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"Anna Suarez"
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Effects of postpartum PTSD on maternal mental health and child socioemotional development - a two-year follow-up study
by
Yakupova, Vera
,
Suarez, Anna
in
Adult
,
anxiety and stress on birth outcomes and childhood health
,
Child
2024
Background
Postpartum posttraumatic stress disorder (PP-PTSD) is a prevalent, yet often unrecognized mental health problem, particularly in low- and middle-income countries. Moreover, the long-term effects of PP-PTSD symptoms on maternal well-being and child socioemotional development beyond the first year postpartum remain largely unknown. This study focused on the association between PP-PTSD symptoms within one year after childbirth and maternal depressive symptoms and child behavioral problems two years later.
Methods
Russian women (
n
= 419) completed the City Birth Trauma Scale and the Edinburgh Postnatal Depression Scale evaluating symptoms of PP-PTSD and postpartum depression (PPD) via a web-based survey. Mothers also filled in the Beck Depression Inventory that assessed their depressive symptoms and the Child Behavior Checklist that assessed child’s behavioral problems 2.24 years later.
Results
The regression analysis showed a significant association between PP-PTSD and elevated depressive symptoms 2 years later even after adjustment for PPD (β = 0.19, 95% Confidence Interval 0.11, 0.26,
p
< 0.01). Children of mothers with higher PP-PTSD symptoms had higher internalizing, externalizing, and total behavioral problems, independent of PPD and concurrent depressive symptoms (β > 0.12,
p
< 0.01 for all).
Conclusions
Childbirth-related PTSD presents risk for maternal psychological well-being and child socioemotional development beyond comorbidity with maternal depression. Raising awareness about PP-PTSD among families, communities, healthcare providers, and policymakers is essential in order to decrease stigma of childbirth-related distress, particularly, in low- and middle-income countries like Russia, improve support system during the postpartum period, promote mother–infant bonding in affected women, and, thus, prevent long-term consequences of traumatic childbirth for maternal and child mental health outcomes.
Clinical trial number
Not applicable.
Journal Article
Childbirth experiences of women with a history of physical, sexual, and child abuse: a cross-sectional study of 2,575 Russian women
2024
Background
A substantial number of women who subsequently become pregnant and give birth have a history of physical, sexual, and/or child abuse. This study investigated the associations of these types of traumas and their cumulative effect with childbirth experiences, namely, mode of birth, maternal and child complications during pregnancy/childbirth, preterm birth, medical procedures, and obstetric violence during labour.
Methods
A group of Russian women (
n
= 2,575) who gave birth within the previous 12 months, completed a web-based survey, where they provided demographic information, details about their childbirth experiences, and a history of trauma.
Results
Women with any type of past abuse were at higher risk for maternal complications during pregnancy/childbirth (exp(β) < 0.73,
p
< 0.010 for all). More specific to the type of trauma were associations of physical abuse with caesarean birth, child abuse with complications during pregnancy/childbirth for the baby, and physical and child abuse with obstetric violence (exp(β) < 0.54,
p
< 0.022 for all). There was a cumulative effect of trauma for all the outcomes except for medical procedures during childbirth and preterm birth.
Conclusion
This study provides insights into potential different individual effects of physical, sexual, and/or child abuse as well as their cumulative impact on the childbirth experiences. The robust findings about maternal complications during pregnancy/childbirth and obstetric violence highlight the importance of trauma-informed care, supportive policies, and interventions to create safe and empowering birthing environments that prioritise patient autonomy, dignity, and respectful communication.
