RESEARCH PAPER
The relationship between biological factors (vitamin D, prolactin, oxytocin, thyroid hormones) , Pregnancy-Related Anxiety and Maternal-Foetal Attachment
 
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1
Department and Clinic of Psychiatry, Medical University, Wrocław, Poland
 
2
Department of Perinatology, Medical University, Wrocław, Poland
 
 
Corresponding author
Agata Alicja Mikolajkow   

Department and Clinic of Psychiatry, Wroclaw Medical University
 
 
J Pre Clin Clin Res. 2023;17(3):121-126
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
Pregnancy-Related Anxiety (PrA) is a common issue in pregnancy, which is distinctive from Generalized Anxiety Disorder. It has numerous negative outcomes for both mother and child. The aim of this study was to investigate the relationship between vitamin D, thyroid function, prolactin, oxytocin and Pregnancy-Related Anxiety, and to check for any correlations between anxiety levels and maternal-foetal bonding in pregnancy and postpartum.

Material and methods:
Seventy pregnant women participated in the study. The relationship was investigated between Pregnancy-Related Anxiety and biological factors and maternal-foetal attachment, using serum levels of vitamin D, TSH, prolactin, oxytocin, and scores of PRAQ-R2, MFAS and MORS questionnaires

Results:
No significant association was found between vitamin D, oxytocin, prolactin, TSH and PrA. Weak positive correlations were found between own appearance subscale of PRAQ-R2 and mothers’ perception of giving self subscale in MFAS. A weak positive correlation was also found between PRAQ-R2 and its’ subscale concerning own appearance and MORS invasion subscale

Conclusions:
Vitamin D, oxytocin, prolactin and thyroid function are believed to be associated with anxiety disorders. No such association was found. It might suggest that PrA is a distinctive disorder with other pathogenetic factors. Disorders of maternal-foetal attachment may be related to concerns about own appearance in pregnant women; therefore, this issue should be addressed early in pregnancy.

Mikołajków AA, Fuchs T, Malyszczak K. The relationship between biological factors (vitamin D, prolactin, oxytocin, thyroid hormones), Pregnancy-Related Anxiety and Maternal-Foetal Attachment. J Pre Clin Cin Res. 2023; 17(3): 121–126. doi: 10.26444/jpccr/171530
 
REFERENCES (52)
1.
Brunton RJ, Dryer R, Saliba A, Kohlhoff J. The initial development of the Pregnancy-related Anxiety Scale. Women and Birth. 2019;32(1):118–130. doi:10.1016/j.wombi.2018.05.004.
 
2.
Blackmore ER, Gustafsson H, Gilchrist M, Wyman C, O’Connor TG. Pregnancy-related anxiety: Evidence of distinct clinical significance from a prospective longitudinal study. J Affect Disord. 2016;197:251–258. doi:10.1016/j.jad.2016.03.008.
 
3.
Highet N, Stevenson AL, Purtell C, Coo S. Qualitative insights into women’s personal experiences of perinatal depression and anxiety. Women and Birth. 2014;27(3):179–184. doi:10.1016/j.wombi.2014.05.003.
 
4.
Dikmen-Yildiz P, Ayers S, Phillips L. Depression, anxiety, PTSD and comorbidity in perinatal women in Turkey: A longitudinal population-based study. Midwifery. 2017;55(1):29–37. doi:10.1016/j.midw.2017.09.001.
 
5.
Nath A, Venkatesh S, Balan S, Metgud CS, Krishna M, Murthy GVS. The prevalence and determinants of pregnancy-related anxiety amongst pregnant women at less than 24 weeks of pregnancy in Bangalore, Southern India. Int J Womens Health. 2019;11:241–248. doi:10.2147/ijwh.s193306.
 
6.
Zhu CS, Tan TC, Chen HY, Malhotra R, Allen JC, Østbye T. Threatened miscarriage and depressive and anxiety symptoms among women and partners in early pregnancy. J Affect Disord. 2018;237:1–9. doi:10.1016/j.jad.2018.04.012.
 
