Hypothalamic-pituitary-adrenal axis and autonomic nervous system reactivity in children prenatally exposed to maternal depression: A systematic review of prospective studies

Neurosci Biobehav Rev. 2020 Oct:117:243-252. doi: 10.1016/j.neubiorev.2018.05.033. Epub 2018 Oct 23.

Abstract

Depression is a common condition affecting up to 20% of all pregnant women, and is associated with subsequent developmental and behavioral problems in children, such as conduct disorder and ADHD. One proposed mechanism underlying these associations is modification of the fetal hypothalamic pituitary adrenal (HPA)-axis and the autonomic nervous system (ANS), resulting in altered responses to stress. This review examined the evidence regarding altered HPA-axis and ANS reactivity in children prenatally exposed to high maternal depressive symptoms. A systematic search was conducted in the electronic databases MEDLINE, EMBASE and PsycINFO, for studies published till 25 July 2017. A total of 13 studies comprising 2271 mother-infant dyads were included. None of the studies were suitable for meta-analysis. Risk of bias assessment showed low risk for four studies. Only three studies described an independent association between exposure to high maternal prenatal depressive symptoms and altered stress reactivity in children. There is limited evidence of an independent association between prenatal exposure to maternal depression and altered HPA or ANS reactivity in children.

Keywords: Autonomic nervous system; DOHaD; Depression; Hypothalamic-pituitary-adrenal axis; Pregnancy; Prenatal programming.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Autonomic Nervous System
  • Child
  • Depression
  • Female
  • Humans
  • Hydrocortisone
  • Hypothalamo-Hypophyseal System*
  • Infant
  • Pituitary-Adrenal System
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Prospective Studies
  • Stress, Psychological

Substances

  • Hydrocortisone