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Depression sufferers at risk of multiple chronic diseases

May 30, 2019

Science Daily/University of Queensland

Women who experience symptoms of depression are at risk of developing multiple chronic diseases, research led by The University of Queensland has found.

 

UQ School of Public Health PhD scholar Xiaolin Xu said women who experienced symptoms of depression, even without a clinical diagnosis, were at risk of developing multiple chronic diseases.

 

"These days, many people suffer from multiple chronic diseases such as diabetes, heart disease, stroke and cancer," Mr Xu said.

 

"We looked at how women progress in the development of these chronic diseases before and after the onset of depressive symptoms."

 

The Australian Longitudinal Study on Women's Health followed healthy, middle-aged women with no previous diagnosis of depression or chronic illness over 20 years.

 

The study found 43.2 per cent of women experienced elevated symptoms of depression and just under half the cohort reported they were diagnosed or taking treatment for depression.

 

Women from the depressed group were 1.8 times more likely to have multiple chronic health conditions before they first experienced depressive symptoms.

 

"Experiencing depressive symptoms appeared to amplify the risk of chronic illness," Mr Xu said.

 

"After women started experiencing these symptoms, they were 2.4 times more likely to suffer from multiple chronic conditions compared to women without depressive symptoms."

 

The research suggests depression and chronic diseases share a similar genetic or biological pathway.

 

"Inflammation in the body has been linked to the development of both depression and chronic physical diseases," he said.

 

"Chronic diseases, like diabetes and hypertension, are also commonly associated with depression."

 

These findings help strengthen healthcare professionals understanding of mental and physical health.

 

"Healthcare professionals need to know that clinical and sub-clinical depression (elevated depressive symptoms) can be linked to other chronic physical conditions," he said.

 

"When treating patients for these symptoms, healthcare professionals must realise these people are at risk of developing further chronic illness."

 

Women with both conditions were more likely to come from low-income households, be overweight and inactive, smoke tobacco and drink alcohol.

 

"Maintaining a healthy weight, exercising regularly, eating a balanced diet, and reducing harmful behaviours could help prevent and slow the progression of multiple chronic diseases."

https://www.sciencedaily.com/releases/2019/05/190530101121.htm

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Among older women, 10,000 steps per day not needed for lower mortality

Older women who took 4,400 steps per day had lower mortality than those taking 2,700; risk of death continued to decrease with more steps up to 7,500 steps per day before levelling off

May 29, 2019

Science Daily/Brigham and Women's Hospital

A new study found that older women, taking as few as 4,400 steps per day was significantly associated with lower risk of death compared to taking 2,700 steps per day. Risk of death continued to decrease with more steps taken but leveled off at around 7,500 steps per day -- less than the 10,000 steps default goal in many wearables.

 

In the world of step goals and activity trackers, the number 10,000 can sound like a magic one. Many wearable devices that track the number of steps a person takes each day come pre-programmed with a daily goal of 10,000 steps. But while a large body of evidence shows that physical activity is good for a person's health and longevity, few studies have examined how many steps a day are associated with good health, particularly long-term health outcomes. A new study led by investigators from Brigham and Women's Hospital sought to address this knowledge gap by examining outcomes over an average of more than four years for older women in the Women's Health Study who had measured their steps for a full week. The team reports that, among older women, taking as few as 4,400 steps per day was significantly associated with lower risk of death compared to taking 2,700 steps per day. Risk of death continued to decrease with more steps taken but leveled off at around 7,500 steps per day -- less than the 10,000 steps default goal in many wearables. The team's results are presented today at the American College of Sports Medicine Annual Meeting and published simultaneously in JAMA Internal Medicine.

 

"Taking 10,000 steps a day can sound daunting. But we find that even a modest increase in steps taken is tied to significantly lower mortality in older women," said I-Min Lee, MBBS, ScD, an epidemiologist in the Division of Preventive Medicine at the Brigham. "Our study adds to a growing understanding of the importance of physical activity for health, clarifies the number of steps related to lower mortality and amplifies the message: Step more -- even a little more is helpful."

