Subcortical brain volumes in young infants exposed to antenatal maternal depression: Findings from a South African birth cohort

Nynke A Groenewold; Catherine J Wedderburn; Jennifer A Pellowski; Jean-Paul Fouché; Liza Michalak; Annerine Roos; Roger P Woods; Katherine L Narr; Heather J Zar; Kirsten A Donald; Dan J Stein

doi:10.1016/j.nicl.2022.103206

Subcortical brain volumes in young infants exposed to antenatal maternal depression: Findings from a South African birth cohort

Neuroimage Clin. 2022:36:103206. doi: 10.1016/j.nicl.2022.103206. Epub 2022 Sep 19.

Authors

Affiliations

¹ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SA-MRC) Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Electronic address: nynke.groenewold@uct.ac.za.
² Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom.
³ Department of Behavioral and Social Sciences and International Health Institute, Brown University School of Public Health, Providence, RI, USA; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁴ Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁵ Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.
⁶ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa; SA-MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa.
⁷ Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA.
⁸ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SA-MRC) Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa.
⁹ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
¹⁰ Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa; SA-MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa.

Abstract

Background: Several studies have reported enlarged amygdala and smaller hippocampus volumes in children and adolescents exposed to maternal depression. It is unclear whether similar volumetric differences are detectable in the infants' first weeks of life, following exposure in utero. We investigated subcortical volumes in 2-to-6 week old infants exposed to antenatal maternal depression (AMD) from a South African birth cohort.

Methods: AMD was measured with the Beck Depression Inventory 2nd edition (BDI-II) at 28-32 weeks gestation. T2-weighted structural images were acquired during natural sleep on a 3T Siemens Allegra scanner. Subcortical regions were segmented based on the University of North Carolina neonatal brain atlas. Volumetric estimates were compared between AMD-exposed (BDI-II ⩾ 20) and unexposed (BDI-II < 14) infants, adjusted for age, sex and total intracranial volume using analysis of covariance.

Results: Larger volumes were observed in AMD-exposed (N = 49) compared to unexposed infants (N = 75) for the right amygdala (1.93% difference, p = 0.039) and bilateral caudate nucleus (left: 5.79% difference, p = 0.001; right: 6.09% difference, p < 0.001). A significant AMD-by-sex interaction was found for the hippocampus (left: F(1,118) = 4.80, p = 0.030; right: F(1,118) = 5.16, p = 0.025), reflecting greater volume in AMD-exposed females (left: 5.09% difference, p = 0.001, right: 3.54% difference, p = 0.010), but not males.

Conclusions: Volumetric differences in subcortical regions can be detected in AMD-exposed infants soon after birth, suggesting structural changes may occur in utero. Female infants might exhibit volumetric changes that are not observed in male infants. The potential mechanisms underlying these early volumetric differences, and their significance for long-term child mental health, require further investigation.

Keywords: Brain morphometry; Child development; Depressive disorders; Magnetic resonance imaging; Prenatal stress; Sex differences.

MeSH terms

Adolescent
Amygdala / diagnostic imaging
Birth Cohort*
Brain / diagnostic imaging
Caudate Nucleus
Child
Depressive Disorder*
Female
Humans
Infant
Infant, Newborn
Magnetic Resonance Imaging / methods
Pregnancy