In order to achieve the objectives of the present study, a cohort of mother-fetus/infant dyads has been recruited in early pregnancy and followed up in mid and late pregnancy and within 6 weeks post delivery. Presentations of the project were given at various clinical sites in Berlin (obstetric practices, midwives, prenatal care centers, birth hospitals, and counseling services, such as Profamilia Berlin) to involve them in identifying potential study subjects for enrollment into the study.
Overall, a total of N=473 women were screened for eligibility of whom 265 women were recruited to participate. After completing the Childhood Trauma Interview (CTI) to determine study group membership, 66 women were not eligible to continue further, leaving a total sample size of N=199 women included in the study. 165 participants remained in the study until the end of the study, 34 women dropped out or were lost to follow-up.
Of the 199 women in the study, 108 were included in the CT+ group and 91 in the CT- group. Magnetic resonance imaging (MRI) was performed in 104 neonates born to these mothers.
Serial measures of maternal psychological, behavioral and physiological characteristics have been collected across early, mid and late gestation. The following biological assays have been completed: Saliva samples collected during participants’ everyday life over a four-day period in early and late pregnancy have been analyzed for cortisol concentrations for all participants. From maternal blood and cord blood samples, metabolic and proinflammatory markers have been assessed and analyses addressing the main study objectives are still ongoing with the results emerging supporting the main hypotheses of the grant. For example, women exposed to maltreatment exhibited lower cortisol concentrations in early pregnancy and a stronger increase in cortisol output from early to late pregnancy. Because alterations in gestational stress biology, such as the observed differences in cortisol concentrations, may in turn affect fetal brain development, we investigated the association of maternal cortisol concentrations during pregnancy and white matter microstructure parameters in one month old neonates. We observed lower maturity of selected white matter fiber tracts in newborns whose mothers had higher cortisol concentrations during pregnancy. Additional analyses have been performed with other datasets and support the moderating role of CT-related sequelae, especially depression, in the association between CT and inflammation during pregnancy as well as in the association between CT and white matter development in the offspring. The same analyses are currently being conducted in the current cohort.
Continuously across the duration of the grant, presentations have been given at national and international research meetings. Furthermore, regular presentations at local institutions that support pregnant and postpartum women (e.g. Frühe Hilfen, Babylotsen) have been given to increase awareness of the high prevalence of childhood maltreatment and how this may affect well-being of pregnant women and their children.