 

According to previous studies, the average number of steps taken by people in the U.S. is between 4,000 and 5,000 per day. The origin of the 10,000-step goal is unclear but may trace back to 1965, when a Japanese company began marketing a pedometer called Manpo-kei, which translates to "10,000 steps meter" in Japanese.

 

To conduct their study, Lee and colleagues included participants from the Women's Health Study, a randomized trial originally conducted to evaluate risk of cardiovascular disease and cancer among women taking low-dose aspirin and vitamin E. When the original trial ended, participants were invited to participate in a long-term observational study. For the present study of steps and health, almost 18,000 women were asked to wear an ActiGraph GT3X+ accelerometer device -- a research grade wearable -- on their hips for seven consecutive days during all waking hours. The team analyzed 16,741 of the women who were compliant with wearing the device; their average age was 72.

 

Participants were followed for an average of more than four years, during which time 504 women died. Participants in the bottom 25 percent of steps walked (average of 2,700 steps per day) were at greatest risk of death, with 275 women dying. Those who walked modestly more (average of 4,400 per day) were at 41 percent lower risk of death. Risk of death continued to decrease with more steps walked, up to 7,500 steps per day, after which risk leveled off. The team also found that for women who walked the same number of steps per day, the intensity -- how fast or slow they walked -- was not associated with risk of death.

 

Due to the observational nature of the study, the authors cannot definitively separate cause from correlation (that is, to differentiate between "do more steps lower mortality?" or "do women in better health step more?"). However, the team did take several measures to try to ensure that the association observed was more likely causal than not, such as excluding women with heart disease, cancer, diabetes and less than excellent or good self-rated health and excluding the first year of follow-up data. The findings also are supported by previous experiments showing physical activity causes beneficial changes in short-term markers of health e.g., blood pressure, insulin/glucose levels, lipid profile, inflammation, and more.

 

The Women's Health Study included primarily older, white women, and further studies will be needed in younger and diverse populations to determine if the findings are applicable to other groups, especially those who may, on average, take more steps. Other outcomes -- such as quality of life and risk of specific diseases -- were not assessed, but will be addressed in future studies.

 

"Of course, no single study stands alone. But our work continues to make the case for the importance of physical activity," said Lee. "Clearly, even a modest number of steps was related to lower mortality rate among these older women. We hope these findings provide encouragement for individuals for whom 10,000 steps a day may seem unattainable."

https://www.sciencedaily.com/releases/2019/05/190529180228.htm

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Thoughts on body image in pregnancy important indicator of emotional wellbeing

May 23, 2019

Science Daily/University of York

Researchers have shown that a new way of assessing women's relationship with their bodies during pregnancy could help predict how well the mother might bond with her unborn baby and her longer-term emotional wellbeing.

 

Results from the study suggest that introducing a standardised method of assessing women's feelings towards their changing bodies during antenatal care could provide important information on how they might respond to being a new mum.

 

The BUMPS method, developed by scientists at the University of York and Anglia Ruskin University, is a self-reporting system based on questions relating to satisfaction with appearing pregnant, weight gain concerns, and the physical burdens of pregnancy.

 

In a study of more than 600 pregnant women, data from the BUMPS questionnaire revealed that women who felt more positively about their body changes in pregnancy were more likely to have better relationships with their partners; lower depression and anxiety scores; and were better at interpreting their bodily signals.

 

Combined scores from the questionnaire provided a strong predictor of whether a pregnant woman would have a positive attachment to their unborn child or not. Low scores, suggested that these women may need additional emotional support during pregnancy and monitoring after birth for signs of postnatal depression.

 

Dr Catherine Preston, an expert in body image from the University of York's Department of Psychology, said: "Our previous research has demonstrated that there is a relationship between how we perceive our bodies and our emotional state, but bodily experience is not systematically considered during pregnancy even though it is a time when dramatic bodily changes occur.

 

"Women are under constant pressure about their appearance and during pregnancy and after birth is no exception. It is important therefore that pregnancy care is not just about the physical health of the mother and the health of the unborn child, but also about women's emotional wellbeing, which can give us a lot of important information about how they might react to being a new mum in the longer-term."

