The Impact of Depressive Symptoms during Pregnancy on the Neuroendocrine and Neonatal

The Impact of Maternal Depressive Symptoms on Newborn Neurological Development

The health of a mother can have a significant impact on the health of her unborn child. As a result, dangerous habits such as smoking, consuming alcohol, and participating in stressful events are always prohibited in order to avoid any negative consequences. Marcus et al. describe how depression symptoms in pregnant women and those in the postpartum stage can impair newborn neurological and limbic-hypothalamic-pituitary-axis (LHPA) development. The scientists discovered a connection between maternal depressive symptoms and neonatal and neuroendocrine outcomes. As a result, this paper discusses the article's content, including the evaluated literature, methods, and findings.

Effects of Maternal Depressive Symptoms on Fetal Development

According to the authors a key effect of depressive symptoms among pregnant mothers, especially those with dysthymia, results in loss of fetal weight, lengths, abdominal circumference, and femur length. Such newborns are also found to have lower levels of serotonin or dopamine than usual as well as higher levels of cortisol. The article further reveals that depressive conditions among mothers result in neurobehavioral dysregulation among infants, a concept that has been measured by the use of Brazelton Neonatal Behavioral Assessment Scale (NBAS) (Marcus et al. 25). In particular, Marcus et al claim that mothers with dysthymia or depressive symptoms during pregnancy affect the neurobehavioral regulation patterns of the infants. Such exposure results in the poor performance of hand-to-mouth activity items including cuddliness of the newborn. In addition, mothers who are genetically vulnerable could also develop hormonal changes as a result of stress, thus, causing alteration of the neuroendocrine function, gene expression, and neuronal circuitry among infants and children.

Impact of Maternal Depressive Symptoms on LHPA in Infants

The article further links depressive symptoms among mothers with the level of LHPA in the infants. The system is important to a child as it facilitates an alert state and responds to stress through the rapid synthesis of cortisol. During pregnancy, a stressed mother will release excess corticotrophin releasing hormone (CRH) which in turn stimulates the pituitary anterior to release ACTH (Marcus et al. 27). The unregulated release of such hormone during the second and third trimester may result in spontaneous preterm birth. Mothers with depression may also have LHPA in an "over-drive" state causing increased central nervous system levels, increased central drive, and alteration in the inhibition of LHPA (Marcus et al. 28). Through the use of the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS), it is also revealed that depressive symptoms can affect infant neurobehavioral outcomes.

Research Design and Methodology

The research design that was adopted for the study included longitudinal assessments of the depressive symptoms among mothers which were done 28 weeks, 32 weeks, and 37 weeks during the gestation period, and later after birth. The participants were asked 21 questions which were based on the Beck Depression Inventory (BDI). The researchers had a follow-up interview with those who had a score greater than 20 in relation to the diagnosis of SCID. The sample size considered was 2466, and the participants were expected to be over 20 years of age. The participants were within their eighth to twenty-eighth gestational weeks and were expected to participate for over a period of 3 years. The survey questionnaires considered for the study were: The Edinburgh Postpartum Depression Scale (EPDS) and a General Health Questionnaire. They both addressed various depressive symptoms items among mothers as well as the possible exposure of children to stress during and after birth.

Findings and Conclusion

The hypothesis considered, thus, was that women who have depressive symptoms during pregnancy and in the postpartum stage would have infants possessing unique neonatal LHPA activity patterns and different CNS responses. The blood from the umbilical cord artery was used to measure the ACTH and cortisol levels of the infants. Trained nursing staff were later required to conduct neurobehavioral evaluation of the infants through the use of a NNNS. The results showed that maternal depressive symptoms are directly associated with the development of LHPA among infants (Marcus et al. 29). With a noted increase in the elevation of cord ACTH among the newborns, it was also found out that depressive symptoms can affect the fetal brain by increasing their sensitivity to stress signals.

In summary, the article associates depressive symptoms among pregnant mothers with harmful endocrine impacts among infants. The result of stress was identified to cause an increase in ACTH increase during the time of birth as well as the production of CRH. It was also revealed that there is an increase in the activation of LHPA axis among infants born by depressed mothers; this was identified by the increase levels of ACTH in the cord blood measured. It is, therefore, important to note from the study that the level of stress and depression among pregnant mothers has a direct impact on the neurocognitive development of infants. The hypothesis from the study can, thus, be that an increase in depression levels among pregnant women during and after pregnancy results in the worsening neuroendocrine and neonatal outcomes among infants.

Work Cited

Marcus, Sheila, et al. "Depressive symptoms during pregnancy: impact on neuroendocrine and neonatal outcomes." Infant Behavior and Development 34.1 (2011): 26-34.