Journal Article
Parental Burnout and Early-Childhood Behavioral Problems: Longitudinal Associations Beyond Maternal Depression
2026
Background: Parenting is increasingly recognized as a highly demanding and stressful role that, in the absence of sufficient resources, may lead to parental burnout (PB). This risk may be particularly pronounced in the Russian context, where limited access to childcare for children under three and reduced extended family support coincide with strong social expectations of intensive parenting. Although PB and maternal depression frequently co-occur, it remains unclear whether PB exerts a unique influence on child development, especially during toddlerhood. The present study examined the association between PB and behavioral problems in children aged 1.5 to 4 years while controlling for maternal depression assessed both during the first year postpartum and concurrently with PB. Methods: Using a longitudinal design, maternal mental health was assessed within the first 12 months postpartum (Stage 1) and again at follow-up (Stage 2), on average 2.24 years later, in 419 Russian mother–child dyads. Mothers completed measures of postpartum depression (PPD) (Edinburgh Postnatal Depression Scale), current depressive symptoms (Beck Depression Inventory-II), and PB (Parental Burnout Inventory). Child emotional and behavioral problems were assessed at Stage 2 using the Russian version of the Child Behavior Checklist (CBCL/1½–5). Results: Mothers of children with borderline/clinically significant internalizing, externalizing, and total problems had significantly higher PB, PPD, and present maternal depressive symptoms, although the effect sizes were small. PB was strongly associated with all domains of child behavioral problems, also after correction for both postpartum and present depressive symptoms, as well as for other important covariates. Higher maternal PB symptoms further increased the odds of children having borderline/clinically significant internalizing and externalizing problems, although those effects were not independent of maternal depression. In turn, neither postpartum nor present maternal depressive symptoms were associated with any of the child behavioral problems domains. Conclusions: PB represents a distinct and clinically relevant risk factor for emotional and behavioral problems in toddlers, beyond the effects of maternal postpartum or present depression, in a context characterized by high caregiving demands and limited institutional support. These findings highlight an urgent need for programs aimed at identifying and supporting families in which parents experience high levels of exhaustion, regardless of whether they meet the criteria for other diagnosable mental health disorders. Addressing PB during toddlerhood may be critical for protecting both parental well-being and early child development.
Journal Article
Long-Term Effects of Maternal Depression during Postpartum and Early Parenthood Period on Child Socioemotional Development
2023
Most research on the impact of maternal depressive symptoms on child development is conducted during the first year postpartum. Findings on long-term effects of maternal depression are still contradictory and underexplored. The present study investigates the long-term impact of maternal depression during the postpartum and early parenthood periods on child behavioral problems at the mean age of 2.25 years. The Edinburgh postnatal depression scale and Beck depression Inventory were used to assess postpartum and early parenthood depression, respectively. The Child Behavior Checklist was used to examine child’s behavioral problems. The regression analysis showed statistically significant associations between child behavioral problems and maternal depression during early parenthood and no significant associations with postpartum depression. Four maternal depressive symptoms’ trajectories were identified: consistently low, consistently high, decreased, and increased. The children of mothers with consistently high depressive symptoms at both research stages had the most significant total, internalizing, and externalizing problems. Children of mothers whose depressive symptoms decreased over time had the lowest scores in all three domains of behavioral problems. It is extremely important to implement programs for screening and early intervention for maternal mental health problems that could greatly influence the well-being of women and their children’s development.
Journal Article
The impacts of the COVID-19 pandemic on birth satisfaction and birth experiences in Russian women
2022
Women's satisfaction with their childbirth experiences has significant impacts on their health and the health of their children. Recently, childbirth and maternity care systems have been disrupted by the COVID-19 pandemic. This study aimed to investigate the association of birth satisfaction with mode of birth, medical interventions, support during labour, type of childbirth healthcare plan and antenatal education in the context of the COVID-19 pandemic in Russia.
1,645 Russian women who gave birth during the first year of the COVID-19 pandemic and 611 matched controls who gave birth in the previous year participated in an anonymous Internet survey about their childbirth experience. The survey included questions regarding women's demographic and obstetric characteristics as well as their childbirth experiences. Birth satisfaction was measured using the Birth Satisfaction Scale Revised Indicator (BSS-RI).
Birth satisfaction scores did not show notable changes before and during the pandemic (Pearson Chi-square = 19.7,
= 0.22). Women had lower BSS-RI scores if they tested positive for COVID-19 during labour (
= 9.18,
= 0.002), but not during pregnancy or postpartum (
> 0.32). In both cohorts women who had vaginal births rated birth satisfaction higher than those who had caesarean births. The more medical interventions there were, the lower were the BSS-RI scores (
= -0.234, 95% CI: -0.760; -0.506,
< 0.001), but only during the pandemic. Birth satisfaction was higher if women had a support person present during labour (
> 7.44,
< 0.001), which was not possible for over 70% of participants during the pandemic. In both cohorts birth satisfaction was associated with the childbirth healthcare plan (
> 5.27,
< 0.001), but not with antenatal education (
< 0.15,
> 0.43).
