The influence of maternal anxiety and cortisol during pregnancy on childhood anxiety symptoms

McGuinn, Laura A.; Tamayo‐Ortiz, Marcela; Rosa, Maria José; Harari, Homero; Osorio-Valencia, Erika; Schnaas, Lourdes; Hernández-Chávez, Carmen; Wright, Rosalind J.; Klein, Daniel N.; Téllez‐Rojo, Martha María; Wright, Robert O.

doi:10.1016/j.psyneuen.2022.105704

Cited by 15 publications

(5 citation statements)

References 64 publications

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“…For example, one US study that analyzed data from three different pregnancy cohorts found a relationship between maternal stress during pregnancy and emotional issues in offspring observed at ages 8 to 9 years (15). While many of the studies originate from Europe, North America, and Australia, similar ndings have been reported in other regions (13,(21)(22)(23)(24)(25). In one South African study, three-year-old children born to mothers experiencing both depression and anxiety during pregnancy faced a higher risk of emotional di culties compared to their counterparts born to mothers experiencing only one of these issues; children born to mothers without these symptoms were found to be at the lowest risk (22).…”

Section: Introductionmentioning

confidence: 83%

Prenatal maternal stress: triangulating evidence for intrauterine exposure effects on birth and early childhood outcomes across multiple approaches

Lund,

Hannigan,

Ask

et al. 2024

Preprint

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Background: Maternal stress during pregnancy may impact offspring development via changes in the intrauterine environment. However, genetic and environmental factors shared between mothers and children might skew our understanding of this pathway. This study assesses whether prenatal maternal stress has causal links to offspring birthweight, gestational age, or emotional and behavioral difficulties, triangulating across methods that account for various measured and unmeasured confounders. Methods: We used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa), including maternal reports on prenatal stress at work, at home, and via stressful life events as exposures. Outcomes were children’s birth weight and gestational age, from the Medical Birth Registry of Norway, and maternal reports on early childhood emotional and behavioral difficulties. We assessed associations using four approaches: sibling control analyses, gene-environment interaction analyses, intergenerational Mendelian Randomization (MR), and negative control (i.e., post-natal stress) analyses. Results: Maternal prenatal stress was observationally associated with lower birthweight (e.g., 𝛽work = -0.01 [95%CI: -0.02,-0.01]), earlier birth (e.g., 𝛽work = -0.04 [95%CI:-0.04,-0.03])), and more emotional (e.g., 𝛽events = [0.08 95%CI:0.07,0.9]) and behavioral difficulties (e.g., 𝛽relationship = 0.08 [95%CI: 0.07,0.09]) in the full sample (N = 112,784). However, sibling control analyses (N = 36,511), revealed substantial attenuation of all associations after accounting for familial factors. Gene-environment interaction models (N = 76,288) showed no clear evidence of moderation of associations by mothers’ polygenic scores for traits linked to stress sensitivity. Intergenerational MR analyses (N = 29,288) showed no clear evidence of causal effects of maternal plasma cortisol on any offspring outcomes. Negative control exposure analyses revealed similar effect sizes whether exposures were measured prenatally or postnatally. Conclusion: Our results indicate that links between prenatal maternal stress and variation in early offspring outcomes are more likely to be confounded than causal. While no observational study can rule out causality, the consistency of our findings across different approaches is striking. Other sources of prenatal stress or more extreme levels may represent intrauterine causal risk factors for offspring development. Nonetheless, our research contributes to identifying boundary conditions of the fetal programming and developmental origins of health and disease hypotheses, which may not be as universal as sometimes assumed.

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Section: Introductionmentioning

confidence: 83%

Prenatal maternal stress: triangulating evidence for intrauterine exposure effects on birth and early childhood outcomes across multiple approaches

Lund,

Hannigan,

Ask

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Wu et al 13 studied mother-infant dyads and found an association between prenatal maternal stress and infant cognitive outcome mediated by fetal left hippocampal volume. McGuinn et al 14 found that higher levels of pregnancy-specific anxiety in the mother were associated with higher anxiety symptoms in the child. Changes in fetal circulation due to maternal anxiety may be related to long-term effects on the offspring.…”

Section: Discussionmentioning

confidence: 99%

Effects of maternal anxiety on fetal and maternal circulation

Jorge

Nomura

2023

Rev. Assoc. Med. Bras.

