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It remains unclear how the COVID-19 pandemic has affected the mother–infant relationship and associations between maternal postpartum depression (PPD) and offspring temperament. This study examined the impact of the pandemic on these links and how maternal ratings of the mother–infant relationship mediated associations between PPD and infant temperament in a sample of treatment-seeking mothers in Ontario, Canada before and during the COVID-19 pandemic. Mothers with infants <12 months of age and Edinburgh Postnatal Depression Scale scores ≥10 enrolled in two separate randomized controlled trials of 1-day cognitive behavioral therapy-based workshops for PPD conducted before COVID-19 (n = 392) and during the pandemic (n = 403). Mothers reported on depressive symptomatology, infant temperament, and the mother–infant relationship. Maternal PPD was associated with more infant negative affectivity and mother–infant relationship difficulties. While associations between PPD and infant-focused anxiety were stronger during COVID-19, the pandemic did not otherwise affect associations between PPD and infant temperament. Mediation analyses suggested that aspects of the mother-infant relationship mediated associations between PPD and infant negative affectivity. Findings highlight the importance of detecting PPD and intervening to potentially improve outcomes for mothers and their children. [ABSTRACT FROM AUTHOR]

Objectives Prenatal maternal metabolic problems such as pre-pregnancy adiposity, excess gestational weight gain, and gestational diabetes mellitus (GDM) are associated with an increased risk of psychopathology in offspring. We examined whether these exposures were linked to symptoms of emotional and behavioral problems in offspring at 2 years of age, or if associations were due to confounding variables. Methods Data from 815 mother-child pairs enrolled at the Edmonton site of the Canadian Healthy Infant Longitudinal Development cohort were used to examine associations between gestational metabolic complications and scores on the externalizing and internalizing scales of the Child Behavior Checklist (CBCL-1½ to 5) at age two. Associations between maternal metabolic complications and offspring psychopathology were assessed before and after adjustment for gestational diet, socioeconomic status (SES), postpartum depression (PPD), prenatal smoking and breastfeeding. Results Pre-pregnancy body mass index and GDM, but not gestational weight gain, predicted more offspring externalizing and internalizing problems. However, after adjustment for confounding variables, these associations were no longer statistically significant. Post-hoc analyses revealed that gestational diet accounted for unique variance in both externalizing (semi-partial r.sub.diet = - 0.20, p < 0.001) and internalizing (semi-partial r.sub.diet = - 0.16, p = 0.01) problems. PPD and SES also accounted for a similar amount of variance for both externalizing (semi-partial r.sub.PPD = 0.17, p < 0.001; r.sub.ses = - 0.11, p = 0.03) and internalizing problems (semi-partial r.sub.PPD = 0.21, p < 0.001; r.sub.ses = - 0.14, p = 0.004). Conclusions for Practice Since the confounding effect of gestational diet persisted after adjustment for, and was similar in magnitude to, SES and PPD, future research should consider the impact of unhealthy prenatal diets on offspring neurodevelopment., Author(s): John E. Krzeczkowski [sup.1] , Amanda Lau [sup.2] , Jennifer Fitzpatrick [sup.2] , Sukhpreet Tamana [sup.2] , Lisa Smithson [sup.2] , Russell de Souza [sup.3] , Anita L. Kozyrskyj [...]

