General Psychiatry

Maternal Pre- and Postpartum Depression Affects Child’s Brain Development

Linda Peckel
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A significant gender effect was observed in the cohort, but the mechanism behind it remains unclear.

Maternal symptoms of depression during the second trimester of pregnancy, as well as postpartum depression, are associated with alterations in the child’s brain structure that may predispose them to later depression and anxiety, according to a multicenter study conducted in Canada and reported in Biological Psychiatry.1

The study examined physical and psychological health records of 52 women recruited during pregnancy from an ongoing health study in Alberta, Canada, and followed the children born to these women for up to 5 years. Depression in the mothers was monitored both pre-and postpartum using the Edinburgh Postnatal Depression Scale (EPDS) once during every trimester and at 2-3 months after giving birth. Magnetic resonance imaging (MRI) of the children’s brains (32 boys and 20 girls) was performed at between 2.6 and 5.1 years of age.

During early childhood the cortical gray matter normally thins and white matter becomes less diffuse as the brain matures.2-5 Children monitored in the current study showed these signs of maturation earlier in 2 areas of the brain that correlated closely with depression in the mother. Specifically, reductions in cortical thickness of the gray matter in the right inferior frontal and the middle temporal regions in the children’s brains were associated with higher depressive scores in their mothers during the second trimester of pregnancy and again in the postpartum period. White matter changes observed on MRI in the inferior front area corresponded only to depression before birth but not after.

A significant gender effect was observed in the cohort, whereby higher EPDS scores in the mother recorded during the second trimester had greater correlation to changes in cortical thickness in girls than in boys (r= -.80/P < .001 and r= -.55/P= .006, respectively). In the postpartum period the impact of depression in the mother was reversed, as changes the axial, radial, and mean diffusity of the white matter were more significant in boys (r = -.46/p = .015, r = -.57/P = .002, r = -.56/P = .003) than in girls (r = -.09, r = -.07, and r = -.04, all with insignificant P values > .5).

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Clinical Implications

None of the mechanisms behind the changes in gray or white matter, including the gender effect noted, are yet clear. The authors pointed out that changes in brain structure in the children were only observed in association with maternal depression in the second trimester of pregnancy and postpartum, suggesting that these are particularly vulnerable times in brain development. White matter changes seemed to be specifically associated with maternal depression after birth.

Reduced cortical thickness of the right frontal lobe has been linked to a higher risk of depression and anxiety in adolescents.6-9 The implication of the current study is that exposure to maternal depression during pregnancy and the postnatal period may cause premature changes in gray and white matter of the child that may lead to depression later on. This finding supports monitoring and appropriate treatment of depression throughout pregnancy and the postnatal period to preserve the mental health of the child.

References

  1. Lebel C, Walton M, Letoumeau N, Giesbrecht GF, Kaplan BJ, Dewey D. Prepartum and postpartum maternal depressive symptoms are related to children’s brain structure in preschool. Biol Psychiatry. 2015; doi:10.1016/j.biopsych.2015.12.004.
  2. Brown TT, Kuperman JM, Chung Y, et al. Neuroanatomical assessment of biological maturity. Curr Biol. 2012;22:1693–1698.
  3. Hermoye L, Saint-Martin C, Cosnard G, et al. Pediatric diffusion tensor imaging: Normal database and observation of the white matter maturation in early childhood. Neuroimage. 2006;29:493–504.
  4. Zhou D, Lebel C, Treit S. Accelerated longitudinal cortical thinning in adolescence. Neuroimage 2015;104:138–145.
  5. Lebel C, Beaulieu C. Longitudinal development of human brain wiring continues from childhood into adulthood. J Neurosci  2011;31:10937–10947.
  6. Marrus N, Belden A, Nishino T, et al. Ventromedial prefrontal cortex thinning in preschool-onset-depression. J Affect Disord. 2015;180:79–86.
  7. Peterson BS, Warner V, Bansal R, et al. Cortical thinning in persons at increased familial risk for major depression. Proc Natl Acad Sci. 2009;106:6273–6278.
  8. Foland-Ross LC, Gilbert BL, Joormann J, Gotlib IH. Neural markers of familial risk for depression: An investigation of cortical thickness abnormalities in healthy adolescent daughters of mothers with recurrent depression. J Abnorm Psychol. 2015; 124:476–485.
  9. Ducharme S, Albaugh MD, Hudziak JJ, et al. Anxious/depressed symptoms are linked to right ventromedial prefrontal cortical thickness maturation in healthy children and young adults. Cereb Cortex. 2014; 24:2941–2950.

This article originally appeared on Neurology Advisor