{
    "abstract": "The placenta acts as a buffer to regulate the degree of fetal exposure to maternal cortisol through the 11-Beta Hydroxysteroid Dehydrogenase isoenzyme type 2 (11-\u03b2 HSD2) enzyme. We conducted a systematic review and meta-analysis to assess the effect of prenatal psychological distress (PPD) on placental 11-\u03b2 HSD2 gene expression and explore the related mechanistic pathways involved in fetal neurodevelopment.\nWe searched PubMed, Embase, Scopus, APA PsycInfo\u00ae, and ProQuest Dissertations for observational studies assessing the association between PPD and 11-\u03b2 HSD2 expression in human placentas. Adjusted regression coefficients (\u03b2) and corresponding 95% confidence intervals (CIs) were pooled based on three contextual PPD exposure groups: prenatal depression, anxiety symptoms, and perceived stress.\nOf 3159 retrieved records, sixteen longitudinal studies involving 1869 participants across seven countries were included. Overall, exposure to PPD disorders showed weak negative associations with the placental 11-\u03b2 HSD2 gene expression as follows: prenatal depression (\u03b2 -0.01, 95% CI 0.05-0.02, I2=0%), anxiety symptoms (\u03b2 -0.02, 95% CI 0.06-0.01, I2=0%), and perceived stress (\u03b2 -0.01 95% CI 0.06-0.04, I2=62.8%). Third-trimester PPD exposure was more frequently associated with lower placental 11-\u03b2 HSD2 levels. PPD and placental 11-\u03b2 HSD2 were associated with changes in cortisol reactivity and the development of adverse health outcomes in mothers and children. Female-offspring were more vulnerable to PPD exposures.\nThe study presents evidence of a modest role of prenatal psychological distress in regulating placental 11-\u03b2 HSD2 gene expression. Future prospective cohorts utilizing larger sample sizes or advanced statistical methods to enhance the detection of small effect sizes should be planned. Additionally, controlling for key predictors such as the mother's ethnicity, trimester of PPD exposure, mode of delivery, and infant sex is crucial for valid exploration of PPD effects on fetal programming.",
    "authors": [
        {
            "affiliation": "Department of Population Medicine, College of Medicine, QU Health, Qatar University,\u00a0P. O. Box:2713,\u00a0Doha,\u00a0Qatar. Electronic address: aa1304397@qu.edu.qa.",
            "firstname": "Angham Ibrahim",
            "initials": "AI",
            "lastname": "Tartour"
        },
        {
            "affiliation": "Department of Population Medicine, College of Medicine, QU Health, Qatar University,\u00a0P. O. Box:2713,\u00a0Doha,\u00a0Qatar.",
            "firstname": "Tawanda",
            "initials": "T",
            "lastname": "Chivese"
        },
        {
            "affiliation": "Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar.",
            "firstname": "Safa",
            "initials": "S",
            "lastname": "Eltayeb"
        },
        {
            "affiliation": "Office of Research Ethics and Integrity, Qatar University,\u00a0P. O. Box:2713,\u00a0Doha,\u00a0Qatar.",
            "firstname": "Fatima M",
            "initials": "FM",
            "lastname": "Elamin"
        },
        {
            "affiliation": "Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar.",
            "firstname": "Eleni",
            "initials": "E",
            "lastname": "Fthenou"
        },
        {
            "affiliation": "Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University,\u00a0P. O. Box:2713,\u00a0Doha,\u00a0Qatar.",
            "firstname": "Mohammed",
            "initials": "M",
            "lastname": "Seed Ahmed"
        },
        {
            "affiliation": "Department of Population Medicine, College of Medicine, QU Health, Qatar University,\u00a0P. O. Box:2713,\u00a0Doha,\u00a0Qatar.",
            "firstname": "Giridhara Rathnaiah",
            "initials": "GR",
            "lastname": "Babu"
        }
    ],
    "conclusions": "The study presents evidence of a modest role of prenatal psychological distress in regulating placental 11-\u03b2 HSD2 gene expression. Future prospective cohorts utilizing larger sample sizes or advanced statistical methods to enhance the detection of small effect sizes should be planned. Additionally, controlling for key predictors such as the mother's ethnicity, trimester of PPD exposure, mode of delivery, and infant sex is crucial for valid exploration of PPD effects on fetal programming.",
    "copyrights": "Copyright \u00a9 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.",
    "doi": "10.1016/j.psyneuen.2024.107060",
    "journal": "Psychoneuroendocrinology",
    "keywords": [
        "11\u03b2-Hydroxysteroid Dehydrogenase Type 2",
        "Early-life exposures",
        "Fetal reprogramming",
        "Gene expression",
        "Placenta",
        "Prenatal psychological distress"
    ],
    "methods": null,
    "publication_date": "2024-04-28",
    "pubmed_id": "38677195",
    "results": "Of 3159 retrieved records, sixteen longitudinal studies involving 1869 participants across seven countries were included. Overall, exposure to PPD disorders showed weak negative associations with the placental 11-\u03b2 HSD2 gene expression as follows: prenatal depression (\u03b2 -0.01, 95% CI 0.05-0.02, I2=0%), anxiety symptoms (\u03b2 -0.02, 95% CI 0.06-0.01, I2=0%), and perceived stress (\u03b2 -0.01 95% CI 0.06-0.04, I2=62.8%). Third-trimester PPD exposure was more frequently associated with lower placental 11-\u03b2 HSD2 levels. PPD and placental 11-\u03b2 HSD2 were associated with changes in cortisol reactivity and the development of adverse health outcomes in mothers and children. Female-offspring were more vulnerable to PPD exposures.",
    "title": "Prenatal psychological distress and 11\u03b2-HSD2 gene expression in human placentas: Systematic review and meta-analysis.",
    "xml": "<Element 'PubmedArticle' at 0x788505cfab10>"
}