Prenatal Maternal Distress During the COVID-19 Pandemic and Associations With Infant Brain Connectivity
Kathryn Y Manning1, Xiangyu Long1, Dana Watts2
1Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
Insights
Prenatal distress during COVID-19 impacts infant brain development, but social support can protect developing infants. This study highlights the crucial role of social support for maternal and infant well-being.
Area of Science:
- Neuroscience
- Psychiatry
- Public Health
Background:
- The COVID-19 pandemic significantly increased distress in pregnant individuals.
- This elevated distress may negatively impact infant brain development.
- Understanding the relationship between prenatal distress and infant brain outcomes is crucial.
Purpose of the Study:
- To investigate the association between prenatal maternal distress and infant brain structure and function.
- To determine if social support moderates the effects of prenatal distress on infant brain development.
Main Methods:
- The Pregnancy during the COVID-19 Pandemic (PdP) cohort study surveyed 8602 pregnant individuals in Canada.
- Infant brain structure and function were assessed using magnetic resonance imaging (MRI) in a subsample (n=75).
- Data included anxiety, depression, and social support measures, with MRI analysis on 58 diffusion and 41 functional datasets.
Main Results:
- Clinically elevated depression (33.4%) and anxiety (47.1%) symptoms were prevalent.
- Lower social support predicted higher prenatal maternal distress.
- Prenatal maternal distress was significantly linked to infant amygdala-prefrontal microstructural and functional connectivity, with social support acting as a moderator.
Conclusions:
- Prenatal distress during the COVID-19 pandemic can have lasting effects on infant brain development.
- Social support plays a vital role in mitigating these effects for both pregnant individuals and infants.
- Findings underscore the importance of social support in clinical practice and policy for maternal and child health.
Background:
The COVID-19 pandemic has caused substantially elevated distress in pregnant individuals, which has the potential to affect the developing infant brain. Our main objective was to understand how prenatal distress was related to infant brain structure and function and whether social support moderated the associations.
Methods:
The Pregnancy during the COVID-19 Pandemic (PdP) cohort study collected Patient-Reported Outcomes Measurement Information System Anxiety scale, Edinburgh Postnatal Depression Scale, and Social Support Effectiveness Questionnaire data from a population-based sample of pregnant individuals living in Canada (N = 8602). For a subsample of participants, their infants (n = 75) underwent magnetic resonance imaging at 3 months of age to examine whether prenatal maternal distress was associated with infant brain architecture, including the role of social support as a potential protective factor.
Results:
Overall, 33.4% of participants demonstrated clinically elevated depression symptoms and 47.1% of participants demonstrated clinically elevated anxiety symptoms. We identified lower social support as a significant predictor of clinically elevated prenatal maternal distress (t8598 = -22.3, p < .001). Fifty-eight diffusion image datasets (20 female/38 male, 92 ± 14 days old) and 41 functional datasets (13 female/28 male, 92 ± 14 days old) were included in our analysis after removal of poor-quality images and infants without postpartum maternal distress scores. We found significant relationships between prenatal maternal distress and infant amygdala-prefrontal microstructural and functional connectivity measures, and we demonstrate for the first time that social support moderates these relationships.
Conclusions:
Our findings suggest a potentially long-lasting impact of the COVID-19 pandemic on children and show that social support acts as a possible mediator not just for pregnant individuals but also developing infants. These findings provide timely evidence to inform clinical practice and policy surrounding the care of pregnant individuals and highlight the importance of social support.
