When pregnant moms are stressed out, babies' brains suffer
65% of moms of fetuses with heart conditions are stressed, but so are 27% of future moms with uncomplicated pregnancies
January 13, 2020
Science Daily/Children's National Hospital
Knowing that your unborn fetus has congenital heart disease causes such pronounced maternal stress, anxiety and depression that these women's fetuses end up with impaired development in key brain regions before they are born, according to research published online Jan. 13, 2020, in JAMA Pediatrics.
While additional research is needed, the Children's National Hospital study authors say their unprecedented findings underscore the need for universal screening for psychological distress as a routine part of prenatal care and taking other steps to support stressed-out pregnant women and safeguard their newborns' developing brains.
"We were alarmed by the high percentage of pregnant women with a diagnosis of a major fetal heart problem who tested positive for stress, anxiety and depression," says Catherine Limperopoulos, Ph.D., director of the Center for the Developing Brain at Children's National and the study's corresponding author. "Equally concerning is how prevalent psychological distress is among pregnant women generally. We report for the first time that this challenging prenatal environment impairs regions of the fetal brain that play a major role in learning, memory, coordination, and social and behavioral development, making it all the more important for us to identify these women early during pregnancy to intervene," Limperopoulos adds.
Congenital heart disease (CHD), structural problems with the heart, is the most common birth defect.
Still, it remains unclear how exposure to maternal stress impacts brain development in fetuses with CHD.
The multidisciplinary study team enrolled 48 women whose unborn fetuses had been diagnosed with CHD and 92 healthy women with uncomplicated pregnancies. Using validated screening tools, they found:
65% of pregnant women expecting a baby with CHD tested positive for stress
27% of women with uncomplicated pregnancies tested positive for stress
44% of pregnant women expecting a baby with CHD tested positive for anxiety
26% of women with uncomplicated pregnancies tested positive for anxiety
29% of pregnant women expecting a baby with CHD tested positive for depression and
9% women with uncomplicated pregnancies tested positive for depression
All told, they performed 223 fetal magnetic resonance imaging sessions for these 140 fetuses between 21 and 40 weeks of gestation. They measured brain volume in cubic centimeters for the total brain as well as volumetric measurements for key regions such as the cerebrum, cerebellum, brainstem, and left and right hippocampus.
Maternal stress and anxiety in the second trimester were associated with smaller left hippocampi and smaller cerebellums only in pregnancies affected by fetal CHD. What's more, specific regions -- the hippocampus head and body and the left cerebellar lobe -- were more susceptible to stunted growth. The hippocampus is key to memory and learning, while the cerebellum controls motor coordination and plays a role in social and behavioral development.
The hippocampus is a brain structure that is known to be very sensitive to stress. The timing of the CHD diagnosis may have occurred at a particularly vulnerable time for the developing fetal cerebellum, which grows faster than any other brain structure in the second half of gestation, particularly in the third trimester.
"None of these women had been screened for prenatal depression or anxiety. None of them were taking medications. And none of them had received mental health interventions. In the group of women contending with fetal CHD, 81% had attended college and 75% had professional educations, so this does not appear to be an issue of insufficient resources," Limperopoulos adds. "It's critical that we routinely to do these screenings and provide pregnant women with access to interventions to lower their stress levels. Working with our community partners, Children's National is doing just that to help reduce toxic prenatal stress for both the health of the mother and for the future newborns. We hope this becomes standard practice elsewhere."
Adds Yao Wu, Ph.D., a research associate working with Limperopoulos at Children's National and the study's lead author: "Our next goal is exploring effective prenatal cognitive behavioral interventions to reduce psychological distress felt by pregnant women and improve neurodevelopment in babies with CHD."
https://www.sciencedaily.com/releases/2020/01/200113111143.htm
Stress during pregnancy may affect baby's sex, risk of preterm birth
October 15, 2019
Science Daily/Columbia University Irving Medical Center
A new study has identified markers of maternal stress -- both physical and psychological -- that may influence a baby's sex and the likelihood of preterm birth.
It's becoming well established that maternal stress during pregnancy can affect fetal and child development as well as birth outcomes, and a new study from researchers at Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian now identifies the types of physical and psychological stress that may matter most.
The study was published online in the journal PNAS, the Proceedings of the National Academy of Sciences.
"The womb is an influential first home, as important as the one a child is raised in, if not more so," says study leader Catherine Monk, PhD, professor of medical psychology at Columbia University Vagelos College of Physicians and Surgeons and director of Women's Mental Health in the Department of Obstetrics & Gynecology at NewYork-Presbyterian/Columbia University Irving Medical Center.
