Skip to main content Accessibility help

Maternal depression and foetal responses to novel stimuli: insights from a socio-economically disadvantaged Indian cohort

  • M. Fernandes (a1), A. Stein (a2), K. Srinivasan (a3), G. Menezes (a4), M. Renton (a2), J. Zani (a5) and P. G. Ramchandani (a5)...


Maternal stress during pregnancy has pervasive effects on stress responsivity in children. This study is the first to test the hypothesis that maternal prenatal depression, as observed in South India, may be associated with how foetuses respond to a potentially stressful stimulus. We employed measures of foetal heart rate at baseline, during exposure to a vibroacoustic stimulus, and post-stimulation, to study patterns of response and recovery in 133 third trimester foetuses of depressed and non-depressed mothers. We show that the association between maternal depression and foetal stress responsivity is U-shaped with foetuses of mothers with high and low depression scores demonstrating elevated responses, and poorer recovery, than foetuses of mothers with moderate levels. The right amount of intra-uterine stimulation is important in conditioning foetuses towards optimal regulation of their stress response. Our results imply that, in certain environmental contexts, exposure to moderate amounts of intra-uterine stress may facilitate this process.


Corresponding author

*Address for correspondence: M. Fernandes, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Level 3, Women’s Centre, The John Radcliffe Hospital, Oxford, OX3 9DU, UK. (Email


Hide All
1. Talge, NM, Neal, C, Glover, V. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry. 2007; 48, 245261.
2. Gluckman, PD, Hanson, MA, Pinal, C. The developmental origins of adult disease. Maternal Child Nutr. 2005; 1, 130141.
3. Glover, V. Prenatal stress and the origins of psychopathology: an evolutionary perspective. J Child Psychol Psychiatry. 2011; 52, 356367.
4. Glover, V, O’Connor, TG, O’Donnell, K. Prenatal stress and the programming of the HPA axis. Neurosci Biobehav Rev. 2010; 35, 1722.
5. DiPietro, JA, Costigan, KA, Gurewitsch, ED. Fetal response to induced maternal stress. Early Hum Dev. 2003; 74, 125138.
6. DiPietro, JA, Hodgson, DM, Costigan, KA, Hilton, SC, Johnson, TRB. Development of fetal movement - fetal heart rate coupling from 20 weeks through term. Early Hum Dev. 1996; 44, 139151.
7. DiPietro, JA, Hodgson, DM, Costigan, KA, Hilton, SC, Johnson, TRB. Fetal neurobehavioral development. Child Dev. 1996; 67, 25532567.
8. Monk, C, Fifer, W, Myers, M, et al. Maternal stress responses and anxiety during pregnancy: effects on fetal heart rate. Dev Psychobiol. 2000; 36, 6777.
9. Monk, C, Myers, MM, Sloan, RP, Ellman, LM, Fifer, WP. Effects of women’s stress-elicited physiological activity and chronic anxiety on fetal heart rate. J Dev Behav Pediatr. 2003; 24, 3238.
10. Sandman, CA, Glynn, L, Wadhwa, PD, et al. Maternal hypothalamic-pituitary-adrenal disregulation during the third trimester influences human fetal responses. Dev Neurosci. 2003; 25, 4149.
11. Sandman, CA, Wadhwa, PD, Chicz-DeMet, A, Dunkel-Schetter, C, Porto, M. Maternal stress, hpa activity, and fetal/infant outcome. Ann N Y Acad Sci. 1997; 814, 266275.
12. Allister, L. The effects of maternal depression on fetal heart rate response to vibroacoustic stimulation. Dev Neuropsychol. 2001; 20, 639651.
13. DiPietro, JA, Kivlighan, KT, Costigan, KA, et al. Prenatal antecedents of newborn neurological maturation. Child Dev. 2010; 81, 115130.
14. Del Giudice, M. Fetal programming by maternal stress: insights from a conflict perspective. Psychoneuroendocrinology. 2012; 37, 16141629.
15. Bennett, HA, Einarson, A, Taddio, A, Koren, G, Einarson, TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2004; 103, 698709.
16. Imran, N, Haider, II. Screening of antenatal depression in Pakistan: risk factors and effects on obstetric and neonatal outcomes. Asia Pac Psychiatry. 2010; 2, 2632.
17. Patel, V, Rodrigues, M, DeSouza, N. Gender, poverty, and postnatal depression: a study of mothers in Goa, India. Am J Psychiatry. 2002; 159, 4347.
18. Gausia, K, Fisher, C, Ali, M, Oosthuizen, J. Magnitude and contributory factors of postnatal depression: a community-based cohort study from a rural subdistrict of Bangladesh. Psychol Med. 2009; 39, 9991007.
19. Goldenberg, RL. Social and psychological factors and pregnancy outcome. In Complications of Pregnancy: Medical, Surgical, Gynecologic, Psychosocial and Perinatal (ed. Merkatz CIR), 1991; pp. 8096. Williams & Wilkins: Baltimore.
20. Desai, SB, Dubey, A, Joshi, BL, et al. Income Poverty and Inequality. Human Development in India Challenges for a Society in Transition. 2010. Oxford University Press: OUP, New Delhi, India. pp. 1112.
21. Murray, D, Cox, JL. Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). J Reprod Infant Psychol. 1990; 8, 99107.
22. Baggaley, RF, Ganaba, R, Filippi, V, et al. Detecting depression after pregnancy: the validity of the K10 and K6 in Burkina Faso. Trop Med Int Health. 2007; 12, 12251229.
23. Parer, JT, Nageotte, MP. Intrapartum fetal surveillance. In Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice (eds. Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR), 2009; pp. 397417. Saunders Elsevier: Philadelphia, USA.
24. Meek, LR, Burda, KM, Paster, E. Effects of prenatal stress on development in mice: maturation and learning. Physiol Behav. 2000; 71, 543549.
25. Fujioka, T, Fujioka, A, Tan, N, et al. Mild prenatal stress enhances learning performance in the non-adopted rat offspring. Neuroscience. 2001; 103, 301307.
26. Fujioka, A, Fujioka, T, Ishida, Y, Maekawa, T, Nakamura, S. Differential effects of prenatal stress on the morphological maturation of hippocampal neurons. Neuroscience. 2006; 141, 907915.
27. Gunnar, MR, Frenn, K, Wewerka, SS, Van Ryzin, MJ. Moderate versus severe early life stress: associations with stress reactivity and regulation in 10–12-year-old children. Psychoneuroendocrinology. 2009; 34, 6275.
28. DiPietro, JA, Novak, MFSX, Costigan, KA, Atella, LD, Reusing, SP. Maternal psychological distress during pregnancy in relation to child development at age 2. Child Dev. 2006; 77, 573587.
29. United Nations. Report WFD. World Fertility Data 2008: United Nations, Department of Economic and Social Affairs, Population Division; 2009.


Type Description Title
Supplementary materials

Fernandes Supplementary Material
Table S1

 Word (17 KB)
17 KB

Maternal depression and foetal responses to novel stimuli: insights from a socio-economically disadvantaged Indian cohort

  • M. Fernandes (a1), A. Stein (a2), K. Srinivasan (a3), G. Menezes (a4), M. Renton (a2), J. Zani (a5) and P. G. Ramchandani (a5)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed