Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study

Vizzini, Loredana; Popović, Maja; Zugna, Daniela; Vitiello, Benedetto; Trevisan, Morena; Pizzi, Costanza; Rusconi, Franca; Gagliardi, Luigi; Merletti, Franco; Richiardi, Lorenzo

doi:10.1017/s2045796018000185

Cited by 61 publications

(40 citation statements)

References 54 publications

(70 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[ 7 – 10 ] Untreated perinatal depression may result in adverse obstetric outcomes and is a risk factor for poor maternal health, inadequate prenatal care, and postnatal depression. [ 10 , 11 ] In addition to the potential negative impact on pregnancy outcomes, perinatal depression is associated with disrupted maternal-infant bonding, increased irritability, and decreased activity. Children born to depressed mothers are at risk for delayed cognitive and language development, lower IQ, and increased prevalence of psychiatric and emotional problems.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic

Kajdy¹,

et al. 2020

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic

Kajdy¹,

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The vertical transmission of maternal immune and endocrine markers is increasingly recognized to modulate fetal neurodevelopment and future mental health of the offspring. Emerging evidence arising from observational studies in humans reveals that prenatal environmental challenges such as maternal distress perception and infections are associated with an impaired fetal neurodevelopment and increased risk for neurological or psychiatric disorders later in life ( 1 – 6 ). Insights into the underlying mechanisms and pathogenesis of prenatally programmed poor mental health are increasingly emerging.…”

Section: Introductionmentioning

confidence: 99%

Prenatal Immune and Endocrine Modulators of Offspring's Brain Development and Cognitive Functions Later in Life

et al. 2018

View full text Add to dashboard Cite

Milestones of brain development in mammals are completed before birth, which provide the prerequisite for cognitive and intellectual performances of the offspring. Prenatal challenges, such as maternal stress experience or infections, have been linked to impaired cognitive development, poor intellectual performances as well as neurodevelopmental and psychiatric disorders in the offspring later in life. Fetal microglial cells may be the target of such challenges and could be functionally modified by maternal markers. Maternal markers can cross the placenta and reach the fetus, a phenomenon commonly referred to as “vertical transfer.” These maternal markers include hormones, such as glucocorticoids, and also maternal immune cells and cytokines, all of which can be altered in response to prenatal challenges. Whilst it is difficult to discriminate between the maternal or fetal origin of glucocorticoids and cytokines in the offspring, immune cells of maternal origin—although low in frequency—can be clearly set apart from offspring's cells in the fetal and adult brain. To date, insights into the functional role of these cells are limited, but it is emergingly recognized that these maternal microchimeric cells may affect fetal brain development, as well as post-natal cognitive performances and behavior. Moreover, the inheritance of vertically transferred cells across generations has been proposed, yielding to the presence of a microchiome in individuals. Hence, it will be one of the scientific challenges in the field of neuroimmunology to identify the functional role of maternal microchimeric cells as well as the brain microchiome. Maternal microchimeric cells, along with hormones and cytokines, may induce epigenetic changes in the fetal brain. Recent data underpin that brain development in response to prenatal stress challenges can be altered across several generations, independent of a genetic predisposition, supporting an epigenetic inheritance. We here discuss how fetal brain development and offspring's cognitive functions later in life is modulated in the turnstile of prenatal challenges by introducing novel and recently emerging pathway, involving maternal hormones and immune markers.

show abstract

“…Both groups experienced worsening depressive symptoms as pregnancy progressed, and women with pre-existing mood disorders reported higher rates of disruption to biological rhythms and sleep, suggesting that disordered sleep contributes to severity of postnatal depression. There is also evidence that disordered sleep in pregnancy can impact infant wellbeing, such as increased risk of attention deficit hyperactivity disorder [19]. Treatment of SDB has been effective at reducing depressive symptoms in the general population [20, 21] and it seems reasonable to extrapolate this to pregnant women.…”

Section: Prognostic Consequencesmentioning

confidence: 99%

Pregnant pause: should we screen for sleep disordered breathing in pregnancy?

Perkins

Einion

2019

Breathe

View full text Add to dashboard Cite

Physiological and hormonal changes in pregnancy can contribute towards sleep disordered breathing in pregnant women (SDBP). When present, SDBP increases the risk of several adverse maternal and fetal outcomes independent of factors such as age, weight and pre-existing maternal comorbidities. SDBP is underdiagnosed and may be hard to recognise because the presentation can be difficult to differentiate from normal pregnancy and the severity may change over the course of gestation. Timely intervention seems likely to help reduce adverse outcomes, but the relative benefits of intervention are still unclear. The definition of what constitutes a sleep-related breathing “disorder” in pregnancy may be different to the general population and so traditional thresholds for intervention may not be relevant in pregnancy. Any modifications to the disease definition in this group, or implementation of more intensive screening, may result in overdiagnosis. Further research is needed to help clinicians evaluate the balance of benefits and harms in this process. Until this is clearer there is a strong imperative for shared decision making in screening and treatment decisions, and screening programmes should be monitored to assess whether improved outcomes can be achieved at the healthcare system level.Key pointsUntreated sleep disordered breathing in pregnancy poses risks to maternal and fetal wellbeing, but it is underdiagnosed.Careful approaches to screening could improve rates of diagnosis, but thresholds for and benefits of intervention are unclear.Clinical guidelines and screening programmes for sleep disordered breathing in pregnancy need to consider the potential harms of overdiagnosis and should involve shared decision making and careful monitoring of outcomes relevant to the individual.Educational aimsExplore current knowledge of the prevalence of sleep disordered breathing in the pregnant population.Explore the relationship between sleep disordered breathing and adverse outcomes.Understand the approaches to diagnosis and management of sleep disordered breathing in pregnancy.Explore issues around screening, underdiagnosis and overdiagnosis in the context of sleep disordered breathing in pregnancy.

show abstract

Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study

Abstract: Maternal anxiety, depression and sleep disorders are associated with a relative increase in the number of ADHD-H, ADHD-I and total ADHD symptoms in preschoolers.

Cited by 61 publications

References 54 publications

Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic

Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic

Prenatal Immune and Endocrine Modulators of Offspring's Brain Development and Cognitive Functions Later in Life

Pregnant pause: should we screen for sleep disordered breathing in pregnancy?

Contact Info

Product

Resources

About