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Title: Psychological and biological sequelae of exposure to prenatal maternal depression : findings from the 25-year prospective South London Child Development Study
Author: Plant, Dominic
ISNI:       0000 0004 5366 4572
Awarding Body: King's College London (University of London)
Current Institution: King's College London (University of London)
Date of Award: 2014
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Background: A wealth of studies has demonstrated the detrimental effects of exposure to maternal stress in utero on emotional psychopathology in childhood. Many of these effects have been attributed to foetal programming of offspring brain development during gestation. Research has also demonstrated an association between exposure to prenatal maternal depression and offspring childhood maltreatment. The main aim of this thesis is to investigate the long-term effects of offspring exposure to prenatal maternal depression on depressive psychopathology in young adulthood, and whether exposure to childhood maltreatment contributes to this association. Secondary aims are to characterise the biological characteristics of young adult offspring who were exposed to prenatal maternal depression, in terms of hypothalamic-pituitary-adrenal (HPA) axis function, inflammation and metabolic function. Previous research has shown that abnormalities in all three systems are associated with exposure to prenatal maternal depression, childhood maltreatment and depressive psychopathology. Methods: The sample comprised 103 offspring from the South London Child Development Study (SLCDS), a prospective longitudinal birth cohort study setup in 1986 that had followed mothers and their offspring from pregnancy to 16 years. This PhD thesis continued the SLCDS by assessing the offspring at age 25. Data on offspring exposure to depression in utero (20 and 36 weeks gestation), childhood maltreatment (birth to 17 years) and young adulthood DSM-IV depressive disorders (18 to 25 years) were obtained through one-to-one clinical interviews. Biological measures of offspring HPA axis function, inflammation and metabolic function were obtained at 25 years. Results: Offspring exposed to prenatal maternal depression were significantly more likely to have a DSM-IV depressive disorder in young adulthood (18 to 25 years) compared to offspring not so exposed. Offspring exposure to childhood maltreatment and further maternal depression during childhood were found individually to mediate this association. Offspring exposed to prenatal maternal depression also exhibited significantly greater systemic inflammation at 25 years compared to non-exposed offspring, whilst offspring exposed to childhood maltreatment demonstrated HPA axis abnormalities compared to non-exposed offspring. No effect of early life adversity on metabolic function was observed. Conclusions: Exposure to prenatal maternal depression results in persistent psychological and biological changes in the offspring that are observable during young adulthood. Childhood maltreatment contributes to these pathologies. These findings have direct implications for policy development and clinical practice: identification and treatment of maternal depression during pregnancy could have a direct impact on reducing levels of child maltreatment as well as depression in the young adult population.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available