Special Issue "Prenatal Psychological Stress Exposure and Neurodevelopment and Health of Children"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (31 July 2019).

Special Issue Editors

Prof. Dr. Tessa Roseboom
Website
Guest Editor
Department of Clinical Epidemiology, Biostatistics and Bioinformatics & Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam 1105 AZ, The Netherlands
Interests: early development and health
Dr. Susanne De Rooij
Website
Guest Editor
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam 1105 AZ, The Netherlands
Department of Developmental Psychology – StressLab, VU University Amsterdam, Amsterdam 1081 BT, The Netherlands
Interests: Early Life Stress
Drs. Laura Bleker
Website
Guest Editor
Department of Clinical Epidemiology, Biostatistics and Bioinformatics & Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam 1105 AZ, The Netherlands
Interests: fetal programming of neurodevelopment

Special Issue Information

Dear Colleagues,

The prenatal environment has long-lasting effects on the neurodevelopment and health of children. Psychological stress is among the factors that may have profound effects on fetal (neuro)development and thereby affect children’s health and wellbeing.

Stress is a complex and multifactorial phenomenon, and can be interpreted in many ways. First, stress, or a ‘stressor’, can point to an event that has the potential to elicit a stress response when a person perceives this event as being ‘beyond one’s capacity to cope with the particular event’. A stressful event may include experiencing a war, losing a loved one, losing a job or experiencing domestic violence. How ‘stressful’ someone then perceives this event differs between individuals. A certain event can lead to feelings of depression in one person, feelings of agitation in another person, whereas someone else may experience no feelings of stress at all. Moreover, while one person can experience many stressful events without developing symptoms of depression or anxiety, another person may feel extremely depressed to the point of losing the will to live, without having experienced a single stressor in his or her life. This is both intriguing as it is frustrating for those trying to understand the phenomenon ‘stress’, in order to target (preventive) strategies. Besides a genetic predisposition for psychopathology, this may be (partly) explained by the fact that many factors are closely interrelated with stress, such as nutrition, smoking behavior, alcohol consumption, and socio-economic status.

Psychological stress in pregnancy is associated with increased risks of neurodevelopmental disorders in the offspring. In order to develop effective preventive strategies, more knowledge is needed on what determines individual susceptibility to stress and how environmental and social factors (such as poverty and violence) may interact with the effects of the different kinds of stress on neurodevelopmental outcomes in the offspring. Disentangling these factors is important in order to integrate effective (preventive) strategies in vulnerable populations, to benefit the (mental) health of both the expecting mother and her unborn child.

Therefore, we are organizing a Special Issue of the International Journal of Environmental Research and Public Health which is focused on “Prenatal psychological stress exposure and neurodevelopment and health of children”.

We invite you to submit original research papers that focus on psychosocial stress, in the broadest sense, and socio-environmental factors in pregnancy that may affect fetal (neuro)development and behavioral outcomes in children. The subtopics include:

  • Determinants of socio-environmental factors and psychosocial stress in pregnancy
  • Particular vulnerable groups of social-environmental problems and psychosocial stress in pregnancy
  • Socio-environmental exposures and (interactions with) psychological stress in pregnancy and association with (neuro)developmental outcomes in the offspring
  • Potential interventions that impact socio-environmental factors or psychological stress in pregnancy

Prof. Dr. Tessa Roseboom
Dr. Susanne de Rooij
Drs. Laura Bleker
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Socio-environment
  • Psychological stress
  • Pregnancy
  • Fetal Neurodevelopment
  • Programming

Published Papers (10 papers)

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Editorial

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Open AccessEditorial
Prenatal Psychological Stress Exposure and Neurodevelopment and Health of Children
Int. J. Environ. Res. Public Health 2019, 16(19), 3657; https://doi.org/10.3390/ijerph16193657 - 29 Sep 2019
Cited by 1
Abstract
Depression and anxiety are highly prevalent in pregnancy, with an estimated prevalence of 12% for depression [...] Full article

