Elsevier

Biological Psychiatry

Volume 80, Issue 11, 1 December 2016, Pages 859-868
Biological Psychiatry

Archival Report
Prepartum and Postpartum Maternal Depressive Symptoms Are Related to Children’s Brain Structure in Preschool

https://doi.org/10.1016/j.biopsych.2015.12.004Get rights and content

Abstract

Background

Perinatal maternal depression is a serious health concern with potential lasting negative consequences for children. Prenatal depression is associated with altered brain gray matter in children, though relations between postpartum depression and children’s brains and the role of white matter are unclear.

Methods

We studied 52 women who provided Edinburgh Postnatal Depression Scale (EPDS) scores during each trimester of pregnancy and at 3 months postpartum and their children who underwent magnetic resonance imaging at age 2.6 to 5.1 years. Associations between maternal depressive symptoms and magnetic resonance imaging measures of cortical thickness and white matter structure in the children were investigated.

Results

Women’s second trimester EPDS scores negatively correlated with children’s cortical thickness in right inferior frontal and middle temporal regions and with radial and mean diffusivity in white matter emanating from the inferior frontal area. Cortical thickness, but not diffusivity, correlations survived correction for postpartum EPDS. Postpartum EPDS scores negatively correlated with children’s right superior frontal cortical thickness and with diffusivity in white matter originating from that region, even after correcting for prenatal EPDS.

Conclusions

Higher maternal depressive symptoms prenatally and postpartum are associated with altered gray matter structure in children; the observed white matter correlations appear to be uniquely related to the postpartum period. The reduced thickness and diffusivity suggest premature brain development in children exposed to higher maternal perinatal depressive symptoms. These results highlight the importance of ensuring optimal women’s mental health throughout the perinatal period, because maternal depressive symptoms appear to increase children’s vulnerability to nonoptimal brain development.

Section snippets

Participants

Participants were 52 women recruited during pregnancy and the children (32 male/20 female) from those pregnancies. Women and children were recruited from an ongoing, prospective study examining maternal nutrition, mental health, and offspring outcomes (32). Table 1 summarizes characteristics of the women and children, including maternal age at child’s birth, maternal postsecondary education (used as a proxy for socioeconomic status), breastfeeding status at 3 months postpartum, and child’s

Maternal Depressive Symptoms and Cortical Thickness

Cortical thickness in two right hemisphere areas was negatively correlated with second trimester maternal depressive symptoms, controlling for child’s age, sex, gestational age, and weight at birth and maternal postsecondary education (Figure 1, Figure 2). One region was located in the right inferior frontal area, including much of the pars opercularis and pars triangularis, and small sections of the precentral and rostral middle frontal areas (r = −.71, p < .001); the other area was located in

Discussion

We report here, for the first time in preschool children, associations between maternal prenatal and postnatal depressive symptoms and white and gray matter brain structure. The thinner cortex and lower diffusivity we observed suggest altered brain development in children exposed to higher levels of maternal depressive symptoms. During childhood, the cortex thins (22, 38) and white matter diffusivity decreases (23, 39) as part of normal maturation processes, including synaptic pruning (40) and

Acknowledgments and Disclosures

This work was supported by the Canadian Institutes of Health Research (CIHR) (funding Grant Nos. IHD-134090 and MOP-136797), Alberta Innovates - Health Solutions, and the National Institute of Environmental Health Sciences (Grant No. 5R21ES021295-03).

We thank the other members of the Alberta Pregnancy Outcomes and Nutrition study team: Catherine J. Field, Rhonda C. Bell, Francois P. Bernier, Marja Cantell, Linda M. Casey, Misha Eliasziw, Anna Farmer, Lisa Gagnon, Laki Goodewardene, David W.

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