Maternal corticosteroids and depression during gestation and decreased fetal heart rate variability

Abstract

Objective Maternal depression during gestation is an adverse factor in fetal brain development that manifests in later childhood behavioral problems. Fetal heart rate variability (FHRV) mediated by parasympathetic input is a marker of gestational nervous system development. Biological mediators of adverse effects of maternal depression may involve the mother's corticosteroids; however, links between depression, corticosteroids, and early nervous system development remain inconclusive.Methods Heart rate was recorded in 23 fetuses by transabdominal Doppler at 28-33 weeks gestation. The SD of interbeat intervals over 20 min assessed FHRV. Maternal depression ratings and hair concentrations of cortisol and cortisone were assayed. An auditory sensory gating paradigm assessed newborn development of cerebral inhibition. Parents rated their infant's temperament characteristics on the Infant Behavior Questionnaire-Revised Short Form (IBQ-R). ResultsMaternal depression was associated with lower FHRV, especially for male fetuses, β = −0.633, P = 0.045. Maternal depression was associated with lower cortisol to total corticosteroids ratios, β = −0.519, P = 0.033. Lower cortisol ratios were associated with decreased FHRV, β = 0.485, P = 0.019. Decreased FHRV was associated with increased newborn sensory gating deficits, β = −0.992, P = 0.035, indicating poorer development of cerebral inhibition. Higher FHRV was related to increased infant IBQ-R self-regulatory behaviors, r = 0.454, P = 0.029. ConclusionMaternal depression is associated via corticosteroids with decreased development of nervous system control of fetal heart rate. Decreased FHRV indicates developmental alterations in gestation that correlate with altered brain function and subsequent regulatory challenges in early infancy.

Pregnant women with bipolar disorder who have a history of childhood maltreatment: Intergenerational effects of trauma on fetal neurodevelopment and birth outcomes

“…Specifically, offspring of women in the symptomatic group with greater exposure to maternal CM had lower FHRV, especially males. This result is consistent with previous studies, including in our own work, providing evidence for an association between increased maternal prenatal distress and lower FHRV 15,22 . As previously discussed, lower FHRV is associated with a more reactive temperament in infancy, and can indicate less adept emotion regulation as well as biological sensitivity and susceptibility to stress and stress‐related psychopathology 52 …”

“…FHRV typically increases throughout gestation, and lower FHRV has been associated with a more reactive temperament (i.e., greater irritability), 17 which, in turn, is a risk factor for childhood and adolescent neuropsychiatric disorders including depression, anxiety, attention‐deficit hyperactivity disorder, and behavioral problems 18–21 . We and others have shown that increased maternal prenatal distress is associated with lower FHRV 15,22 . However, some have found evidence to suggest accelerated development where maternal distress was associated with increased FHRV, and others found no association 16 .…”

“…This result is consistent with previous studies, including in our own work, providing evidence for an association between increased maternal prenatal distress and lower FHRV. 15,22 As previously discussed, lower FHRV is associated with a more reactive temperament in infancy, and can indicate less adept emotion regulation as well as biological sensitivity and susceptibility to stress and stress-related psychopathology. 52 With respect to group differences in birth outcomes, women in the symptomatic versus euthymic group were more likely to give birth preterm.…”

“…[18][19][20][21] We and others have shown that increased maternal prenatal distress is associated with lower FHRV. 15,22 However, some have found evidence to suggest accelerated development where maternal distress was associated with increased FHRV, and others found no association. 16 In another study from our group, maternal report of childhood emotional abuse was associated with lower FHRV, mediated by maternal sleep disturbance across pregnancy.…”

Special Issue: “Exercise Intervention during Pregnancy and Maternal Health”

“…Many studies show that gestational psychological and emotional complications influence maternal, fetal, newborn, and even infant wellbeing. The scientific literature reports adverse outcomes such as premature delivery, longer and instrumental deliveries, low birth weight, and even alterations in the physical and cognitive development of the baby, as well as in the mother–child relationship [ 32 , 33 , 34 ].…”