Postpartum depression (PPD) affects up to one in five and negatively affects mothers, birthing parents, and their infants. The impact of PPD exposure on infant emotion regulation (ER) may be particularly harmful given its associations with later psychiatric problems. It remains unclear if treating maternal PPD can improve infant ER. To examine the impact of a nine-week peer-delivered group cognitive behavioral therapy (CBT) intervention on infant ER assessed across physiological and behavioral levels. Seventy-three mother-infant dyads were enrolled in a randomized controlled trial from 2018 to 2020. Mothers/birthing parents were randomized to the experimental group or waitlist control group. Measures of infant ER were collected at baseline (T1) and nine weeks later (T2). Infant ER was assessed using two physiological measures (frontal alpha asymmetry (FAA) and High Frequency-Heart Rate Variability (HF-HRV)), and parental-report of infant temperament. Experimental group infants displayed more adaptive changes in both physiological markers of infant ER from T1 to T2 (FAA (F(1,56) = 4.16, p =.046) and HF-HRV (F(1,28.1) = 5.57, p =.03)) than those in the waitlist control group. Despite improvements in maternal PPD, no differences were noted in infant temperament from T1 to T2. A limited sample size, potential lack of generalizability of our results to other populations, and an absence of long-term data collection. A scalable intervention designed for those with PPD may be capable of adaptively improving infant ER. Replication in larger samples is needed to determine if maternal treatment can help disrupt the transmission of psychiatric risk from mothers/birthing parents to their infants. • Mothers were treated with a nine-week peer-delivered group cognitive behavioral therapy intervention. • Maternal treatment led to adaptive changes in two neurophysiological markers of infant emotion regulation. • A scalable, task-shifted maternal intervention may be capable of adaptively improving infant ER. • Maternal treatment may disrupt the transmission of psychiatric risk from mothers/birthing parents to their infants. [ABSTRACT FROM AUTHOR]

Introduction: Mental disorders affect 1 in 5 children having consequences for both the child and their family. Indeed, the siblings of these children are not insulated from these consequences and may experience elevated levels of psychological distress, placing them at increased risk for developing mental disorders. This protocol describes the methodology for a scoping review that will examine how mental disorders in children impact the mental health of their sibling(s). Further, we aim to examine the role of sex, gender, birth order, age of each child, and familial factors (e.g., parent mental illness, family structure), in sibling mental health. The proposed review will also identify resources that aim to support the needs of siblings of children with mental disorders. Taken together, this proposed review aims to take a fundamental step towards determining intervention targets to reduce the transmission of risk between siblings. Aim: The proposed scoping review aims to address the following questions: i) how do mental disorders (in children <18 years of age) impact the mental health of their sibling(s) (also <18 years of age)? ii) Can we identify resources designed to address the needs of siblings of children with mental disorders? Methods: We will conduct the proposed scoping review in keeping with the six-stage Arksey and O'Malley Framework and the scoping review methodology provided by the Joanna Briggs Institute. In section i) we outline our research questions. In section ii) we describe our process for identifying studies that examine the mental health of siblings of a child with a mental disorder and studies that provide evidence on resources directed specifically at these siblings. We will search peer-review and grey literature published between 2011 and 2022 from OVID MEDLINE, OVID EMBASE, CINAHL Complete, Proquest Nursing and Allied Health, PsycINFO (via APA platform), Proquest Sociology Collection and Web of Science Core Collection and Proquest Theses and Dissertations. Section iii) describes our process for selecting relevant studies. In sections iv and v, we describe our methods for charting and summarizing relevant data. Finally, in section vi) we describe our integrative knowledge translation plan that aims to include knowledge users in interpretating and translating evidence gathered from the proposed review. [ABSTRACT FROM AUTHOR]

Studies have long observed the bidirectional nature of mother–infant relationships. While behavioral studies have shown that mothers high in social avoidance tendencies can influence the development of these traits in their offspring, the neurophysiological mechanisms underlying this phenomenon, and the role that the infants play, are not well understood. Here we acquired frontal electroencephalogram asymmetry (FA) data simultaneously in 40 mother–infant dyads (Mage mother = 31.6 years; Mage infant = 9 months). Using an actor–partner interdependence model, we examined whether mother (or infant) resting-state FA predicted infant (or mother) FA during two subsequent emotion-eliciting conditions (happy and fear). Maternal social approach versus avoidance traits were assessed as moderators to examine the impact of maternal characteristics on these mother–infant FA relations. In dyads led by mothers with high social avoidance/low social approach characteristics, maternal resting-state FA predicted infant FA during both emotion-eliciting conditions. We did not observe any effects of infant FA on mothers. Therefore, we speculate that individual differences in FA patterns might be a putative brain mechanism through which socially avoidant mothers transfer affective/behavioral information to their infants. [ABSTRACT FROM AUTHOR]

