Stress, anxiety in pregnancy may affect child development, study suggests

Increased depression, anxiety and stress during pregnancy can alter the fetal brain and negatively impact a child’s early cognitive development, according to a new study pointing to the importance of mental health support for pregnant women.

Previous research found that anxiety during pregnancy appeared to affect the child’s brain development and that the mother’s mental health could alter the biochemistry and structure of the baby’s brain in the womb.

The small study from Children’s National Hospital in Washington, DC, published Friday in JAMA Network Open, is believed to be the first of its kind to show that the altered fetal brain caused by psychological stress is negatively associated with neurological development may be associated with infants. including social-emotional development.

Stress-related symptoms are one of the most common problems in pregnancy, affecting about a quarter of all pregnant women, including those with healthy pregnancies and high socioeconomic status.

“What is clear is that early interventions could help mothers reduce their stress, which can have a positive impact on their symptoms and, in turn, on their baby long after birth,” lead author of the study, Catherine Limperopoulos, said in a statement. Limperopoulos is the chief and director of the hospital’s Developing Brain Institute, one of the top 10 children’s hospitals in the United States.

For this study, a cohort of 97 pregnant women and their babies were recruited for a longitudinal observational study between January 2016 and October 2020 at time.

Eighty-seven participants each participated in two fetal studies, for a total of 184 fetal magnetic resonance imaging (MRI) visits. Maternal psychological distress was measured between 24 and 40 weeks of gestation, and an infant neurodevelopmental test was also performed at 18 months.

The scientists noted changes in the depth of the grooves, or folds, in the fetal brain and in the volume of the hippocampus, a part of the brain that plays an important role in learning and memory. These changes could explain some of the developmental problems observed after birth, including social-emotional issues, self-regulation, and difficulty building positive relationships, including parent-child interactions, the researchers said.

“Furthermore, we found that prenatal maternal stress, even when it did not reach mental disorder severity, was associated with decreased infant cognitive functioning,” they wrote in the study.

“This finding is consistent with results from previous studies showing cognitive impairment in children after early exposure to maternal stress… Our results suggest that the prevalence of prenatal maternal stress may not be as high in our cohort as in the high-risk population, its association with infant outcomes cannot be ignored.”

The participants in this study were healthy and had low-risk pregnancies. Most were employed, well educated and lived in areas with good access to healthcare. Despite favorable factors, 36 percent of participants had stress, anxiety, and/or depression that crossed the positivity threshold.

Further studies with a larger cohort from different populations and geographic regions are needed in the future to further confirm the results, they added.

The study cited several limitations, including the fact that assessments of distress may not fully reflect the mental state of the parent throughout the pregnancy. While cognitive, language, and motor skills were assessed by a licensed psychologist, mental health status and social-emotional ratings for infants were self-reported by the parents. The results may also not reflect other geographic areas and socioeconomic populations.

Overall, the researchers said the mounting evidence underscores the importance of mental health support for pregnant women.

“These results are particularly instructive given the nature of the ongoing COVID-19 pandemic … and the understudied association between increased maternal stress during the pandemic and the health of the next generation of infants,” the authors wrote, noting that more than one Million infants have been born in the US so far during the pandemic.

“However, we lack knowledge about the influence of pandemic-related maternal stress on the long-term neurological development of infants. Our ongoing studies will continue to explore the link between increased maternal stress amid the pandemic and children’s lifelong health.”

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