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Pre and postnatal maternal distress and infant gut immunity in the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort Open Access


Other title
immunoglobulin A
infant gut microbiome
maternal distress
depressive symptoms
gut immunity
psychological stress
Type of item
Degree grantor
University of Alberta
Author or creator
Kang, Liane J
Supervisor and department
Kozyrskyj, Anita (Pediatrics)
Examining committee member and department
Davenport, Margie (Physical Education and Recreation)
Persad, Sujata (Pediatrics)
Wine, Eytan (Pediatrics)
Giesbrecht, Gerald (Pediatrics)
Medical Sciences-Paediatrics

Date accepted
Graduation date
2017-06:Spring 2017
Master of Science
Degree level
Introduction: Secretory immunoglobulin A (sIgA) plays a critical role in gut mucosal immunity and is a marker of immune maturation in early life. Delayed IgA production is associated with increased risk of allergic diseases. Animal models of stressful events before birth and during infancy show changes in the maternal vaginal microbiome and in intestinal microbial composition of offspring. A human study found infants born to mothers with greater prenatal stress more likely to have gut dysbiosis, imbalance in microbial composition, but there is a gap in literature on stress-microbiome-immunity pathways in humans. This study investigated differences in infant fecal sIgA levels according to the depression and stress status of the mother pre and postnatally. Methods: Data were obtained from a sub-sample of 403 term infants from the Vancouver, Edmonton and Winnipeg sites of the general cohort in the Canadian Healthy Infant Longitudinal Development (CHILD) Study. Mothers of the infants were enrolled during pregnancy and were asked to report stress and depressive symptoms through scored-scales administered to the general CHILD cohort at several time points throughout pregnancy and postpartum. Center for Epidemiologic Studies Depression (CES-D) Scale ascertained depressive symptoms, and Perceived Stress Scale (PSS) determined perceived stress. Infant stool samples were collected at a mean age of 3.8 months, and fecal sIgA levels were measured using the Immundiagnostik sIgA ELISA kit. Using IBM SPSS version 24, Mann-Whitney U-tests detected median differences in IgA levels according to maternal distress status, and logistic regression models estimated the odds of lowest and highest quartile, lowest tertile and below median sIgA in infants. Results: About 12% of women had prenatal depressive symptoms, 9% had symptoms postpartum and 9% had symptoms both pre and postnatally. With perceived stress scores in the highest quartile, 16.7% of mothers fell in this category at prenatal only, 10.2% for postnatal only and 18.7% for both pre and postnatal. Mothers with any depressive symptoms had infants with significantly lower sIgA compared to mothers without symptoms (p=0.004). Median sIgA levels are 6.3 (IQR=3.6 – 12.4) mg/g feces, 5.2 (IQR = 2.0 – 9.8) mg/g feces, 5.7 (IQR = 2.6 – 8.6) mg/g feces, 4.4 (IQR = 2.4 – 8.0) mg/g feces for exposure to less symptoms (below cut-off), prenatal, postnatal, both pre and postnatal symptoms respectively, which are mutually exclusive categories. Median sIgA levels with higher stress were not significantly different compared to the reference group, but after stratification for the presence of other children and pets at home, significant differences were seen when the mother had both pre and postnatal higher stress. The odds of low fecal sIgA was 3.07 times higher when the mother had both pre and postnatal symptoms (95% CI: 1.25 – 7.55) compared to less symptoms (reference group), after controlling for infant age, antibiotics exposure, maternal asthma or allergy, prenatal SSRI use, pets, breastfeeding and gravida. In the same model, the odds ratio for prenatal only depressive symptoms was 2.44 (95% CI: 1.07 – 5.57). No significant odds ratios were found with higher perceived stress. Conclusion: Infants born to mothers with higher levels of depressive symptoms and perceived stress appear to have lower fecal sIgA levels independent of various study covariates. Due to the association with lower sIgA and possibly changes in the infant gut microbiome, maternal distress may put infants at higher risk of later development of allergic diseases.
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
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