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The perinatal origins of childhood anxiety disorders and the role of early-life maternal predictors

Published online by Cambridge University Press:  29 June 2020

Megan Galbally*
Affiliation:
1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia School of Medicine, University of Notre Dame, Fremantle, Australia King Edward Memorial Hospital, Subiaco, Australia
Stuart J. Watson
Affiliation:
1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia School of Medicine, University of Notre Dame, Fremantle, Australia
Elisabeth F. C. van Rossum
Affiliation:
Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
Wai Chen
Affiliation:
School of Medicine, University of Notre Dame, Fremantle, Australia Graduate School of Education, University of Western Australia, Crawley, Australia
Edo Ronald de Kloet
Affiliation:
Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
Andrew J. Lewis
Affiliation:
1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
*
Author for correspondence: Megan Galbally, E-mail: m.galbally@murdoch.edu.au

Abstract

Background

The development of childhood anxiety disorders (CADs) is likely to depend on pathways that can be programmed by early-life risk factors. We test the hypothesis that early-life maternal factors can predict this programming effect on CAD.

Methods

Data were obtained from 198 women and children from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy, postpartum and until 4 years of age. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV), together with antenatal hair cortisol concentrations, maternal childhood trauma and parenting stress at 6 months postpartum. CAD was assessed with the Preschool Age Psychiatric Assessment and the Child Behaviour Checklist.

Results

Antenatal depression, a history of maternal childhood trauma and lower gestational age at birth were each associated with anxiety disorders at 4 years of age in their children. A multivariate binary logistic model with these early predictors explained approximately 9% of variance in CAD outcome at 4 years of age; however, only maternal trauma and gestational age were significant predictors in the model. The effect of early parenting stress on CAD was found to vary by the concentration of maternal antenatal hair cortisol, whereby postpartum parenting stress was associated with CAD only when there were higher maternal antenatal cortisol levels.

Conclusions

This study suggests the importance of maternal factors pre-conception, pregnancy and in the postnatal period, which predict CADs and this is consistent with a developmental programming hypothesis for CAD.

Type
Original Article
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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