The associations between prenatal depressive symptoms and the neural and psychological attachment to infants among birthing parents.

• In Event: Parents develop, too: Maternal and Paternal Neural Reorganization Across the Perinatal Period

Abstract

Introduction: Neural responses to infant cues have been associated with sensitive parenting behaviors and positive mother-infant relationships. However, depressed mothers exhibit altered neural sensitivity toward their infant cues (e.g. elevated responses to negative infant cues) and more negative birthing parent-infant relationships. 50% to 80% of postpartum depression has depressive symptoms that started during pregnancy, and depressive symptoms during pregnancy may negatively influence the brain and psychological adaptation to parenthood. However, the link between prenatal depressive symptoms and maternal neural responses to infant cues after a child's birth has not been well understood.

Hypothesis: We hypothesized that elevated depressive symptoms during pregnancy would be associated with greater neural responses to infant cry sounds and more negative attachment to own infant among new birthing parents during the first-month postpartum period.

Method: 87 pregnant individuals were recruited during the first trimester. In each trimester, depressive symptom levels were measured using the Edinburgh Postnatal Depression Scale (EPDS). Within 4 weeks after a child's birth, participants participated in a neuroimaging study using fMRI and completed questionnaires on mother-infant attachment and positive and negative perceptions of parenting. In the scanner, participants listened to (A) own infant cry, (B) control infant cry, (D) own infant cry matched noise, or (D) control infant cry matched noise. A whole-brain linear mixed effects model with an EPDS score of the trimester as a between-subjects variable, Sound (cry, white noise) and Identity (own infant, unknown infant) as within-subjects factors, and EPDS scores of other trimesters as covariates was conducted. The results were reported at p<0.05, corrected.

Results: Depressive symptoms in early pregnancy (the first trimester) were associated with greater activation in response to own infant cry sounds in the left inferior parietal lobe (BA40, k=72). Depressive symptoms in early pregnancy were also associated with greater activation in response to infant cry sounds (across own and control infant cry sounds) in the right inferior parietal lobe (BA40, k=40). Greater activation in this region was further associated with more negative mother-infant attachment, r(82)=-0.21, p<0.05, and more negative perceptions about parenting r(81)=0.31, p<0.005. Depressive symptoms in late pregnancy (the third trimester) were associated with greater activation in response to own infant cry sounds in the left inferior frontal gyrus (BA46, k=35), and greater activation in responses to infant cry sounds in the left precuneus (k=57). All of the results remained significant after controlling for depressive symptoms in the postpartum period.

Discussion: The results suggest that depressive symptoms during early and late pregnancy may be significant in predicting later brain responses to infant cry sounds. The brain regions implicated are important for processing emotional information and emotion regulation. Brain responses to infant cry sounds that were associated with depressive symptoms in early pregnancy are also linked to weaker feelings of attachment to own infants among new mothers. The findings highlight the importance of the early identification of pregnant individuals with elevated depressive symptoms during pregnancy, and the early intervention for prenatal depression.

Authors

• Pilyoung Kim, University of Denver
  Presenting Author

• Shannon Powers, University of Denver

• Jacqueline Martinez, University of Denver

• Tom Yeh, University of Colorado-Boulder