 

The questionnaire was taken at each trimester of pregnancy to understand how perceptions of the body might change through the different stages. Questions in the study range from the type of clothes that a woman decides to wear during pregnancy, to concerns about the size of their 'bump,' and any frustrations they might have at not being able to be as physically active as they once were.

 

Dr Preston said: "There is growing evidence that women's experience of their body during pregnancy can have a positive or negative impact on both maternal and infant wellbeing, so more should be done within our care systems to protect women against the more negative effects.

 

"There are many midwives who independently do a fantastic job of offering this support, but currently there is no standardised method or criteria for measuring this to inform the level of care required.

 

"Our next step in this work is define those boundaries -- what does a pregnant woman need to score in our scale in order to prompt further investigation or support? We are also interested to investigate whether we see variations in attitudes to body image in pregnancies of women from different cultural backgrounds and what impact this might have in post-natal care."

 

The team also plan to assess more women post-pregnancy to understand the longer-term impacts of negative and positive body image on both mother and child.

https://www.sciencedaily.com/releases/2019/05/190523104931.htm

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Exposure to air pollution before and after birth may affect fundamental cognitive abilities

May 23, 2019

Science Daily/Barcelona Institute for Global Health (ISGlobal)

A growing body of research suggests that exposure to air pollution in the earliest stages of life is associated with negative effects on cognitive abilities. A new study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by "la Caixa," has provided new data: exposure to particulate matter with a diameter of less than 2.5 μm (PM2.5) during pregnancy and the first years of life is associated with a reduction in fundamental cognitive abilities, such as working memory and executive attention.

 

The study, carried out as part of the BREATHE project, has been published in Environmental Health Perspectives. The objective was to build on the knowledge generated by earlier studies carried out by the same team, which found lower levels of cognitive development in children attending schools with higher levels of traffic-related air pollution.

 

The study included 2,221 children between 7 and 10 years of age attending schools in the city of Barcelona. The children's cognitive abilities were assessed using various computerized tests. Exposure to air pollution at home during pregnancy and throughout childhood was estimated with a mathematical model using real measurements.

 

The study found that greater PM2.5 exposure from pregnancy until age 7 years was associated with lower working memory scores on tests administered between the ages of 7 and 10 years. The results suggest that exposure to fine particulate matter throughout the study period had a cumulative effect, although the associations were stronger when the most recent years of exposure were taken into account. Working memory is a cognitive system responsible for temporarily holding information for subsequent manipulation. It plays a fundamental role in learning, reasoning, problem-solving and language comprehension.

 

Sex-stratified analysis showed that the relationship between PM2.5 exposure and diminished working memory was found only in boys. "As yet, we don't understand what causes these differences, but there are various hormonal and genetic mechanisms that could lead to girls having a better response to inflammatory processes triggered by fine particulate matter and being less susceptible to the toxicity of these particles," commented Ioar Rivas, ISGlobal researcher and lead author of the study.

 

The study also found that higher exposure to particulate matter was associated with a reduction in executive attention in both boys and girls. Executive attention is one of the three networks that make up a person's attention capacity. It is involved in high-level forms of attention, such as the detection and resolution of conflicts between options and responses, error detection, response inhibition, and the regulation of thoughts and feelings.

 

Whereas previous studies in the BREATHE project analysed exposure to air pollution at schools over the course of a year, this study assessed exposures at the participants' homes over a much longer time: from the prenatal period to 7 years of age.

 

"This study reinforces our previous findings and confirms that exposure to air pollution at the beginning of life and throughout childhood is a threat to neurodevelopment and an obstacle that prevents children from reaching their full potential," commented Jordi Sunyer, Childhood and Environment Programme Coordinator at ISGlobal and last author of the study.

https://www.sciencedaily.com/releases/2019/05/190523104925.htm

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Prior eating disorders linked to long-term depression risk for mothers

May 13, 2019

Science Daily/University College London

A history of eating disorders and body image concerns before or during pregnancy are associated with future depressive symptoms among mothers, finds a new UCL-led study published in the British Journal of Psychiatry.