Our study highlights the significant impacts of the COVID-19 pandemic on the birth experiences of Russian women. Sustaining the rights of women to informed decisions during labour, respect for their preferred childbirth healthcare plan, presence of the birth team of choice and professional support for home birth are essential for higher birth satisfaction and better health outcomes for mothers and their infants.
Journal Article
Associations between maternal risk factors of adverse pregnancy and birth outcomes and the offspring epigenetic clock of gestational age at birth
2017
Background
A recent study has shown that it is possible to accurately estimate gestational age (GA) at birth from the DNA methylation (DNAm) of fetal umbilical cord blood/newborn blood spots. This DNAm GA predictor may provide additional information relevant to developmental stage. In 814 mother-neonate pairs, we evaluated the associations between DNAm GA and a number of maternal and offspring characteristics. These characteristics reflect prenatal environmental adversity and are expected to influence newborn developmental stage.
Results
DNAm GA acceleration (GAA; i.e., older DNAm GA than chronological GA) of the offspring at birth was associated with maternal age of over 40 years at delivery, pre-eclampsia and fetal demise in a previous pregnancy, maternal pre-eclampsia and treatment with antenatal betamethasone in the index pregnancy, lower neonatal birth size, lower 1-min Apgar score, and female sex. DNAm GA deceleration (GAD; i.e., younger DNAm GA than chronological GA) of the offspring at birth was associated with insulin-treated gestational diabetes mellitus (GDM) in a previous pregnancy and Sjögren’s syndrome. These findings were more accentuated when the DNAm GA calculation was based on the raw difference between DNAm GA and GA than on the residual from the linear regression of DNAm GA on GA.
Conclusions
Our findings show that variations in the DNAm GA of the offspring at birth are associated with a number of maternal and offspring characteristics known to reflect exposure to prenatal environmental adversity. Future studies should be aimed at determining if this biological variation is predictive of developmental adversity.
Journal Article
Evidence of SARS-CoV-2 infection in postmortem lung, kidney, and liver samples, revealing cellular targets involved in COVID-19 pathogenesis
by
Valdés-Véliz, Rodolfo
,
Cruz-Sui, Otto
,
Marín-Prida, Javier
in
Alveoli
,
CD34 antigen
,
Cell culture
2023
There is an urgent need to understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-host interactions involved in virus spread and pathogenesis, which might contribute to the identification of new therapeutic targets. In this study, we investigated the presence of SARS-CoV-2 in postmortem lung, kidney, and liver samples of patients who died with coronavirus disease (COVID-19) and its relationship with host factors involved in virus spread and pathogenesis, using microscopy-based methods. The cases analyzed showed advanced stages of diffuse acute alveolar damage and fibrosis. We identified the SARS-CoV-2 nucleocapsid (NC) in a variety of cells, colocalizing with mitochondrial proteins, lipid droplets (LDs), and key host proteins that have been implicated in inflammation, tissue repair, and the SARS-CoV-2 life cycle (vimentin, NLRP3, fibronectin, LC3B, DDX3X, and PPARγ), pointing to vimentin and LDs as platforms involved not only in the viral life cycle but also in inflammation and pathogenesis. SARS-CoV-2 isolated from a patient´s nasal swab was grown in cell culture and used to infect hamsters. Target cells identified in human tissue samples included lung epithelial and endothelial cells; lipogenic fibroblast-like cells (FLCs) showing features of lipofibroblasts such as activated PPARγ signaling and LDs; lung FLCs expressing fibronectin and vimentin and macrophages, both with evidence of NLRP3- and IL1β-induced responses; regulatory cells expressing immune-checkpoint proteins involved in lung repair responses and contributing to inflammatory responses in the lung; CD34+ liver endothelial cells and hepatocytes expressing vimentin; renal interstitial cells; and the juxtaglomerular apparatus. This suggests that SARS-CoV-2 may directly interfere with critical lung, renal, and liver functions involved in COVID-19-pathogenesis.
Journal Article
The epigenetic clock and pubertal, neuroendocrine, psychiatric, and cognitive outcomes in adolescents
by
Kajantie, Eero
,
Lahti-Pulkkinen, Marius
,
Reynolds, Rebecca M.
in
Adolescents
,
Aging
,
Aging (Biology)
2018
Background
Molecular aging biomarkers, such as epigenetic age predictors, predict risk factors of premature aging, and morbidity/mortality more accurately than chronological age in middle-aged and elderly populations. Yet, it remains elusive if such biomarkers are associated with aging-related outcomes earlier in life when individuals begin to diverge in aging trajectories. We tested if the Horvath epigenetic age predictor is associated with pubertal, neuroendocrine, psychiatric, and cognitive aging-related outcomes in a sample of 239 adolescents, 11.0–13.2 years-old.
