Parental psychological distress during pregnancy and childhood cardiovascular development. The Generation R Study

Background: Maternal psychological distress during pregnancy might lead to higher fetal cortisol exposure, which subsequently leads to fetal cardiovascular developmental adaptations and cardiovascular dysfunction in later life. Aims: We examined whether maternal and paternal psychological distress was associated with the cardiovascular outcome measurements in school age children. Study design and subjects: In a population-based prospective cohort study among 4831 children, we assessed maternal and paternal psychological distress during pregnancy by questionnaire, using the Brief Symptom Inventory (see Fig. 1). Outcome measures: At the child age of six years, we performed blood pressure and carotid-femoral pulse wave velocity measurements, and M-mode measurements of left cardiac structures and fractional shortening. Results: We did not observe associations of high maternal and paternal psychological symptom scores with childhood blood pressure and carotid-femoral pulse wave velocity after adjustment for potential confounders. Maternal overall psychological symptoms were associated with a lower childhood left ventricular mass (difference - 1.10. g (95% confidence interval - 2.13 to - 0.07) between mothers with high scores and normal scores), but not with other cardiac structures and fractional shortening. Paternal overall psychological symptoms showed a similar association with childhood left ventricular mass (difference - 1.34 grams (95% confidence interval - 3.69 to 1.02) between fathers with high scores and normal scores). Conclusions: Our results do not support the hypothesis that maternal psychological distress affects cardiovascular development in early life. Similar associations of maternal and paternal psychological distress with left ventricular mass suggest that these associations could be due to unmeasured social and environmental factors, rather than direct intra-uterine effects.

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