Sleep duration and sleep loss during pregnancy: a longitudinal FinnBrain birth cohort study.

PURPOSE: To investigate sleep duration and sleep loss during antenatal period and assess associative factors, including maternal characteristic and mood symptoms. METHODS: A cohort of 3038 women was enrolled. Self-reported sleep duration and sleep loss, the latter being calculated from preferred sleep need and actual sleep duration, were measured in early, mid- and late pregnancy, and at delivery. The associations with age, BMI, parity, education, smoking, napping, and depressive and anxiety symptoms were evaluated. RESULTS: Sleep duration was longest in early pregnancy and shortest at delivery (7.93 h-7.76 h, p < 0.001). The proportion of short sleepers (< 6 h) increased from 1.4% to 5.9% throughout the studied period (p < 0.001). Mean sleep loss remained stable in early- and mid-pregnancy, lowering in late pregnancy (p < 0.001) and increasing again until delivery (p = 0.003). The number of women with notable sleep loss (> 2 h) was similar during the first three measurement points (9.4%, 8.9% and 9.5%), but increased until delivery (14.1%, p < 0.001). Older, multiparous, and more-depressive women slept less (p < 0.001, p < 0.001, p = 0.017). Women with higher BMI were more likely to sleep < 6 h in late pregnancy (p = 0.012). Multiparous, more-depressive, and higher-BMI women reported more sleep loss (p < 0.001, p < 0.001, p = 0.049). CONCLUSION: We confirmed earlier reported decrease in sleep duration at the end of pregnancy. As a novel finding, we showed a notable increase in sleep loss during the last month of pregnancy. Various factors were associated with both short sleep and sleep loss, especially multiparity, napping and depressive symptoms.

Mother-Infant Interaction and Maternal Postnatal Psychological Distress Associate with Child's Social-Emotional Development During Early Childhood: A FinnBrain Birth Cohort Study.

We studied the effects of mother-infant interaction and maternal pre- and postnatal psychological distress on children's social-emotional problems and competences, as well as whether interaction quality moderates the association between distress and children's outcomes. Maternal pre- and postnatal psychological distress were measured using the SCL and EPDS questionnaires, whereas mother-infant interaction was measured when the child was 8 months old using the EA Scales. Children's social-emotional development was measured using the BITSEA questionnaire at 2 years old and using the SDQ questionnaire at 4 years old, where higher maternal structuring was associated with fewer social-emotional problems in children and higher maternal sensitivity was associated with greater social-emotional competence in children at 2 years old. Further, higher postnatal distress was found associated with greater social-emotional problems at 2 years old, though neither these effects nor moderating effects at 4 years old were observed after multiple-comparison corrections. Our findings support direct associations of both mother-infant interaction and maternal postnatal psychological distress with children's social-emotional development during toddlerhood.

Lower maternal emotional availability is related to increased attention toward fearful faces during infancy.

It has been suggested that infants' age-typical attention biases for faces and facial expressions have an inherent connection with the parent-infant interaction. However, only a few previous studies have addressed this topic. To investigate the association between maternal caregiving behaviors and an infant's attention for emotional faces, 149 mother-infant dyads were assessed when the infants were 8 months. Caregiving behaviors were observed during free-play interactions and coded using the Emotional Availability Scales. The composite score of four parental dimensions, that are sensitivity, structuring, non-intrusiveness, and non-hostility, was used in the analyses. Attention disengagement from faces was measured using eye tracking and face-distractor paradigm with neutral, happy, and fearful faces and scrambled-face control pictures as stimuli. The main finding was that lower maternal emotional availability was related to an infant's higher attention to fearful faces (p = .042), when infant sex and maternal age, education, and concurrent depressive and anxiety symptoms were controlled. This finding indicates that low maternal emotional availability may sensitize infants' emotion processing system for the signals of fear at least during this specific age around 8 months. The significance of the increased attention toward fearful faces during infancy is an important topic for future research.

Attention biases for emotional facial expressions during a free viewing task increase between 2.5 and 5 years of age.

