Maternal depression and anxiety and fetal-neonatal growth☆

Pinto, Tiago Miguel; Caldas, Filipa; Nogueira-Silva, Cristina; Figueiredo, Bárbara

doi:10.1016/j.jped.2016.11.005

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Original articles • J. Pediatr. (Rio J.) 93 (5) • Sep-Oct 2017 • https://doi.org/10.1016/j.jped.2016.11.005 copy

Maternal depression and anxiety and fetal-neonatal growth^☆ ☆ Please cite this article as: Pinto TM, Caldas F, Nogueira-Silva C, Figueiredo B. Maternal depression and anxiety and fetal-neonatal growth. J Pediatr (Rio J). 2017;93:452–9.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

Maternal depression and anxiety have been found to negatively affect fetal and neonatal growth. However, the independent effects of maternal depression and anxiety on fetal-neonatal growth outcomes and trajectories remain unclear. This study aimed to analyze simultaneously the effects of maternal prenatal depression and anxiety on (1) neonatal growth outcomes, and (2), on fetal-neonatal growth trajectories, from the 2nd trimester of pregnancy to childbirth.

Methods:

A sample of 172 women was recruited and completed self-reported measures of depression and anxiety during the 2nd and 3rd trimesters of pregnancy, and at childbirth. Fetal and neonatal biometrical data were collected from clinical reports at the same assessment moments.

Results:

Neonates of prenatally anxious mothers showed lower weight (p = 0.006), length (p = 0.025), and ponderal index (p = 0.049) at birth than neonates of prenatally non-anxious mothers. Moreover, fetuses-neonates of high-anxiety mothers showed a lower increase of weight from the 2nd trimester of pregnancy to childbirth than fetuses-neonates of low-anxiety mothers (p < 0.001). Considering maternal depression and anxiety simultaneously, only the effect of maternal anxiety was found on these markers of fetal-neonatal growth outcomes and trajectories.

Conclusion:

This study demonstrates the independent longitudinal effect of maternal anxiety on major markers of fetal-neonatal growth outcomes and trajectories, simultaneously considering the effect of maternal depression and anxiety.

KEYWORDS
Maternal depression; Maternal anxiety; Fetal-neonatal growth outcomes; Fetal-neonatal growth trajectories

		Mothers
		n = 172 (%)
Age (years)	15-17	4.8
	18-29	51.5
	30-41	43.7

Socio-economic level	High	15.7
	Medium-high	4.7
	Medium	17.6
	Medium-low	22.2
	Low	39.8

Professional status	Employed	67.1
	Unemployed	25.7
	Household/student	7.2

Education (in years)	<9	27.5
	9-12	54.5
	>12	18.0

Parity	Primiparous	52.1
Parity	Multiparous	47.9

Delivery type	Eutocic	56.3
Delivery type	Dystocic	43.7

Tobacco consumption	Yes	16.2
Tobacco consumption	No	83.8

Coffee consumption	Yes	29.3
Coffee consumption	No	70.7
		Neonates
		n = 168 (%)
Sex	Male	56.3
Sex	Female	43.7

Reanimation	Yes	6.0
Reanimation	No	94.0

Weight (g)	<2500	6.6
	2500-4199	91.0
	≥4200	2.4

Length (cm)	<50	63.5
Length (cm)	≥50	36.5

Ponderal Index	<2.50	18.8
Ponderal Index	≥2.50	81.2

Gestational age at birth (weeks)	<37	4.2
Gestational age at birth (weeks)	≥37	95.8

		Pregnancy
		2nd trimester		3rd trimester		Childbirth
Depression		n = 172 (%)		n = 165 (%)		n = 160 (%)
Non-depressed (EPDS < 10)		75.6		75.8		76.3
Depressed (EPDS ≥ 10)		24.4		24.2		23.7

Anxiety		n = 170 (%)		n = 164 (%)		n = 160 (%)
Non-anxious (STAI-S < 45)		84.1		76.8		79.9
Anxious (STAI-S ≥ 45)		15.9		23.2		23.1
	M	SD	M	SD	M	SD
Fetal/neonatal weight	417.51	120.66	1722.36	397.96	3177.64	479.97
Depressive symptoms	6.78	4.38	6.48	4.39	6.17	4.84
Anxious symptoms	36.48	8.98	37.77	10.28	36.66	10.32

	Prenatal depression							Prenatal anxiety
	Non-depressed		Depressed					Non-anxious		Anxious
	(n = 114)		(n = 39)					(n = 122)		(n = 28)
Growth outcomes	M	SD	M	SD	F	df	ηp ²	M	SD	M	SD	F	df	ηp ²
Weight	3213.74	465.79	3088.21	517.33	2.85	1,145	0.02	3360.21	397.12	3142.34	495.21	12.36^b b p < 0.01.	1145	0.08
Length	48.66	2.19	48.18	2.35	1.24	1,145	0.01	48.96	2.09	48.43	2.27	5.11^a a p < 0.05.	1145	0.03
Ponderal index	2.79	0.36	2.74	0.20	1.99	1,145	0.02	2.86	0.27	2.75	0.34	3.96^a a p < 0.05.	1145	0.03
Gestational age at birth	38.89	1.29	38.57	1.50	0.85	1,145	0.00	38.81	1.17	38.80	1.40	0.26	1145	0.00

Sociedade Brasileira de Pediatria Av. Carlos Gomes, 328 cj. 304, 90480-000 Porto Alegre RS Brazil, Tel.: +55 51 3328-9520 - Porto Alegre - RS - Brazil
E-mail: jped@jped.com.br

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[1] * Corresponding author. E-mail:tmpinto@psi.uminho.pt (T.M. Pinto).

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Maternal depression and anxiety and fetal-neonatal growth☆ ☆ Please cite this article as: Pinto TM, Caldas F, Nogueira-Silva C, Figueiredo B. Maternal depression and anxiety and fetal-neonatal growth. J Pediatr (Rio J). 2017;93:452–9.

Abstract

Objective:

Methods:

Results:

Conclusion:

Maternal depression and anxiety and fetal-neonatal growth^☆ ☆ Please cite this article as: Pinto TM, Caldas F, Nogueira-Silva C, Figueiredo B. Maternal depression and anxiety and fetal-neonatal growth. J Pediatr (Rio J). 2017;93:452–9.