Influence of in utero exposure to maternal depression and natural disaster-related stress on infant temperament at 6 months: The children of Superstorm Sandy.

This study examined the effects of in utero exposure to maternal depression and Superstorm Sandy, a hurricane that hit metropolitan New York in 2012, on infant temperament at 6 months. Temperament was assessed using the Infant Behavior Questionnaire-Revised. Maternal depression was measured by the Edinburgh Postnatal Depression Scale. The main effects and the interaction of maternal depression and Sandy exposure on infant temperament were examined using a multivariable generalized linear model. Results show that prenatal maternal depression was associated with lower emotion regulation and greater distress. Stratification and interaction analyses suggested that the adverse effects of prenatal maternal depression on problematic temperament were amplified by in utero Sandy exposure. This study underscores the importance of providing prenatal screening and treatment for maternal depression during pregnancy while also identifying high-risk families who may have suffered from disaster-related traumas to provide necessary services. As the frequency of natural disasters may increase due to climate change, it is important to understand the consequences of in utero stress on child development and to formulate plans for early identification.

El estudio examinó los efectos del estar expuesto in-utero a la depresión materna y a la Gran Tormenta Sandy, un huracán que afectó el área metropolitana de Nueva York en 2012, sobre el temperamento del infante a los 6 meses. Se evaluó el temperamento usando el Revisado Cuestionario de Conducta del Infante. La depresión materna fue medida por medio de la Escala de Depresión Posnatal de Edinburgh. Los principales efectos y la interacción de la depresión materna y el estar expuesto a Sandy sobre el temperamento del infante se examinaron usando el Modelo Lineal General de Variables Múltiples. Los resultados muestran que la depresión materna prenatal se asoció con una más baja regulación de la emoción y una mayor angustia. Los análisis de estratificación e interacción sugirieron que los efectos adversos de la depresión materna prenatal sobre el temperamento problemático se ampliaron por el hecho de haber estado expuesto a Sandy in-utero. El estudio subraya la importancia de proveer examen y tratamiento prenatal para la depresión materna durante el embarazo, mientras simultáneamente se identifican las familias bajo alto riesgo que pudieran haber sufrido de traumas relacionados con desastres con el fin de proveer los servicios necesarios. Ya que la frecuencia de desastres naturales pudiera aumentar debido a los cambios climáticos, es importante comprender las consecuencias que el estrés in-utero tiene sobre el desarrollo del niño y formular planes para la temprana identificación.

Cette étude a examiné les effets de l'exposition à la dépression maternelle et à la grande tempête Sandy in-utero sur le tempérament du bébé à 6 mois, la tempête Sandy ayant été un cyclone ayant frappé la ville de New York aux Etats-Unis en 2012. Le tempérament a été évalué en utilisant le Questionnaire Révisé du Comportement du Nourrisson. La dépression maternelle a été mesurée au moyen d'Echelle de Dépression Postnatale d'Edinburgh. Les principaux effets et l'interaction de la dépression maternelle et l'exposition à Sandy sur le tempérament du bébé ont été examinés en utilisant un Modèle Général de Linéarité (MGL). Les résultats montrent que la dépression maternelle prénatale est liée à une émotion-régulation moindre et à une plus grande détresse. Les analyses de stratification et d'interaction suggèrent que les effets adverses de la dépression maternelle prénatale sur un tempérament problématique ont été amplifiés par l'exposition à Sandy in-utero. Cette étude souligne l'importance qu'il y a d'offrir un dépistage et un traitement pour la dépression maternelle durant la grossesse, tout en identifiant simultanément les familles à haut risque qui peuvent avoir souffert de traumatismes liés à des désastres naturels de façon à offrir des services nécessaires. Comme la fréquence des catastrophes naturelles peut augmenter avec le changement climatique il est important de comprendre les conséquences du stress in-utero sur le développement de l'enfant et de formuler des plans d'identification précoce.

Placental MAOA expression mediates prenatal stress effects on temperament in 12-month-olds.