 

"We found that women who have had an eating disorder at any point before childbirth, even if it was years earlier in adolescence, were more likely to experience depressive symptoms during pregnancy and up to 18 years after the birth of their child," said the study's lead author Dr Francesca Solmi (UCL Psychiatry).

 

"This finding suggests that many people with eating disorders might not fully recover since we know that eating disorders and depression often happen at the same time."

 

The researchers used data from the 'Children of the 90s' cohort study, including 9,276 women.

 

Previous studies had suggested that depressive symptoms among mothers with eating disorders might improve after the perinatal period, but those studies didn't have such a long follow-up time to confirm that the increased risk of depressive symptoms does in fact persist for women who have had an eating disorder.

 

The research team found that women who had ever had anorexia nervosa or bulimia nervosa experienced more depressive symptoms over an 18-year follow-up than those who had never had an eating disorder.

 

"Depressive symptoms in mothers have been shown to be associated with a number of negative outcomes for their children, such as emotional and behavioural problems. It is therefore important, to identify and treat eating disorders early, as these could be one potential cause of the depressive symptoms," said Dr Solmi.

 

"We should also identify pregnant women with an eating disorder, so that they can be provided with mental health support. This could benefit both mother and child in the long run."

 

Dr Abigail Easter, one of the authors of the paper who has developed training materials to help identify eating disorders in pregnancy, added: "There is a need for more training for practitioners and midwives on how to recognise eating disorders in pregnancy, which could help to reduce the long-term impact of mental ill-health."

 

Current guidelines from the National Institute for Health and Care Excellence (NICE) recommend that health care professionals use a questionnaire to identify depressive symptoms in pregnant women. The current study supports the value of this, as well as for identifying eating disorders.

 

"There's a lot of stigma around both depression and eating disorders, so many people might not feel comfortable talking about it or seeking help. Assessment of mental illness in pregnancy, as standard practice, could help health professionals pick up on signs of depression and/or eating disorders at this crucial stage of life," said first author Yu Wei Chua, who began the study at UCL before moving over to the University of Strathclyde.

 

The study was conducted by researchers at UCL, University of Strathclyde and King's College London, and was funded by Wellcome and the National Institute for Health Research UCLH Biomedical Research Centre.

https://www.sciencedaily.com/releases/2019/05/190513212359.htm

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People fail to recognize male postnatal depression

New research shows significant gender differences

May 13, 2019

Science Daily/Anglia Ruskin University

A new study shows that people are almost twice as likely to correctly identify signs of postnatal depression in women than in men.

 

The research, published in the Journal of Mental Health and led by Professor Viren Swami of Anglia Ruskin University, involved 406 British adults aged between 18 and 70.

 

The participants were presented with case studies of a man and a woman both displaying symptoms of postnatal depression, a mental health issue which affects as many as 13% of new parents.

 

This new study found that participants of both sexes were less likely to say that there was something wrong with the male (76%) compared to the female (97%).

 

Of the participants who did identify a problem, they were significantly more likely to diagnose postnatal depression in the female case study than the male case study. The study found that 90% of participants correctly described the female case study as suffering from postnatal depression but only 46% said the male had postnatal depression.

 

The participants commonly believed that the man was suffering from stress or tiredness. In fact, stress was chosen 21% of the time for the man compared to only 0.5% for the woman, despite identical symptoms.

 

Overall the study found that attitudes were significantly more negative towards the male case study compared to the female. It found that participants reported lower perceived distress towards the male case study's condition, believed that the male's condition would be easier to treat, expressed less sympathy for the male and were less likely to suggest that the male seek help.

 

Lead author Viren Swami, Professor of Social Psychology at Anglia Ruskin University, said: "Our findings suggest that the British public are significantly more likely to believe that something is 'wrong' when seeing a woman displaying the symptoms of postnatal depression, and they are also far more likely to correctly label the condition as postnatal depression.

 

"There may be a number of reasons for this gender difference. It is possible that general awareness of paternal postnatal depression still remains relatively low and there might be a perception among the British public that postnatal depression is a 'women's issue' due to gender-specific factors such as pregnancy-induced hormonal changes and delivery complications.