Results
Each year increase in epigenetic age acceleration (AA) was associated with 0.06 SD units higher weight-for-age, 0.08 SD units taller height-for-age, -0.09 SD units less missed from the expected adult height, 13 and 16% higher odds, respectively, for each stage increase in breast/genitals development on the Tanner Staging Questionnaire and pubertal stage on the Pubertal Development Scale, 4.2% higher salivary cortisol upon awakening, and 18 to 34% higher odds for internalizing and thought problems on the Child Behavior Checklist (
p
values < 0.045). AA was not significantly associated with cognition.
Conclusions
Our findings suggest that already in adolescence, AA is associated with physiological age acceleration, which may index risk of earlier aging. AA may identify individuals for preventive interventions decades before aging-related diseases become manifest.
Journal Article
Past Traumatic Life Events, Postpartum PTSD, and the Role of Labor Support
2023
The aim of this study was to investigate the association of postpartum post-traumatic stress disorder (PP-PTSD) symptoms and subjective rates of traumatic birth experience with past traumatic life events (physical and sexual assault, child abuse, perinatal loss, previous traumatic birth experience, and the cumulative traumatic experience). A sample of Russian women (n = 2579) who gave birth within the previous 12 months, filled in a web-based survey, where they reported demographic and obstetric characteristics and past traumatic experiences, evaluated their birth experience (0 = not traumatic, 10 = extremely traumatic), and completed the City Birth Trauma Scale (CBiTS). We found that PP-PTSD symptoms were higher among women who previously experienced physical (F = 22.02, p < 0.001) and sexual (F = 15.98, p < 0.001) assault and child abuse (F = 69.25, p < 0.001), with only associations with child abuse (F = 21.14, p < 0.001) remaining significant for subjective rates of traumatic birth experience. Perinatal loss and previous traumatic birth showed moderate but inconsistent effects. Support during labor did not have a buffering effect for participants with past traumatic experiences but showed a universally protective effect against PP-PTSD. Trauma-informed practices and allowing women to have a supportive birth team of choice during childbirth are promising avenues to minimize the incidence of PP-PTSD and improve the childbirth experience for all women.
Journal Article
16.4 EFFECT OF GENOTYPE AND EARLY ADVERSITY ENVIRONMENT ON DNA METHYLATION
by
Girchenko, Polina
,
Czamara, Darina
,
Binder, Elisabeth
in
DNA methylation
,
Epigenetics
,
Genotype & phenotype
2018
Abstract
Background
Fetal or prenatal programming, i.e. the process in which environmental events during pregnancy are shaping and determining the development of the embryo, can be embedded by epigenetic changes including DNA methylation. Apart from environment, also the genome plays an important role and a variety of studies which identified meQTLs (methylation quantitative trait loci, i.e. SNPs which are associated with methylation levels) have been published.
Methods
Focusing on variably methylated regions (VMRs), we investigated if genotype (G), prenatal environment (E) or the combination of both (GxE, G+E) best explain cordblood DNA methylation in sample of 817 Finnish neonates. Furthermore, we used an epigenetic clock predictor to evaluate if accelerated or decelerated epigenetic age was associated with prenatal environment or with childhood psychiatric problems at age 3.
Results
We found that SNP genotype alone best explained methylation status in 44%, SNP x environment in 32% and SNP and prenatal environment in 24% of all VMRs. While functionally relevant meQTLs were located in close proximity to the specific CpG-site, functionally relevant SNPs involved in interaction models showed much broader peaks.
Concerning the epigenetic clock, lower gestational age was associated with maternal depression diagnosis and greater depressive symptoms throughout pregnancy. Epigenetic age deceleration was associated with pre-eclampsia. Furthermore, lower epigenetic gestational age was significantly associated with greater total and internalizing problems in boys.
Discussion
Not only environment but also genotype should be considered in epigenetic studies. Furthermore, our results suggest that long-distance effects are present in GxE interactions. The epigenetic clock which mirrors prenatal environment is partially predictive for future development of the child. Lower epigenetic gestational age seems to be developmentally disadvantageous for boys, who in early childhood show greater psychiatric problems.
Journal Article