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Maternal Psychopathology Influences Infant Heart Rate Variability: Generation R Study

From the Generation R Study Group (B.D., A.T., V.W.J.); Department of Child and Adolescent Psychiatry (B.D., M.P.v.d.B., A.T., F.C.V., H.T.); Department of Psychiatry (J.H.M.T., M.P.v.d.B., V.W.J.); Department of Epidemiology (A.H., H.T.); and the Department of Pediatrics (V.W.J., H.A.M.), Erasmus MC, Rotterdam, Netherlands.

Address correspondence and reprint requests to Henning Tiemeier, Department of Child and Adolescent Psychiatry, Erasmus MC, P.O. Box 2060, 3000 CB Rotterdam, Netherlands. E-mail: h.tiemeier{at}erasmusmc.nl

Objective: To assess the determinants of heart rate (HR) and heart rate variability (HRV) in children. The autonomic nervous system as measured by HR and HRV is considered a biological marker of psychopathology in children.

Methods: We examined the relationship of maternal psychopathology with infant HR and HRV. HR was recorded at 14 months in 528 infants. The high-frequency component of HRV was used as an indicator of cardiac vagal modulation. The presence of a lifetime maternal psychiatric diagnosis was assessed with the Composite International Diagnostic Interview. Presence of maternal psychiatric symptoms during pregnancy and 2 months after birth was assessed, using the Brief Symptom Inventory.

Results: A maternal history of a psychiatric disorder was associated with a 0.24-standard deviation (SD) higher mean HR in the infant (β = 0.24, 95% Confidence Interval (CI) = 0.03, 0.4, p = .025) and a 0.14-SD lower high-frequency power (β = –0.14, 95% CI = –0.6, –0.03, p = .003). Likewise, postnatal maternal anxiety and depression symptoms were associated with infant mean HR. A 1-point increase in the mean anxiety symptom score was associated with 0.14-SD higher mean HR in the infant (β = 0.14, 95% CI = 0.05, 0.2, p = .004), and a 1-point increase in mean depression score with a 0.11-SD increase (β = 0.11, 95% CI = 0.01, 0.2, p = .025). No significant associations of prenatal maternal affective symptoms with infants autonomic functioning were found.

Conclusion: Maternal lifetime psychiatric diagnosis and postnatal psychiatric symptoms are associated with infant autonomic functioning, namely, higher mean HR and lower vagal modulation.

Key Words: heart rate • heart rate variability • infant • maternal psychopathology • prenatal • postnatal

Abbreviations: ANS = autonomic nervous system; BSI = Brief Symptom Inventory; CIDI = Composite International Diagnostic Interview; HF = high frequency; HR = heart rate; HRV = heart rate variability; IBQ = Infant Behavior Questionnaire; WHO = World Health Organization.