7.
Ahmed A, Feng C, Bowen A, Muhajarine N. Latent trajectory groups of perinatal depressive and anxiety symptoms from pregnancy to early postpartum and their antenatal risk factors. Arch Womens Ment Health. 2018;21(6):689–698. doi:10.1007/s00737-018-0845-y.
 
8.
Brunton R, Dryer R, Saliba A, Kohlhoff J. Re-examining pregnancy-related anxiety: A replication study. Women and Birth. 2019;32(1):131–137. doi:10.1016/j.wombi.2018.04.013.
 
9.
Huang MZ, Kao CH, Lin KC, Hwang JL, Puthussery S, Gau ML. Psychological health of women who have conceived using assisted reproductive technology in Taiwan: Findings from a longitudinal study. BMC Womens Health. 2019;19(1):1–11. doi:10.1186/s12905-019-0801-7.
 
10.
Mudra S, Göbel A, Barkmann C, et al. The longitudinal course of pregnancy-related anxiety in parous and nulliparous women and its association with symptoms of social and generalized anxiety. J Affect Disord. 2020;260:111–118. doi:10.1016/j.jad.2019.08.033.
 
11.
Garza-Veloz I, Castruita-De La Rosa C, Ortiz-Castro Y, et al. Maternal distress and the development of hypertensive disorders of pregnancy. J Obstet Gynaecol. 2017;37(8):1004–1008. doi:10.1080/01443615.2017.1313823.
 
12.
Grigoriadis S, Graves L, Peer M, et al. A systematic review and metaanalysis of the effects of antenatal anxiety on postpartum outcomes. Arch Womens Ment Health. 2019;22(5):543–556. doi:10.1007/s00737- 018-0930-2.
 
13.
Hoff CE, Movva N, Rosen Vollmar AK, Pérez-Escamilla R. Impact of Maternal Anxiety on Breastfeeding Outcomes: A Systematic Review. Adv Nutr. 2019;10(5):816–826. doi:10.1093/advances/nmy132.
 
14.
Bayrampour H, Salmon C, Vinturache A, Tough S. Effect of depressive and anxiety symptoms during pregnancy on risk of obstetric interventions. J Obstet Gynaecol Res. 2015;41(7):1040–1048. doi:10.1111/jog.12683.
 
15.
Hopkins J, Miller JL, Butler K, Gibson L, Hedrick L, Boyle DA. The relation between social support, anxiety and distress symptoms and maternal fetal attachment. J Reprod Infant Psychol. 2018;36(4):381–392. doi:10.1080/02646838.2018.1466385.
 
16.
Gelaye B, Sanchez SE, Andrade A, et al. Association of antepartum depression, generalized anxiety, and posttraumatic stress disorder with infant birth weight and gestational age at delivery. J Affect Disord. 2020;262:310–316. doi:10.1016/j.jad.2019.11.006.
 
17.
Hasanjanzadeh P, Faramarzi M. Relationship between maternal general and specific-pregnancy stress, anxiety, and depression symptoms and pregnancy outcome. J Clin Diagnostic Res. 2017;11(4):VC04-VC07. doi:10.7860/JCDR/2017/24352.9616.
 
18.
Romero-Gonzalez B, Caparros-Gonzalez RA, Gonzalez-Perez R, Delgado-Puertas P, Peralta-Ramirez MI. Newborn infants’ hair cortisol levels reflect chronic maternal stress during pregnancy. PLoS One. 2018;13(7):1–13. doi:10.1371/journal.pone.0200279.
 
19.
Korja R, Nolvi S, Grant KA, McMahon C. The Relations Between Maternal Prenatal Anxiety or Stress and Child’s Early Negative Creativie or Self-Regulation: A Systematic Review. Child Psychiatry Hum Dev. 2017;48(6):851–869. doi:10.1007/s10578-017-0709-0.
 
20.
Madigan S, Oatley H, Racine N, et al. A Meta-Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development. J Am Acad Child Adolesc Psychiatry. 2018;57(9):645–657. doi:10.1016/j. jaac.2018.06.012.
 
21.
Adamson B, Letourneau N, Lebel C. Prenatal maternal anxiety and children’s brain structure and function: A systematic review of neuroimaging studies. J Affect Disord. 2018;241:117–126. doi:10.1016/j. jad.2018.08.029.
 
