Effect of prenatal exposure to maternal cortisol and psychological distress on infant development in Bengaluru, southern India: a prospective cohort study

BMC Psychiatry

Study Protocol

Gian Carlo Di Renzo¹  Gudlavalleti Venkata Satyanarayana Murthy²  Giridhara R. Babu³  Anita Nath³ 

[1] Department of Ob/Gyn, Centre for Perinatal and Reproductive Medicine, the Midwifery School, The University of Perugia, Perugia, Italy;The Permanent International and European School of Perinatal, Neonatal and Reproductive Medicine, Florence, Santa Maria della Misericordia University Hospital, 06132 San Sisto, Perugia, Italy;Indian Institute of Public Health Hyderabad-Bengaluru Campus, South, Public Health Foundation of India, Plot # 1, Rd Number 44, Masthan Nagar, Kavuri Hills, Madhapur, 500033, Hyderabad, Telangana, India;International Center for Eye Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK;Wellcome Trust DBT India Alliance Intermediate fellow in clinical and public health, Indian Institute of Public Health-Bengaluru Campus, Public Health Foundation of India, SIHFW Campus, First Cross, Magadi road, 560023, Bengaluru, Karnataka, India;

关键词: Pregnancy;    Mental stress;    Prenatal;    Depression;    Anxiety;    Cortisol;    Infant development;   

DOI  :  10.1186/s12888-017-1424-x

 received in 2017-06-27, accepted in 2017-07-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe mental health status of a pregnant woman and its consequent impact on foetal well being is not given much importance compared to the risk imposed by obstetric complications and medical conditions. Maternal psychological distress is a major public health problem and needs timely detection and intervention to prevent any adverse pregnancy outcome. There is ample evidence from literature that justifies the association of prenatal maternal mental stress and elevated cortisol with delayed infant motor and cognitive development; evidence from India being rather limited. The study aim is to prospectively assess the association of maternal psychological distress and cortisol level with motor and cognitive development of the infant.MethodsA sample of 2612 eligible pregnant women who have been registered for antenatal care at selected public sector hospitals in Bengaluru will be recruited after obtaining written informed consent. They will be assessed for the presence of maternal psychological distress in the form of depression and anxiety using appropriate scales and saliva samples will be collected for cortisol estimation during early, mid and late pregnancy. Follow up visits after delivery will be done on day 10, 3 months, 8 months and 12 months. The Bayley Scales of Infant and Toddler Development [BSID] (Third edition) will be used to measure both motor and mental milestones in terms of Psychomotor Development Index (PDI) and Mental Development Index (MDI). Logistic regression model will be used to determine the association between the exposure variables and outcomes which will be reported as Odd’s Ratio (OR) and 95% confidence intervals (CI).DiscussionOur study findings could add to the growing evidence that maternal psychological distress during pregnancy adversely influences growth and development in the offspring and subsequent development of the child. While maternal anxiety and depression can be measured by using self reporting instruments, estimation of maternal endogenous cortisol levels could serve as a biomarker of prenatal psychological stress. Findings from this study could be used to focus upon the burden of mental health problems during pregnancy and to consider steps to scale up prenatal mental health services in health care settings.

【 授权许可】

CC BY   
© The Author(s). 2017