Depression during pregnancy: molecular regulations of mothers’ and children's behaviour

Abstract

Depression in pregnancy (also called 'antenatal depression') is being increasingly recognized as a clinically relevant condition that affects obstetric outcome, maternal behaviour and children's future mental health. The present review focuses on the molecular mechanisms operating in utero that underlie the potential effects of antenatal depression on mothers' and children's behaviour. In particular, I discuss evidence, coming largely from animal and cellular studies, that activation of the main hormonal stress-response system, the HPA (hypothalamic-pituitary-adrenal) axis, in mothers who are depressed during pregnancy may affect maternal care as well as offspring's behaviour and future psychopathology. The evidence summarized in the present review supports the notion that preventing or treating depression in pregnancy will alleviate not only the suffering of mothers, but also the suffering of the next generation.

Delineating the association between mode of delivery and postpartum depression symptoms: a longitudinal study

“…Depression in mothers before and after childbirth is a major public health concern, with consequences on pregnancy outcome , mother affective status , and child behavioral and emotional development . The prevalence of postpartum depression (PPD) is estimated at around 10–20% and well‐established risk factors include presence of antepartum depression, psychiatric history, low self‐esteem, stressful life events and lack of social support .…”

Maternal depression and anxiety disorders (MDAD) and child development: A Manitoba population-based study

“…[3] Exposure to maternal depression and anxiety disorders (MDAD) has been shown to have a negative influence on child development in infancy,[4] early childhood,[5, 6] and at school entry,[7, 8] and is associated with poor birth outcomes,[4] elevated stress response,[4, 9, 10] negative temperament,[11] social, emotional and behavioural problems, [12, 13] impaired cognitive performance[14] and compromised physical health. [5] What is less is clear are the mechanisms through which MDAD influences child development.…”

“…Possible pathways include: biological , such as developmental or fetal programming, [4,15,16] epigenetic processes; [2, 9, 10] and birth outcomes; [17–20] and family/social context , including maternal sensitivity;[21–23] and socioeconomic factors such as low income, lone parenthood and teen motherhood. [24] These influences may be mutual or bi-directional [25] and have been found to mediate the relationship between MDAD and child outcomes.…”

Intergenerational transmission of depression: clinical observations and molecular mechanisms

“…Glucocorticoid hormones, the final product of the HPA axis, play a crucial role during fetal development, in processes such as tissue maturation and cellular differentiation 110 . The glucocorticoid receptor (GR) is a central mediator in fetal programming and in the development and regulation of the HPA axis, and has thus been the focus of much research in recent years 111 . There are many factors which affect the function and expression of the GR in the placenta, with one study showing that up to twelve different isoforms are present, whose expression can be dictated partly by fetal sex, as well as fetal size 112 .…”