Examining dynamic changes in prefrontal connectivity and internalizing symptoms during the first and third trimesters...

Pregnancy is characterized by pronounced neuroplasticity and heightened risk for psychopathology. While previous research has primarily examined postpartum depression, less work has investigated changes in internalizing symptoms measured dimensionally across the peripartum period. Furthermore, limited research has identified functional changes in the prefrontal cortex (PFC) across pregnancy, a brain area implicated in psychopathology. Understanding the dynamic changes in internalizing symptoms and PFC neuroconnectivity throughout pregnancy and their interrelations is crucial for early identification of perinatal psychopathology. This pre-registered longitudinal study examined changes in and associations between internalizing symptoms and PFC functional connectivity throughout the first and third trimesters of pregnancy. Pregnant individuals recruited from a community sample of females engaged in prenatal care (N = 60, M_age = 32.31, SD = 5.34, 90% White, 91.7% non-Hispanic/Latine) completed structured clinical interviews assessing mood and anxiety symptoms and resting-state functional near-infrared spectroscopy measuring PFC connectivity during the first and third trimesters of pregnancy. From the first to third trimester, longitudinal results revealed a significant decrease in symptoms of distress and fear and significant increases in neuroconnectivity anchored in left medial frontal areas of the PFC. Cross-sectionally, higher first trimester fear was associated with lower within-region right medial PFC and higher within-region left medial PFC connectivity. Longitudinal decreases in distress from first to third trimester were associated with increased connectivity between left medial and right lateral PFC, alongside weakened connectivity between bilateral medial frontal regions. These findings demonstrate that internalizing symptoms relate to prefrontal connectivity from first to third trimester in a community sample of pregnant women. Examining internalizing symptoms dimensionally across pregnancy allows for characterization of the full range of symptoms that impact pregnant individuals. Future research should explore prevention and intervention implications of the relations between neural profiles and internalizing symptoms during pregnancy to improve long-term outcomes for the mother and child.