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Prenatal Stress Exposure Amplifies Effect of Maternal Suicidal Ideation on Early Childhood Behavioral Trajectories

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Abstract

The in utero environment influences fetal development and may predispose to disease later in life. This study examines whether maternal suicidal ideation during pregnancy is associated with children’s behavioral trajectories across early childhood, and whether prenatal maternal traumatic stress accelerates the trajectories. The study included mother-child dyads (N = 331, 51.1% boys) from the longitudinal Stress In Pregnancy study; 31.1% (n = 103) mothers were Exposed to Superstorm Sandy. During their second trimester, 12.4% (n = 41) women reported suicidal ideation during pregnancy. Mothers completed the Behavior Assessment Scale for Children-2 annually from ages 2- to 6-years-old to assess multiple behavioral domains. Hierarchical linear modeling estimated within-person longitudinal trajectories of clinical behaviors, and between-person effects of maternal suicidal ideation and disaster-related stress in utero on changes in child behavior. For children exposed to both risks, Atypical behaviors (i.e., unusual behaviors, social disconnection) increased linearly across early childhood. Exposure to Superstorm Sandy and maternal suicidal ideation were independently associated with non-linear increases in Anxiety severity and maternal suicidal ideation during pregnancy was associated with a linear increase in Attention problems across early childhood. Maternal suicidal ideation during pregnancy is associated with increased risk for a range of behavioral and emotional difficulties in early childhood and the trajectory of atypical behaviors was amplified by disaster-related traumatic stress. Findings highlight the need for health professionals to screen for suicidal ideation among their pregnant patients. Pregnant women who experience severe stress may require additional monitoring and support to reduce risk for poorer early childhood outcomes.

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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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References

  • Admon, L. K., Dalton, V. K., Kolenic, G. E., Ettner, S. L., Tilea, A., Haffajee, R. L., Brownlee, R. M., Zochowski, M. K., Tabb, K. M., Muzik, M., & Zivin, K. (2021). Trends in suicidality 1 year before and after birth among commercially insured childbearing individuals in the United States, 2006–2017. JAMA Psychiatry, 78(2), 171–176.

    Article  PubMed  Google Scholar 

  • Aquino, M. R., Edge, D., & Smith, D. M. (2015). Pregnancy as an ideal time for intervention to address the complex needs of black and minority ethnic women: views of British midwives. Midwifery, 31(3), 373–379. https://doi.org/10.1016/j.midw.2014.11.006

    Article  PubMed  Google Scholar 

  • Barker, D. J. (2004). The developmental origins of well-being. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 359(1449), 1359–1366.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brand, S. R., Engel, S. M., Canfield, R. L., & Yehuda, R. (2006). The effect of maternal PTSD following in utero trauma exposure on behavior and temperament in the 9-month-old infant. Annals of the New York Academy of Sciences, 1071, 454–458.

    Article  PubMed  Google Scholar 

  • Broeren, S., Muris, P., Diamantopoulou, S., & Baker, J. R. (2013). The course of childhood anxiety symptoms: developmental trajectories and child-related factors in normal children. Journal of Abnormal Child Psychology, 41(1), 81–95. https://doi.org/10.1007/s10802-012-9669-9

    Article  PubMed  Google Scholar 

  • Burns, E. R., Farr, S. L., & Howards, P. P. (2015). Stressful life events experienced by women in the year before their infants’ births — United States, 2000–2010. Morbidity and Mortality Weekly Report, 64(9). U.S. Department of Health & Human Services, Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6409a3.htm

  • Buthmann, J., Ham, J., Davey, K., Finik, J., Dana, K., Pehme, P., Zhang, W., Glover, V., & Nomura, Y. (2019). Infant temperament: repercussions of Superstorm Sandy-related maternal stress. Child Psychiatry and Human Development, 50(1), 150–162.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cao-Lei, L., Yogendran, S., Dufoix, R., Elgbeili, G., Laplante, D. P., & King, S. (2021). Prenatal maternal stress from a natural disaster and hippocampal volumes: gene-by-environment interactions in young adolescents from project ice storm. Frontiers in Behavioral Neuroscience, 15, 706660. https://doi.org/10.3389/fnbeh.2021.706660

    Article  PubMed  PubMed Central  Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.

    Article  PubMed  Google Scholar 

  • Cohen, S., & Williamson, G. M. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health. Newbury Park, CA: Sage.

