2002 International International Biennial Scientific Meeting

ANXIETY AND STRESS IN PREGNANCY- EFFECTS ON THE CHILD

Vivette Glover, T O'Connor, J Heron and Jean Golding

Institute of Reproductive and Developmental Biology, Imperial College School of Medicine, Hammersmith Campus, London

v.glover@ic.ac.uk

Maternal depression and anxiety are as common during pregnancy as in the postnatal period. We have shown, using a cohort of 7,700 women, that antenatal anxiety at 32 weeks is associated with increased behavioural problems at 4 years, especially hyperactivity/attention deficit in boys (OR=1.85 95%CI 1.21-2.81). This is after allowing for a range of relevant psychosocial and obstetric variables, including gestational age, and both antenatal and postnatal anxiety and depression occurring at other times. The results suggest that the effect was mediated in utero and unlikely to be due to later parenting or a genetic effect. These antenatal effects on child behaviour were independent of and additive to the effects of postnatal depression on child behaviour, and of a similar magnitude.

In animal models, prenatal stress has also been found to be associated with changes in laterality. Atypical handedness in children has been associated with a range of disorders, such as dyslexia, autism and attention deficit/hyperactivity which have been suggested to be partly neurodevelopmental in origin, and all much more common in boys than girls. We have used the same cohort as for the first study to test the hypothesis that antenatal maternal anxiety was linked with mixed handedness in the child. The results of a multivariate analysis, showed that the link with early antenatal anxiety, at 18 weeks, was highly significant, and changed little even after controlling for maternal anxiety at other time points, including postnatal, and other co-variates including maternal and paternal handedness (OR=1.4, P <0.001). We have also started to study possible mechanisms for these programming effects. We have found, using paired fetal and maternal blood samples, that there is a strong correlation between maternal and fetal plasma cortisol levels. There is also a strong positive correlation between fetal cortisol and testosterone levels. We suggest that if the mother is stressed or very anxious during pregnancy that this raises her cortisol levels. This results in raised fetal cortisol and testosterone levels, and these contribute to the expression of a range of developmental disorders.