Longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple-hit hypothesis for fetal brain development, a secondary analysis of the UPBEAT study
Summary: Background: Maternal antenatal depression is associated with offspring psychological disorders, but obesity is also widely implicated in maternal depression and neurodevelopment. In pregnant women with obesity we explored interrelationships between antenatal depressive symptom trajectories...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022002425 |
| _version_ | 1811344434356289536 |
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| author | Julie Nihouarn Sigurdardottir Sara White Angela Flynn Claire Singh Annette Briley Mary Rutherford Lucilla Poston |
| author_facet | Julie Nihouarn Sigurdardottir Sara White Angela Flynn Claire Singh Annette Briley Mary Rutherford Lucilla Poston |
| author_sort | Julie Nihouarn Sigurdardottir |
| collection | DOAJ |
| description | Summary: Background: Maternal antenatal depression is associated with offspring psychological disorders, but obesity is also widely implicated in maternal depression and neurodevelopment. In pregnant women with obesity we explored interrelationships between antenatal depressive symptom trajectories and multiple exposures implicated in fetal neurodevelopment which could explain these associations, as a prelude to exploring associations with infant mental health. Methods: The UK Pregnancies Better Eating and Activity Trial (UPBEAT) recruited multi-ethnic pregnant women with obesity (BMI >= 30kg/m2) between March 2009 and June 2014 from 8 UK sites and 1369 were included to model longitudinal antenatal depressive symptoms from Edinburgh Postnatal Depression Scale (EPDS) scores using Latent Class Growth Analysis. Classes were compared on maternal baseline demography, biomarkers of metabolism, inflammation and placental function, infection, diet and by pregnancy and birth outcomes. Odds ratios, mean differences and 95% Confidence Intervals were calculated using robust auxiliary modelling techniques. Findings: The chosen model produced four classes: “Not Depressed” (n=575 [42%], “reference”), “Mild” (n=523 [37·5%]), “Moderate” (n=219 [16%]) and “Severe” (n=62 [4·5%]) symptom trajectories. Socio-economic deprivation and ethnic diversity were greater in Severe and Moderate classes. Dietary glycaemic load and saturated fat intake were higher in Severe and Moderate classes (at 17 and 27 weeks). Higher Interleukin-6, glycoprotein acetyls (17 weeks), glucose (34 weeks) and lower placental growth factor (PlGF, 17 and 27 weeks) was found in the Severe class. PlGF was lower in the Moderate class (27 weeks). Infection was least likely in the Not Depressed class across gestation. Risks of preterm birth were associated with Severe depressive symptoms (aOR 3·05[1·11 to 8·36]). Interpretation: Comprehensive phenotyping exposes important fetal exposures implicated in adverse neurodevelopment, differing by depression class. This study expands substantially on causal models of suboptimal fetal neurodevelopment and offers potential new targets for intervention in obese pregnant women. Funding: JNS was funded by a PhD studentship from the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London. UPBEAT was supported by the European Union's 7th Framework Programme (FP7/2007-2013), project EarlyNutrition; grant agreement no. 289346 and the National Institute for Health Research (NIHR) (UK) Programme Grants for Applied Research Programme (RP-0407-10452), Medical Research Council UK Project Grant (MR/L002477/1). Support was also provided by the Chief Scientist Office Scotland, Guy's and St Thomas’ Charity and Tommy's Charity (Registered charity no. 1060508). LP and SLW are funded by Tommy's Charity. |
| first_indexed | 2024-04-13T19:47:16Z |
| format | Article |
| id | doaj.art-7e43cf54f782402db5b6950106b4c53d |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-13T19:47:16Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-7e43cf54f782402db5b6950106b4c53d2022-12-22T02:32:40ZengElsevierEClinicalMedicine2589-53702022-08-0150101512Longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple-hit hypothesis for fetal brain development, a secondary analysis of the UPBEAT studyJulie Nihouarn Sigurdardottir0Sara White1Angela Flynn2Claire Singh3Annette Briley4Mary Rutherford5Lucilla Poston6Department of Perinatal Imaging and Health, School of Biomedical Engineering & Imaging Sciences, King's College London, 1st Floor South Wing, St Thomas’ Hospital, London, SE1 7EH, United Kingdom; Corresponding author.Department of Women and Children's Health, School of Life Course and Population Health Sciences, King's College London, 10th Floor, North Wing, St Thomas's, London, SE1 7EH, United KingdomDepartment of Women and Children's Health, School of Life Course and Population Health Sciences, King's College London, 10th Floor, North Wing, St Thomas's, London, SE1 7EH, United KingdomFlorence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 57 Waterloo Road, London SE1 8WA, United KingdomDepartment of Women and Children's Health, School of Life Course and Population Health