The normative, developmental changes in affect-biased attention during the preschool years are largely unknown. To investigate the attention bias for emotional versus neutral faces, an eye-tracking measurement and free viewing of paired pictures of facial expressions (i.e., happy, fearful, sad, or angry faces) and nonface pictures with neutral faces were conducted with 367 children participating in a Finnish cohort study at the age of 2.5 years and with 477 children at the age of 5 years, 216 of which having follow-up measurements. We found an attention-orienting bias for happy and fearful faces versus neutral faces at both age points. An attention-orienting bias for sad faces emerged between 2.5 and 5 years. In addition, there were significant biases in sustained attention toward happy, fearful, sad, and angry faces versus neutral faces, with a bias in sustained attention for fearful faces being the strongest. All biases in sustained attention increased between 2.5 and 5 years of age. Moderate correlations in saccadic latencies were found between 2.5 and 5 years. In conclusion, attention biases for emotional facial expressions seem to be age-specific and specific for the attentional subcomponent. This implies that future studies on affect-biased attention during the preschool years should use small age ranges and cover multiple subcomponents of attention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mother-infant interaction and maternal postnatal psychological distress are associated with negative emotional reactivity among infants and toddlers- A FinnBrain Birth Cohort study.

Studies have reported mixed findings regarding the effects of mother-infant interaction and maternal distress on children's negative emotional reactivity. In the current study (N = 134 and 107), we examined the effects of maternal Emotional Availability (sensitivity, structuring, non-intrusiveness and non-hostility) and maternal psychological distress on negative reactivity among children in the FinnBrain birth cohort study. In addition, the possible moderating effect of mother-infant interaction on the associations between maternal psychological distress and children's negative reactivity was examined. We used questionnaires to asses maternal psychological distress, observations of mother-infant interaction and observations as well maternal reports of child temperament to overcome the key limitations of many studies relying on single-method assessments. Our results showed that higher maternal sensitivity and structuring at 8 months of child's age were associated with lower mother-reported negative reactivity among children at 24 months. Higher maternal postnatal distress associated with higher parent-reported negative reactivity in children at 12 and 24 months of age when the effects of prenatal distress and the quality of mother-infant interaction were controlled for. Mother-infant interaction and maternal psychological distress did not associate with observations of child negative reactivity. We found no moderation effects of mother-infant interaction regarding the associations between maternal distress and children's negative emotional reactivity. Our findings reflect the importance of developing interventions to reduce the maternal distress symptoms while enhancing maternal sensitivity and structuring to prevent the possible harmful effects of these on child negative reactivity.

Prenatal maternal depressive symptoms are associated with neonatal left amygdala microstructure in a sex-dependent way.

Exposures to prenatal maternal depressive symptoms (PMDS) may lead to neurodevelopmental changes in the offspring in a sex-dependent way. Although a connection between PMDS and infant brain development has been established by earlier studies, the relationship between PMDS exposures measured at various prenatal stages and microstructural alterations in fundamental subcortical structures such as the amygdala remains unknown. In this study, we investigated the associations between PMDS measured during gestational weeks 14, 24 and 34 and infant amygdala microstructural properties using diffusion tensor imaging. We explored amygdala mean diffusivity (MD) alterations in response to PMDS in infants aged 11 to 54 days from birth. PMDS had no significant main effect on the amygdala MD metrics. However, there was a significant interaction effect for PMDS and infant sex in the left amygdala MD. Compared with girls, boys exposed to greater PMDS during gestational week 14 showed significantly higher left amygdala MD. These results indicate that PMDS are linked to infants' amygdala microstructure in boys. These associations may be relevant to later neuropsychiatric outcomes in the offspring. Further research is required to better understand the mechanisms underlying these associations and to develop effective interventions to counteract any potential adverse consequences.

Course of child social-emotional and sleep symptoms, parental distress and pandemic-related stressors during COVID-19.