Research

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Open AccessArticle
What If Pregnancy Is Not Seventh Heaven? The Influence of Specific Life Events during Pregnancy and Delivery on the Transition of Antenatal into Postpartum Anxiety and Depression
Int. J. Environ. Res. Public Health 2019, 16(16), 2851; https://doi.org/10.3390/ijerph16162851 - 09 Aug 2019
Cited by 2
Abstract
Introduction: Postpartum symptoms of anxiety and depression are known to have a negative impact on mother and child, and major life events constitute a major risk factor for these symptoms. We aimed to investigate to what extent specific life events during pregnancy, delivery [...] Read more.
Introduction: Postpartum symptoms of anxiety and depression are known to have a negative impact on mother and child, and major life events constitute a major risk factor for these symptoms. We aimed to investigate to what extent specific life events during pregnancy, delivery complications, unfavorable obstetric outcomes, and antenatal levels of anxiety or depression symptoms were independently associated with postpartum levels of anxiety and depression symptoms. Methods: Within a prospective population-based cohort study (n = 3842) in The Netherlands, antenatal symptoms of anxiety or depression were measured at the end of the first trimester and at five months postpartum. Antenatal life events were assessed during the third trimester, and information on delivery and obstetric outcomes was obtained from midwives and gynecologists. Linear regression analyses were performed to quantify the associations. Results: Antenatal levels of both anxiety and depression symptoms were associated with postpartum levels of anxiety and depression symptoms. Life events related to health and sickness of self or loved ones, to the relation with the partner or conflicts with loved ones, or to work, finance, or housing problems were significantly associated with higher postpartum levels of anxiety symptoms (p < 0.001) and depression symptoms (p < 0.001) adjusted for antenatal levels. No statistically significant results were observed for pregnancy-related events, delivery complications, or unfavorable obstetric outcomes. Conclusions: Women with increased antenatal levels of anxiety or depression symptoms are at increased risk of elevated levels of both postpartum depression and anxiety symptoms. Experiencing life events during pregnancy that were not related to the pregnancy was associated with higher levels of anxiety and depression in the postpartum period, as opposed to pregnancy-related events, delivery complications, or unfavorable obstetric outcomes. These results suggest that events during pregnancy but not related to the pregnancy and birth are a highly important predictor for postpartum mental health. Full article
Open AccessArticle
Do the Emotions of Middle-Income Mothers Affect Fetal Development More Than Those of High-Income Mothers?—The Association between Maternal Emotion and Fetal Development
Int. J. Environ. Res. Public Health 2019, 16(11), 2065; https://doi.org/10.3390/ijerph16112065 - 11 Jun 2019
Cited by 1
Abstract
This study examines the relationship between the emotions of mothers and fetal development and explores the modifying effect that family income has on this relationship. Socio-demographic information, maternal depression, stress, positive and negative emotions, and maternal-fetal attachment data were collected at 16–20 weeks [...] Read more.
This study examines the relationship between the emotions of mothers and fetal development and explores the modifying effect that family income has on this relationship. Socio-demographic information, maternal depression, stress, positive and negative emotions, and maternal-fetal attachment data were collected at 16–20 weeks of pregnancy. Data on fetal body weight and biparietal diameter indicating fetal development were collected at 33–35 weeks to observe the longitudinal effects of mothers’ emotions on fetal development. We divided subjects into two groups: those with more than 150% of the median income were classified as the high-income group and less than 150% as the middle-income group. T-test, correlation analysis, and multiple regression analysis on maternal emotional status and fetal development were performed for each group. A positive correlation was found between maternal-fetal attachment and negative emotion that was associated with the biparietal diameter and fetal body weight only in the middle-income group. Results of the multiple regression analysis were statistically significant, indicating that maternal-fetal attachment was associated with fetal weight. These results show that the management of subjective emotion is associated with healthy development of the fetus and contributes to health equity. Full article
Open AccessArticle
Toddler Temperament Mediates the Effect of Prenatal Maternal Stress on Childhood Anxiety Symptomatology: The QF2011 Queensland Flood Study
Int. J. Environ. Res. Public Health 2019, 16(11), 1998; https://doi.org/10.3390/ijerph16111998 - 05 Jun 2019
Cited by 5
Abstract
It is not known whether alterations to temperamental characteristics associated with prenatal maternal stress (PNMS) exposure account for the development of childhood anxiety symptomatology (internalizing behaviors and anxiety symptoms). The QF2011 Queensland flood study examined whether (1) toddler temperamental characteristics explained the association [...] Read more.