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OBJECTIVE:The aim of this study was to evaluate the association between maternal anxiety in the third trimester and changes in fetal and maternal circulation assessed by Doppler velocimetry. METHODS: This is a prospective, cross-sectional study. The inclusion criteria were good health, a singleton pregnancy, maternal age between 18 and 40 years, and gestational age between 34 and 40 weeks. Doppler measurements included mean uterine artery pulsatility index, fetal middle cerebral artery pulsatility index, peak of systolic velocity, umbilical artery, and umbilical vein. The Beck Anxiety Inventory questionnaire, validated for the Brazilian population, with 21 self-reported items, was applied. RESULTS:The study included 34 pregnant women, and 6 (17.7%) presented a total Beck Anxiety Inventory score showing moderate or severe maternal anxiety. The mean maternal age was 28.1 years (SD 5.7 years); the mean gestational age at interview was 36.5 weeks (SD 1.8 weeks), and the mean Beck Anxiety Inventory total score was 12.3 (SD 9.8). The group with moderate or severe anxiety, compared to the group with minimal or mild anxiety, presented an association with lower maternal age (median 21.5 vs. 29.5 years, p=0.019), lower fetal umbilical vein blood flow (median 189.4 vs. 249.5 mL/min, p=0.047), and lower umbilical vein-corrected blood flow (median 68.5 vs. 84.9 mL/kg/min, p=0.038). CONCLUSION: Maternal anxiety may affect fetal circulation patterns in late pregnancy and is associated with reduced blood flow in the fetal umbilical vein. The underlying physiopathology needs further investigation.

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“…Of these, cortisol awakening response during pregnancy appeared to be the sole mediating variable of maternal ACEs and children’s internalizing problems, suggesting that prenatally, maternal cortisol output in the mornings was more predictive of children’s psychological distress at four years of age relative to total daily cortisol secretion or cortisol change during the day. 45 McGuinn et al 71 report conflicting results, such that only total cortisol output, and not cortisol awakening response, predicted children’s anxiety postnatally. However, that study did not examine the experiences of mothers’ early childhood, which is known to influence HPA axis functioning in adulthood including during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the association between maternal adverse childhood experiences and preschool children’s behavioural problems: a systematic review of mediators and moderators

Kurbatfinski,

Letourneau,

Dewey

et al. 2023

Clinical Medicine Insights: Psychiatry

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Background Adverse childhood experiences (ACEs) are pernicious events (e.g., physical abuse) that occur before 18 years of age within the household. Mothers’ ACEs are associated intergenerationally with their preschool children’s (two-to-five-year-old) behavioural problems, impacting lifelong mental health trajectories. Mediators (e.g., mental health) may explain how mothers’ ACEs exert their influence on children's behavioural development whereas moderators (e.g., child sex) may affect the strength and direction of the association, revealing potential points of intervention. Therefore, this study aimed to: (1) identify mediators and moderators of this association; and (2) describe and compare moderation and mediation outcomes. Methods This review (#CRD42022307214) extracted data from peer-reviewed literature formally analyzing at least one moderating or mediating variable of the association between maternal ACEs and preschool children’s behavioural problems using MEDLINE, Embase, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, SCOPUS, and Web of Science databases (n = 7). Validity was assessed using the Joanna Briggs Institute checklists. Results Thirteen full-text studies with moderate-to-high validity were identified. Most studies examined mediating variables, with unanimous support for mediation through maternal depression. The mediating roles of adult attachment styles and anxiety were conflicting. No studies examined environmental factors (e.g., neurotoxins). Conclusions Mothers’ depression is a significant contributor to children’s behavioural problems in the context of ACEs and should be a target of early intervention to prevent lifelong challenges. Future research should focus on examining more moderating variables and consider the roles of environmental factors. More research is needed on the moderating and mediating roles of genes.

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The influence of maternal anxiety and cortisol during pregnancy on childhood anxiety symptoms

Cited by 15 publications

References 64 publications

Prenatal maternal stress: triangulating evidence for intrauterine exposure effects on birth and early childhood outcomes across multiple approaches

Prenatal maternal stress: triangulating evidence for intrauterine exposure effects on birth and early childhood outcomes across multiple approaches

Effects of maternal anxiety on fetal and maternal circulation

Factors affecting the association between maternal adverse childhood experiences and preschool children’s behavioural problems: a systematic review of mediators and moderators

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