Research on the longitudinal courses of child social-emotional symptoms and sleep during the COVID-19 pandemic within societies would be of key value for promoting child well-being in global crises. We characterized the course of children's social-emotional and sleep symptoms before and throughout the pandemic in a Finnish longitudinal cohort of 1825 5- to 9-year-old children (46% girls) with four follow-up points during the pandemic from up to 695 participants (spring 2020-summer 2021). Second, we examined the role of parental distress and COVID-related stressful events in child symptoms. Child total and behavioral symptoms increased in spring 2020 but decreased thereafter and remained stable throughout the rest of the follow-up. Sleep symptoms decreased in spring 2020 and remained stable thereafter. Parental distress was linked with higher child social-emotional and sleep symptoms. The cross-sectional associations between COVID-related stressors and child symptoms were partially mediated by parental distress. The findings propose that children can be protected from the long-term adverse influences of the pandemic, and parental well-being likely plays a mediating role between pandemic-related stressors and child well-being. Further research focusing on the societal and resilience factors underlying family and child responses to the pandemic is warranted.

Gestational anemia and maternal antenatal and postpartum psychological distress in a prospective FinnBrain Birth Cohort Study.

BACKGROUND: Gestational anemia, most commonly caused by iron deficiency, may increase the risk of maternal anxiety and depression and have a potentially far-reaching impact on mother's and newborn's health. Several mechanisms, such as effects of iron deficiency on cerebral neurotransmitter metabolism, have been suggested. None of the earlier studies have assessed the association between gestational anemia and depression, anxiety and pregnancy-related anxiety simultaneously. METHODS: Women, participating in the FinnBrain Birth Cohort Study and attending maternity welfare clinics in Turku, whose hemoglobin (Hb) values during pregnancy were available were included in this study (n = 1273). The study group consisted of 301 women with Hb levels < 11.0 g/dL at any time during pregnancy, and 972 women with Hb ≥ 11.0 g/dL were included in the control group. Symptoms of depression, anxiety, and pregnancy-related anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS), Symptom Checklist-90 (SCL), and Pregnancy-Related Anxiety Questionnaire (PRAQ) questionnaires at 14, 24, and 34 gestational weeks, and EPDS and SCL were also performed 3 and 6 months postpartum. RESULTS: Gestational anemia was not associated with an increased risk of depression either prenatally or postpartum when the analyses were adjusted for maternal age at birth, parity, smoking during pregnancy, maternal education, and gestational age. However, a weak connection was found between gestational anemia and prenatal anxiety in the early pregnancy. Furthermore, the analysis between women with Hb < 10.0 g/dL and those with Hb ≥ 10.0 g/dL showed an association between gestational anemia and anxiety in the late pregnancy, but otherwise no difference in psychological distress was found. CONCLUSIONS: No evidence supporting the association between gestational anemia and antenatal or postpartum depression was found. However, a weak connection between gestational anemia and antenatal anxiety was observed. This finding needs further investigation to establish timing and investigate causality.

The stability of early developing attentional bias for faces and fear from 8 to 30 and 60 months in the FinnBrain Birth Cohort Study.

Most infants exhibit an attentional bias for faces and fearful facial expressions. These biases reduce toward the third year of life, but little is known about the development of the biases beyond early childhood. We used the same methodology longitudinally to assess attention disengagement patterns from nonface control pictures and faces (neutral, happy, and fearful expressions) in a large sample of children at 8, 30, and 60 months (N = 389/393/492, respectively; N = 72 for data in all three assessment; girls > 45.3% in each assessment). "Face bias" was measured as a difference in disengagement probability (DP) from faces (neutral/happy) versus nonface patterns. "Fear bias" was calculated as a difference in DP for fearful versus happy/neutral faces. At group level, DPs followed a nonlinear longitudinal trajectory in all face conditions, being lowest at 8 months, highest at 30 months, and intermediate at 60 months. Face bias declined between 8 and 30 months, but did not change between 30 and 60 months. Fear bias declined linearly from 8 to 60 months. Individual differences in disengagement were generally not stable across age, but weak correlations were found in face bias between 8- and 60-month, and in DPs between 30- and 60-month (rs = .22-.41). The results suggest that prioritized attention to faces-that is, a hallmark of infant cognition and a key aspect of human social behavior-follows a nonlinear trajectory in early childhood and may have only weak continuity from infancy to mid childhood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sex-specific associations between maternal pregnancy-specific anxiety and newborn amygdalar volumes - preliminary findings from the FinnBrain Birth Cohort Study.