 

"What is clear is that much more can be done to promote better understanding of paternal postnatal depression, so people don't brush it off as simply tiredness or stress. This is particularly important as many men who experience symptoms of depression following the birth of their child may not be confident about asking for help and may be missed by healthcare professionals in the routine assessments of new parents."

https://www.sciencedaily.com/releases/2019/05/190513104502.htm

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The enduring effects of mother-child interactions as children become adults

May 9, 2019

Science Daily/Wiley

Interactions between a mother and her child have been linked to cognitive outcomes in childhood, but little work has looked at farther-reaching effects.

 

In a Journal of Marriage & Family study that examined data from the Wisconsin Longitudinal Study, more positive mother-child interactions during the first 16 years of life predicted higher education in adulthood, which predicted less decline in episodic memory, or the memory of autobiographical events. Additionally, more positive mother-child interactions were associated with better episodic memory through higher marital satisfaction.

 

The results provide evidence for the broad and enduring effects of early life maternal relationships on later life developmental processes.

 

"The findings highlight the importance of taking a more integrative and lifespan perspective to assess how early life experiences affect socioemotional and cognitive development," the authors wrote.

https://www.sciencedaily.com/releases/2019/05/190509080042.htm

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Maternal nut consumption during pregnancy linked to improvements in neurodevelopment in children

May 7, 2019

Science Daily/Barcelona Institute for Global Health (ISGlobal)

Nuts are known to help reduce the risk of hypertension, oxidative stress and diabetes and they may exercise a protective effect against cognitive decline in older age. To this list of beneficial health effects, we can now add new evidence from a study led by the Barcelona Institute for Global Health (ISGlobal), an institute supported by "la Caixa." The study, published in the European Journal of Epidemiology, found links between a maternal diet rich in nuts during the first trimester of pregnancy and improved neurodevelopment in the child.

 

The study was carried out in Spain and included over 2,200 mother and child pairs enrolled in cohorts belonging to the INMA Project located in Asturias, Guipuzcoa, Sabadell and Valencia. Information on maternal nut intake was obtained from questionnaires on eating habits, which the mothers completed during the first and last trimester of their pregnancy. The children's neuropsychological development was assessed using several internationally validated standard tests 18 months, 5 years, and 8 years after birth.

 

Analysis of the results showed that the group of children whose mothers ate more nuts during the first trimester of pregnancy obtained the best results in all the tests measuring cognitive function, attention capacity and working memory.

 

"This is the first study to explore the possible benefits of eating nuts during pregnancy for the child's neurodevelopment in the long term. The brain undergoes a series of complex processes during gestation and this means that maternal nutrition is a determining factor in fetal brain development and can have long-term effects, explains Florence Gignac, ISGlobal researcher and first author of the study. "The nuts we took into account in this study were walnuts, almonds, peanuts, pine nuts and hazelnuts. We think that the beneficial effects observed might be due to the fact that the nuts provided high levels of folic acid and, in particular, essential fatty acids like omega-3 and omega-6. These components tend to accumulate in neural tissue, particularly in the frontal areas of the brain, which influence memory and executive functions."

 

The benefits described in this study were observed in the group of mothers who reported the highest consumption of nuts -- a weekly average of just under three 30g servings. This is slightly lower than the average weekly consumption recommended in the healthy eating guide published by the Spanish Society of Community Nutrition (SENC: Guía de la alimentación saludable), which is between three and seven servings per week. "This makes us think that if the mothers consumed the recommended weekly average the benefits could be much greater," Gignac explains. Estimated nut consumption in Spain is more than double the European average (4.8 g vs. 2.2 g).

 

The study also analysed the mothers' nut consumption during the third trimester of their pregnancy, but in this case either no associations were observed with the neuropsychological outcomes or the associations found were weaker. "This is not the first time we have observed more marked effects when an exposure occurs at a specific stage of the pregnancy. While our study does not explain the causes of the difference between the first and third trimesters, the scientific literature speculates that the rhythm of fetal development varies throughout the pregnancy and that there are periods when development is particularly sensitive to maternal diet" explains Jordi Júlvez, ISGlobal researcher and last author of the study.

