Mapping Antenatal Maternal Stress - Child Outcomes

Mapping Antenatal Maternal Stress - Child Outcomes (MAMS-CO)

This study is a sub-study of Mapping Antenatal Maternal Stress (MAMS). Women previously enrolled in MAMS, their children and their partners/spouses were recruited for a set of more comprehensive assessments to characterise early neurodevelopmental outcomes in children, their associations with antenatal and postnatal maternal emotional health, and how paternal genetics, mental health and parenting styles and perceptions may influence this relationship.

There is considerable evidence that maternal symptoms of depression and anxiety are associated, independent of birth outcomes, with detrimental outcomes in offspring, including cognitive, emotional and social development, as well as increased risk for psychopathology. Prior neuroimaging evidence has revealed effects of prenatal maternal symptoms of depression or anxiety on offspring brain structure and connectivity. In particular, individual differences in the volume and structure of limbic regions (i.e., hippocampus and amygdala) as well as prefrontal cortical regions implicated in psychopathology are associated with the quality of pre- and post-natal maternal mental health. The more recent studies reveal effects on critical connections between cortical and limbic regions, such as those from the amygdala to the insular cortex. There is also increasing evidence that the effects of maternal antenatal mood are of equal or greater importance in predicting child outcomes than maternal symptoms in the postnatal period.

In addition, whilst literature on paternal involvement has largely reflected a positive impact on child outcomes, these studies were done in western populations and may not be generalised in the context of local population, given the differences in ethnic and cultural backgrounds.

As such, the current study builds on the MAMS study's focus on maternal mental health and wellbeing, by undertaking more comprehensive assessments related to child outcomes and parent-child interactions, including paternal factors. The polygenic risk score (PRS) framework used in MAMS can be extended to fathers and children to investigate inter-individual variations in response to adversity.

Data will be collected through questionnaires done online, measurements, and assessments done during lab-based visits.

• Collection of samples such as buccal swabs and saliva
• Sleep actigraphy measures on infants
• Body measurements such as height, weight, and blood pressure
• Child developmental and behavioral assessments, including cognitive and language assessments
• Cognitive, socio-emotional and parenting tasks for mothers
• Mother-child interaction tasks
• Mother and infant EEG measurements
• Child eye-tracking tasks
• MRI measurements from the infant at postnatal 1 and 6 months
• Questionnaires related to depression, anxiety, psychosocial risk factors such as life stressors, social and partner support, socioeconomic factors, medical history, behavior, cognition, lifestyle, health status, parental bonding, childhood adversity experienced, socio-emotional factors, executive function, family dynamics, sleep quality, personality traits

Inclusion Criteria:

Mother:

1. Enrolled in MAMS study
2. Intends for herself and her child to stay in Singapore for the next 5 years
3. Access to a smartphone or standard laptop/ desktop
4. Willing to take part in this study and able to provide written consent
5. Aged 21-42 years

Father:

1. Partner is already enrolled in MAMS study
2. Aged 21-75 years

Exclusion Criteria:

Mother:

1. Women with pre-existing or a history of psychotic depression, schizophrenia and bipolar disorders
2. Women currently on oral/IV steroids and/or thyroids medication
3. Women with a history of thyroid disease
4. Women currently involved in on-going interventional randomized controlled trials