    Google Scholar 

  • Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. The British Journal of Psychiatry: The Journal of Mental Science, 150, 782–786.

    Article  PubMed  Google Scholar 

  • de Lijster, J. M., van den Dries, M. A., van der Ende, J., Utens, E., Jaddoe, V. W., Dieleman, G. C., Hillegers, M., Tiemeier, H., & Legerstee, J. S. (2019). Developmental trajectories of anxiety and depression symptoms from early to middle childhood: a population-based cohort study in the Netherlands. Journal of Abnormal Child Psychology, 47, 1785–1798.

    Article  PubMed  PubMed Central  Google Scholar 

  • Evans, G. W., Li, D., & Whipple, S. S. (2013). Cumulative risk and child development. Psychological Bulletin, 139(6), 1342–1396. https://doi.org/10.1037/a0031808

    Article  PubMed  Google Scholar 

  • Finik, J., & Nomura, Y. (2017). Cohort profile: Stress in Pregnancy (SIP) study. International Journal of Epidemiology, 46(5), 1388–1388k. https://doi.org/10.1093/ije/dyw264

    Article  PubMed  PubMed Central  Google Scholar 

  • Gavin, A. R., Tabb, K. M., Melville, J. L., Guo, Y., & Katon, W. (2011). Prevalence and correlates of suicidal ideation during pregnancy. Archives of Women’s Mental Health, 14(3), 239–246. https://doi.org/10.1007/s00737-011-0207-5

    Article  PubMed  PubMed Central  Google Scholar 

  • Gelaye, B., Domingue, A., Rebelo, F., Friedman, L. E., Qiu, C., Sanchez, S. E., Larrabure-Torrealva, G., & Williams, M. A. (2019). Association of antepartum suicidal ideation during the third trimester with infant birth weight and gestational age at delivery. Psychology, Health & Medicine, 24(2), 127–136.

    Article  Google Scholar 

  • Gelaye, B., Kajeepeta, S., & Williams, M. A. (2016). Suicidal ideation in pregnancy: an epidemiologic review. Archives of Women’s Mental Health, 19(5), 741–751.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: a meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27. https://doi.org/10.1007/s10567-010-0080-1

    Article  PubMed  Google Scholar 

  • Halperin, J. M., Marks, D. J., Chacko, A., Bedard, A. C., O’Neill, S., Curchack-Lichtin, J., Bourchtein, E., & Berwid, O. G. (2020). Training Executive, Attention, and Motor Skills (TEAMS): a preliminary randomized clinical trial of preschool youth with ADHD. Journal of Abnormal Child Psychology, 48(3), 375–389. https://doi.org/10.1007/s10802-019-00610-w

    Article  PubMed  PubMed Central  Google Scholar 

  • Harville, E., Xiong, X., & Buekens, P. (2010). Disasters and perinatal health: a systematic review. Obstetrical & Gynecological Survey, 65(11), 713–728.

    Article  Google Scholar 

  • Huizink, A. C., Mulder, E. J., Robles de Medina, P. G., Visser, G. H., & Buitelaar, J. K. (2004). Is pregnancy anxiety a distinctive syndrome? Early Human Development, 79(2), 81–91. https://doi.org/10.1016/j.earlhumdev.2004.04.014

    Article  PubMed  Google Scholar 

  • Huizink, A. C., Robles de Medina, P. G., Mulder, E. J., Visser, G. H., & Buitelaar, J. K. (2003). Stress during pregnancy is associated with developmental outcome in infancy. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 44(6), 810–818.

    Article  PubMed  Google Scholar 

  • Isaksson, J., Nilsson, K. W., Nyberg, F., Hogmark, A., & Lindblad, F. (2012). Cortisol levels in children with attention-deficit/hyperactivity disorder. Journal of Psychiatric Research, 46(11), 1398–1405. https://doi.org/10.1016/j.jpsychires.2012.08.021

    Article  PubMed  Google Scholar 

  • Jones, S. L., Dufoix, R., Laplante, D. P., Elgbeili, G., Patel, R., Chakravarty, M. M., King, S., & Pruessner, J. C. (2019). Larger amygdala volume mediates the association between prenatal maternal stress and higher levels of externalizing behaviors: sex specific effects in project ice storm. Frontiers in Human Neuroscience, 13, 144.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jones, E., Lattof, S. R., & Coast, E. (2017). Interventions to provide culturally-appropriate maternity care services: factors affecting implementation. BMC Pregnancy and Childbirth, 17(1), 267. https://doi.org/10.1186/s12884-017-1449-7