Sciences, King's College London, 10th Floor, North Wing, St Thomas's, London, SE1 7EH, United Kingdom; Caring Futures Institute, Flinders University, Sturt Rd, Bedford Park 5042, South Australia, AustraliaDepartment of Perinatal Imaging and Health, School of Biomedical Engineering & Imaging Sciences, King's College London, 1st Floor South Wing, St Thomas’ Hospital, London, SE1 7EH, United KingdomDepartment of Women and Children's Health, School of Life Course and Population Health Sciences, King's College London, 10th Floor, North Wing, St Thomas's, London, SE1 7EH, United KingdomSummary: Background: Maternal antenatal depression is associated with offspring psychological disorders, but obesity is also widely implicated in maternal depression and neurodevelopment. In pregnant women with obesity we explored interrelationships between antenatal depressive symptom trajectories and multiple exposures implicated in fetal neurodevelopment which could explain these associations, as a prelude to exploring associations with infant mental health. Methods: The UK Pregnancies Better Eating and Activity Trial (UPBEAT) recruited multi-ethnic pregnant women with obesity (BMI >= 30kg/m2) between March 2009 and June 2014 from 8 UK sites and 1369 were included to model longitudinal antenatal depressive symptoms from Edinburgh Postnatal Depression Scale (EPDS) scores using Latent Class Growth Analysis. Classes were compared on maternal baseline demography, biomarkers of metabolism, inflammation and placental function, infection, diet and by pregnancy and birth outcomes. Odds ratios, mean differences and 95% Confidence Intervals were calculated using robust auxiliary modelling techniques. Findings: The chosen model produced four classes: “Not Depressed” (n=575 [42%], “reference”), “Mild” (n=523 [37·5%]), “Moderate” (n=219 [16%]) and “Severe” (n=62 [4·5%]) symptom trajectories. Socio-economic deprivation and ethnic diversity were greater in Severe and Moderate classes. Dietary glycaemic load and saturated fat intake were higher in Severe and Moderate classes (at 17 and 27 weeks). Higher Interleukin-6, glycoprotein acetyls (17 weeks), glucose (34 weeks) and lower placental growth factor (PlGF, 17 and 27 weeks) was found in the Severe class. PlGF was lower in the Moderate class (27 weeks). Infection was least likely in the Not Depressed class across gestation. Risks of preterm birth were associated with Severe depressive symptoms (aOR 3·05[1·11 to 8·36]). Interpretation: Comprehensive phenotyping exposes important fetal exposures implicated in adverse neurodevelopment, differing by depression class. This study expands substantially on causal models of suboptimal fetal neurodevelopment and offers potential new targets for intervention in obese pregnant women. Funding: JNS was funded by a PhD studentship from the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust and King's College London. UPBEAT was supported by the European Union's 7th Framework Programme (FP7/2007-2013), project EarlyNutrition; grant agreement no. 289346 and the National Institute for Health Research (NIHR) (UK) Programme Grants for Applied Research Programme (RP-0407-10452), Medical Research Council UK Project Grant (MR/L002477/1). Support was also provided by the Chief Scientist Office Scotland, Guy's and St Thomas’ Charity and Tommy's Charity (Registered charity no. 1060508). LP and SLW are funded by Tommy's Charity.http://www.sciencedirect.com/science/article/pii/S2589537022002425DepressionAntenatalPregnancyEPDSLCGALatent class growth analysis |
| spellingShingle | Julie Nihouarn Sigurdardottir Sara White Angela Flynn Claire Singh Annette Briley Mary Rutherford Lucilla Poston Longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple-hit hypothesis for fetal brain development, a secondary analysis of the UPBEAT study EClinicalMedicine Depression Antenatal Pregnancy EPDS LCGA Latent class growth analysis |
| title | Longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple-hit hypothesis for fetal brain development, a secondary analysis of the UPBEAT study |
| title_full | Longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple-hit hypothesis for fetal brain development, a secondary analysis of the UPBEAT study |
| title_fullStr | Longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple-hit hypothesis for fetal brain development, a secondary analysis of the UPBEAT study |
| title_full_unstemmed | Longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple-hit hypothesis for fetal brain development, a secondary analysis of the UPBEAT study |
| title_short | Longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple-hit hypothesis for fetal brain development, a secondary analysis of the UPBEAT study |
| title_sort | longitudinal phenotyping of maternal antenatal depression in obese pregnant women supports multiple hit hypothesis for fetal brain development a secondary analysis of the upbeat study |
| topic | Depression Antenatal Pregnancy EPDS LCGA Latent class growth analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022002425 |
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