It is not known whether alterations to temperamental characteristics associated with prenatal maternal stress (PNMS) exposure account for the development of childhood anxiety symptomatology (internalizing behaviors and anxiety symptoms). The QF2011 Queensland flood study examined whether (1) toddler temperamental characteristics explained the association between PNMS exposure and childhood anxiety symptomatology; and (2) whether effects were dependent upon child sex or the timing of gestational exposure to PNMS. We investigated the effects of various aspects of flood-related stress in pregnancy (objective hardship, cognitive appraisal, subjective distress) on maternal report of 16-month toddler temperament (attentional control, shy-inhibition, negative reactivity), 4-year maternal-reported childhood anxiety symptomatology (internalizing and anxiety symptoms; N = 104), and teacher reports of internalizing behaviors (N = 77). Severity of maternal objective hardship during pregnancy and shy-inhibited behaviors were uniquely associated with 4-year child anxiety symptoms. Mediation analyses found that higher levels of 16-month negative reactivity accounted, in part, for the relationship between increased maternal objective flood-related hardship and greater internalizing behaviors (maternal but not teacher report). Neither child sex nor gestational timing of exposure moderated the hypothesized mediations. Our findings highlight several pathways through which varying aspects of disaster-related PNMS may influence early childhood anxiety symptomatology. Full article
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Open AccessArticle
Brain Magnetic Resonance Imaging Findings in Children after Antenatal Maternal Depression Treatment, a Longitudinal Study Built on a Pilot Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2019, 16(10), 1816; https://doi.org/10.3390/ijerph16101816 - 22 May 2019
Cited by 3
Abstract
Antenatal depression is associated with an increased risk of offspring neuro-developmental disorders, potentially as a consequence of an altered brain development in utero. We hypothesized that reducing maternal depression by Cognitive Behavioral Therapy (CBT) during pregnancy may ameliorate the offspring’s brain (micro)structural [...] Read more.
Antenatal depression is associated with an increased risk of offspring neuro-developmental disorders, potentially as a consequence of an altered brain development in utero. We hypothesized that reducing maternal depression by Cognitive Behavioral Therapy (CBT) during pregnancy may ameliorate the offspring’s brain (micro)structural outcomes. 54 pregnant women with a diagnosed clinical depression were randomly allocated to CBT or Treatment as Usual (TAU), showing moderate to large depression symptom improvements after CBT. In 16 of their children (69% boys, N(TAU) = 8, N(CBT) = 8, mean age = 5.9 years, range = 3.9–7.1 years) brain Magnetic Resonance Imaging (MRI) scans were conducted. Children from the CBT group had a thicker right lateral occipital cortex (difference: 0.13 mm, 95% CI = 0.005–0.26) and lingual gyrus (difference: 0.18 mm, 95% CI = 0.01–0.34). In the CBT group, Voxel-Based Morphometry analysis identified one cluster showing increased gray matter concentration in the right medial temporal lobe at p < 0.05 uncorrected, and fixel-based analysis revealed reduced fiber-bundle cross-section in the Fornix, the Optical Tract, and the Stria Terminalis at p < 0.01 uncorrected. However, none of the results survived correction for multiple testing. Our explorative analyses provided some indication that antenatal CBT for depression may ameliorate offspring’s brain (micro)structural outcomes, but the sample size was extremely small, and our results should be cautiously interpreted. Larger studies are warranted to confirm our preliminary conclusions that CBT for antenatal depression affects brain development in children. Full article
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Open AccessArticle
The Impact of Objective and Subjective Sleep Parameters on Depressive Symptoms during Pregnancy in Women with a Mental Disorder: An Explorative Study
Int. J. Environ. Res. Public Health 2019, 16(9), 1587; https://doi.org/10.3390/ijerph16091587 - 07 May 2019
Cited by 3
Abstract
Poor sleep quality during pregnancy is associated with both antepartum and postpartum depression and adverse birth outcomes. This study evaluated both objective and subjective sleep quality and the effects on the subsequent course of antepartum depressive symptoms in psychiatric patients. This observational explorative [...] Read more.
Poor sleep quality during pregnancy is associated with both antepartum and postpartum depression and adverse birth outcomes. This study evaluated both objective and subjective sleep quality and the effects on the subsequent course of antepartum depressive symptoms in psychiatric patients. This observational explorative study was embedded in an ongoing study focusing on pregnant women with a mental disorder and was performed in 18 patients (24–29 weeks pregnant). Depressive symptoms were assessed throughout pregnancy using the Edinburgh Postnatal Depression Scale (EPDS) with 5-week intervals. Sleep was assessed with actigraphy, the Pittsburgh Sleep Quality Index (PSQI) and sleep diaries at the start of the study. We studied correlations between sleep parameters and EPDS scores cross-sectionally using Spearman correlation. Next, we studied the course of antepartum EPDS scores over time per sleep parameter using generalized linear mixed modelling analysis. Objectively measured fragmentation index, total PSQI score and 4 PSQI subscales (sleep quality, sleep duration, sleep disturbances and daytime dysfunctions) were significantly correlated with EPDS scores when measured cross-sectionally at the start. Six objectively and subjectively measured sleep parameters had moderate to large effects on the course of depressive symptoms through the third trimester, but these effects were not statistically significant. More research is necessary to explore the causality of the direction between sleep problems and antepartum depressive symptoms we found in psychiatric patients. Full article
Open AccessArticle
Social Support—A Protective Factor for Depressed Perinatal Women?
Int. J. Environ. Res. Public Health 2019, 16(8), 1426; https://doi.org/10.3390/ijerph16081426 - 21 Apr 2019
Cited by 20
Abstract
