Maternal generalized anxiety disorder during pregnancy and fetal brain development: A comparative study on cord blood brain-derived neurotrophic factor levels

Uğuz, Faruk; Sönmez, Erdem Önder; Sahingoz, Mine; Gökmen, Zeynel; Başaran, Mustafa; Gezginç, Kazım; Sönmez, Gülsüm; Kaya, Nazmiye; Erdem, Sami; Çiçekler, Hümeyra; Tasyurek, Erkan

doi:10.1016/j.jpsychores.2013.04.010

Cited by 43 publications

(31 citation statements)

References 42 publications

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“…It has been shown that maternal stress influences the development of the functions of the hippocampus in offspring, which is related to the reduction in the expression of BDNF . On the other hand, a study in maternal generalized anxiety disorder (GAD) during pregnancy, BDNF levels in cord blood in newborns of healthy women were significantly higher compared with infants of mothers with GAD . In stress‐induced pregnancy complications, such as pre‐eclampsia, BDNF levels are significantly lower compared with normotensive women .…”

Section: Discussionmentioning

confidence: 99%

Brain‐derived neurotrophic factor is expressed in rat and human placenta and its serum levels are similarly regulated throughout pregnancy in both species

Garcés

Sánchez

Torres-Sierra

et al. 2014

Clinical Endocrinology

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Section: Discussionmentioning

confidence: 99%

Brain‐derived neurotrophic factor is expressed in rat and human placenta and its serum levels are similarly regulated throughout pregnancy in both species

Garcés

Sánchez

Torres-Sierra

et al. 2014

Clinical Endocrinology

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“…19 Few studies have investigated the impact of maternal GAD on short-and long-term child development outcome; the available data suggests that maternal GAD negatively impacts neurodevelopment and growth of the infant. Uguz and colleagues 20 found that maternal GAD during pregnancy led to significantly lower levels of fetal brain-derived neurotrophic factor potentially negatively impacting the neurodevelopment of the fetus.…”

Section: Consequences Of Gad In Mother and Infantmentioning

confidence: 99%

Perinatal Generalized Anxiety Disorder: Assessment and Treatment

Misri

Abizadeh

Sanders

et al. 2015

Journal of Women's Health

102

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Perinatal generalized anxiety disorder (GAD) has a high prevalence of 8.5%-10.5% during pregnancy and 4.4%-10.8% postpartum. Despite its attendant dysfunction in the patient, this potentially debilitating mental health condition is often underdiagnosed. This overview will provide guidance for clinicians in making timely diagnosis and managing symptoms appropriately. A significant barrier to the diagnosis of GAD in the perinatal population is difficulty in distinguishing normal versus pathological worry. Because a perinatal-specific screening tool for GAD is nonexistent, early identification, diagnosis and treatment is often compromised. The resultant maternal dysfunction can potentially impact mother-infant bonding and influence neurodevelopmental outcomes in the children. Comorbid occurrence of GAD and major depressive disorder changes the illness course and its treatment outcome. Psychoeducation is a key component in overcoming denial/stigma and facilitating successful intervention. Treatment strategies are contingent upon illness severity. Cognitive behavior therapy (CBT), relaxation, and mindfulness therapy are indicated for mild GAD. Moderate/severe illness requires pharmacotherapy and CBT, individually or in combination. No psychotropic medications are approved by the FDA or Health Canada in pregnancy or the postpartum; off-label pharmacological treatment is instituted only if the benefit of therapy outweighs its risk. SSRIs/SNRIs are the first-line treatment for anxiety disorders due to data supporting their efficacy and overall favorable side effect profile. Benzodiazepines are an option for short-term treatment. While research on atypical antipsychotics is evolving, some can be considered for severe manifestations where the response to antidepressants or benzodiazepines has been insufficient. A case example will illustrate the onset, clinical course, and treatment strategies of GAD through pregnancy and the postpartum.

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“…This may be due to the substantial hormonal, physiological, psychological and social changes that occur during this time. Antenatal anxiety has been associated with a range of adverse perinatal outcomes for women and their offspring including poor pregnancy and birth outcomes as well as compromised physical, psychological and cognitive development from infancy to adulthood (Wadhwa et al 1993; Bhagwanani et al 1997; Kurki et al 2000; Mulder et al 2002; O’Connor et al 2002; Andersson et al 2004; Van Den Bergh et al 2005; Talge et al 2007; Hanlon et al 2009; Nasreen et al 2010; Misri et al 2010; Uguz et al 2013). …”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of anxiety disorders amongst low-income pregnant women in urban South Africa: a cross-sectional study

Heyningen

Honikman

Myer

et al. 2017

Arch Womens Ment Health

105

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Purpose Anxiety is highly prevalent in many populations; however, the burden of anxiety disorders among pregnant women in low-resource settings is not well documented. We investigated the prevalence and predictors of antenatal anxiety disorders among low-income women living with psychosocial adversity. Methods Pregnant women were recruited from an urban, primary level clinic in Cape Town, South Africa. The MINI Plus diagnostic interview assessed prevalence of anxiety disorders. Four self-report questionnaires measured psychosocial characteristics. Logistic regression models explored demographic and socioeconomic characteristics, psychosocial risk factors and psychiatric comorbidity as predictors for anxiety disorders. Results Among 376 participants, the prevalence of any anxiety disorder was 23%. Although 11% of all women had post-traumatic stress disorder, 18% of the total sample was diagnosed with other anxiety disorders. Multivariable analysis revealed several predictors for anxiety including: a history of mental health problems (Adjusted Odds Ratio [AOR]: 4.11; 95% confidence interval (CI): 2.03–8.32), MDE diagnosis (AOR: 3.83; CI 1.99–7.31), multi-gravidity (AOR: 2.87; CI: 1.17–7.07), food insecurity (AOR: 2.57; CI: 1.48–4.46), unplanned and unwanted pregnancy (AOR: 2.14; CI: 1.11–4.15), pregnancy loss (AOR: 2.10; CI: 1.19–3.75); and experience of threatening life events (AOR: 1.30; CI: 1.04–1.57). Increased perceived social support appeared to reduce the risk for antenatal anxiety (AOR: 0.95; CI: 0.91–0.99). Conclusion A range of antenatal anxiety disorders are prevalent amongst pregnant women living in low-resource settings. Women who experience psychosocial adversity may be exposed to multiple risk factors, which render them vulnerable to developing antenatal anxiety disorders.

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Maternal generalized anxiety disorder during pregnancy and fetal brain development: A comparative study on cord blood brain-derived neurotrophic factor levels

Cited by 43 publications

References 42 publications

Brain‐derived neurotrophic factor is expressed in rat and human placenta and its serum levels are similarly regulated throughout pregnancy in both species

Brain‐derived neurotrophic factor is expressed in rat and human placenta and its serum levels are similarly regulated throughout pregnancy in both species

Perinatal Generalized Anxiety Disorder: Assessment and Treatment

Prevalence and predictors of anxiety disorders amongst low-income pregnant women in urban South Africa: a cross-sectional study

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