Background Optimal maternal nutrition during pregnancy has been linked to better cognitive and behavioral development in children. However, its influence on the effects of suboptimal postnatal exposures like reduced stimulation and support in the home is not known. Objectives To examine the effect of maternal pregnancy diet on executive function and/or behavioral development in children raised in suboptimal home environments. Methods Data were provided by 808 mother–infant dyads from the Canadian Maternal-Infant Research on Environmental Chemicals–Child Development study. Maternal pregnancy diet was self-reported using the Healthy Eating Index 2010 questionnaire. Stimulation and support in the home was assessed using the Home Observation for Measurement of the Environment (HOME) when children were 3–4 y old. Child executive function was reported by mothers at this age using the Behavior Rating Inventory of Executive Functioning–Preschool Edition, and child behavior was assessed using the Behavior Assessment System for Children–2nd Edition. We examined the interaction of maternal pregnancy diet and postnatal HOME scores on child executive function and behavior using linear regression adjusted for maternal education, postpartum depression, prepregnancy BMI, and smoking. Results Maternal pregnancy diet was associated with an increasingly positive association with child working memory (β: 0.21; 95% CI: 0.82, 3.41; P =  0.001), planning (β: 0.17; 95% CI: 0.38, 2.84; P =  0.007), and adaptability (β: –0.13; 95% CI: –1.72, –0.08; P =  0.032) as levels of postnatal stimulation decreased. Conclusions The positive association of maternal pregnancy diet quality and executive function and adaptability in 3- to 4-y-olds appeared to increase with decreasing levels of postnatal stimulation and support. These results suggest that overall maternal pregnancy diet could be linked to better child neurodevelopment in families experiencing barriers to providing stimulation and support to children in their home. [ABSTRACT FROM AUTHOR]

Background: Exposure to maternal postpartum depression (PPD) increases the risk for emotion regulatory and psychiatric problems in offspring. This study aimed to determine if maternal cognitive behavioral therapy (CBT) for PPD improves infant emotion regulatory capacity. Methods: Participants were 40 infants of mothers with a primary diagnosis of major depressive disorder matched 1:1-40 healthy control infants of nondepressed mothers on infant age, sex, and socioeconomic status. Mothers with PPD received nine weeks of group CBT. Dyads were tested at two time points. Visit 1 occurred following the first CBT session (baseline visit for control infants). Visit 2 took place after CBT (nine weeks post-baseline for controls). At both visits, infant emotion regulation was assessed using resting-state frontal electroencephalography alpha asymmetry (FAA), heart rate variability (HRV), and maternal and partner ratings of orientation or regulation behaviors (infant behavior questionnaire-revised [short form]). Changes in maternal characteristics (depression, bonding, and emotion regulation) from pretreatment to posttreatment were examined to determine if they explained infant changes. Results: At Visit 1, infants of women with PPD exhibited poorer emotion regulation relative to the healthy control infants. At Visit 2, following maternal PPD treatment, infants exhibited improved emotion regulation (shifted from right to left FAA [p = .01, d = 0.60], increased HRV [p = .003, d = 0.56], mother [p = .015, d = 0.29] and partner [p = .049, d = 0.35] reported orientation or regulation behaviors) such that they no longer differed from the healthy control infants. Changes in maternal characteristics did not appear to account for these changes. Conclusion: Treating PPD may promote adaptive changes in physiological and behavioral systems underlying infant emotion regulation. [ABSTRACT FROM AUTHOR]

