Background: It is well established that adverse experiences during childhood increase the chances of developing emotional psychopathology in adulthood, particularly during vulnerable times, such as pregnancy. Furthermore, research has also demonstrated an association between maternal depression in pregnancy and poorer offspring developmental outcomes. The primary aim of this thesis is to investigate the pathways by which maternal history of abuse during childhood interacts with depression during pregnancy, and how both conditions affect offspring development at six days, eight weeks and one year after birth. The second aim of this study is to explore the alterations in maternal hypothalamic-pituitary-adrenal (HPA) axis functioning during pregnancy among women who are depressed and/or have experienced childhood abuse, and whether these are related to offspring behavioural and physiological regulation as well as to offspring HPA axis response to stress. Methods: The sample comprises 125 pregnant women recruited in the area of South London. Women were assessed in pregnancy for maternal depression and history of abuse in childhood in a one-to-one clinical interviews (25 weeks gestation), and for maternal HPA axis (25 and 32 weeks gestation) through the collection of salivary samples. Infants were administered the Neonatal Behavioural Assessment Scale (NBAS) at six days, with an assessment of the HPA axis functioning before and after the NBAS. Infant HPA axis response was reassessed at eight weeks and one year before and after routine immunization. Results: Women who have been abused in their childhood were 7 times more likely to develop depression in pregnancy than non-abused women. Furthermore, women who were depressed in pregnancy and especially those with both childhood abuse and antenatal depression, showed an increase in the evening cortisol levels at 32 weeks gestation compared with the other women. Neonates of depressed women had poorer behavioural regulation at 6 days, with an increase in their HPA axis stress response following the NBAS compared with neonates of non-depressed mothers, irrespective of maternal history of childhood abuse. At one year, infants of mothers with childhood abuse and depression exhibited greater stress following the immunization compared with infants of non-depressed mothers, but this difference was not seen at 8 weeks. Conclusions: The effects of exposure to childhood abuse and depression in pregnancy can be seen in the mothers’ high level of stress hormone circulating in the evening in the 3rd trimester of pregnancy. Moreover, the effects are also seen in the next generation during the first year of life, as observed in the persistent biological and behavioural changes in the offspring. These findings have implications for clinical practice: doctors and midwives in antenatal clinics should be aware of the importance of asking about women’s own childhood histories and their mental health during pregnancy in order to offer support during their transition to motherhood.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:677198 |
| Date | January 2015 |
| Creators | Fantini, Enrica |
| Contributors | Pariante, Carmine Maria ; Pawlby, Susan Jennifer |
| Publisher | King's College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://kclpure.kcl.ac.uk/portal/en/theses/pregnancy-to-one-year(64ebceae-cd84-4622-805f-dc6d085f1fdf).html |
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