 

"In any case," adds Júlvez, "as this is the first study to explore this effect, we must treat the findings with caution and work on reproducing them in the future with more cohort studies as well as randomised controlled trials."

https://www.sciencedaily.com/releases/2019/05/190507080134.htmMay 7, 2019

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Sleep and exercise affect new moms differently than new dads

April 30, 2019

Science Daily/Penn State

Sleep and exercise are vital to the wellbeing of new parents, but these essentials affect new moms differently than new dads, according to researchers.

 

In a study looking at the daily lives of new parents, a team led by Penn State researchers found that in general, getting more physical activity and more sleep from day to day was linked with more personal well-being, a better couple relationship and more closeness with their baby.

 

However, fathers who slept more on average than other fathers reported lower overall well-being and less closeness with their partner and child. In contrast, mothers who slept more on average than other mothers reported greater well-being.

 

Additionally, the researchers found that on days when fathers exercised more than usual, there was a lower likelihood of an argument between the couple. But, on days when mothers exercised more than usual, there was a higher chance of an argument.

 

Mark Feinberg, research professor in the Edna Bennett Pierce Prevention Research Center at Penn State, who led the study, said these differences may be due to mothers often being seen as the primary caretaker.

 

"Fathers may resist or feel resentful when mothers spend more time than usual on their own needs such as exercise, leaving fathers to pick up more responsibility for child care -- leading to arguments," Feinberg said. "But, it's also possible that the extra time spent with the child is stressful for fathers, leading fathers to be more irritable on such days and leading to more arguments with the partner."

 

The findings -- published in the Monographs of the Society for Research In Child Development -- were part of a study that examined how factors like exercise, sleep and different daily stressors affected the day-to-day lives and family relationships of new parents.

 

Feinberg said that while early parenthood is stressful for parents both as individuals and as a couple, it is also a vital period of rapid development for the newborn child, making it especially important to understand and support parents' well-being during this time.

 

"In general, new parents report higher levels of stress, depression and couple conflict, as well as less sleep, companionship and romance with their partner," Feinberg said. "Ironically, it's also the period when children are most vulnerable, when their brains and regulatory systems are rapidly developing to set the stage for their functioning for the rest of their lives, and when they are most dependent on parents for consistent affection and support."

 

According to Feinberg, the current study is one of the first to explore these stress and resilience factors among new parents on a daily level.

 

He said that looking at how changes in one stressful or replenishing factor are linked to changes in parents' well-being and relationships from day to day -- instead of annually, for example -- can give researchers a better understanding on how to help parents achieve better functioning and well-being on more days.

 

"In past research, we might find that on average, one father sleeps more, is less depressed, and more affectionate with his child than another father," Feinberg said. "But that doesn't tell us if enhancing sleep for that father would affect his level of depression or parenting warmth."

 

For the study, the researchers used data from 143 mothers and 140 fathers collected ten months after their child's birth. The researchers interviewed the mothers and fathers separately by phone every night for eight days to gather data about the previous 24 hours.

 

They gathered data about time spent sleeping, at work, doing chores and physical activity. They also asked the participants about stress, well-being, and their relationships with their spouse and child.

 

Feinberg said the results may be used to help parents find and reinforce their strengths and have more good days than bad.

 

"Some parents are happier or sleep better overall than others, but most parents experience some difficult days and some good days," Feinberg said. "Most parents already have a good place to start from at least on some days, so it's a matter of figuring out what works on those days and then doing more of that. This would be an easier and maybe more effective approach than thinking that we have to help someone completely change their routines and emotional patterns."

 

Additionally, Feinberg said parents may be able to explore their own day-to-day dynamics by using mobile apps on a smartphone.

 

"Studying daily fluctuation is a very rich way to understand the complex unfolding of individual and family life," Feinberg said. "There are many apps and devices that are available for recording daily experiences such as sleep and physical activity. With a little bit more added functionality -- being able to look at patterns across different experiences, and even across family members -- these tools could provide even more benefit."

https://www.sciencedaily.com/releases/2019/04/190430121736.htm

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Pregnancy shifts the daily schedule forward

New study finds both schedule, activity level changes in normal full-term pregnancies

April 30, 2019

Science Daily/Washington University in St. Louis

Add this to the list of what to expect: Getting up earlier, at least in the first trimester.

