Does Antenatal Maternal Psychological Distress Affect Placental Circulation in the Third Trimester?

Does antenatal maternal psychological distress affect placental circulation in the third trimester?

PLoS One. 2013; 8(2): e57071
Helbig A, Kaasen A, Malt UF, Haugen G

Some types of antenatal maternal psychological distress may be associated with reduced fetal growth and birthweight. A stress-mediated reduction in placental blood flow has been suggested as a mechanism. Previous studies have examined this using ultrasound-derived arterial resistance measures in the uterine (UtA) and umbilical (UA) arteries, with mixed conclusions. However, a reduction in placental volume blood flow may occur before changes in arterial resistance measures are seen. Fetoplacental volume blood flow can be quantified non-invasively in the umbilical vein (UV). Our objective was to study whether specific types of maternal psychological distress affect the placental circulation, using volume blood flow quantification in addition to arterial resistance measures.This was a prospective observational study of 104 non-smoking pregnant women (gestational age 30 weeks) with uncomplicated obstetric histories. Psychological distress was measured by General Health Questionnaire-28 (subscales anxiety and depression) and Impact of Event Scale-22 (subscales intrusion, avoidance and arousal). UtA and UA resistance measures and UV volume blood flow normalized for fetal abdominal circumference, were obtained by Doppler ultrasound.IES intrusion scores above the mean were associated with a reduction in normalized UV volume blood flow (corresponding to -0.61 SD; P?=?0.003). Adjusting for UA resistance increased the strength of this association (difference -0.66 SD; P<0.001). Other distress types were not associated with UV volume blood flow. Maternal distress was not associated with arterial resistance measures, despite adjustment for confounders.Intrusive thoughts and emotional distress regarding the fetus were associated with reduced fetoplacental volume blood flow in third trimester. Uterine and umbilical artery resistance measures were not associated with maternal distress. Our findings support a decrease in fetoplacental blood flow as a possible pathway between maternal distress and reduced fetal growth. HubMed – depression


Early neurodevelopment and self-reported adolescent symptoms of depression and anxiety in a national canadian cohort study.

PLoS One. 2013; 8(2): e56804
North CR, Wild TC, Zwaigenbaum L, Colman I

Little is known about the mental health outcomes of young children who experience developmental delay. The objective of this study was to assess whether delay in attaining developmental milestones was related to depressive and anxious symptoms in adolescence.The sample included 3508 Canadian children who participated in a nationally representative prospective cohort study. The person most knowledgeable about the child reported on attainment of developmental milestones spanning several developmental domains at ages 2-3. The children were followed into adolescence and self-reported depressive and anxious symptoms were used from adolescents ages 12-13. An overall assessment of developmental milestones as well as a supplementary analysis of specific categories of developmental milestones was conducted.Cohort members who displayed delayed developmental milestones in early childhood were more likely to experience higher levels of depressive and anxious symptoms as adolescents. However, there was no interaction between delayed developmental milestones and stressful life events. In the supplementary analysis, two developmental domains (self-care and speech/communication) were associated with higher levels of depressive and anxious symptoms in adolescence.Delay in attainment of early developmental milestones is significantly associated with adolescent depressive and anxious symptoms. HubMed – depression


Health and the 2008 economic recession: evidence from the United kingdom.

PLoS One. 2013; 8(2): e56674
Astell-Burt T, Feng X

The economic recession which began in 2008 has resulted in a substantial increase in unemployment across many countries, including the United Kingdom. Strong association between unemployment and poor health status among individuals is widely recognised. We investigated whether the prevalence of poor health at a population level increased concurrent to the rise in unemployment during the economic recession, and whether the impact on health varied by geographical and socioeconomic circumstances.Health, demographic and socioeconomic measures on 1.36 million survey responses aged 16-64 were extracted from the Quarterly Labour Force Survey of the United Kingdom, collected every three months, from January 2006 to December 2010. The likelihood of self-reporting poor health status and specific types of health problems (depression, mental illness, cardiovascular and respiratory) across time were estimated separately using logistic regression. Explanatory variables included economic status (International Labour Organization definition), occupational class, age, gender, country of birth, ethnicity, educational qualifications, couple status, household tenure, number of dependents, and geographical region.Unemployment (age-gender adjusted) rose from 4.5% in January 2008 to 7.1% by September 2009. The reporting of poor health status increased from 25.7% in July 2009 to 29.5% by December 2010. Similar increases were found for cardiovascular and respiratory health problems; not depression or mental illness. The prevalence of poor health status among the unemployed decreased from 28.8% in July 2008, to 24.9% by March 2009; but this was followed by an increase in poor health experienced across all regions and by all socioeconomic groups, including those who remained employed, regardless of their occupational class.Although our study found no exacerbation of pre-recession health inequalities, the rise in poor health status not only for the unemployed, but also among people who remained employed, regardless of their occupational class, justifies concern voiced among many public health commentators. HubMed – depression