Maternal childhood trauma and perinatal distress are related to infants’ focused attention from 6 to 18 months

Maternal distress is repeatedly reported to have negative impacts on the cognitive development in children and is linked to neurodevelopmental disorders (e.g. attention-deficit/hyperactivity disorder and autism spectrum disorder). However, studies examining the associations between maternal distress and the development of attention in infancy are few. This study investigated the longitudinal relationships between maternal distress (depressive symptoms, anxiety symptoms, and exposure to childhood trauma) and the development of focused attention in infancy in 118 mother-infant dyads. We found that maternal exposure to non-interpersonal traumatic events in childhood was associated with the less focused attention of the infants to audio-visual stimuli at 6, 10, and 18 months. In addition, exposure to interpersonal traumatic events in childhood was identified as a moderator of the negative effect of maternal anxiety during the 2nd trimester on the development of focused attention in infants. We discuss the possible mechanisms accounting for these cross-generational effects. Our findings underscore the importance of maternal mental health to the development of focused attention in infancy and address the need for early screening of maternal mental health during pregnancy.

Exposure to prenatal maternal distress and infant white matter neurodevelopment

The prenatal period represents a critical time for brain growth and development. These rapid neurological advances render the fetus susceptible to various influences with life-long implications for mental health. Maternal distress signals are a dominant early life influence, contributing to birth outcomes and risk for offspring psychopathology. This prospective longitudinal study evaluated the association between prenatal maternal distress and infant white matter microstructure. Participants included a racially and socioeconomically diverse sample of 85 mother–infant dyads. Prenatal distress was assessed at 17 and 29 weeks’ gestational age (GA). Infant structural data were collected via diffusion tensor imaging (DTI) at 42–45 weeks’ postconceptional age. Findings demonstrated that higher prenatal maternal distress at 29 weeks’ GA was associated with increased fractional anisotropy, b = .283, t(64) = 2.319, p = .024, and with increased axial diffusivity, b = .254, t(64) = 2.067, p = .043, within the right anterior cingulate white matter tract. No other significant associations were found with prenatal distress exposure and tract fractional anisotropy or axial diffusivity at 29 weeks’ GA, or earlier in gestation.

Cumulative Effects of Prenatal and Concurrent Maternal Distress on Psychiatric Disorders in Adolescent Offspring

Background: Mental disorders affect 20% of children and adolescents globally and are among the most chronic and costly problems affecting youth. Offspring exposure to maternal disorders (depression, anxiety, and/or stress) prenatally as well as in adolescence increases the risk of psychopathology in adolescence. Objective: Exposure to maternal distress in pregnancy, as well as in adolescence, has independently been linked to psychopathology in youth. However, our understanding of the cumulative effects of exposure to maternal distress over time remains incomplete. Methods: 1964 participants enrolled in the 2014 Ontario Child Health Study (OCHS) aged 12-17 years completed the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Maternal prenatal distress was defined as mother-reported depression and/or anxiety during pregnancy requiring treatment. Maternal concurrent distress was self-reported when offspring were 12-17 years of age using the Kessler Psychological Distress Scale (K6). We examined associations between increasing levels of exposure to maternal distress (no exposure, prenatal exposure only, concurrent exposure only, both prenatal and concurrent exposure) and the risk of psychiatric disorder in 12-17-year-olds. Results: The odds of major depressive disorder (OR=1.29, 95% CI: 1.01- 1.67) and ADHD (OR=1.30, 95% CI: 1.02-1.65) increased with increasing exposure to maternal distress. Associations between increasing levels of maternal distress and several psychiatric disorders were amplified in males. Conclusions: The accumulation of exposure to maternal distress over time predicts offspring psychopathology in adolescence and emphasizes the significance of the early detection of maternal distress and ongoing monitoring and intervention to reduce the burden of mental disorders in offspring.

Prenatal maternal distress during the COVID-19 pandemic and its effects on the infant brain

The COVID-19 pandemic has caused elevated distress in pregnant individuals, which has the potential to impact the developing infant. In this study, we examined anxiety and depression symptoms during the pandemic in a large sample of pregnant individuals (n=8602). For a sub-sample of participants, their infants underwent magnetic resonance imaging (MRI) at 3-months of age to examine whether this prenatal maternal distress was associated with infant brain changes. We found significantly elevated prenatal maternal distress compared to pre-pandemic rates, with 47% and 33% of participants reporting clinically significant symptoms of anxiety and depression, respectively. Importantly, we identified social support as a protective factor for clinically elevated prenatal maternal distress. We found significant relationships between prenatal maternal distress and infant amygdala-prefrontal microstructural and functional connectivity and demonstrate for the first time that social support moderates this relationship. Our findings suggest a potentially long-lasting impact of the COVID-19 pandemic on children and show that social support acts as a protective factor not just for pregnant individuals, but also for their developing infants. These findings provide timely evidence to inform clinical practice and policy surrounding the care of pregnant individuals and highlight the importance of social support.

