Prenatal risks Flashcards
What complications in adulthood can come about due to a) Low birth weight, birth phenotype, early postnatal growth and b) Prenatal stress?
a) hypertension, ischaemic heart disease, obesity, insulin resistance, type 2 diabetes.
b) Behaviour, cognition, memory, learning, emotion, stress response
What is maternal anxiety and prenatal stress associated with?
Anxiety: Fetal heart rate went up in anxious group in a study.
Stress: Child has increased risk of anxiety, depression, ADHD, CD etc.
Reduced birthweight, mixed handedness, altered fingerprint pattern, altered microbiome, asthma, decreased telomere length.
What are examples of prenatal stress?
Maternal anxiety and depression Maternal daily hassles Pregnancy specific anxiety Partner or family discord Acute disasters (hurricane?)
What are the 4 causal study areas and what have they shown?
Animal studies- stress pregnant rat. Role in HPA axis: Effects blocked by adrenalectomy. Corticosterone reinstates effect.
Offspring behave in a more anxious way- there is a heightened response to stress with more corticosterone compared to controls.
This is because there is LESS FEEDBACK CONTROL.
What was found in human studies?
Human studies-
ALSPAC study. Data on maternal anxiety/depression, paternal anxiety/depression, maternal age, birthweight, smoking, alcohol etc. Compared children of 15% most anxious/depressed mothers with the rest.
Top 15% group children had 2x more likelihood of developing mental disorder at age 13. Attributable load due to prenatal anxiety/depression/stress.
Changes observed at birth?
Changes observed at birth- GG polymorphism in COMT + anxious mother had worst working memory at age 8. Double hit hypothesis: Genetic predisposition + mother anxiety required.
What was found in terms of underlying mechanisms?
Underlying mechanisms-
Role of placenta: Filters substance coming from mother. Has 11B-HSD2. The higher the anxiety before C section, the lower the 11B-HSD2, so decreased cortisol breakdown->more in fetus.
Are there ethnic differences in the effects of prenatal stress on the placenta?
Epigenetic modifications:
Prenatal depression associated with methylation pattern in blood. Epigenetics can transfer stress to 3rd generation.
Amniotic cortisol: Increased AFC caused lower score in cognitive test.
Insecure attachment: Increased cortisol means decreased cognitive score.
Secure attachment: Increased cortisol no effect on cognitive score.
Therefore, sensitive mothering can reverse effects of increased cortisol.
Why is prenatal stress related to child development?
Anxiety and ADHD in the wild means more vigilance to detect dangers.
What are other findings explained by evolutionary perspective?
Sex difference: Anxiety in females as looking after offspring, conduct problems in males who go out and hunt.
Dose responsive effects of stress to degree of stress in environment.
Children not affected in same way- genetic variation.
What are the roles of professionals?
Detect and treat anxiety and depression in pregnancy and post natally. (CBT, pharmacological treatments)
Support socially and with violence/abuse.
Housing.
