Mental health problems in pregnancy link maternal history of childhood maltreatment to altered newborn amygdala connectivity.

Abstract

Childhood maltreatment affects 25% of the U.S. population and increases risk for psychopathology, including anxiety disorders, across generations. Before postnatal exposures, offspring with a mother who has a history of childhood maltreatment are born with greater functional connectivity in amygdala-prefrontal stress circuits. Similarly, maternal stress during pregnancy associates with both greater positive and greater inverse amygdala-prefrontal connectivity in infants in a sex-specific manner. Altered newborn amygdala-prefrontal circuits that support stress processing may reflect accelerated neural maturation. Prior studies on associations between maternal history of childhood maltreatment and newborn amygdala connectivity adjust for prenatal maternal stress yet have not examined whether these associations are mediated by prenatal maternal stress. Because history of childhood maltreatment strongly correlates with maternal mental health problems during pregnancy, including stress, depression, sleep problems, and pregnancy specific distress, we test whether these problems mediate the association between maternal history of childhood maltreatment and altered newborn amygdala-prefrontal connectivity. Participants (N = 59) report their history of childhood maltreatment and mental health symptoms in the 3rd trimester. We measure resting state functional connectivity using fMRI in infants (mean age = 3.15 ± 1.42 weeks). Prenatal maternal sleep problems mediate associations between maternal history of childhood maltreatment and infant's amygdala connectivity in both sexes. Pregnancy specific distress mediates the associations in males. Overall, females show greater positive connectivity, whereas males show greater inverse connectivity; mediation findings are more consistent in males. Our study provides evidence that prenatal maternal mental health problems - particularly sleep problems and pregnancy specific distress - link maternal history of childhood maltreatment to newborn amygdala connectivity. These findings highlight modifiable prenatal factors for trauma-responsive intervention.