Symptoms of depression during pregnancy are associated with increased systolic blood pressure responses towards infant distress

Abstract

A mother's response towards her infant's distress is important for the mother-infant relationship and infant development. There is evidence that maternal responses are impaired in depressed mothers. Further understanding of how depression disrupts maternal responses is important to direct treatment strategies. There is evidence that maternal responses develop during pregnancy. Further understanding of the relationship between depression and maternal responses during pregnancy is therefore important. We have previously found that depression during pregnancy is associated with reduced attentional engagement with infant distress but is unclear whether this is an insensitive or avoidance response. In the current study, we investigated the impact of anhedonic symptoms of depression on pregnant women's autonomic response towards infant distress. We found that women experiencing anhedonic depressive symptoms during pregnancy had significantly larger systolic blood pressure responses towards infant distress (β, 1.6 mmHg, 95 % CI 0.5 to 2.6, p = 0.004) than non-depressed pregnant women. These results suggest that anhedonic symptoms during pregnancy may be associated with increased sympathetic sensitivity. This suggests that depression is not, at a sympathetic level at least, associated with insensitivity to infant distress and rather depression may be associated with an abnormally sensitive response.

Salivary cortisol response to infant distress in pregnant women with depressive symptoms

“…The current study importantly provides early evidence to suggest that, whilst HPA axis responses to stress are in general attenuated during pregnancy, there continues to be a robust salivary cortisol response to an acute stressor in women who are experiencing current symptoms of depression. Such evidence is consistent with a recent report of increased systolic blood pressure responses towards infant distress in pregnant depressed women compared with non-depressed controls (Pearson et al 2012 ). Taken together, these studies raise the intriguing possibility that depression during pregnancy is associated with a failure to demonstrate the usual attenuation of physiological responses to acute stress, which may be an important factor when considering alterations in the foetal environment that may be associated with disturbed maternal prenatal mood.…”

“…A limited number of studies have investigated mood-related changes in cardiovascular reactivity to acute stress during pregnancy (Monk et al 2000 ; Pearson et al 2012 ). The largest study, to date, suggested anhedonic symptoms of depression during pregnancy are associated with increased systolic blood pressure in response to infant distress stimuli (Pearson et al 2012 ). However, a critical gap in the literature is that it is currently unknown how maternal HPA axis reactivity in response to stress is altered in women who experience depression during pregnancy.…”

“…In the current study, salivary cortisol response to a film of distressed (crying) infants was examined in two groups of pregnant women with and without depressive symptoms. The distressed infant film was chosen as an acute stress induction because there is evidence that infant-related stimuli may be a particularly potent probe of mood-related differences in responsivity during pregnancy (Pearson et al 2012 ). It was predicted that cortisol responses would be increased in women who scored higher on a measure of depressive symptoms.…”

Approaching the biology of human parental attachment: Brain imaging, oxytocin and coordinated assessments of mothers and fathers

“…Notably, enhanced responsiveness to negative emotions, (mediated by enhanced amygdala response), has been observed in non-parent depression (Arnone et al, 2012). In depressed mothers, studies suggest women may avoid or limit exposure to distressing infant stimuli (Field, 2010; Murray et al, 1996; Pearson et al, 2012). In anxiety and depression, modulating stress and emotional responsiveness is an important target for treatment and is associated with clinical improvement (Harmer et al, 2011).…”

Associations between symptoms of depression and heart rate variability: An exploratory study

“…In line with our findings, melancholic features have previously been related to HRV parameters and poor cardiovascular prognosis. For example, anhedonia (loss of interest/pleasure) has been reported to be a predictor of cardiovascular events (Leroy et al, 2010) and to be associated with increased sympathetic sensitivity during pregnancy (Pearson et al, 2012); guilt, in normal volunteers has been associated with prolonged cardiac sympathetic arousal as measured by pre-ejection period (PEP) (Fourie et al, 2011). Another melancholic symptom, late insomnia, assessed by daily diary measures of late insomnia has been reported to have an inverse association with Cardiac Vagal Control, which is based on HF HRV (Rottenberg et al, 2007).…”