Table 1.
Findings of reviewed structural and functional imaging studies in infants and children of mothers with perinatal depression and anxiety
| Structural MRI in Infants | ||||
|---|---|---|---|---|
| Depression | ||||
| Author (year) | Method | Sample | Symptom Rating | Findings |
| (Rifkin-Graboi et al., 2013) | Structural MRI, DTI | n = 157 (157 neonates near birth, aged 14 days or younger) |
Edinburgh Postnatal Depression Scale Antenatal: 26 weeks gestation |
High prenatal maternal depression: ↓ FA and ↓ AD in the right amygdala of neonates No difference in amygdala volume Did not report measurement of antenatal psychotropic use |
| Anxiety | ||||
| Author (year) | Method | Sample | Symptom Rating | Findings |
| (Qiu et al., 2013) | Structural MRI | n = 175 (175 neonates near birth, aged 5–17 days 35 infants aged 6 months at follow up) |
State-Trait Anxiety Inventory Antenatal: 26 weeks gestation Postnatal: 3 months after delivery |
Left hippocampus: - ↓ growth in first 6 months with higher prenatal maternal anxiety - ↓ volume at 6 months with higher postnatal maternal anxiety Right hippocampus: - ↓ growth in first 6 months with higher prenatal maternal anxiety - ↑ growth in first 6 months with higher postnatal maternal anxiety Did not report measurement of antenatal psychotropic use |
| (Rifkin-Graboi et al., 2015) | Structural MRI, DTI | n = 54 (54 neonates near birth, aged 5–17 days) |
State-Trait Anxiety Inventory Antenatal: 26–28 weeks gestation Postnatal: 3 months after delivery Infant Toddler Socio-Emotional Assessment questionnaire |
High prenatal maternal anxiety: - No effect on amygdala microstructure - ↓ FA: * right cerebellum * right insular cortex * perception areas (right middle occipital, inferior temporal, bilateral superior temporal, left postcentral) * personal, social, emotional processing areas (right angular region, right uncinate fasciculus, posterior cingulate, parahippocampus) * cognitive and emotional regulation areas (right dorsolateral prefrontal, inferior frontal, inferior fronto-occipital fasciculus) - ↓ AD: Left lateral orbitofrontal region, left inferior cerebellar peduncle - ↑ AD: Genu of the corpus callosum Did not report measurement of antenatal psychotropic use |
|
Functional MRI in Infants | ||||
| Depression | ||||
| Author (year) | Method | Sample | Symptom Rating | Findings |
| (Qiu et al., 2015) | fMRI, resting- state |
n = 24 (24 infants aged 6 months) |
Edinburgh Postnatal Depression Scale Antenatal: 26 weeks gestation Postnatal: 3 months after delivery |
Higher prenatal maternal depression: ↑ Functional connectivity between the amygdala and areas of the • Emotional regulation network – left insula and bilateral medial prefrontal cortex (anterior cingulate, medial orbitofrontal, ventromedial prefrontal cortices) • Sensory and perceptual network – left superior, middle, temporal cortices • Emotional memory network – left entorhinal cortex Did not report measurement of antenatal psychotropic use |
| (Posner et al., 2016) | fMRI, resting- state and diffusion MRI, tractography |
n = 64 (20 infants with and 44 infants without in utero exposure to prenatal maternal depression, aged 4.1 to 7.5 weeks) |
Center for Epidemiological Studies Depression scale Antenatal: 34 and 37 weeks gestation |
Resting-state fMRI: ↓ Functional connectivity between amygdala and bilateral dorsal prefrontal cortex Tractography: ↓ Structural connectivity between right amygdala and right ventral prefrontal cortex Did not report measurement of antenatal psychotropic use |
|
Structural MRI in Children | ||||
| Depression | ||||
| Author (year) | Method | Sample | Symptom Rating | Findings |
| (Lebel et al., 2016) | Structural MRI, cortical thickness, tractography and DTI | n = 52 20 female; 32 male, aged 2.6- 5.1 |
Edinburgh Postnatal Depression Scale was completed once during each trimester and once 2–3 months postnatal. | Higher antenatal maternal depression: ↓ cortical thickness in right inferior frontal and middle temporal region and with white matter tracts emanating from the inferior frontal area Higher postnatal maternal depression: ↓ cortical thickness in superior frontal and with white matter measures of fibers originating from that region Antenatal psychotropic use was controlled for in statistical analyses |
| (Wen et al., 2017) | Structural MRI and DTI | n = 342 4.5 years of age. 203 (95 boys and 108 girls) had good T1 data 188 (88 boys and 100 girls) had good DTI data. |