Because stress can manifest in a variety of ways, both as a subjective experience and in physical and lifestyle measurements, Monk and her colleagues examined 27 indicators of psychosocial, physical, and lifestyle stress collected from questionnaires, diaries, and daily physical assessments of 187 otherwise healthy pregnant women, ages 18 to 45.
About 17% (32) of the women were psychologically stressed, with clinically meaningful high levels of depression, anxiety, and perceived stress. Another 16% (30) were physically stressed, with relatively higher daily blood pressure and greater caloric intake compared with other healthy pregnant women. The majority (nearly 67%, or 125) were healthy.
Fewer Baby Boys with Mental Stress?
The study suggested that pregnant women experiencing physical and psychological stress are less likely to have a boy. On average, around 105 males are born for every 100 female births. But in this study, the sex ratio in the physically and psychologically stressed groups favored girls, with male-to-female ratios of 4:9 and 2:3, respectively.
"Other researchers have seen this pattern after social upheavals, such as the 9/11 terrorist attacks in New York City, after which the relative number of male births decreased," says Monk. "This stress in women is likely of long-standing nature; studies have shown that males are more vulnerable to adverse prenatal environments, suggesting that highly stressed women may be less likely to give birth to a male due to the loss of prior male pregnancies, often without even knowing they were pregnant."
Other Impacts of Stress
· Physically stressed mothers, with higher blood pressure and caloric intake, were more likely to give birth prematurely than unstressed mothers.
· Among physically stressed mothers, fetuses had reduced heart rate-movement coupling -- an indicator of slower central nervous system development -- compared with unstressed mothers.
· Psychologically stressed mothers had more birth complications than physically stressed mothers.
Social Support Matters
The researchers also found that what most differentiated the three groups was the amount of social support a mother received from friends and family. For example, the more social support a mother received, the greater the likelihood of her having a male baby.
When social support was statistically equalized across the groups, the stress effects on preterm birth disappeared. "Screening for depression and anxiety are gradually becoming a routine part of prenatal practice," says Monk. "But while our study was small, the results suggest enhancing social support is potentially an effective target for clinical intervention."
An estimated 30% of pregnant women report psychosocial stress from job strain or related to depression and anxiety, according to the researchers. Such stress has been associated with increased risk of premature birth, which is linked to higher rates of infant mortality and of physical and mental disorders, such as attention-deficit hyperactivity disorder and anxiety, among offspring.
How a mother's mental state might specifically affect a fetus was not examined in the study. "We know from animal studies that exposure to high levels of stress can raise levels of stress hormones like cortisol in the uterus, which in turn can affect the fetus," says Monk. "Stress can also affect the mother's immune system, leading to changes that affect neurological and behavioral development in the fetus. What's clear from our study is that maternal mental health matters, not only for the mother but also for her future child."
https://www.sciencedaily.com/releases/2019/10/191015171554.htm
Maternal stress leads to overweight in children
January 9, 2019
Science Daily/Helmholtz Centre for Environmental Research - UFZ
Researchers were able to identify mother's perceived stress during the first year of the child's life as a risk factor for developing overweight in infancy. Researchers found this to have long-lasting effects on girls' weight development in particular.
Overweight is unhealthy. Yet more and more people in Germany are overweight, particularly children. As part of the LiNA mother-child study coordinated by the Helmholtz Centre for Environmental Research (UFZ), researchers were able to identify mother's perceived stress during the first year of the child's life as a risk factor for developing overweight in infancy. According to the study recently published in the BMC Public Health specialist magazine, researchers from the UFZ, the University of Bristol and the Berlin Institute of Health found this to have long-lasting effects on girls' weight development in particular.
In Germany, nearly ten percent of children aged two to six are overweight, of which three percent are classified as obese. High-caloric diets and too little exercise are known to be risk factors for obesity. "Maternal stress is also thought to contribute to the development of obesity in children," explains nutritionist Dr Kristin Junge from the Department of Environmental Immunology at the UFZ. "In terms of child development, the period between pregnancy and the first years of life is particularly sensitive to external influences, which may lead to illness or obesity." And this may include psychological influences such as maternal stress. In their current study, UFZ researchers are investigating whether and how perceived maternal stress during pregnancy and the first two years of life, affects the child's weight development up to the age of five. To do so, they analysed data available from the LiNA mother-child study.