    Article  PubMed  PubMed Central  Google Scholar 

  • Kertz, S. J., Sylvester, C., Tillman, R., & Luby, J. L. (2019). Latent class profiles of anxiety symptom trajectories from preschool through school age. Journal of Clinical Child and Adolescent Psychology, 48(2), 316–331. https://doi.org/10.1080/15374416.2017.1295380

    Article  PubMed  Google Scholar 

  • King, S., & Laplante, D. P. (2005). The effects of prenatal maternal stress on children’s cognitive development: Project Ice Storm. Stress (Amsterdam, Netherlands), 8(1), 35–45.

    Article  PubMed  Google Scholar 

  • Laplante, D. P., Brunet, A., Schmitz, N., Ciampi, A., & King, S. (2008). Project Ice Storm: prenatal maternal stress affects cognitive and linguistic functioning in 5 1/2-year-old children. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 1063–1072.

    Article  PubMed  Google Scholar 

  • Lautarescu, A., Craig, M. C., & Glover, V. (2020). Prenatal stress: effects on fetal and child brain development. International Review of Neurobiology, 150, 17–40.

    Article  PubMed  Google Scholar 

  • Lupien, S. J., Sasseville, M., François, N., Giguère, C. E., Boissonneault, J., Plusquellec, P., Godbout, R., Xiong, L., Potvin, S., Kouassi, E., Lesage, A., & the Signature Consortium. (2017). The DSM5/RDoC debate on the future of mental health research: implication for studies on human stress and presentation of the signature bank. Stress, 20(1), 2–18.

    Article  Google Scholar 

  • Maas, C. J. M., & Hox, J. J. (2004). Robustness issues in multilevel regression analysis. Statistica Neerlandica, 58(2), 127–137.

    Article  Google Scholar 

  • Mangla, K., Hoffman, M. C., Trumpff, C., O’Grady, S., & Monk, C. (2019). Maternal self-harm deaths: an unrecognized and preventable outcome. American Journal of Obstetrics and Gynecology, 221(4), 295–303. https://doi.org/10.1016/j.ajog.2019.02.056

    Article  PubMed  Google Scholar 

  • McDowell, I. (2006). Measuring health: a guide to rating scales and questionnaires. Oxford University Press.

    Book  Google Scholar 

  • McLean, M. A., Simcock, G., Elgbeili, G., Laplante, D. P., Kildea, S., Hurrion, E., Lequertier, B., Cobham, V. E., & King, S. (2020). Disaster-related prenatal maternal stress, and childhood HPA-axis regulation and anxiety: the QF2011 Queensland Flood Study. Psychoneuroendocrinology, 118, 104716.

    Article  PubMed  Google Scholar 

  • Moss, K. M., Simcock, G., Cobham, V., Kildea, S., Elgbeili, G., Laplante, D. P., & King, S. (2017). A potential psychological mechanism linking disaster-related prenatal maternal stress with child cognitive and motor development at 16 months: the QF2011 Queensland Flood Study. Developmental Psychology, 53(4), 629–641.

    Article  PubMed  Google Scholar 

  • Newport, D. J., Levey, L. C., Pennell, P. B., Ragan, K., & Stowe, Z. N. (2007). Suicidal ideation in pregnancy: assessment and clinical implications. Archives of Women’s Mental Health, 10(5), 181–187. https://doi.org/10.1007/s00737-007-0192-x

    Article  PubMed  Google Scholar 

  • O’Connor, D. B., Branley-Bell, D., Green, J. A., Ferguson, E., O’Carroll, R. E., & O’Connor, R. C. (2020). Effects of childhood trauma, daily stress, and emotions on daily cortisol levels in individuals vulnerable to suicide. Journal of Abnormal Psychology, 129(1), 92–107.

    Article  PubMed  Google Scholar 

  • O’Connor, D. B., Ferguson, E., Green, J., O’Carroll, R. E., & O’Connor, R. C. (2016). Cortisol and suicidal behavior: A meta-analysis. Psychoneuroendocrinology, 63, 370–379.

