Prenatal depression effects and interventions: A review

This review covers research on the negative effects of prenatal depression and cortisol on fetal growth, prematurity and low birthweight. Although prenatal depression and cortisol were typically measured at around 20 weeks gestation, other research suggests the stability of depression and cortisol levels across pregnancy. Women with Dysthymia as compared to Major Depression Disorder had higher cortisol levels, and their newborns had lower gestational age and birthweight. The cortisol effects in these studies were unfortunately confounded by low serotonin and low dopamine levels which in themselves could contribute to non-optimal pregnancy outcomes. The negative effects of depression and cortisol were also potentially confounded by comorbid anxiety, by demographic factors including younger age, less education and lower SES of the mothers and by the absence of a partner or a partner who was unhappy about the pregnancy or a partner who was depressed. Substance use (especially caffeine use) was still another risk factor. All of these problems including prenatal depression, elevated cortisol, prematurity and low birthweight and even postpartum depression have been reduced by prenatal massage therapy provided by the women's partners. Massage therapy combined with group interpersonal psychotherapy was also effective for reducing depression and cortisol levels. Several limitations of these studies were noted and suggestions for future research included exploring other predictor variables like progesterone/estriol ratios, immune factors and genetic determinants. Further research is needed both on the potential use of cortisol as a screening measure and the use of other therapies that might reduce prenatal depression and cortisol in the women and prematurity and low birthweight in their infants.     

IQ stability: the relation between child and young adult intelligence test scores in low-birthweight samples

The stability of IQ from childhood to adulthood in low-birthweight subjects was measured in two independent samples with follow-up intervals of approximately 14 and 9.5 years. In both samples, intelligence was assessed with the WISC at a mean age of 9.5. Twenty-six subjects were retested with the WAIS at a mean age of 23.5, and 78 subjects with the BPP (the Danish Military Draft Board Intelligence Test) at the age of 19.1. Both samples obtained childhood and adult test scores below the expected means. For the Wechsler Verbal, Performance and Full-Scale IQs, the stability quotients were 0.86, 0.86, and 0.89 in the WAIS sample, and the retest correlations for the three IQs with the BPP score were 0.66, 0.65, and 0.74. Thus, the majority of children showed stable patterns of intellectual development from middle childhood to young adulthood.     

Academic achievement of low birthweight children at age 11: the role of cognitive abilities at school entry

We examine the extent to which deficits in academic achievement in low birthweight (LBW) children at age 11 are explained by deficits in cognitive abilities at school entry. Data come from a longitudinal study of a stratified sample of LBW and normal birthweight (NBW) children from an innercity and middle class suburbs in the Detroit area. Woodcock-Johnson Psychoeducational Battery-Revised was used to measure reading and math at age 11. WISC-R and specific neuropsychologic tests were administered at age 6. On reading, the LBW-NBW difference was -3.6 points (SE = 1.2). The difference was explained almost entirely by IQ at age 6. On math, the LBW-NBW difference was -6.1 points (SE = 1.1). The difference on math was trivial and not significant, when IQ and neuropsychological tests at age 6 were controlled. Level of LBW was unrelated to reading, but it had a gradient relationship with math, with birthweight < or = 1,500 g associated with a greater deficit than heavier LBW. The results imply that most of the LBW-NBW gap in academic achievement at age 11 could be eliminated by eliminating differences in cognitive abilities at age 6. Interventions to improve academic performance of LBW children should focus on the preschool years.