Maternal corticosteroids and depression during gestation and decreased fetal heart rate variability

Objective Maternal depression during gestation is an adverse factor in fetal brain development that manifests in later childhood behavioral problems. Fetal heart rate variability (FHRV) mediated by parasympathetic input is a marker of gestational nervous system development. Biological mediators of adverse effects of maternal depression may involve the mother's corticosteroids; however, links between depression, corticosteroids, and early nervous system development remain inconclusive. Methods Heart rate was recorded in 23 fetuses by transabdominal Doppler at 28-33weeks gestation. The SD of interbeat intervals over 20min assessed FHRV. Maternal depression ratings and hair concentrations of cortisol and cortisone were assayed. An auditory sensory gating paradigm assessed newborn development of cerebral inhibition. Parents rated their infant's temperament characteristics on the Infant Behavior Questionnaire-Revised Short Form (IBQ-R). Results Maternal depression was associated with lower FHRV, especially for male fetuses, beta=-0.633, P=0.045. Maternal depression was associated with lower cortisol to total corticosteroids ratios, beta=-0.519, P=0.033. Lower cortisol ratios were associated with decreased FHRV, beta=0.485, P=0.019. Decreased FHRV was associated with increased newborn sensory gating deficits, beta=-0.992, P=0.035, indicating poorer development of cerebral inhibition. Higher FHRV was related to increased infant IBQ-R self-regulatory behaviors, r=0.454, P=0.029. Conclusion Maternal depression is associated via corticosteroids with decreased development of nervous system control of fetal heart rate. Decreased FHRV indicates developmental alterations in gestation that correlate with altered brain function and subsequent regulatory challenges in early infancy. Copyright (C) 2021 Wolters Kluwer Health, Inc. All rights reserved.

Automated summary

Maternal depression during gestation is associated with decreased fetal heart rate variability, especially for male fetuses. The lower cortisol to total corticosteroids ratios associated with maternal depression suggests its influence. Decreased FHRV is related to increased newborn sensory gating deficits, indicating impaired development of cerebral inhibition. Higher FHRV is associated with increased infant self-regulatory behaviors.