Previous literature links maternal pregnancy-specific anxiety (PSA) with later difficulties in child emotional and social cognition as well as memory, functions closely related to the amygdala and the hippocampus. Some evidence also suggests that PSA affects child amygdalar volumes in a sex-dependent way. However, no studies investigating the associations between PSA and newborn amygdalar and hippocampal volumes have been reported. We investigated the associations between PSA and newborn amygdalar and hippocampal volumes and whether associations are sex-specific in 122 healthy newborns (68 males/54 females) scanned at 2-5 weeks postpartum. PSA was measured at gestational week 24 with the Pregnancy-Related Anxiety Questionnaire Revised 2 (PRAQ-R2). The associations were analyzed with linear regression controlling for confounding variables. PSA was associated positively with left amygdalar volume in girls, but no significant main effect was found in the whole group or in boys. No significant main or sex-specific effect was found for hippocampal volumes. Although this was an exploratory study, the findings suggest a sexually dimorphic association of mid-pregnancy PSA with newborn amygdalar volumes.

Age and sex differences in the cortisol stress reactivity and recovery among infants exposed to prenatal psychological distress.

BACKGROUND: Altered hypothalamic-pituitary-adrenal axis (HPA) functioning is one of the potential mechanisms bridging exposure to maternal prenatal psychological distress (PPD) and later risk for offspring psychiatric illness. Research on infant cortisol stress reactivity, on scarcely studied recovery and their associations with maternal PPD is needed to clarify these mechanisms. Knowledge on sex differences in prospective settings is largely lacking. We aimed at filling these gaps by building upon our previous report showing that exposure to maternal prenatal depressive and anxiety symptoms associates with slower cortisol recovery among 10-week-old female infants. METHODS: In all, 363, 205 and 263 infants at 10 weeks, six and 14 months of age from the FinnBrain Birth Cohort Study participated in a stress test comprising of venipuncture and nasopharynx sampling. Five saliva cortisol samples were collected during each visit to measure cortisol reactivity and recovery. PPD was assessed from maternal self-reports for depressive, anxiety and pregnancy-related anxiety symptoms at gestational weeks 14, 24 and 34. RESULTS: An 11% enhanced recovery among 14-month-old females was associated with higher depressive and anxiety symptoms (95% CI=1-23%) and pregnancy-related anxiety symptoms (2-21%). No alterations in the female cortisol reactivity or male cortisol stress responses were observed. CONCLUSIONS: The opposite directions in the associations between the PPD exposure and infant cortisol recovery among 10-week-old and 14-month-old females suggest sex- and age-dependent associations between HPA axis functioning and PPD exposure among healthy infants. Follow-up is needed to characterize the impact of this altered negative feedback mechanism on later health.

Children's diurnal cortisol output and temperament in two different childcare settings at 2 and 3.5 years of age.

Prior research suggests that child temperament may play an important role in early childhood stress regulation. We compared children's diurnal cortisol and the association between cortisol and temperament in two different childcare settings. Cortisol was measured from saliva samples over 2 days in children (N = 84) attending out-of-home childcare and in children (N = 27), who were cared for at home at the age of 3.5 years. There was no difference between the childcare groups in total diurnal cortisol. However, of the individual measurements, afternoon cortisol levels were higher in the out-of-home childcare group during their childcare day when compared with their home day. Child temperament was not associated with total diurnal cortisol. Comparison with our prior measurements showed that the association between temperamental surgency/extroversion and total diurnal cortisol diminished along with the child age from 2 to 3.5 years in both childcare settings. This may indicate that more extroverted children are physiologically more reactive to environmental stimuli when they are younger, but this association does not appear as the children develop. Our results further suggest that the afternoon hours in the out-of-home childcare may be demanding and accelerate the hypothalamus-pituitary-adrenal axis activation in young children independent of their age.

