Stress, anxiety and depression during pregnancy can hinder the cognitive development of the baby

summary: Stress, anxiety, and depression during pregnancy were associated with altered key features in fetal brain development, resulting in lower offspring cognitive decline at 18 months of age.

source: National Children’s Hospital

The higher level of anxiety, depression and stress in women during pregnancy altered key features of the fetal brain, which subsequently led to lower cognitive development for their sons at 18 months of age.

These changes also increased absorption and disorganization behaviors, according to a new study by Children’s National Hospital published in JAMA Network is open. The researchers followed a group of 97 pregnant women and their babies.

The findings further suggest that persistent psychological stress after the birth of a child may affect parent-child interaction and infant self-regulation.

This is the first study that highlights an important link between altered intrauterine fetal brain development and the long-term cognitive developmental consequences of fetuses exposed to high levels of toxic stress during pregnancy.

While they were in the womb, the researchers noticed changes in sulcular depth and left hippocampal volume, which could explain postnatal neurodevelopmental problems.

Once they are young children, these children may have ongoing social and emotional problems and have difficulty establishing positive relationships with others, including their mothers. To further confirm this, prospective studies with a larger sample size reflecting more regions and populations are needed.

“By identifying pregnant women with elevated levels of psychological distress, clinicians can identify children who are at risk for later neurodevelopmental impairment and may benefit from early, targeted interventions,” said Catherine Limperopoulos, PhD, president and director of the center. Institute for Brain Development at the National Pediatrics Division and senior study author.

Regardless of their socioeconomic status, one in four pregnant women experiences stress-related symptoms, the most common pregnancy complication. The relationship between altered fetal brain development, prenatal psychological distress and long-term neurodevelopmental outcomes remains unknown.

Studying fetal brain development in the womb poses challenges due to fetal and maternal movements, imaging technology, signal-to-noise ratio issues and changes in brain development.

All pregnant participants were in good health, and most had some level of education and employment. To identify maternal prenatal stress, anxiety, and depression, the researchers used self-verified questionnaires.

This shows the belly of a pregnant woman
Regardless of their socioeconomic status, one in four pregnant women experiences stress-related symptoms, the most common pregnancy complication. The image is in the public domain

Fetal brain volumes and cortical folds were measured from reconstructed 3D images derived from MRI scans. The amount of creatine and choline in the fetal brain was measured using proton magnetic resonance spectroscopy. The child’s neurodevelopment at 18 months was measured using validated scales and ratings.

This study builds on previous work by the Institute for Brain Development led by Limperopoulos, which found that anxiety in pregnant women appears to affect their children’s brain development. Her team also found that maternal mental health, even for women of high socioeconomic status, alters the makeup and biochemistry of the developing fetus’s brain. Mounting evidence confirms the importance of mental health support for pregnant women.

“We are looking forward to changing the healthcare paradigm and adopting these changes more broadly to better support mothers,” said Limperopoulos.

“What is clear is that early interventions can help mothers reduce their stress, which can positively affect their symptoms and therefore their babies long after birth.”

About this News Psychology and Neurodevelopment

author: press office
source: National Children’s Hospital
Contact: Press Office – Children’s National Hospital
picture: The image is in the public domain

original search: open access.
Association of elevated maternal psychiatric disorders, altered fetal brain, and offspring cognitive, emotional, and social outcomes at 18 months of age.Written by Catherine Limperopoulos et al. JAMA Network is open


a summary

Association of elevated maternal psychiatric disorders, altered fetal brain, and offspring cognitive, emotional, and social outcomes at 18 months of age.

Importance

Prenatal maternal psychiatric disorder is associated with disturbances in fetal brain development. However, the relationship between altered fetal brain development, prenatal maternal psychological distress, and long-term neurodevelopmental outcomes is unknown.

objective

To determine the association of fetal brain development using magnetic resonance imaging (MRI) volumes and cortical folding and metabolites in determining maternal psychological distress with 18-month infant neurodevelopment.

Design, setup and participants

see also

This indicates a head made up of floating bubbles

Mother and infant pairs were prospectively recruited in a longitudinal observational cohort study from January 2016 to October 2020 at Children’s National Hospital in Washington, DC. Data analysis was performed from January 2016 to July 2021.

exposures

Maternal prenatal stress, anxiety and depression.

Main findings and measures

Maternal stress, anxiety, and depression were measured before birth using validated self-report questionnaires. Fetal brain volumes and cortical folding were measured from 3D and reconstructed T2 MRI scans. The amount of creatine and choline in the fetal brain was measured using proton magnetic resonance spectroscopy. Infant neurodevelopment was measured at 18 months of age using the Bayley Scales for Infant and Toddler Development III and the Social and Emotional Assessment for Infants and Children. Parenting stress was measured in the parent and child using a short form of the Parental Stress Index in an 18-month test.

consequences

The group consisted of 97 mother-infant pairs (medium [SD] Mother’s age 34.79 [5.64] years) who underwent 184 fetal MRI visits (87 participants with two fetal studies each) with maternal stress measures between 24 and 40 weeks gestation and completed infant neurodevelopmental examination.

Maternal prenatal stress was negatively associated with infant cognitive performance (β = −0.51; 95% CI, −0.92 to −0.09; s= .01), and this association was mediated by fetal left hippocampal volume. In addition, prenatal maternal anxiety, stress, and depression were positively associated with all measures of paternal stress in the 18-month test.

Finally, fetal cortical positional variability index and sulcus depth were negatively associated with infant social emotional functioning (local variability index: β = −54.62; 95% CI, 85.05 to −24.19; s<.001; point depth: β = −14.22; 95% CI, 23.59 to −4.85; s= .002) and efficiency scores (local turnover index: β = −24.01; 95% CI, 40.34 to 7.69; s= .003; nitrification depth: β = −7.53; 95% CI, 11.73 to -3.32; s<.001).

Conclusions and relevance

In this cohort study of 97 mother-infant dichotomies, fetal cortical local sweating index and sulcus depth were associated with 18-month infant social-emotional and efficacy outcomes, and fetal left hippocampal volume mediated the association between maternal prenatal stress and infant cognitive outcomes.

These findings suggest that altered prenatal brain development in the setting of high maternal distress has socio-cognitive outcomes for infants, and identification of early biomarkers associated with long-term neurodevelopment may aid in early targeted interventions.