5 ]. Moreover, persistent and severe symptoms are associated with adverse effects regarding fetal development and increased pregnancy risks, such as preeclampsia, vaginal bleeding, preterm birth and postpartum complications [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

Lee

Wen

Hsiung

et al. 2021

IJERPH

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During pregnancy, a woman’s enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be “Decreased then Increased” (56.8%). Other noticeable patterns were “Continuously Increased” (28.4%), “Increased then Decreased” (10.5%) and “Continuously Decreased” (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants’ major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the “moderately distressful” level. This study provides evidence that could be used to predict women’s pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.

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“…However, maternal stress, such as depressive symptoms or elevated levels of glucocorticoids during pregnancy can compromise this barrier function and increase the risk of adverse developmental and health outcomes ( Moisiadis and Matthews, 2014a , 2014b ). Depressive symptoms during pregnancy are common with a prevalence of 4–20% ( Smith et al, 2020 ) and have been associated for example, with fetal hyperactivity and central adiposity ( Dieter et al, 2001 ; Ertel et al, 2010 ; Gentile, 2017 ), recurrent respiratory infections ( Korhonen et al, 2019 ), and motor, cognitive, language, adaptability and social-emotional outcomes ( Rogers et al, 2020 ). Even mild maternal symptoms have been associated with emotional problems in early childhood ( Pietikäinen et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Placental DNA methylation marks are associated with maternal depressive symptoms during early pregnancy

Lund

Kyläniemi

Pettersson

et al. 2021

Neurobiology of Stress

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Maternal depressive symptoms during pregnancy are a significant risk factor for adverse developmental and health outcomes of the offspring. The molecular mechanisms mediating the long-term effects of this exposure are not well understood. Previous studies have found association between prenatal exposure to maternal psychological distress and placental DNA methylation of candidate genes, which can influence placental barrier function and development of the fetus. Our objective in this study was to determine epigenome wide association of maternal depressive symptoms in early pregnancy with the placental DNA methylation. For this purpose we examined DNA methylomes of 92 placental samples by using reduced representation bisulfite sequencing. The placental samples were collected after deliveries of 39 girls and 59 boys, whose mothers had Edinburgh Postnatal Depression Score ranging from 0 to 19 at gestational week 14. According to our results maternal depressive symptoms are associated with DNA methylation of 2833 CpG sites, which are particularly over-represented in genic enhancers. The genes overlapping or nearest to these sites are functionally enriched for development of neurons and show expression enrichment in several regions of developing brain. The genomic regions harboring the DNA methylation marks are enriched for single nucleotide polymorphisms associated with mental disease trait class. Potential cellular signaling cascades mediating the effects include inflammatory and hormonal pathways. As a conclusion our results suggest that maternal depressive symptoms during early pregnancy are associated with DNA methylation marks in placenta in genes, which are important for the development and long-term health of the brain. Whether similar marks can be detected in exposed children remains to be elucidated in further studies.

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Prenatal Maternal Psychological Distress and Offspring Risk for Recurrent Respiratory Infections

Cited by 16 publications

References 29 publications

Maternal prenatal stress exposure and sex-specific risk of severe infection in offspring

Maternal prenatal stress exposure and sex-specific risk of severe infection in offspring

Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

Placental DNA methylation marks are associated with maternal depressive symptoms during early pregnancy

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