Maternal Psychological Distress and Executive Functions Are Associated During Early Parenthood - A FinnBrain Birth Cohort Study.

Parental executive functioning (EF) and parenting behaviors can be affected by the multiple stressors that are often present during early parenthood. However, little is known about how commonly experienced psychological distress during early parenthood is associated with parental EF capacity. We explored the links between psychological distress and EFs in a general population sample of 150 Finnish birth cohort mothers with 2.5-year-old children. The symptoms of depression, anxiety, insomnia, and poor couple relationship adjustment were measured with the self-report questionnaires EPDS, SCL-90, AIS, and RDAS. EFs were assessed with five computerized Cogstate tasks. When the psychological distress measures were added to a hierarchical regression analysis as continuous variables, no significant single or additive associations with EFs were found. When the distress measures were dichotomized to compare symptoms below/above cutoffs indicating clinically elevated levels, single distress domains remained as non-significant predictors, but a cumulative risk index of the number of concurrent clinically elevated distress domains was significantly associated with EFs. Thus, mothers with a higher number of concurrent clinically elevated psychological distress domains (i.e., depression, anxiety, insomnia, and poor couple relationship adjustment) tended to have lower EFs. This association is possibly bi-directional - clinically elevated distress within several domains could have a cumulative, depleting effect on maternal EF capacity, but a lower EF capacity could also increase the vulnerability for experienced distress within several concurrent domains. Longitudinal studies are needed to clarify potential causal links between stressors and EF.

Neonatal amygdala volumes and the development of self-regulation from early infancy to toddlerhood.

Objective: At the broadest level, self-regulation (SR) refers to a range of separate, but interrelated, processes (e.g., working memory, inhibition, and emotion regulation) central for the regulation of cognition, emotion, and behavior that contribute to a plethora of health and mental health outcomes. SR skills develop rapidly in early childhood, but their neurobiological underpinnings are not yet well understood. The amygdala is one key structure in negative emotion generation that may disrupt SR. In the current study, we investigated the associations between neonatal amygdala volumes and mother-reported and observed child SR during the first 3 years of life. We expected that larger neonatal amygdala volumes would be related to poorer SR in children. Method: We measured amygdala volumes from magnetic resonance imaging (MRI) performed at age M = 3.7 ± 1.0. We examined the associations between the amygdala volumes corrected for intracranial volume (ICV) and (a) parent-reported indicators of SR at 6, 12, and 24 months (N = 102) and (b) observed task-based indicators of SR (working memory and inhibitory control) at 30 months of age in a smaller subset of participants (N = 80). Results: Bilateral neonatal amygdala volumes predicted poorer working memory at 30 months in girls, whereas no association was detected between amygdalae and inhibitory control or parent-reported SR. The left amygdala by sex interaction survived correction for multiple comparisons. Conclusions: Neonatal amygdala volume is associated with working memory, particularly among girls, and the association is observed earlier than in prior studies. Moreover, our findings suggest that the neural correlates for parent-reported, compared to observed early life SR, may differ. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Gut microbiota diversity but not composition is related to saliva cortisol stress response at the age of 2.5 months.