Social support before and after childbirth is a possible protective factor for perinatal depression. Currently, there is a lack of longitudinal studies beyond the first year postpartum exploring the relationship of social support with depression and anxiety. Social support is also a possible [...] Read more.
Social support before and after childbirth is a possible protective factor for perinatal depression. Currently, there is a lack of longitudinal studies beyond the first year postpartum exploring the relationship of social support with depression and anxiety. Social support is also a possible protective factor for adverse child development, which is a known consequence of perinatal depression. The present study followed up a cohort of depressed women (n = 54) from a randomised controlled trial of psychological treatment for antenatal depression. We examined the trajectory of the relationships between perceived social support (Social Provisions Scale), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory) twice in pregnancy and twice postpartum up to two years. The influence of social support on child development and parenting-related stress was also explored. Two aspects of social support, Reassurance of Worth and Reliable Alliance, were strongly related to perinatal depression and anxiety, particularly when predicting symptoms in late pregnancy. However, the effect of postnatal depression on child development at 9 and 24 months post-birth was not mediated by social support. These results suggest the importance of adjusting current interventions for depressed perinatal women to focus on social support in late pregnancy and the first six months postpartum. Full article
Open AccessArticle
The Effect of Heart Rate Variability Biofeedback Training on Mental Health of Pregnant and Non-Pregnant Women: A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2019, 16(6), 1051; https://doi.org/10.3390/ijerph16061051 - 23 Mar 2019
Cited by 7
Abstract
In this study, we examined the efficacy of heart rate variability (HRV)-biofeedback on stress and stress-related mental health problems in women. Furthermore, we examined whether the efficacy differed between pregnant and non-pregnant women. Fifty women (20 pregnant, 30 non-pregnant; mean age 31.6, SD [...] Read more.
In this study, we examined the efficacy of heart rate variability (HRV)-biofeedback on stress and stress-related mental health problems in women. Furthermore, we examined whether the efficacy differed between pregnant and non-pregnant women. Fifty women (20 pregnant, 30 non-pregnant; mean age 31.6, SD = 5.9) were randomized into an intervention (n = 29) or a waitlist condition (n = 21). All participants completed questionnaires on stress, anxiety, depressive symptoms, sleep, and psychological well-being on three occasions with 6-week intervals. Women in the intervention condition received HRV-biofeedback training between assessment 1 and 2, and women in the waitlist condition received the intervention between assessment 2 and 3. The intervention consisted of a 5-week HRV-biofeedback training program with weekly 60–90 min. sessions and daily exercises at home. Results indicated a statistically significant beneficial effect of HRV-biofeedback on psychological well-being for all women, and an additional statistically significant beneficial effect on anxiety complaints for pregnant women. No significant effect was found for the other stress-related complaints. These findings support the use of HRV-biofeedback as a stress-reducing technique among women reporting stress and related complaints in clinical practice to improve their well-being. Furthermore, it supports the use of this technique for reducing anxiety during pregnancy. Full article
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Open AccessArticle
Associations of Prenatal and Postnatal Maternal Depressive Symptoms with Offspring Cognition and Behavior in Mid-Childhood: A Prospective Cohort Study
Int. J. Environ. Res. Public Health 2019, 16(6), 1007; https://doi.org/10.3390/ijerph16061007 - 20 Mar 2019
Cited by 11
Abstract
Exposure to maternal depressive symptoms in the peri-pregnancy periods may be associated with poorer child development, but research is often limited to only maternal assessments of behavior and cognition. This study investigates the specific periods of prenatal and postnatal exposure to maternal depressive [...] Read more.
Exposure to maternal depressive symptoms in the peri-pregnancy periods may be associated with poorer child development, but research is often limited to only maternal assessments of behavior and cognition. This study investigates the specific periods of prenatal and postnatal exposure to maternal depressive symptoms in association with child development using reports from teachers and mothers. This study is based on 1225 mother–child pairs from Project Viva, a prospective pre-birth cohort study. Mothers reported depressive symptoms on the Edinburgh Postpartum Depression Scale (EPDS) in mid-pregnancy as well as at 6 months and 12 months postpartum. Teachers and mothers reported child executive functions using the Behavioral Rating Inventory of Executive Function (BRIEF) and behavior using the Strengths and Difficulties Questionnaire (SDQ). Children completed the Kaufman Brief Intelligence Test (KBIT-2), the Wide Range Assessment of Visual Motor Abilities (WRAVMA), and the Visual Memory Index of the Wide Range Assessment of Memory and Learning (WRAML). We used multivariable linear regression models to examine associations of prenatal and postpartum depressive symptoms with outcomes. Many of the crude associations observed were attenuated after adjusting for demographic factors and maternal IQ, yet some remained significant. For example, high prenatal maternal depressive symptoms were associated with poorer scores on the BRIEF Behavior Regulation Index and some SDQ scales based on reports from teachers and mothers. High prenatal maternal depressive symptoms were associated with poorer behavioral development. Postpartum symptoms did not show strong associations with outcomes once we adjusted for the prenatal period. Full article