 

New research from Washington University in St. Louis finds that women and mice both shift their daily schedules earlier by up to a few hours during the first third of their pregnancy. A new study by researchers in Arts & Sciences and at the School of Medicine shows how impending motherhood induces changes in daily timing of a mother which, when disrupted, may put a pregnancy at risk, as reported in the Journal of Biological Rhythms.

 

"This is a very important first step in understanding what's happening in term pregnancy, and it has a potential to inform our ability to intervene and prevent preterm birth in certain populations," said Carmel A. Martin-Fairey, a postdoctoral fellow in the department of biology in Arts & Sciences and in obstetrics and gynecology at the School of Medicine.

 

Nationwide, one in 10 babies is born too early, before 37 weeks of pregnancy have been completed. Shift work and other disruptions of a regular sleep-wake schedule have been associated with preterm birth and other poor reproductive outcomes. But previously little was known about circadian timing during pregnancy.

 

Monitoring before and during pregnancy

Nearly all organisms have a biological clock that keeps daily time, driving 24-hour rhythms in behavior and physiology. These rhythms involve sleep and wake cycles, metabolism, hormone secretion, activity level and other physical processes -- and may influence reproduction in many species, including humans.

 

The new study tracked 39 St. Louis area women as part of a larger, ongoing study of 1,000 births. Study participants wore wristwatches that continuously monitored their daily activity and rest for two full weeks before they attempted to conceive. Once the women found out they were pregnant, they again donned the watches for the duration of their pregnancies up until delivery.

 

In mice, the experimental setup was very similar, with researchers monitoring both pre-pregnancy and during-pregnancy activity -- in part by observing the time that the mice spent on a running wheel.

 

The study found that mice and women both shift their daily schedule earlier by up to a few hours during the first third of their pregnancy.

 

In mice, this advance in the daily rest-activity pattern was detectable by the third day of pregnancy and persisted until 10 days before delivery. Similarly, the advance of the daily schedule in pregnant women gradually returned to normal before delivering.

 

"For the mice at least, the fact their activity advanced so early in pregnancy was surprising. We had no idea," said Sarah England, the Alan A. and Edith L. Wolff Professor of Medicine in obstetrics and gynecology. England is associate program director of the March of Dimes Prematurity Research Center at the School of Medicine and a co-author of the new study.

 

"What happens in early pregnancy is that they shift their total activity to earlier in the day," said Erik Herzog, professor of biology in Arts & Sciences and lead author of the new study. "But they don't seem to sleep more or be more active during their early pregnancy. It's just a change in their daily timing."

 

"Later in pregnancy, that's when we start to see that they're carrying a load and running less," Herzog said, of the mice in the study. "So they seem to be separable processes."

 

Certainly, a wearying workload can cause a childbearing mother to alter her schedule and sleep-rest patterns. But Herzog said this study shows it's more than that because of how early in the pregnancy the clock shift occurs.

 

"There's the fatigue perhaps, or extra work that's required to carry a baby. But there's something about the daily timing system that's changing early in pregnancy probably due to the hormones that are associated with pregnancy," he said.

 

Researchers also observed that the total amount of activity during pregnancy was significantly reduced -- in both mice and women.

 

"In the mice it was centered around late gestation, whereas in women it was significantly reduced across the entire gestation," Martin-Fairey said.

 

A first step toward understanding circadian rhythms in pregnancy

So, the new research results provide a look into potential medical issues because they indicate that pregnancy induces changes in daily rhythms, altering both time of onset and amount of activity.

 

"This finding is fascinating because while we know that miscarriage, preterm birth and other serious complications during pregnancy are linked to disruptions in a mom's circadian rhythm, we don't know how it works," said Kelle H. Moley, MD, chief scientific officer for March of Dimes in a statement. "This study takes us one step closer to understanding how normal circadian rhythm supports healthy pregnancy."

 

This is the first publication that these collaborators have published related to circadian rhythms using data from this large St. Louis study. Other future work will help researchers better understand the impact of shift work and other high-risk groups for preterm birth.