    Article  PubMed  Google Scholar 

  • O’Connor, D. B., Green, J. A., Ferguson, E., O’Carroll, R. E., & O’Connor, R. C. (2017). Cortisol reactivity and suicidal behavior: Investigating the role of hypothalamic-pituitary-adrenal axis responses to stress in suicide attempters and ideators. Psychoneuroendocrinology, 75, 183–191. https://doi.org/10.1016/j.psyneuen.2016.10.019

    Article  PubMed  Google Scholar 

  • O’Connor, T. G., Heron, J., Golding, J., Glover, V., & ALSPAC Study Team. (2003). Maternal antenatal anxiety and behavioural/emotional problems in children: a test of a programming hypothesis. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 44(7), 1025–1036. https://doi.org/10.1111/1469-7610.00187

    Article  PubMed  Google Scholar 

  • Olino, T. M., Michelini, G., Mennies, R. J., Kotov, R., & Klein, D. N. (2021). Does maternal psychopathology bias reports of offspring symptoms? A study using moderated non-linear factor analysis. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 62(10), 1195–1201. https://doi.org/10.1111/jcpp.13394

    Article  PubMed  Google Scholar 

  • Ooi, J., Dodd, H. F., Meiser-Stedman, R., Hudson, J. L., Bridges, J., & Pass, L. (2022). The efficacy of interventions for behaviourally inhibited preschool-aged children: a meta-analysis. Journal of Anxiety Disorders, 88, 102559.

    Article  PubMed  Google Scholar 

  • Pauli-Pott, U., Schloß, S., Skoluda, N., Nater, U. M., & Becker, K. (2019). Low hair cortisol concentration predicts the development of attention deficit hyperactivity disorder. Psychoneuroendocrinology, 110, 104442.

    Article  PubMed  Google Scholar 

  • Pinto, R., Rijsdijk, F., Ouellet-Morin, I., Asherson, P., McLoughlin, G., & Kuntsi, J. (2016). The aetiological association between the dynamics of cortisol productivity and ADHD. Journal of Neural Transmission, 123, 991–1000.

    Article  PubMed  PubMed Central  Google Scholar 

  • Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: applications and data analysis methods (2nd ed.). Sage Publications Inc.

    Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment system for children, (BASC-2). American Guidance Service.

    Google Scholar 

  • Rice, F., Harold, G. T., Boivin, J., van den Bree, M., Hay, D. F., & Thapar, A. (2010). The links between prenatal stress and offspring development and psychopathology: disentangling environmental and inherited influences. Psychological Medicine, 40(2), 335–345.

    Article  PubMed  Google Scholar 

  • Rollins, P. R., & De Froy, A. M. (2023). Reexamining pathways early autism intervention in children before and after the third birthday: A randomized control trial. Journal of Autism and Developmental Disorders, 53(3), 1189–1201. https://doi.org/10.1007/s10803-022-05599-8

    Article  PubMed  Google Scholar 

  • Rueda, M. R., & Posner, M. I. (2013). Development of attention networks. Body and MindIn P. D. Zelazo (Ed.), The Oxford handbook of developmental psychology (Vol. 1, pp. 683–705). New York, NY.

    Google Scholar 

  • Sameroff, A. J. (1998). Environmental risk factors in infancy. Pediatrics, 102(5 Suppl E), 1287–1292.

  • Schafer, J. L., & Graham, J. W. (2002). Missing data: our view of the state of the art. Psychological Methods, 7(2), 147–177. https://doi.org/10.1037/1082-989X.7.2.147

    Article  PubMed  Google Scholar 

  • Sheftall, A. H., Bergdoll, E. E., James, M., Bauer, C., Spector, E., Vakil, F., Armstrong, E., Allen, J., & Bridge, J. A. (2020). Emotion regulation in elementary school-aged children with a maternal history of suicidal behavior: a pilot study. Child Psychiatry and Human Development, 51(5), 792–800. https://doi.org/10.1007/s10578-020-01010-8

    Article  PubMed  PubMed Central  Google Scholar 

  • Simcock, G., Cobham, V. E., Laplante, D. P., Elgbeili, G., Gruber, R., Kildea, S., & King, S. (2019). A cross-lagged panel analysis of children’s sleep, attention, and mood in a prenatally stressed cohort: the QF2011 Queensland flood study. Journal of Affective Disorders, 255, 96–104. https://doi.org/10.1016/j.jad.2019.05.041

    Article  PubMed  Google Scholar 

  • Snijders, T. A. B., & Bosker, R. J. (2012). Multilevel analysis: An introduction to basic and advanced multilevel modeling. Sage Publishing.

