Maternal anxiety and depression during pregnancy and newborn's brain white matter development

Authors: GRAHAM, RACHEL - University Arkansas For Medical Sciences (UAMS); BELLANDO, BETTY JAYNE - University Arkansas For Medical Sciences (UAMS); SORENSEN, SETH - University Arkansas For Medical Sciences (UAMS); JIANG, LI - University Arkansas For Medical Sciences (UAMS); GLASIER, CHARLES - University Arkansas For Medical Sciences (UAMS); RAMAKRISHNAIAH, RAGHU - University Arkansas For Medical Sciences (UAMS); LU, FANG - University Arkansas For Medical Sciences (UAMS); ROWELL, AMY - University Arkansas For Medical Sciences (UAMS); OU, XIAWEI - Arkansas Children'S Nutrition Research Center (ACNC)

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 2/10/2020
Publication Date: N/A
Citation: N/A

Interpretive Summary:

Technical Abstract: This prospective study examined the relationships between maternal depression and anxiety during pregnancy and newborn’s brain white matter development. Healthy pregnant women were recruited at the 3rd trimester. Depression was assessed using the Beck Depression Inventory, Second Edition (BDI-II), and anxiety was assessed using the State-Trait Anxiety Inventory(STAI). Their newborns underwent an MRI examination of the brain at 2 weeks of age, which included diffusion tensor imaging to evaluate white matter development. Fractional anisotropy (FA) maps were generated and correlated with the BDI and STAI scores using tract-based spatial statistics. Negative correlations between FA values and BDI/STAI scores were found in multiple white matter regions, suggesting that depression and anxiety during pregnancy may impact the in utero brain white matter development. It is estimated that about 13% of pregnant women in the United States suffer from an anxiety related disorder, and 13.3% from a mood disorder, including depression.1 Published evidence has shown that there are negative effects of antenatal depression and anxiety on offspring, including hyperactivity and inattention in boys, emotional problems in both boys and girls, and atopic disorders including asthma.2-3 However, less is known about why these negative effects would happen. Evaluating infant’s brain development right after birth provides an opportunity to link maternal depression/anxiety during pregnancy with later unfavorable neurodevelopmental outcomes. In this study, diffusion tensor imaging (DTI) was utilized to examine brain white matter microstructural development in newborns from mothers who had normal pregnancy and were recruited for evaluation of depression and anxiety symptoms at ~36 weeks of gestation. The goal of this study is to see whether there are significant associations between infants' white matter development and their mothers' depression and anxiety test scores. This is a prospective study in which healthy pregnant women were recruited and studied at ~36 weeks of pregnancy, and their newborns were studied at age ~2 weeks. Inclusion criteria for the pregnant women included: singleton pregnancy, <36 weeks of pregnancy, and = 18 years of age. Exclusion for the pregnant women included: hypertension, diabetes, or other preexisting medical conditions known to influence fetal growth, medications known to influence fetal growth, recreational drug, tobacco, or alcohol use while pregnant, pregnancy conception with assisted fertility treatment, and medical conditions developed during pregnancy (such as gestational diabetes, preeclampsia) suspected to influence fetal growth. Infants born preterm (<37 weeks of gestation), with congenital defects, small for gestational age, with a low Apgar score or any other medical complications at birth affecting development were also excluded. Maternal anxiety and depression scores were obtained using the State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory, Second Edition (BDI-II), which were both administered by a licensed psychological examiner at ~36 weeks of pregnancy. Both the state (S) result and the trait (T) result of the STAI examination were obtained, yielding a total of three psychological scores per maternal subject. In addition, maternal IQ was also assessed using the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II). At around age 2 weeks, the infants underwent an MRI examination of the brain at natural sleep without sedation using a Siemens PRISMA scanner and a 20-channel head coil. Pulse sequences included 3D T1 and T2 weighted images to screen for structural abnormalities by neuroradiologists, and diffusion weighted images with b value ranging from 0 to 1500 and diffusion directions uniformly distributed in 99 directions. In total, 34 infants had both valid DTI data and valid S