Maternal Psychological Distress and Children’s Internalizing/Externalizing Problems during the COVID-19 Pandemic: The Moderating Role Played by Hypermentalization

In order to explore the psychological impact of the COVID-19 outbreak on the caregiver–child relationship, we investigated the interplay among COVID-19 exposure and children’s internalizing/externalizing problems during the Italian lockdown, hypothesizing a mediation effect played by maternal distress. Additionally, we included maternal reflective functioning (i.e., hypermentalization) as a moderator factor among this interplay. A total of 305 Italian mothers of children aged 6–13 years (M = 10.3; SD = 2.4) filled in an online survey. Findings revealed an indirect effect of maternal COVID-19 exposure on children’s anxious/depressed (k2 = 0.46) and attention problems (k2 = 0.32) via maternal distress. Hypermentalization moderated the impact of maternal COVID-19 exposure on children’s anxious/depressed problems (β = −1.08, p = 0.04). Hypermentalization moderated both the relation between maternal distress and children’s aggressive behaviors (β = 12.226; p < 0.001) and between maternal distress and children’s attention problems (β = 5.617, p < 0.001). We found pivotal significant effects of maternal hypermentalization on children’s anxious/depressed and attention problems, indicating that the higher the mother’s hypermentalization was, the higher the children’s problems were. Our results broaden what we knew on the role of maternal reflective and emotional functioning on children’s emotional/behavioral adjustment during stressful situations.

“The Mental Health Piece is Huge”: perspectives on developing a prenatal maternal psychological intervention for congenital heart disease

Objectives: Women carrying a fetus diagnosed with congenital heart disease often experience significant distress because of their medical diagnosis. Given the well-documented impact associated with elevated prenatal stress and critical importance of developing targeted interventions, this study aims to examine stressors, coping and resilience resources, and mental health treatment preferences in pregnant women receiving a congenital heart disease diagnosis to inform the development of a psychological intervention to reduce maternal distress prenatally. Methods: Three groups of participants were included consisting of two pregnant women carrying a fetus with congenital heart disease, five women of children (4−16 months) with congenital heart disease, and five paediatric cardiology medical providers. Responses were gathered via semi-structured interviews and analysed using qualitative thematic analysis. Results: Information regarding four broad areas were analysed of emotional distress during pregnancy; experience of initial diagnosis; coping and resilience; and perspectives on a mental health intervention in pregnancy. Anxiety regarding baby’s future, guilt following diagnosis, and various coping strategies emerged as primary themes among the participant sample. Medical staff corroborated mothers’ heightened anxiety and viewed a psychotherapeutic intervention during the prenatal period as essential and complimentary to standard of care. Conclusion: We identified salient themes and preferred components for a future psychological intervention delivered prenatally. Practice Implications: Patients’ and providers’ perspectives regarding the nature of maternal distress, resilience and treatment preferences can inform the development of interventions to support the emotional well-being of pregnant women carrying a fetus with congenital heart disease to optimise care and potentially improve outcomes for fetal brain development.

Maternal Childhood Trauma and Perinatal Distress Predict Infants’ Attention From 6 to 18 Months

Maternal distress is repeatedly reported to have negative impacts on the cognitive development in children. Studies examining the association between maternal distress and the development of attention in infancy are few. This study investigated the longitudinal relationships between maternal distress (depressive symptoms, anxiety symptoms, and exposure to childhood trauma) and the development of attention in infancy in 118 mother-infant dyads. We found that maternal exposure to non-interpersonal traumatic events in childhood and a large degree of anxiety during the 2nd trimester was associated with less attention of the infants to audio-visual stimuli at 6, 10, and 18 months. In addition, exposure to interpersonal traumatic events in childhood was identified as a moderator of the negative effect of maternal anxiety during the 2nd trimester on the development of attention in infants. We discuss the possible mechanisms accounting for these cross-generational effects. Our findings underscore the importance of maternal mental health to the development of attention in infancy and address the need for early screening of maternal mental health during pregnancy.