Poor early childhood outcomes attributable to maternal depression in Mexican women

Abstract Background Neonatal encephalopathy (NE) contributes substantially to child mortality and disability globally. We compared cytokine profiles in term Ugandan neonates with and without NE, with and without perinatal infection or inflammation and identified biomarkers predicting neonatal and early childhood outcomes. Methods In this exploratory biomarker study, serum IL-1α, IL-6, IL-8, IL-10, TNFα, and VEGF (<12 h) were compared between NE and non-NE infants with and without perinatal infection/inflammation. Neonatal (severity of NE, mortality) and early childhood (death or neurodevelopmental impairment to 2.5 years) outcomes were assessed. Predictors of outcomes were explored with multivariable linear and logistic regression and receiver-operating characteristic analyses. Results Cytokine assays on 159 NE and 157 non-NE infants were performed; data on early childhood outcomes were available for 150 and 129, respectively. NE infants had higher IL-10 (p < 0.001), higher IL-6 (p < 0.017), and lower VEGF (p < 0.001) levels. Moderate and severe NE was associated with higher IL-10 levels compared to non-NE infants (p < 0.001). Elevated IL-1α was associated with perinatal infection/inflammation (p = 0.013). Among NE infants, IL-10 predicted neonatal mortality (p = 0.01) and adverse early childhood outcome (adjusted OR 2.28, 95% CI 1.35–3.86, p = 0.002). Conclusions Our findings support a potential role for IL-10 as a biomarker for adverse outcomes after neonatal encephalopathy. Impact Neonatal encephalopathy is a common cause of child death and disability globally. Inflammatory cytokines are potential biomarkers of encephalopathy severity and outcome. In this Ugandan health facility-based cohort, neonatal encephalopathy was associated with elevated serum IL-10 and IL-6, and reduced VEGF at birth. Elevated serum IL-10 within 12 h after birth predicted severity of neonatal encephalopathy, neonatal mortality, and adverse early childhood developmental outcomes, independent of perinatal infection or inflammation, and provides evidence to the contribution of the inflammatory processes. Our findings support a role for IL-10 as a biomarker for adverse outcomes after neonatal encephalopathy in a sub-Saharan African cohort.

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Maternal Depression in Early Childhood and Developmental Vulnerability at School Entry

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1425 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Elizabeth Wall-Wieler ◽

Leslie L. Roos ◽

Ian Gotlib

Keyword(s):

Early Childhood ◽

Maternal Depression ◽

Well Being ◽

Population Based ◽

School Entry ◽

Childhood Development ◽

Small Samples ◽

Physician Visits ◽

Developmental Domains ◽

The Relationship

IntroductionStudies on the relationship between exposure to maternal depression in early childhood and childhood development have been limited by small samples, lack of information on timing of maternal depression, and use of a composite measure of childhood development. Objectives and ApproachWe linked multiple Manitoba datasets to examine the relationship between exposure to maternal depression in early childhood and childhood development at school entry across five domains, and age at exposure to maternal depression on developmental outcomes using a population-based cohort (n = 52,103). Maternal depression was defined using physician visits, hospitalizations, and pharmaceutical data, while developmental vulnerability was assessed using the well-validated Early Development Instrument. Relative risk of developmental vulnerability was assessed using log-binomial regression models, adjusted for maternal and childhood characteristics at the birth of the child. ResultsChildren exposed to maternal depression before age 5 had a 17% higher risk of having at least one developmental vulnerability at school entry than children not exposed to such depression before age 5. Exposure to maternal depression before age 5 was most strongly associated with social competence (aRR = 1.28, 95% CI 1.20, 1.38), physical health and well-being (aRR = 1.28, 95% CI 1.20, 1.36), and emotional maturity (aRR = 1.27, 95% CI 1.18, 1.37). For most developmental domains, exposure to maternal depression before age 1 and between ages 4 and 5 had the greatest association with developmental vulnerability. Conclusion / ImplicationsOur findings that children exposed to maternal depression were at higher risk of developmental vulnerability at school entry is consistent with previous studies. However, we found that the association between exposure to maternal depression and development varied across developmental domains, and the relationship varied depending on the age of exposure to maternal depression. Ongoing analyses of discordant cousins will shed more light on the causal nature of this relationship.

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