    Google Scholar 

  • Spielberger, C. D. (1989). State-trait anxiety inventory: bibliography (2nd ed.). Consulting Psychologists Press.

    Google Scholar 

  • Tabb, K. M., Gavin, A. R., Guo, Y., Huang, H., Debiec, K., & Katon, W. (2013). Views and experiences of suicidal ideation during pregnancy and the postpartum: findings from interviews with maternal care clinic patients. Women & Health, 53(5), 519–535.

    Article  Google Scholar 

  • Tein, J. Y., Coxe, S., & Cham, H. (2013). Statistical power to detect the correct number of classes in latent profile analysis. Structural Equation Modeling: A Multidisciplinary Journal, 20(4), 640–657. https://doi.org/10.1080/10705511.2013.824781

    Article  PubMed  Google Scholar 

  • van Aalst, M. K. (2006). The impacts of climate change on the risk of natural disasters. Disasters, 30(1), 5–18. https://doi.org/10.1111/j.1467-9523.2006.00303.x

    Article  PubMed  Google Scholar 

  • Van den Bergh, B., van den Heuvel, M. I., Lahti, M., Braeken, M., de Rooij, S. R., Entringer, S., Hoyer, D., Roseboom, T., Räikkönen, K., King, S., & Schwab, M. (2020). Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neuroscience and Biobehavioral Reviews, 117, 26–64.

    Article  PubMed  Google Scholar 

  • Van Heeringen, K., & Mann, J. J. (2014). The neurobiology of suicide. The Lancet Psychiatry, 1(1), 63–72. https://doi.org/10.1016/S2215-0366(14)70220-2

    Article  PubMed  Google Scholar 

  • Volker, M. A., Lopata, C., Smerbeck, A. M., Knoll, V. A., Thomeer, M. L., Toomey, J. A., & Rodgers, J. D. (2010). BASC-2 PRS profiles for students with high-functioning autism spectrum disorders. Journal of Autism and Developmental Disorders, 40(2), 188–199.

    Article  PubMed  Google Scholar 

  • Zhang, W., Rajendran, K., Ham, J., Finik, J., Buthmann, J., Davey, K., Pehme, P. M., Dana, K., Pritchett, A., Laws, H., & Nomura, Y. (2018). Prenatal exposure to disaster-related traumatic stress and developmental trajectories of temperament in early childhood: Superstorm Sandy pregnancy study. Journal of Affective Disorders, 234, 335–345.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhong, Q. Y., Gelaye, B., Miller, M., Fricchione, G. L., Cai, T., Johnson, P. A., Henderson, D. C., & Williams, M. A. (2016). Suicidal behavior-related hospitalizations among pregnant women in the USA, 2006–2012. Archives of Women’s Mental Health, 19(3), 463–472.

    Article  PubMed  Google Scholar 

  • Zhong, Q. Y., Gelaye, B., Karlson, E. W., Avillach, P., Smoller, J. W., Cai, T., & Williams, M. A. (2019). Associations of antepartum suicidal behaviour with adverse infant and obstetric outcomes. Paediatric and Perinatal Epidemiology, 33(2), 137–144.

    Article  PubMed  Google Scholar 

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Funding

This work was supported by the National Institute of Mental Health of the National Institutes of Health (YN, grant numbers, K01 MH080062, ARRA supplement, K01 MH080062S, and R01MH102729). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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  1. Psychology Department, The City College of New York, City University of New York, New York, NY, USA

    Sarah O’Neill

  2. Psychology Department, The Graduate Center, City University of New York, New York, NY, USA

    Sarah O’Neill & Yoko Nomura

  3. Psychology Department, Queens College, City University of New York, Flushing, NY, USA

    Yoko Nomura

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O’Neill, S., Nomura, Y. Prenatal Stress Exposure Amplifies Effect of Maternal Suicidal Ideation on Early Childhood Behavioral Trajectories. Res Child Adolesc Psychopathol 51, 1257–1271 (2023). https://doi.org/10.1007/s10802-023-01062-z

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