Prenatal Maternal Distress During the COVID-19 Pandemic and Associations With Infant Brain Connectivity

Kathryn Y Manning; Xiangyu Long; Dana Watts; Lianne Tomfohr-Madsen; Gerald F Giesbrecht; Catherine Lebel

doi:10.1016/j.biopsych.2022.05.011

Prenatal Maternal Distress During the COVID-19 Pandemic and Associations With Infant Brain Connectivity

Biol Psychiatry. 2022 Nov 1;92(9):701-708. doi: 10.1016/j.biopsych.2022.05.011. Epub 2022 May 16.

Authors

Kathryn Y Manning¹, Xiangyu Long¹, Dana Watts², Lianne Tomfohr-Madsen³, Gerald F Giesbrecht⁴, Catherine Lebel⁵

Affiliations

¹ Department 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.
² Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
³ Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; Department of Educational and Counselling Psychology, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
⁵ Department 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. Electronic address: clebel@ucalgary.ca.

Abstract

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.

Keywords: Brain; Functional connectivity; Infant; MRI; Prenatal mental health; White matter.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety / epidemiology
Brain / diagnostic imaging
COVID-19*
Child
Cohort Studies
Depression / epidemiology
Female
Humans
Infant
Male
Pandemics
Pregnancy