 

"In preterm birth, there is a health disparity with African-American women having a higher rate," England said. "We are well-situated in St. Louis to delve into some of the mechanisms underlying this disparity."

 

"Sleep in medicine is poorly studied," said Emily S. Jungheim, MD, associate professor in the department of obstetrics and gynecology in the School of Medicine and a co-author on the new study. "Even among healthy women and men -- those who eat well, who exercise -- the one thing they're willing to do without a second thought is skimp on their sleep. A lot of people don't pay attention to how important it might be."

 

But sleep is something that can always be improved. Women who are looking to conceive can prioritize sleep.

 

"A lot of times if you're looking at things during pregnancy, the cat's already out of the bag," Jungheim said. "There's nothing you can do to fix it because things are already so far gone. But if you can identify a risk factor for preterm birth in a regular reproductive-age woman before she gets pregnant, you actually have time to modify it, and to see if you've fixed it -- before she gets pregnant."

https://www.sciencedaily.com/releases/2019/04/190430121727.htm

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Women/Prenatal/Infant12 Larry Minikes Women/Prenatal/Infant12 Larry Minikes

Possible link between autism and antidepressants use during pregnancy

April 30, 2019

Science Daily/Duke-NUS Medical School

An international team led by Duke-NUS Medical School has found a potential link between autistic-like behaviour in adult mice and exposure to a common antidepressant in the womb. They also identified a treatment that helped improve memory loss and social interactions, according to the new study published in the journal Molecular Brain.

 

Antidepressants are commonly prescribed for treating major depression and post-traumatic stress disorder, including in pregnant women. One of the most commonly prescribed antidepressants is fluoxetine, a serotonin reuptake inhibitor. Fluoxetine can cross the placenta and is also detected in breast milk. Little is known about its safety during pregnancy, and not enough studies have been conducted on its long-term effects on offspring.

 

"Many human association studies have been conducted to investigate connections between antidepressant exposure during pregnancy and children with autism and attention deficit disorder (ADHD). But they have not been able to pinpoint a causal relationship," stated Associate Professor Hyunsoo Shawn Je, from Duke-NUS' Neuroscience and Behavioural Disorders (NBD) Programme, a senior and corresponding author of the study.

 

The team from Duke-NUS and their collaborators in South Korea and Singapore investigated adult mice born to mothers treated with fluoxetine (sold under the brand names Prozac and Sarafem) over a 15-day time period that corresponds to the second trimester in humans, in comparison with those born to mothers given normal saline as controls. They found key differences in behaviour. For example, the unexposed mice normally explored all three arms of a Y-shaped maze over a ten-minute time period and, over the courses of multiple arm entries, mice usually enter a less recently visited arm, while the fluoxetine-exposed ones were less inclined to explore unvisited arm.

 

In a second experiment, the mice were introduced to two juvenile mice, one after the other. When the second new mouse was introduced, mice that were not exposed to fluoxetine were more likely to only sniff the newly introduced mouse, recognizing that they had already met the first mouse. But the fluoxetine-exposed group sniffed both mice, indicating that they had impaired social novelty recognition.

 

The team then examined nerve signal transmission in the prefrontal cortex, a part of the brain involved in moderating social behaviour. They found impaired transmission caused by an overactive serotonin receptor. Treating fluoxetine-exposed mice with a compound that blocks the receptor alleviated their behavioural problems and improved their working memory.

 

The team next wants to examine autistic children born to mothers treated with antidepressants using positron emission tomography (PET) scans, an imaging technique used to observe metabolic processes in the body. If they also show enhanced serotonin receptor activity in the same area of the brain, the team plans to test whether FDA-approved serotonin receptor blockers can normalize their behaviours.

 

"The consensus among experts is that the rise in the number of people diagnosed with autism around the world is likely due to more awareness and testing rather than an increase in the prevalence of autism," noted Professor Patrick Casey, Senior Vice Dean for Research at Duke-NUS. "This collaborative study by our researchers offers a compelling case for a link between autism and antidepressant exposure in the womb in an animal model, and a possible mechanism that could potentially be exploited for future therapies."

https://www.sciencedaily.com/releases/2019/04/190430103509.htm

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