22.
Kang YT, Yao Y, Dou J, et al. Prevalence and risk factors of maternal anxiety in late pregnancy in China. Int J Environ Res Public Health. 2016;13(5). doi:10.3390/ijerph13050468.
 
23.
Alqahtani AH, Al Khedair K, Al-Jeheiman R, Al-Turki HA, Al Qahtani NH. Anxiety and depression during pregnancy in women attending clinics in a University Hospital in Eastern province of Saudi Arabia: Prevalence and associated factors. Int J Womens Health. 2018;10:101–108. doi:10.2147/IJWH.S153273.
 
24.
Alipour Z, Kazemi A, Kheirabadi G, Eslami AA. Relationship Between Marital Quality, Social Support and Mental Health During Pregnancy. Community Ment Health J. 2019;55(6):1064–1070. doi:10.1007/s10597- 019-00387-8.
 
25.
Martini J, Petzoldt J, Einsle F, Beesdo-Baum K, Höfler M, Wittchen HU. Risk factors and course patterns of anxiety and depressive disorders during pregnancy and after delivery: A prospective-longitudinal study. J Affect Disord. 2015;175:385–395. doi:10.1016/j.jad.2015.01.012.
 
26.
Ucar N, Pinar SE. The hospital stressors and depression, anxiety levels in pregnant women hospitalized due to preterm delivery: A follow-up study. Perspect Psychiatr Care. 2020;56(2):290–296. doi:10.1111/ppc.12426.
 
27.
Stahl SM. Stahl’s Essential Psychopharmacology. Neuroscientific Basis and Practical Applications. 4 ed. Stahl SM, editor. Cambridge Medicine; 2020.
 
28.
McEwen BB. General Introduction to Vasopressin and Oxytocin: Structure, Metabolism, Evolutionary Aspects, Neural Pathway, Receptor Distribution, and Functional Aspects Relevant to Memory Processing. Adv Pharmacol. 2004;50:1–50. doi:10.1016/S1054-3589(04)50001-7.
 
29.
Ma X, Wei Q, Jiang Z, Shi Y, Zhang Y, Shi H. The role of serum oxytocin levels in the second trimester in regulating prenatal anxiety and depression: A sample from Shanghai Maternal-Child Pairs Cohort study. J Affect Disord. 2020;264:150–156. doi:10.1016/j.jad.2019.12.019.
 
30.
Serati M, Grassi S, Redaelli M, et al. Is There an Association Between Oxytocin Levels in Plasma and Pregnant Women’s Mental Health? J Am Psychiatr Nurses Assoc. 2019. doi:10.1177/1078390319890400.
 
31.
Lara-Cinisomo S, D’Anna-Hernandez K, Fujimoto EM, Pedersen CA. Exploring associations between perinatal depression, anxiety, and urinary oxytocin levels in Latinas. Arch Womens Ment Health. 2019;22(4):447–455. doi:10.1007/s00737-018-0910-6.
 
32.
Zelkowitz P, Gold I, Feeley N, et al. Psychosocial stress moderates the relationships between oxytocin, perinatal depression, and maternal behavior. Horm Behav. 2014;66(2):351–360. doi:10.1016/j. yhbeh.2014.06.014
 
33.
Torner L. Actions of prolactin in the brain: From physiological adaptations to stress and neurogenesis to psychopathology. Front Endocrinol (Lausanne). 2016;7(3):1–6. doi:10.3389/fendo.2016.00025.
 
34.
Larsen CM, Grattan DR. Prolactin, neurogenesis, and maternal behaviors. 2012:201–209. doi:https://doi.org/10.1016/j.bbi….
 
35.
Konstantakou P, Chalarakis N, Valsamakis G, et al. Associations of Thyroid Hormones Profile During Normal Pregnancy and Postpartum With Anxiety, Depression, and Obsessive/Compulsive Disorder Scores in Euthyroid Women. Front Neurosci. 2021;15(8):1–10. doi:10.3389/ fnins.2021.663348.
 