Other

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Open AccessOpinion
Programming Effects of Prenatal Stress on Neurodevelopment—The Pitfall of Introducing a Self-Fulfilling Prophecy
Int. J. Environ. Res. Public Health 2019, 16(13), 2301; https://doi.org/10.3390/ijerph16132301 - 28 Jun 2019
Cited by 1
Abstract
There is increasing interest for the potential harmful effects of prenatal stress on the developing fetal brain, both in scientific literature and in public press. Results from animal studies suggest that gestational stress leads to an altered offspring neurodevelopment with adverse behavioral and [...] Read more.
There is increasing interest for the potential harmful effects of prenatal stress on the developing fetal brain, both in scientific literature and in public press. Results from animal studies suggest that gestational stress leads to an altered offspring neurodevelopment with adverse behavioral and cognitive consequences. Furthermore, there are indications in human studies that severe prenatal stress has negative consequences for the child’s neurodevelopment. However, stress is an umbrella term and studies of maternal stress have focused on a wide range of stress inducing situations, ranging from daily hassles to traumatic stress after bereavement or a natural disaster. Mild to moderate stress, experienced by many women during their pregnancy, has not consistently been shown to exert substantial negative effects on the child’s neurodevelopment. Additionally, the vast majority of human studies are observational cohort studies that are hampered by their fundamental inability to show a causal relationship. Furthermore, our limited knowledge on the possible underlying mechanisms and the effects of interventions for prenatal stress on child neurodevelopmental outcomes emphasize our incomplete understanding of the actual effects of prenatal stress on child neurodevelopment. Until we have a better understanding, it seems counterproductive to alarm all pregnant women for possible harmful effects of all sorts of prenatal stress, if only to avoid the induction of stress itself. Full article
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