Antidepressants May Mitigate the Effects of Prenatal Maternal Anxiety on Infant Auditory Sensory Gating

Abstract

Objective Prenatal maternal anxiety has detrimental effects on the resulting offspring’s neurocognitive development, including impaired attentional function. Antidepressants are commonly utilized during pregnancy, yet their impact on offspring attention and their interaction with maternal anxiety has not been assessed. Using P50 auditory sensory gating, a putative marker of early attentional processes measurable in young infants, the impact of maternal anxiety and antidepressant use are explored. Method Two hundred forty-two mother-infant dyads were classified relative to maternal history of anxiety and maternal prenatal antidepressant use. Infant P50 auditory sensory gating was recorded during active sleep at a mean± standard deviation of 76 ± 38 days of age. Results In the absence of prenatal antidepressant exposure, infants with mothers with a history of anxiety diagnoses had diminished P50 sensory gating (p<.001). Prenatal antidepressants mitigated the effect of anxiety (uncorrected p=.041). The effect of maternal anxiety was limited to amplitude of response to the second stimulus while antidepressants impacted the amplitude or response to both the first and second stimulus. Conclusion Maternal anxiety disorders are associated less inhibition during infant sensory gating, a performance deficit mitigated by prenatal antidepressant use. This effect may be important in considering the risks and benefits of prenatal antidepressant treatment. Cholinergic mechanisms are hypothesized for both anxiety and antidepressant effects; however the cholinergic receptors involved are likely different for anxiety and antidepressant effects. Additional work focused on understanding how treatment impacts the relationship between maternal prenatal illness and offspring neurocognitive development is indicated.

Diminished Infant P50 Sensory Gating Predicts Increased 40-Month-Old Attention, Anxiety/Depression, and Externalizing Symptoms

“…=49, p<.001) than response to the first stimulus (2.29±1.12 μV) demonstrating the presence of sensory gating. Mean ± standard deviation for P50 sensory gating ratios was 0.44±0.31, consistent with reported infant values (Hunter et al, 2011; Hunter et al, 2012). Those infants with robust sensory gating were older than infants with diminished sensory gating although the difference did not reach significance and no relationship between age and P50 sensory gating values has previously been identified (Suzuki & Azuma, 1977).…”

“…Having a parent with psychosis as a presumed increased genetic vulnerability or a mother with anxiety, and/or prenatal exposure to nicotine or other illicit substances as possible environmental risk factors are well-established larger effect size risk factors for later attention-driven behavioral impairment. Each of these risk factors is associated with impaired infant P50 sensory gating, with effects identifiable in even relatively small samples (Hunter, Kisley, McCarthy, Freedman, & Ross, 2011; Hunter et al, 2012). …”

Does Fetal Exposure to SSRIs or Maternal Depression Impact Infant Growth?

“…Prescribing a drug for a pregnant woman results from the physician’s judgment that her health is best served by treatment of the disorder, yet our literature is largely focused upon negative outcomes rather potential positive impacts on maternal disease and child outcomes (33, 34). For example, Hunter et al (35), demonstrated that infants born to mothers with anxiety disorders had impaired P50 auditory gating (a marker of infant attentional processing). Their novel finding was that maternal antidepressant treatment during pregnancy improved sensory gating in the offspring.…”

Dietary choline supplementation to dams during pregnancy and lactation mitigates the effects of in utero stress exposure on adult anxiety-related behaviors

“…Hippocampal nicotinic acetylcholine receptors (nAChRs) modulate anxiety- and depressive-related behaviors in adult animals [7–9], and are also sensitive to corticosterone and psychological stress in adulthood [10–12]. Furthermore, cholinergic abnormalities are associated with anxiety and depression in humans [13–18]. In rodents, prenatal stress alters levels of both alpha7* and alpha4 beta2* hippocampal nAChRs [19], and alters stress-dependent hippocampal cholinergic function in adulthood [20], suggesting that the effects of prenatal stress on anxiety-related behaviors may be driven by altered development of the hippocampal cholinergic system.…”