36.
Cleare AJ, McGregor A, Chambers SM, Dawling S, O’Keane V. Thyroxine Replacement Increases Central 5-Hydroxytryptamine Activity and Reduces Depressive Symptoms in Hypothyroidism. Neuroendocrinology. 1996;64(1):65–69. doi:10.1159/000127099
 
37.
Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ. Distribution of the Vitamin D receptor and 1α-hydroxylase in human brain. J Chem Neuroanat. 2005;29(1):21–30. doi:10.1016/j.jchemneu.2004.08.006.
 
38.
Koduah P, Paul F, Dörr JM. Vitamin D in the prevention, prediction and treatment of neurodegenerative and neuroinflammatory diseases. EPMA J. 2017;8(4):313–325. doi:10.1007/s13167-017-0120-8.
 
39.
Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: Relevance for autism. FASEB J. 2014;28(6):2398–2413. doi:10.1096/fj.13-246546.
 
40.
Huang JY, Arnold D, Qiu CF, Miller RS, Williams MA, Enquobahrie DA. Association of serum vitamin d with symptoms of depression and anxiety in early pregnancy. J Women’s Heal. 2014;23(7):588–595. doi:10.1089/jwh.2013.4598.
 
41.
Coleman VH, Carter MM, Morgan MA, Schulkin J. Obstetriciangynecologists’ screening patterns for anxiety during pregnancy. Depress Anxiety. 2008;25(2):114–123. doi:10.1002/da.20278.
 
42.
Patabendige M, Athulathmudali SR, Chandrasinghe SK. Mental Health Problems during Pregnancy and the Postpartum Period: A Multicenter Knowledge Assessment Survey among Healthcare Providers. J Pregnancy. 2020. doi:10.1155/2020/4926702
 
43.
Brunton RJ, Dryer R, Krägeloh C, Saliba A, Kohlhoff J, Medvedev O. The pregnancy-related anxiety scale: A validity examination using Rasch analysis. J Affect Disord. 2018;236:127–135. doi:10.1016/j.jad.2018.04.116.
 
44.
Mikolajkow A, Malyszczak K. Biological factors and consequences of pregnancy-related anxiety – What do we know so far? Polish Psychiatry. 2022;56(6):1289–1314
 
45.
Fallah M, Askari G, Asemi Z. Is vitamin D status associated with depression, anxiety and sleep quality in pregnancy: A systematic review. Adv Biomed Res. 2020;9(1):32. doi:10.4103/abr.abr_188_19.
 
46.
Huizink AC, Mulder EJH, Robles De Medina PG, Visser GHA, Buitelaar JK. Is pregnancy anxiety a distinctive syndrome? Early Hum Dev. 2004;79(2):81–91. doi:10.1016/j.earlhumdev.2004.04.014.
 
47.
Mikolajkow A, Fuchs T, Malyszczak K. Polish Adaption of Pregnancy- Related Anxiety Questionnaire – Revised 2 (PRAQ-R2). Polish Psychiatry. 2023;2674(305):1–10.
 
48.
Cranley MS. Development of a tool for the measurement of maternal attachment during pregnancy. Nurs Res. 1981;30(5):281–284. doi:10.1097/00006199-198109000-00008.
 
49.
Bielawska-Batorowicz E. Determinanty Spostrzegania Dziecka Przez Rodziców w Okresie Poporodowym. Wydawnictwo UŁ; 1995.
 
50.
Oates J, Gervai J, Danis I, Lakatos K, Davies John Oates J. Validation of the Mothers’ Object Relations Scales Short-form (MORS-SF). J Prenat Perinat Psychol Heal. 2018;33(1):38–50.
 
51.
Prevost M, Zelkowitz P, Tulandi T, et al. Oxytocin in pregnancy and the postpartum: Relations to labor and its management. Front Public Heal. 2014;2(1):1–9. doi:10.3389/fpubh.2014.00001.
 
52.
Saxbe D, Khaled M, Horton KT, Mendez AJ. Maternal prenatal plasma oxytocin is positively associated with prenatal psychological symptoms, but method of immunoassay extraction may affect results. Biol Psychol. doi:10.1016/j.biopsycho.2019.107718.
 
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