Columbia University, New York.
University of Pittsburgh Magee-Womens Hospital, Pennsylvania.
J Am Acad Child Adolesc Psychiatry. 2022 Sep;61(9):1155-1167. doi: 10.1016/j.jaac.2022.03.021. Epub 2022 Mar 30.
Maternal prenatal stress and mood symptoms are associated with risk for child psychopathology. Within the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies (ECHO-FGS), a racially and ethnically diverse cohort, we studied associations between prenatal stress and depressive symptoms with child neurobehavior, and potential mediation by fetal growth velocity (FGV) in low-risk pregnancies.
For 730 mother-child pairs, we had serial ultrasound measurements, self-reports of prenatal stress and depression, observations of child executive functions and motor skills from 4 to 8 years, and maternal reports of child psychiatric problems. We tested associations between prenatal stress and depressive symptoms with child neurobehavior in regression analyses, and associations with FGV in mixed effect models. Post hoc we tested severity of prenatal symptoms; FGV at 25, 50, and 75 percentiles; and moderation by biological sex and by race and ethnicity.
Prenatal stress and depressive symptoms were associated with child psychiatric problems, and prenatal depressive symptoms with decrements in executive functions and motor skills, especially in biological male children. Neither prenatal stress nor depressive symptoms were associated with FGV.
In one of the largest cohorts with observed child outcomes, and the first with broad representation of race and ethnicity in the United States, we found that prenatal stress and depressive symptoms were associated with greater reports of child psychiatric symptoms. Only prenatal depressive symptoms were associated with observed decrements in cognitive abilities, most significantly in biological male children. Stress during low-risk pregnancies may be less detrimental than theorized. There was no mediation by FGV. These findings support the need to attend to even small changes in prenatal distress, as these may have long-lasting implications.
孕妇产前压力和情绪症状与儿童精神病理学风险相关。在 Eunice Kennedy Shriver 国立儿童健康与人类发育研究所（NICHD）胎儿生长研究（ECHO-FGS）中，我们研究了在低风险妊娠中，产前压力和抑郁症状与儿童神经行为之间的关联，以及胎儿生长速度（FGV）的潜在中介作用。
对于 730 对母婴对，我们进行了一系列超声测量、产前压力和抑郁的自我报告、4 至 8 岁儿童执行功能和运动技能的观察以及儿童精神科问题的母亲报告。我们在回归分析中测试了产前压力和抑郁症状与儿童神经行为之间的关联，以及在混合效应模型中与 FGV 的关联。事后我们测试了产前症状的严重程度；FGV 在 25%、50%和 75%的百分位数；以及生物性别、种族和民族的调节作用。
产前压力和抑郁症状与儿童精神科问题相关，产前抑郁症状与执行功能和运动技能下降相关，尤其是在生物男性儿童中。产前压力和抑郁症状均与 FGV 无关。
在最大的具有观察到的儿童结局的队列之一中，并且是美国首次具有广泛代表性的种族和民族的队列中，我们发现产前压力和抑郁症状与更多的儿童精神科症状报告相关。只有产前抑郁症状与观察到的认知能力下降相关，在生物男性儿童中更为显著。低风险妊娠期间的压力可能没有理论上那么有害。FGV 没有介导作用。这些发现支持需要关注产前困扰的哪怕是微小变化，因为这些变化可能会产生持久的影响。