Edinburgh Postnatal Depression Scale Antenatal: 26 weeks’ gestation Postnatal: 3 months The Beck’s Depression Inventory-II Postnatal: 1, 2, 3 and 4.5 years postpartum. |
MRI Results Higher antenatal maternal depression: ↑ left amygdala volume in girls DTI Results Higher antenatal maternal depression: ↑ right amygdala FA Did not report measurement of antenatal psychotropic use |
| (Sandman et al., 2015) | Structural MRI | n = 81 (81 children aged 6–9 years old) |
Centers for Epidemiologic Studies Depression scale (CES-D) Prenatal: 19, 25, and 31 weeks gestation |
Exposure to prenatal maternal depression in utero at • 19 weeks gestation: 8% overall cortical thinning in children aged 6–9 years old • 25 weeks gestation: 19% overall cortical thinning (24% thinning of frontal lobes, most prominent in the right superior, medial orbital, frontal pole) in children aged 6–9 years old • 31 weeks gestation: 7% overall cortical thinning in children aged 6–9 years old Did not report measurement of antenatal psychotropic use |
| (El Marroun et al., 2016) | Structural MRI | n = 654 327 male, 327 female, mean age of 7.9 years at the MRI assessment, children aged 6–9 |
Brief Symptom Inventory Parental: 20.6 weeks of gestation Postnatal: 3 years |
Higher prenatal maternal depression: ↓ cortical thickness in superior frontal cortex in the left hemisphere ↑ cortical surface area in the caudal middle frontal region. Women with antenatal psychotropic use were excluded from study |
| (El Marroun et al., 2018) | DTI | n = 636 (322 male, 314 female) children aged 6–9 |
Brief Symptom Inventory Parental: 20.6 weeks of gestation Postnatal: 3 years |
Higher prenatal maternal depression: ↑ mean diffusivity in the left uncinate fasciculus and cingulum bundle ↓ FA in the right cingulum bundle. Women with antenatal psychotropic use were excluded from study |
| (Lupien et al., 2011) | Structural MRI | n = 38 17 maternal depressive exposure group (7 boys and 10 girls) and 21 were no maternal depressive exposure group (10 boys and 11 girls). children aged 10 |
Center for Epidemiologic Studies Depression Scale Postnatal: 5, 17, 30, 42, 60, 84, and 156 months |
Children exposed to maternal depressive symptoms ↑ left and right amygdala volumes Did not report measurement of antenatal psychotropic use |
| Anxiety | ||||
| Author (year) | Method | Sample | Symptom Rating | Findings |
| (Buss et al., 2010) | Structural MRI | n = 35 (18 male, 17 female) aged 6–9 |
10-item pregnancy anxiety scale Prenatal: 19, 25, and 31 weeks’ gestation |
Maternal anxiety at 19 weeks’ gestation: ↓ gray matter volume in the prefrontal cortex, premotor cortex, medial temporal lobe, lateral temporal cortex, postcentral gyrus, and the cerebellum extending to the middle occipital gyrus and the fusiform gyrus. While women with antenatal psychotropic use were not excluded from the study, the final sample included no women with antenatal psychotropic use |
|
Functional MRI in Children | ||||
| Depression | ||||
| Author (year) | Method | Sample | Symptom Rating | Findings |
| (Soe et al., 2018) | BOLD resting state | n = 128 (57 male and 71 female children aged 4.5 years old) |
Standardized Edinburgh Postnatal Depression Scale and Beck’s Depression Inventory-II scores Antenatal: 26 weeks gestation Postnatal: average score at 3, 12, 24, 36, 54 months after delivery |
In female children exposed to antenatal v. postnatal depression: ↓ Functional connectivity between left amygdala, right insula, putamen, bilateral subgenual anterior cingulate cortex, left caudate ↓ Functional connectivity between right amygdala, left orbitofrontal cortex, insula, temporal pole Did not report measurement of antenatal psychotropic use |
| (van der Knaap et al., 2018) | BOLD activation, emotional face matching task | n = 31 (15 children aged 6–9 years old exposed to antenatal maternal depressive symptoms 16 children aged 6–9 years old not exposed to antenatal maternal depressive symptoms) |
Brief Symptoms Inventory score Antenatal: 20–25 weeks gestation Postnatal: 3 years after delivery |
In children exposed to antenatal depression: ↑ amygdala responses to negative emotional faces Did not report measurement of antenatal psychotropic use |
Key: MRI: magnetic resonance imaging; DTI: diffusion tensor imaging; FA: fractional anisotropy; AD: axial diffusivity; BOLD: blood oxygen level dependent