The placenta adapts to maternal environment and its alterations may have a lasting impact on child's temperament development. Prenatal stress has been linked to both a downregulation of monoamine oxidase A (MAOA) gene expression in the placenta and to difficult temperament. Capitalizing on an ongoing longitudinal study, we analysed data from 95 mother-child dyads to investigate whether MAOA mediates the association between prenatal stress and infant temperament. Prenatal stress was defined as exposure to Superstorm Sandy (Sandy) during pregnancy. Infant temperament was measured by Infant Behaviour Questionnaire-Revised. MAOA gene expression was quantified in placenta tissue. The Smiling and Laughter subscale score was independently associated with Sandy exposure and MAOA placental gene expression. Mediation analysis confirmed that MAOA expression partially mediated the relationship between Sandy and Smiling and Laughter subscale, suggesting that in utero exposure to Sandy could induce lower frequency of smiling and laughter via downregulation of placental MAOA gene expression. These effects could compromise optimal temperamental trajectory and contribute to risk for psychological problems. Placental epigenetic markers can contribute to a multidimensional model of early intervention for high-risk children.

Association of maternal exposure to Superstorm Sandy and maternal cannabis use with development of psychopathology among offspring: the Stress in Pregnancy Study.

BACKGROUND: Early-life adverse experiences can elevate the magnitude of the risk of developmental psychopathology, but the potential synergistic effects of multiple factors have not been well studied. AIMS: To determine whether prenatal exposures to maternal stress (Superstorm Sandy) and maternal cannabis use synergistically alter the risk of developmental psychopathology. METHOD: The study included 163 children (53.4% girls), longitudinally tracked (ages 2-5 years) in relation to the effects of two early-life adverse exposures (Superstorm Sandy and maternal cannabis use). Offspring were grouped by exposure status (neither, only maternal cannabis use, only Superstorm Sandy or both). DSM-IV disorders for offspring were derived from structured clinical interviews; caregiver-reported ratings of family stress and social support were also assessed. RESULTS: A total of 40.5% had been exposed to Superstorm Sandy and 24.5% to maternal cannabis use. Offspring exposed to both (n = 13, 8.0%), relative to those exposed to neither, had a 31-fold increased risk of disruptive behavioural disorders (DBDs) and a seven-fold increased risk of anxiety disorders. The synergy index demonstrated that offspring with two exposures had synergistic elevation in risk of DBDs (synergy index, 2.06, P = 0.03) and anxiety disorders (synergy index, 2.60, P = 0.004), compared with the sum of single risks. Offspring with two exposures had the highest parenting stress and lowest social support. CONCLUSIONS: Our findings are consistent with the double-hit model suggesting that offspring with multiple early-life adverse exposures (Superstorm Sandy and maternal cannabis use) have synergistically increased risks of mental health problems. Given the increasing frequency of major natural disasters and cannabis use, especially among women under stress, these findings have significant public health implications.

Prenatal exposure to disaster-related traumatic stress and developmental trajectories of temperament in early childhood: Superstorm Sandy pregnancy study.

BACKGROUND: Little is known about the impact of prenatal maternal stress (PNMS) on the developmental trajectory of temperament and few studies have been able to incorporate a natural disaster as a quasi-experimental stressor. The current study investigated PNMS related to Superstorm Sandy ('Sandy'), a hurricane that struck the New York metropolitan area in October 2012, in terms of objective exposure during pregnancy, subjective stress reaction as assessed by maternal symptoms of post-traumatic stress, and their impact on the developmental changes in temperament during early childhood. METHOD: A subsample of 318 mother-child dyads was drawn from the Stress in Pregnancy Study. Temperament was measured at 6, 12, 18, and 24 months of age. RESULTS: Objective exposure was associated with greater High-Intensity Pleasure, Approach, Perceptual Sensitivity and Fearfulness, but lower Cuddliness and Duration of Orientation at 6 months. Objective exposure and its interaction with subjective stress reaction predicted developmental changes in temperament. In particular, objective exposure was linked to greater increases in Activity Level but decreases in High-Intensity Pleasure, Approach, and Fearfulness. The combination of objective exposure and subjective stress reaction was also associated with greater increases in Activity Level. LIMITATIONS: Temperament was measured solely via maternal report. Trimester-specific effects of Sandy on temperament were not examined. CONCLUSION: This is the first study to examine the effects of prenatal maternal exposure to a natural disaster on trajectories of early childhood temperament. Findings suggest that both objective stress exposure and subjective stress reaction in-utero predict developmental trajectories of temperament in early childhood.