Maternal Psychological Disposition May Be Linked to Functional Gastrointestinal Disorders in Newborns

Maternal psychological factors may be associated with the onset of functional gastrointestinal disorders (FGIDs) in offspring, investigators reported in the Journal of Pediatric Gastroenterology and Nutrition.

The observational, prospective, cohort study enrolled healthy, pregnant persons with a low-risk pregnancy who were hospitalized at or after 37 weeks of gestation at a university center in Italy, between January 2015 and December 2018.

The researchers conducted a 3-month follow-up to assess parental psychological status, and all newborns were evaluated at 1 month and 3 months. FGIDs were classified with use of the Rome III criteria and assessed with a validated Rome III questionnaire for infant and toddler FGIDs that was given to the parents.

The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the presence and degree of postpartum depression (PPD) symptoms. The analysis also included use of the Maternity Blues Questionnaire (MBQ), the Symptoms Checklist 90-Revised version (SCL90-R), and the Attachment Style Questionnaire (ASQ).

Among 200 mothers who were enrolled (mean maternal age at delivery, 33 years; SD, 5 years), 113 completed the 3-month follow-up and were included in the final analysis. The prevalence of PPD symptoms was 20.4%, 20.0%, 13.2%, and 13.1%, respectively, at 3 days, 1 week, 1 month, and 3 months postdelivery.

In addition, 40.4% of participants had severe blues based on MBQ scores within the first week after delivery. The investigators observed relevant psychiatric symptoms (SCL90-R) in 7.8% and 10.9% of mothers at 1 week and 3 months postdelivery, respectively; 48.7% of mothers had a secure attachment pattern per the Rome questionnaire.

At 1 month, regurgitation was diagnosed in 26 (23.0%) infants, infantile colic in 31 (27.4%), dyschezia in 17 (15.0%), and functional constipation in 9 (8.0%). At 3 months, these numbers had changed to 16 (14.2%), 11 (9.7%), 4 (3.5%), and 11 (9.7%), respectively.

The study authors found a significant positive association between PPD symptoms at 3 days postdelivery and infantile colic in the newborns 1 month after birth (false discovery rate [FDR]-adjusted P =.028). A significant positive association was also observed between mothers’ PPD symptoms 7 days after delivery and infant regurgitation 1 month after birth (FDR-adjusted P =.042). All other associations at other time points were not significant or did not remain after FDR correction (all uncorrected P >.08).

No significant association was found between FGIDs and severe maternity blues at any time point (all uncorrected P >.1), or between FGIDs and psychiatric symptoms (all FDR-corrected P >.2).

Regarding continuous measurement of adult attachment in mothers of children with and without FGIDs, significant differences were found in mean values in 3 of the 5 dimensions of the ASQ (discomfort with closeness, FDR P =.03; relationships as secondary, FDR P =.047; and need for approval, FDR P =.03). Additionally, mothers with children who had infantile regurgitation beginning 1 month after birth had a higher insecurity score in avoidant and fearful dimensions.

The study authors noted that the role of maternal sensitivity can only be inferred, as it was not directly assessed. In addition, the influence of infant temperament was not included in the analysis.

“[O]ur findings support the notion that maternal psychological disposition should be targeted in early identification programs for mothers at risk of having children suffering from FGIDs, to prevent or at least positively influence their onset,” stated the investigators. “[H]owever, some questions still remain to be elucidated, including the reason why maternal psychological disposition is not anymore associated with FGIDs occurrence after 3 years of life and the other individual, environmental, or familial factors that are likely to have an impact on this association during later stages of development,” they concluded.

Reference

Baldassarre ME, Antonucci LA, Castoro G, et al. Maternal psychological factors and onset of functional gastrointestinal disorders in offspring: a prospective study. J Pediatr Gastroenterol Nutr. 2021;73(1):30-36. doi: 10.1097/MPG.0000000000003107

This article originally appeared on Gastroenterology Advisor