Department of Psychiatry.
Department of Cell and Developmental Biology.
Neuroreport. 2021 Oct 6;32(14):1170-1174. doi: 10.1097/WNR.0000000000001711.
Maternal depression during gestation is an adverse factor in fetal brain development that manifests in later childhood behavioral problems. Fetal heart rate variability (FHRV) mediated by parasympathetic input is a marker of gestational nervous system development. Biological mediators of adverse effects of maternal depression may involve the mother's corticosteroids; however, links between depression, corticosteroids, and early nervous system development remain inconclusive.
Heart rate was recorded in 23 fetuses by transabdominal Doppler at 28-33 weeks gestation. The SD of interbeat intervals over 20 min assessed FHRV. Maternal depression ratings and hair concentrations of cortisol and cortisone were assayed. An auditory sensory gating paradigm assessed newborn development of cerebral inhibition. Parents rated their infant's temperament characteristics on the Infant Behavior Questionnaire-Revised Short Form (IBQ-R).
Maternal depression was associated with lower FHRV, especially for male fetuses, β = -0.633, P = 0.045. Maternal depression was associated with lower cortisol to total corticosteroids ratios, β = -0.519, P = 0.033. Lower cortisol ratios were associated with decreased FHRV, β = 0.485, P = 0.019. Decreased FHRV was associated with increased newborn sensory gating deficits, β = -0.992, P = 0.035, indicating poorer development of cerebral inhibition. Higher FHRV was related to increased infant IBQ-R self-regulatory behaviors, r = 0.454, P = 0.029.
Maternal depression is associated via corticosteroids with decreased development of nervous system control of fetal heart rate. Decreased FHRV indicates developmental alterations in gestation that correlate with altered brain function and subsequent regulatory challenges in early infancy.
孕期母体抑郁是胎儿大脑发育的不利因素，会在儿童后期表现出行为问题。由副交感神经输入介导的胎儿心率变异性（FHRV）是妊娠期神经系统发育的标志。母体抑郁的不良影响的生物学介质可能涉及母亲的皮质醇；然而，抑郁、皮质醇和早期神经系统发育之间的联系仍不清楚。
在 28-33 周妊娠时，通过经腹多普勒记录 23 例胎儿的心率。在 20 分钟以上的时间内，评估心跳间隔的 SD 以评估 FHRV。测定母体抑郁评分和头发中皮质醇和皮质酮的浓度。听觉感觉门控范式评估新生儿大脑抑制的发育情况。父母使用婴儿行为问卷修订短表（IBQ-R）对婴儿的气质特征进行评分。
母体抑郁与 FHRV 降低有关，尤其是男性胎儿，β=-0.633，P=0.045。母体抑郁与皮质醇与总皮质醇比值降低有关，β=-0.519，P=0.033。较低的皮质醇比值与 FHRV 降低有关，β=0.485，P=0.019。FHRV 降低与新生儿感觉门控缺陷增加有关，β=-0.992，P=0.035，表明大脑抑制发育较差。较高的 FHRV 与婴儿 IBQ-R 自我调节行为增加有关，r=0.454，P=0.029。
母体抑郁通过皮质醇与胎儿心率的神经系统控制发育不良有关。FHRV 降低表明妊娠期的发育变化与改变的大脑功能相关，并随后在婴儿早期出现调节挑战。
