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Z YEAR 2 BRS Embryology > Effects of antenatal stress on fetal and child devlopment > Flashcards

Effects of antenatal stress on fetal and child devlopment Flashcards

1
Q

Can the mother’s emotional state in pregnancy and in the early postnatal period have a long lasting effect on her child?

A

yes

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2
Q

Do women have as many symptoms of depression and anxiety during pregnancy as postnatally?

A

Yes

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3
Q

What can pregnancy also be a time of?

A

increased domestic abuse and relationship strain

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4
Q

What is fetal programming?

A

Environment in the womb, during different sensitive periods for specific outcomes, can alterthe development of the fetus, with along lasting effect on the child

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5
Q

What can sensitive early mothering help?

A

attachment, and can counteract some of what happens in the womb

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6
Q

What happens in the fetal brain?

A
  1. 3mm long neural tube - whole brain with 100 billion neurons and 100 trillion connections
  2. 250,000 neurons/minute - all through gestation
  3. Proliferation: 5 weeks gestation through 18 months after birth
  4. Migration
  5. Differentiation
  6. Synaptogenesis
  7. Neural pruning: continues till puberty
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7
Q

What are types of prenatal stress reported to be associated with increased risk of changes in cognitive development and behavior in the child?

A
  1. Maternal anxiety and depression
  2. Maternal daily hassles
  3. Pregnancy specific anxiety
  4. Domestic abuse; partner or family discord
  5. Distress caused by war
  6. Experience of acute disasters, e.g. freezing ice storm, hurricane or 9/11
  7. It’s not just extreme or toxic stress or diagnosed mental illness
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8
Q

What is prenatal stress associated with increased risk for child?

A
  1. Anxiety and Depression
  2. Behavioural problems-ADHD, conduct disorder
  3. Impaired cognitive development
  4. Neonatal behaviour
  5. More difficult infant temperament
  6. Victimisation in childhood
  7. Schizophrenia ( stress in first trimester)
  8. Autism spectrum
  9. Personality disorder
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9
Q

What is prenatal stress associated with increased risk for?

A
  1. Reduced birthweight and gestational age
  2. Preterm delivery
  3. Mixed handedness
  4. Decreased telomere length
  5. Asthma
  6. Altered immune function
  7. Altered microbiome ( in meconium)
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10
Q

How do we find out if the association rather than genetic or postnatal?

A
  • Animal studies
  • Effects of natural disasters
  • Studies which allow for confounders
  • Underlying mechanisms
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11
Q

What does COMT do?

A

inactivates catecholamines
–dopamine, adrenaline and noradrenaline-
gene variants associated with working memory and ADHD

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12
Q

How does maternal stress/anxiety/mental illness affect the baby?

A
  • Placenta rich in enzyme that breaks down cortisol to cortisone
  • More anxious mother was, lower the expression of enzyme
  • If mother stressed down regulation of enzyme that breaks down cortisol in placenta and this allows more cortisol to pass from the mother to foetus
  • At amniocentesis checked cortisol then at 18 months if insecurely attached to mother, cortisol level negatively correlated with how well they did in the baby IQ test. But if securely attached made no difference
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13
Q

What is higher in utero exposure to cortisol associated with?

A

lower cognitive function

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14
Q

What can sensitive early mothering reverse?

A

the effects of high in utero exposure to cortisol

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15
Q

What patterns are observed with increased in utero cortisol?

A
  1. Associated with reduced attention
  2. Associated with increased anxiety
  3. Similar to those observed in children with early maltreatment
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16
Q

What does structural MRI show in studies of effects of prenatal stress on child brain?

A
  • Thinner cortex ( associated with depression and cognitive problems)
  • Enlarged amygdyla (associated with increased anxiety)
17
Q

What does diffusion MRI show in studies of effects of prenatal stress on child brain?

A

•Alterations in uncinate fasciculus which connects amygdyla with frontal cortex ( associated with mood disorders and antisocial behaviour)

18
Q

How are epigenetic modification the basis for fetal programming?

A
  1. Epigenetic changes are functionally relevant modifications
    to the genome that do not involve a change in nucleotide sequence.
  2. Can persist to grandchild generation
19
Q

What is the evolutionary benefit of impulsiveness caused by prenatal stress?

A

more willing to explore new environments

20
Q

What is the evolutionary benefit of conduct disorder caused by prenatal stress?

A

more willing to break rules

21
Q

What is the evolutionary benefit of aggressive caused by prenatal stress?

A

fight predators or other tribes

22
Q

What is the evolutionary benefit of cognitive deficit caused by prenatal stress?

A

side effect of ADHD or autism spectrum

23
Q

What is the evolutionary benefit of autism spectrum caused by prenatal stress?

A

understand things in different ways

24
Q

How can professionals help with pregnancy health?

A
  1. Detect and treat anxiety and depression both in pregnancy and postnatally
    –Psychological interventions (eg CBT)
    –Pharmacological intervention if needed
  2. Help with relationship problems or domestic abuse
  3. Help to create more social support
  4. Practical help with housing etc
  5. Help to teach sensitive mothering – video feedback
25
Q

What is ALSPAC?

A

avon longitudinal study of parents and children

26
Q

Why would predictive adaptive value of changes due to prenatal stress in a stressful environment (predators) in the wild?

A
  1. Anxiety/fear reactivity - beneficial effects of more vigilance
  2. ADHD: shifting attentions helps if predators about (distracted by small noise)
27
Q

What are other ways to reduce antenatal stress?

A
  • yoga
  • gardening
  • music
28
Q

Can stroking the baby help?

A

study shows that if the mothers who had been anxious during pregnancy regularly stroked their baby, the baby showed fewer emotional behavioural problems later

29
Q

Can breastfeeding help

cognitive and emotional/behavioural outcomes?

A

-At first sight breast fed babies do much better in most outcomes
-But many studies have not allowed for confounders
-Breastfeeding mothers are different.
Significant differences between
-breastfeeding, mixed and formula feeding mothers
in:
1. Education
2. SES
3. Smoking
4. Depressive symptoms; antenatal and postnatal
5. And baby’s:
Birthweight

30
Q

What are public health implications of reducing stress/anxiety/depression in pregnancy?

A
  • More than one million children in UK suffer from neurodevelopmental disorders
  • Attributable load of neurodevelopmental problems due to prenatal stress 10-15%
  • Potential to reduce number of affected children in the UK by 100,000-150,000
31
Q

Can breastfeeding help?

A

-Exclusive breastfeeding at one month improves,
IQ ( 3 points) and hyperactivity at 8 years,
-but not emotional problems and conduct disorder
(after allowing for confounders -mothers education, bw, sex of child, SES etc.)
1. Breastfeeding did not moderate the associations between prenatal depression and anxiety and child neurodevelopment, suggesting separate mechanisms of action.
2.

32
Q

Does bottle fed breast milk do better?

A
  • Shows that babies bottle fed breast milk did better on cognitive and memory tests than those fed formula milk.
  • It is the contents of breast milk help cognition

Z YEAR 2 BRS Embryology (10 decks)

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