Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Biol Psychiatry. 2022 Nov 1;92(9):701-708. doi: 10.1016/j.biopsych.2022.05.011. Epub 2022 May 16.
The COVID-19 pandemic has caused substantially elevated distress in pregnant individuals, which has the potential to affect the developing infant brain. Our main objective was to understand how prenatal distress was related to infant brain structure and function and whether social support moderated the associations.
The Pregnancy during the COVID-19 Pandemic (PdP) cohort study collected Patient-Reported Outcomes Measurement Information System Anxiety scale, Edinburgh Postnatal Depression Scale, and Social Support Effectiveness Questionnaire data from a population-based sample of pregnant individuals living in Canada (N = 8602). For a subsample of participants, their infants (n = 75) underwent magnetic resonance imaging at 3 months of age to examine whether prenatal maternal distress was associated with infant brain architecture, including the role of social support as a potential protective factor.
Overall, 33.4% of participants demonstrated clinically elevated depression symptoms and 47.1% of participants demonstrated clinically elevated anxiety symptoms. We identified lower social support as a significant predictor of clinically elevated prenatal maternal distress (t = -22.3, p < .001). Fifty-eight diffusion image datasets (20 female/38 male, 92 ± 14 days old) and 41 functional datasets (13 female/28 male, 92 ± 14 days old) were included in our analysis after removal of poor-quality images and infants without postpartum maternal distress scores. We found significant relationships between prenatal maternal distress and infant amygdala-prefrontal microstructural and functional connectivity measures, and we demonstrate for the first time that social support moderates these relationships.
Our findings suggest a potentially long-lasting impact of the COVID-19 pandemic on children and show that social support acts as a possible mediator not just for pregnant individuals but also developing infants. These findings provide timely evidence to inform clinical practice and policy surrounding the care of pregnant individuals and highlight the importance of social support.
COVID-19 大流行导致孕妇的痛苦明显增加，这有可能影响发育中的婴儿大脑。我们的主要目标是了解产前焦虑与婴儿大脑结构和功能的关系，以及社会支持是否调节了这些关系。
COVID-19 大流行期间的妊娠（PdP）队列研究从居住在加拿大的基于人群的孕妇样本（N=8602）中收集了患者报告的测量信息系统焦虑量表、爱丁堡产后抑郁量表和社会支持有效性问卷的数据。对于参与者的一个子样本，他们的婴儿（n=75）在 3 个月大时接受了磁共振成像检查，以研究产前母亲焦虑是否与婴儿大脑结构有关，包括社会支持作为潜在保护因素的作用。
总体而言，33.4%的参与者表现出临床显著的抑郁症状，47.1%的参与者表现出临床显著的焦虑症状。我们发现较低的社会支持是产前母亲焦虑的显著预测因素（t=-22.3，p<.001）。在去除图像质量差和没有产后母亲焦虑评分的婴儿后，我们的分析中包含了 58 个扩散图像数据集（20 名女性/38 名男性，92±14 天）和 41 个功能数据集（13 名女性/28 名男性，92±14 天）。我们发现产前母亲焦虑与婴儿杏仁核-前额叶的微观结构和功能连接测量值之间存在显著关系，并且我们首次证明社会支持调节了这些关系。
我们的发现表明 COVID-19 大流行对儿童可能产生持久的影响，并表明社会支持不仅是孕妇，也是发育中的婴儿的一个可能的中介因素。这些发现为围绕孕妇护理的临床实践和政策提供了及时的证据，并强调了社会支持的重要性。