LiNA is a long-term study in which sensitive childhood development phases are investigated with special consideration given to lifestyle, environmental pollution and the subsequent occurrence of allergies, respiratory diseases and obesity. Since 2006, UFZ researchers in cooperation with the Städtisches Klinikum St. Georg in Leipzig, and more recently with the Universitätsklinikum Leipzig, have been following several hundred mother-child pairs from pregnancy onwards to investigate the effects of environmental influences and lifestyle habits on health and well-being. As part of the research, regular surveys are completed, pollutant measurements are taken in the living environment, and the mothers and children undergo clinical examinations. The current UFZ study is based on data from 498 mother-child pairs from the LiNA study. Using the data for height and weight, the researchers determined the children's Body Mass Index (BMI) and standardised the results by age and gender. Mothers' perceived stress was assessed by validated questionnaires and included topics such as worries and fears, feelings of tension, general satisfaction as well as coping with daily demands. "We compared the data on mothers' perceived stress during pregnancy and in the first two years of the child's life with the child's BMI development up to the age of five, and investigated whether there was a correlation," explains biochemist Dr Beate Leppert, the study's lead author.
First year of life particularly influential
And the study results show: There is actually a correlation. If mothers' perceived stress was high during the child's first year of life, there was a high probability that her child would develop a higher BMI in the first five years of their life. "The effects of maternal stress seem to have a long-term impact," says Kristin Junge. The correlation between perceived maternal stress in the child's first year of life and an increased BMI was especially evident in girls. "It seems that daughters of stressed mothers in particular are at increased risk of becoming overweight," says Dr Saskia Trump, senior author of the current study,who now works at the Berlin Institute for Health Research. "There are studies that demonstrate that psychological factors such as perceived maternal stress may be experienced less intensely or may be better compensated by boys." Perceived maternal stress during pregnancy or during the child's second year of life showed little evidence for an effect on the weight development of either gender. "The first year of life seems to be a sensitive phase and a characteristic factor for the tendency to be overweight," says Dr Junge. After all, mothers and children usually spend the entire first year together -- a lot of time in which the mother's perceived stress and/or associated behaviour is experienced by the child. "During this time, special attention should therefore be paid to the mother's condition," adds Dr Trump.
Identified stress factors
But what causes perceived maternal stress in the first place? To answer this question, researchers examined further data from the mother-child study and searched for possible influencing factors, such as household income, level of education, and the quality of the living environment. The results showed that mothers with a considerably higher perceived stress level were often exposed to high levels of traffic or noise, had poor living conditions or had a low household income. Maternal stress caused by difficult living conditions or an unfavourable living environment can lead to children becoming overweight in the long term. "Stress perceived by mothers should be taken seriously," says Dr Junge. "Midwives, gynaecologists, paediatricians and GPs should be particularly attentive to signs of stress in the first year following the child's birth." After all, if mothers are helped early on or are offered support, we may be able to kill two birds with one stone: To improve maternal well-being and also prevent their children becoming overweight. Following from this study, the UFZ team will continue to investigate whether the effects of perceived maternal stress also extend beyond the age of five.
https://www.sciencedaily.com/releases/2019/01/190109102419.htm
Skin-to-skin contact with baby in neonatal unit decreases maternal stress levels
Already linked to happier, healthier newborns, study finds that snuggling with babies in intensive care eases mothers' anxiety that can interfere with parent-child bonding
October 23, 2015
Science Daily/American Academy of Pediatrics
Research shows that stable parent-child bonds are fundamental to healthy child development. For parents of babies born prematurely or with special medical needs, this early bonding can be interrupted by the complex medical care required in a neonatal intensive care unit.
An ongoing study conducted at a large metropolitan NICU, however, shows that a little skin-to-skin snuggling between mothers and babies can go a long way toward reducing maternal stress levels.
The study, to be presented at the American Academy of Pediatrics (AAP) National Conference & Exhibition, examined mothers' stress levels before and after they held their babies "kangaroo style" (skin-to-skin inside the pouch of the parent's shirt) for at least one hour.
"We found that all of the mothers reported an objective decrease in their stress level after skin-to-skin contact with their babies," said neonatologist Natalia Isaza, MD, FAAP of Children's National Health System in Washington, DC. This was especially true regarding the reported stress of being separated from their infants, feeling helpless and unable to protect their infant from pain and painful procedures, and the general experience in the NICU, she said.
Birthweights of the infants ranged from less than 1 pound to over 8 pounds (0.38 to 3.7 kg), and their ages varied from 3 to 109 days. The infants were being treated for a diversity of health issues, with more than half requiring oxygen support.
"We already know there are physiological benefits in the newborns when they are held skin-to-skin," Dr. Isaza said, such as stabilization of heart rate, breathing patterns and blood oxygen levels, gains in sleep time and weight, decreased crying, greater breastfeeding success and earlier hospital discharge. "Now we have more evidence that skin-to-skin contact can also decrease parental stress that can interfere with bonding, health and emotional wellness, and the interpersonal relations of parents, as well as breastfeeding rates."
"This is a simple technique to benefit both parent and child that perhaps should be encouraged in all NICUs," Dr. Isaza said.
http://www.sciencedaily.com/releases/2015/10/151023083247.htm