Background: Many pregnant women are consuming diets of poor overall quality. Although many studies have linked poor prenatal diet quality to an increased risk of specific diseases in offspring, it is not known if exposure to poor prenatal diet affects core neurophysiological regulatory systems in offspring known to lie upstream of multiple diseases.Objective: We aimed to examine the association between prenatal diet quality and autonomic nervous system (ANS) function in infants at 6 mo of age.Methods: Data from 400 women (aged >18 y, with uncomplicated pregnancies) and their infants participating in the Maternal-Infant Research on Environmental Chemicals-Infant Development cohort were used to investigate links between prenatal diet quality and infant ANS function at 6 mo of age. Prenatal diet quality was assessed using the Healthy Eating Index (2010), calculated from a validated FFQ completed by women during the first trimester. Infant ANS function was measured using 2 assessments of heart rate variability (HRV) including root mean square of successive differences (RMSSD) and SD of N-N intervals (SDNN). Associations were analyzed before and after adjustment for socioeconomic status, maternal depression symptoms, maternal cardiometabolic dysfunction, breastfeeding, and prenatal smoking.Results: Poorer prenatal diet quality was associated with lower infant HRV assessed using RMSSD (B: 0.07; 95% CI: 0.01, 0.13; R2 = 0.013) and SDNN (B: 0.18; 95% CI: 0.02, 0.35; R2 = 0.011). These associations remained significant after adjustment for confounding variables [RMSSD: B: 0.09; 95% CI: 0.003, 0.18; squared semipartial correlation (sp2) = 0.14 and SDNN B: 0.24; 95% CI: 0.0, 0.49; sp2 = 0.13].Conclusions: In a large cohort study, poorer prenatal diet quality was associated with lower offspring HRV, a marker of decreased capacity of the ANS to respond adaptively to challenge. Therefore, poor prenatal diet may play a significant role in the programming of multiple organ systems and could increase general susceptibility to disease in offspring. [ABSTRACT FROM AUTHOR]

Background: Prenatal exposure to maternal metabolic complications has been linked to offspring neurodevelopmental problems. However, no studies investigating these links have examined the role of maternal prenatal diet.Aims: To determine if prenatal exposure to maternal adiposity or hyperglycemia is associated with neurodevelopmental problems in 3-4 year old children, and if links persist following adjustment for confounding variables, including prenatal diet.Method: 808 mother-child pairs from the Maternal-Infant Research on Environmental Chemicals-Child Development Plus cohort were used to examine associations between pre-pregnancy body mass index (BMI), hyperglycemia and offspring verbal, performance and full-scale IQ scores, as well as internalizing and externalizing problems. Associations were examined before and after adjustment for prenatal diet along with home environment, maternal depression, education and prenatal smoking. Semi-partial correlations were examined post-hoc to assess the impact of each confounder in the adjusted models.Results: In the unadjusted models, BMI and hyperglycemia predicted lower verbal and full-scale IQ. BMI was also linked to externalizing problems. However, associations were not significant after adjustment. In adjusted models, post-hoc analysis revealed that prenatal diet and home environment accounted for significant variance in verbal and full-scale IQ. The home environment and maternal depression accounted for significant variance in externalizing problems.Conclusion: In the adjusted models, maternal metabolic complications were not associated with offspring neurodevelopment. Even while adjusting for well-known risk factors for adverse offspring cognition (home environment, maternal depression), we show for the first time that maternal prenatal diet is an important confounder of the links between maternal metabolic complications and offspring cognition. [ABSTRACT FROM AUTHOR]

Background: Preterm birth is associated with an increased risk of depression and anxiety, but it is not known if this is due to greater exposure to risk, or if perinatal adversity amplifies the impact of traditional risk factors. This study sought to determine if exposure to perinatal adversity modifies associations between traditional risk and resilience factors and depression and anxiety in adulthood. Methods: A sample of 142 extremely low‐birth‐weight (ELBW < 1,000 g) survivors and 133 sociodemographically matched normal birth weight (NBW) control participants was followed longitudinally to 22–26 years of age. Separate postnatal risk and resilience scales were created using eight risk and seven resilience factors, respectively. Depression and anxiety were assessed using the internalizing scale of the Young Adult Self‐Report (YASR). This scale was also dichotomized at the 90th percentile to define clinically significant psychopathology. Results: While the average number of risk exposures did not differ between groups, ELBW survivors were more susceptible to risk than NBW control participants. For the ELBW group, each additional risk factor resulted in a 2‐point increase in internalizing scores, and two and a half times the odds of clinically significant internalizing symptoms (OR = 2.47, 95% CI = 1.63, 3.76). The protective effect of resiliency factors was also blunted among ELBW survivors. Conclusions: Extremely low‐birth‐weight survivors may be more sensitive to traditional risk factors for psychopathology and less protected by resiliency factors. Intervention strategies aimed at preventing or reducing exposure to traditional childhood risk factors for psychopathology may reduce the burden of mental illness in adult survivors of prematurity. [ABSTRACT FROM AUTHOR]