Human brain and intestinal microbes reportedly maintain a constant bidirectional connection through diverse neural, endocrine, immune, and metabolic pathways. Increasing evidence indicates that this communication system, referred to as microbiota-gut-brain axis, enables the gut microbes to influence several aspects of brain function and behavior, including hypothalamic-pituitary-adrenal (HPA) axis stress responses, and on the other hand, stress can affect gut microbiota. However, the role of gut microbiota in the HPA axis functioning in humans remains to be specified especially in early life. This study aimed at identifying the potential link between the cortisol stress response and the gut microbiota at the age of 2.5 months. Fecal microbiota profiles were acquired by 16S rRNA gene sequencing, while salivary cortisol responses after an exposure to a mild acute stressor represented the HPA axis reactivity. We observed that a blunted cortisol stress response was weakly associated with a diverse gut microbiota diversity at the age of 2.5 months. Gut microbiota composition was not associated with cortisol stress responsiveness, but rather with covariates, i.e. factors that influence gut microbiota composition and colonization.LAY SUMMARYThis exploratory study aimed at identifying possible links between cortisol stress responses and fecal microbiota composition in early infancy. In a well-characterized study population of 2.5-month-old infants, we observed that an attenuated cortisol stress responsiveness after a mild stressor was weakly associated with a diverse fecal microbiota. Our results suggest that the gut microbiota composition is associated with environmental factors, such as delivery mode and number of siblings, rather than with cortisol stress responsiveness, in this age group.

Behavioral Regulatory Problems Are Associated With a Lower Attentional Bias to Fearful Faces During Infancy.

To investigate the role of early regulatory problems (RP), such as problems in feeding, sleeping, and calming down during later development, the association between parent-reported RP at 3 months (no-RP, n = 110; RP, n = 66) and attention to emotional faces at 8 months was studied. Eight-month-old infants had a strong tendency to look at faces and to specifically fearful faces, and the individual variance in this tendency was assessed with eye tracking using a face-distractor paradigm. The early RPs were related to a lower attention bias to fearful faces compared to happy and neutral faces after controlling for temperamental negative affectivity. This suggests that early RPs are related to the processing of emotional information later during infancy.

Child Temperament and Total Diurnal Cortisol in Out-of-Home Center-Based Child Care and in At-Home Parental Care.

The association between child temperament characteristics and total diurnal saliva cortisol in 84 children (M = 2.3 years, SD = 0.6) attending out-of-home, center-based child care and 79 children (M = 2.0 years, SD = 0.5) attending at-home parental care was examined. Saliva samples were collected during two consecutive days, that is, Sunday and Monday, with four samples taken per day. While children higher in surgency had higher total diurnal cortisol production, we did not find evidence that temperament moderated the associations between child-care context and total diurnal cortisol. Negative affectivity and effortful control were not related to cortisol output. Our findings suggest that temperamental surgency may be associated with higher total cortisol production in early childhood across child-care settings.

Sex differences in the associations between maternal prenatal distress and infant cortisol reactivity and recovery.

Previous research suggests that maternal prenatal psychological distress (PPD) is related to altered cortisol reactivity in the exposed child. There are indications for the sex differences in vulnerability for prenatal adversities that depend on the exposure and child outcome. Still, it is not known whether the association between maternal PPD and infant cortisol stress response is moderated by sex. In addition, the recovery phase of the cortisol stress response has not been given as much attention as reactivity. Our aim was to study the sex differences in the associations between self-reported maternal prenatal depressive-, anxiety- and pregnancy-related anxiety symptoms through gestational weeks 14, 24 and 34 and the saliva cortisol reactivity to and recovery from the acute stress among 10-week-old infants. The study population comprised of 363 mother-infant pairs from the FinnBrain Birth Cohort Study. We found evidence for sex-dependent associations between PPD exposure and infant cortisol response. A less steep recovery slope (-10 % per one SD increase in PPD [95 % CI = -18 to -2 %] and -8 % [-16 to 0 %] depending on the exposure) and a possibly less steep reactivity slope (-14 % [95 % CI = -25 to 0 %] and -10 % [-21 to 3 %]) were associated with higher PPD exposure in females. Of the PPD measures, the strongly intercorrelated, and thus combined, depressive and anxiety symptom score provided the most robust prediction of infant cortisol recovery. Our results demonstrate sexually dimorphic alterations in the functioning of the infant hypothalamus-pituitary-adrenal axis and especially in the functioning of the negative feedback loop of the axis after prenatal PPD exposure among healthy babies.