PsychiatricNewsby Joan Arehart-TreichelSeptember 27, 2013
Evidence that depression can be transmitted from a pregnant woman to her unborn child was published online August 21 in Biological Psychiatry.
Anqi Qiu, Ph.D., an associate professor of bioengineering at the National University of Singapore, and colleagues evaluated 157 women for depression when they were in the 26th week of pregnancy. The researchers used the Edinburgh Postnatal Depression Scale (EPDS), a 10-item self-report scale designed as a screening instrument for postnatal depression, but which also has been well validated for use in antenatal depression. The EPDS rates the intensity of depressive symptoms during the preceding seven days. Scores of 13 or higher indicate depression. Twenty-eight of the women scored within this range.
After the women’s infants were born, the researchers used structural MRI imaging to evaluate the size of the amygdalae in the infants. They also used a technique called diffusion tensor imaging to determine the microstructure of the infants’ amygdalae. The researchers were interested in evaluating this brain region in the infants because previous research has shown it to be associated with emotion regulation and depression. They reasoned that if maternal antenatal depression had an impact on the amygdala during gestation, it might make the fetus vulnerable to depression after birth.
After taking household income, maternal age, maternal smoking exposure, postconceptual age at brain imaging, and birth weight into consideration, the researchers could find no difference in amygdala volume between the newborns of the 28 women who had been depressed during pregnancy and those of the 129 women who had not been depressed during pregnancy. However, they did find that nerve axons in the right amygdala in the newborns of the depressed mothers were significantly different from nerve axons in the right amygdala in the newborns of the nondepressed mothers. (A similar trend was also found for the left amygdala.)
“Our findings suggest that an increased risk for depression may be transmitted from mother to child during fetal life,” Qiu said in an interview with Psychiatric News. “And together with previous studies of infant behavior, they suggest that screening for antenatal maternal depressive symptoms and intervention programs should begin during the prenatal period.”“This study adds to the growing literature that demonstrates that untreated maternal depression has potentially negative effects on the developing fetus,” Jennifer Payne, M.D., an associate professor of psychiatry at Johns Hopkins Medical Institutions and an expert on women’s mood disorders, told Psychiatric News. “Many people mistakenly think that depression should not be treated during pregnancy. This study shows that untreated depression is an exposure for the child in the same way that taking a medication is an exposure.”
by Rifkin-Graboi A, Bai J, Chen H, Hameed WB, Sim LW, Tint MT, Leutscher-Broekman B, Chong YS, Gluckman PD, Fortier MV, Meaney MJ, and Qiu A.Biological Psychiatry. 2013 Aug 19. [Epub ahead of print]
BACKGROUND: Antenatal maternal cortisol levels associate with alterations in the amygdala, a structure associated with emotion regulation, in the offspring. However, because offspring brain and behavior are commonly assessed years after birth, the timing of such maternal influences is unclear. This study aimed to examine the association between antenatal maternal depressive symptomatology and neonatal amygdala volume and microstructure and thus establish evidence for the transgenerational transmission of vulnerability for affective disorders during prenatal development.METHODS: Our study recruited Asian mothers at 10 to 13 weeks pregnancy and assessed maternal depression at 26 weeks gestation using the Edinburgh Postnatal Depression Scale. Structural magnetic resonance imaging and diffusion tensor imaging were performed with 157 nonsedated, 6- to 14-day-old newborns and then analyzed to extract the volume, fractional anisotropy, and axial diffusivity values of the amygdala.RESULTS: Adjusting for household income, maternal age, and smoking exposure, postconceptual age at magnetic resonance imaging, and birth weight, we found significantly lower fractional anisotropy [p = .009] and axial diffusivity [p = .028], but not volume [p = .993], in the right amygdala in the infants of mothers with high compared with those with low-normal Edinburgh Postnatal Depression Scale scores.CONCLUSIONS: The results reveal a significant relation between antenatal maternal depression and the neonatal microstructure of the right amygdala, a brain region closely associated with stress reactivity and vulnerability for mood anxiety disorders. These findings suggest the prenatal transmission of vulnerability for depression from mother to child and that interventions targeting maternal depression should begin early in pregnancy.