The perinatal origins of childhood anxiety disorders and the role of early-life maternal predictors

Abstract

Background The development of childhood anxiety disorders (CADs) is likely to depend on pathways that can be programmed by early-life risk factors. We test the hypothesis that early-life maternal factors can predict this programming effect on CAD. Methods Data were obtained from 198 women and children from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy, postpartum and until 4 years of age. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV), together with antenatal hair cortisol concentrations, maternal childhood trauma and parenting stress at 6 months postpartum. CAD was assessed with the Preschool Age Psychiatric Assessment and the Child Behaviour Checklist. Results Antenatal depression, a history of maternal childhood trauma and lower gestational age at birth were each associated with anxiety disorders at 4 years of age in their children. A multivariate binary logistic model with these early predictors explained approximately 9% of variance in CAD outcome at 4 years of age; however, only maternal trauma and gestational age were significant predictors in the model. The effect of early parenting stress on CAD was found to vary by the concentration of maternal antenatal hair cortisol, whereby postpartum parenting stress was associated with CAD only when there were higher maternal antenatal cortisol levels. Conclusions This study suggests the importance of maternal factors pre-conception, pregnancy and in the postnatal period, which predict CADs and this is consistent with a developmental programming hypothesis for CAD.

Parenting stress, maternal depression and child mental health in a Melbourne cohort before and during the COVID‐19 pandemic

“…Given the robust nature of the measures and design that included the ability to adjust for previous depressive disorders and trajectories that included symptoms predating the pandemic, we found evidence that those mothers vulnerable to depression were impacted on their mental health through exposure to the significant pandemic related stresses such as those emerging in Melbourne. In contrast, it is reassuring that in a cohort previously reported as a high risk for child mental disorders, we did not find differences for children's mental health in those exposed to these pandemic conditions compared to those who were not 30 . Of note parenting stress did not differ and it may be that while women experienced a decline in their mental health, there were clearly compensatory aspects that were protective for their parenting and their children.…”

“…In contrast, it is reassuring that in a cohort previously reported as a high risk for child mental disorders, we did not find differences for children's mental health in those exposed to these pandemic conditions compared to those who were not. 30 Of note parenting stress did not differ and it may be that while women experienced a decline in their mental health, there were clearly compensatory aspects that were protective for their parenting and their children. For example, increased paternal involvement in child care has been reported as a protective factor in a Chinese sample.…”

Mineralocorticoid receptor and glucocorticoid receptor work alone and together in cell-type-specific manner: Implications for resilience prediction and targeted therapy

“…connectivity of the ‘right’ amygdala, in female offspring only ( Buss et al, 2012 ; Graham et al, 2019 ; Soe et al, 2018 ). Remarkable is that the female prevalence of the maternal programming effect is associated with the 12 months infant cortisol reactivity and with internalization and emotional problems at an age of 4 years ( Galbally et al, 2022b ). In a subsequent study, the association of maternal depression appeared to be female-specific for infant cortisol reactivity and later emotional disorder of the 4 year old.…”

“…These associations were found mediated by reduced expression of placental 11HSD-2 mRNA. A diminished 11HSD-2 activity would result in excess cortisol that passes through the placenta, and which then could become engaged in female-specific programming of an emotional ‘amygdala’ ( Galbally et al, 2021 , 2022a , 2022b ; Jahnke et al, 2021 ). In animal studies the GR-mediated glucocorticoid amygdala programming of an emotional phenotype was uncovered before ( Daskalakis et al, 2014b ; Moriceau et al, 2006 ), but if this is also sex-specific and involves lateralization of the amygdala awaits further research.…”

Effects of maternal childhood trauma on child emotional health: maternal mental health and frontoamygdala pathways

“…Such adversities (including abuse, neglect, and maladaptive family environments) pose significant psychological health risks to the exposed individual (McLaughlin et al., 2012). Less discussed, but equally as important, are the health risks such adversities pose to future generations (Bouvette‐Turcot et al., 2020; Cooke, Racine, Plamondon, Tough, & Madigan, 2019; Galbally et al., 2020; Pawlby, Hay, Sharp, Cerith, & Pariante, 2011; Plant, Barker, Waters, Pawlby, & Pariante, 2013; Plant, Pawlby, Pariante, & Jones, 2018; Rijlaarsdam et al., 2014; Su, D'Arcy, & Meng, 2022). While mechanisms underlying the transgenerational impact of maternal early trauma on child emotional outcomes remain elusive, research suggests that effects on maternal mood and children's neurodevelopment are important pathways of influence.…”