Introduction The long allele of the DRD4 gene can confer different behavioral and emotional phenotypes depending upon environmental exposure, although the physiological changes underlying these phenotypes are not fully known. We sought to extend this work by assessing the interaction of the DRD4 gene and exposure to perinatal adversity (indexed by extremely low birth weight [ELBW]) on resting respiratory sinus arrhythmia (RSA), a neurophysiological measure of emotion regulation, in adulthood. Methods We examined the interaction between the DRD4 gene and perinatal adversity on RSA at age 30-35 in a longitudinal cohort of ELBW survivors ( n = 49) and NBW controls ( n = 63). Buccal DNA samples were genotyped for short and long carriers of the exon III DRD4 VNTR gene. Resting RSA was assessed by electrocardiogram. Results We report an interaction between birth weight status and DRD4 gene ( F = 9.42, p = 0.003) in predicting RSA, such that DRD4 long carriers had the highest and lowest resting RSA depending on whether they were born NBW or ELBW, respectively. DRD4 short carriers were less sensitive to birth weight. Additionally, reduced RSA was correlated with a history of major depressive disorder, suggesting it was a reliable index of emotion dysregulation. Discussion These results suggest that the perinatal environment influences autonomic nervous system functioning in individuals with genotypes that confer additional sensitivity. Whether the long-term autonomic outcomes of this environmental sensitivity are beneficial or detrimental appears to depend on the quality of the early life environment, and may influence the development of emotion regulatory and psychiatric problems in adulthood. [ABSTRACT FROM AUTHOR]

The effects of maternal postpartum depression (PPD) on offspring emotion regulation (ER) are particularly deleterious as difficulties with ER predict an increased risk of psychopathology. This study examined the impact of maternal participation in a public health nurse (PHN)-delivered group cognitive behavioral therapy (CBT) intervention on infant ER. Mothers/birthing parents were ≥ 18 years old with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10, and infants were < 12 months. Between 2017 and 2020, 141 mother-infant dyads were randomized to experimental or control groups. Infant ER was measured at baseline (T1) and nine weeks later (T2) using two neurophysiological measures (frontal alpha asymmetry (FAA) and high-frequency heart rate variability (HF-HRV)), and informant-report of infant temperament. Mothers were a mean of 30.8 years old (SD = 4.7), 92.3% were married/ common-law, and infants were a mean of 5.4 months old (SD = 2.9) and 52.1% were male. A statistically significant group-by-time interaction was found to predict change in HF-HRV between T1 and T2 ( F( 1,68.3) = 4.04, p = .04), but no significant interaction predicted change in FAA or temperament. Results suggest that PHN-delivered group CBT for PPD may lead to adaptive changes in a neurophysiological marker of infant ER, highlighting the importance of early maternal intervention.

Decades of evidence show that mothers provide emotional scaffolding to regulate their infants during moments of distress and that postpartum depression (PPD) can significantly disrupt this process. However, the mechanisms underlying mother-to-infant transmission of regulatory support in real-time are unclear. Examining these mechanisms is critical to understanding how mothers actively shape infant self-regulatory capacity, as well as how psychiatric risk may be transmitted from mother to child. In 32 healthy mother-infant dyads and 26 dyads affected by PPD (M age infants = 5.4 months, 40% male), respiratory sinus arrhythmia (RSA) was acquired simultaneously within dyads on a second-by-second scale during the reunion phase of the still-face task. We examined if the influence of maternal RSA on subsequent infant RSA (measured at the next second) strengthened across the reunion phase. Effects were examined at baseline, then 9 weeks later at a follow-up study visit. Between visits, mothers affected by PPD received 9 weeks of group cognitive behavioral therapy. Among healthy dyads, maternal RSA influenced subsequent decreases in infant RSA, an effect that strengthened across the reunion at both baseline and follow-up visits. In the PPD dyads, this same pattern was also observed, but only at the follow-up visit. Therefore, while mother-to-infant RSA influence patterns differed between healthy and PPD dyads at baseline, the same pattern was observed in both groups at follow-up. This study provides novel evidence for a mechanism that may explain how mothers actively transmit regulatory support to their distressed infants in real-time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).