Maternal Anxiety and Depression during Late Pregnancy and Newborn Brain White Matter Development.

BACKGROUND AND PURPOSE: Anxiety and depression during pregnancy have been associated with an increased risk of adverse neurodevelopmental outcomes in offspring. We aimed to study the in utero effects of maternal anxiety and depression on early brain development. MATERIALS AND METHODS: Pregnant women were recruited at ∼36 weeks of gestation for this prospective study. They were assessed for anxiety symptoms by the State-Trait Anxiety Inventory and for depression symptoms by the Beck Depression Inventory, 2nd Edition. After delivery, infant underwent an MR imaging examination of the brain without sedation, including DTI, for evaluation of white matter (WM) development. Infant fractional anisotropy values, a putative marker of WM integrity, were correlated with the mothers' State-Trait Anxiety Inventory and Beck Depression Inventory scores by using both tract-based spatial statistics and ROI methods. RESULTS: Thirty-four infants were included in this study. Both maternal State-Anxiety and Trait-Anxiety scores negatively correlated (P < .05, corrected) with fractional anisotropy values in widespread brain WM regions; Beck Depression Inventory scores also negatively correlated (P < .05) with fractional anisotropy values in one cluster in the brain. Further ROI analyses confirmed significant negative correlations between average fractional anisotropy values in ROIs including left and right prefrontal WM, left and right middle frontal gyrus WM, and the fornix, and State-Anxiety (R values, -0.47 to -0.67; P values, .008 to <.001), Trait-Anxiety (R, -0.37 to -0.59; P, .04 to <.001), and Beck Depression Inventory (R values, -0.36 to -0.55; P, .05 to .002) scores. CONCLUSIONS: Higher maternal anxiety and depression symptom scores during late pregnancy were associated with lower estimated infant brain WM development, which indicated in utero influences of maternal mental health during pregnancy on the developing brain.

Health outcomes among American Indians with spinal cord injury.

OBJECTIVE: To identify factors related to risk for poor health outcomes and secondary conditions in a sample of American Indians with spinal cord injury (SCI). DESIGN: Interviews were conducted by telephone with most participants; those who did not have telephones returned materials by mail. SETTING: A large rehabilitation hospital in the Western/ Mountain region of the United States. PARTICIPANTS: Ninety-seven American Indians with SCI completed a comprehensive health interview. All participants were adults with traumatic SCI and were at least 1 year postinjury. MAIN OUTCOME MEASURES: Selected items from the Behavioral Risk Factor Surveillance System were used to assess health behaviors and general health outcomes. Two secondary conditions were also investigated as outcome measures: pressure sores and post-SCI injuries. RESULTS: Multiple linear regression was used to predict seven health-related outcomes. Depressive symptomatology and post-SCI injuries were the primary predictors of the majority of health outcomes. Alcohol consumption was associated with a greater risk for post-SCI injuries, and being older at injury was associated with poorer health outcomes. CONCLUSIONS: Interventions to reduce depression, injuries, and alcohol misuse have potential for improving health among American Indians with SCI.