"From the womb to the world: Unveiling the hidden influence of maternal mood in crafting the blueprint of a brilliant mind."
Our health, sports skills, smarts, and sicknesses – all these things about us happen because of how our inherited genes mix with the world around us. And guess what? This mixing starts even before we're born! Studies following people from when they were in their mom's belly until they grew up tell us that smoking while pregnant can make babies weigh less. Drinking alcohol can lead to heart problems or joint issues. And eating unhealthy can increase the chances of a kid becoming obese when they grow up.
But what about how a mom feels mentally? Until recently, scientists believed it only mattered after the baby was born. They thought if a mom wasn't feeling well emotionally and it led to her not taking good care of her baby, it could make the child more likely to have issues like feeling sad, being hyperactive, or feeling anxious. But now, experts like Catherine Monk, a medical psychologist at Columbia University in New York, say a mom's mental health is super important even before the baby is born. She has been studying how a mom's stress, sadness, or nervousness during pregnancy can affect her baby for over 20 years. In a recent article, she explained how a mom's feelings can shape her baby's growing brain.
Monk talked to Knowable about the proof they have and why she thinks it's a chance to help moms take care of their mental health before problems happen — not to blame them. This chat has been shortened and made clear for easier understanding.
How did you start figuring out if a mom's feelings could affect her baby?
We had pregnant women in the lab do a color-word matching test, a common thinking challenge. Usually, everyone gets a bit nervous doing it, and their heart rate and blood pressure go up. We expected to see the babies' heart rate change too, but when we looked at the results from all the women together, we didn't find anything significant.
We also asked these women how worried or anxious they felt by using a set of questions. When we looked at the information and separated it into two groups – women who were not very anxious and women who were more anxious – something interesting popped up. The babies of moms who weren't very anxious didn't change their heart rate at all during the test. However, the babies of more anxious moms had an increase in their heart rate when faced with the stressful task. This tells us that even though both groups of babies hear the same sounds and feel the same things from their moms, the babies of anxious moms react differently.
If a baby's heart rate changes a lot in response to signals from its mom, how does that connect to a higher chance of anxiety and ADHD?
In another study, we discovered that babies whose heart rate reacted a lot to signals from moms with prenatal depression had less connection between two brain areas: the amygdala and prefrontal cortex. The amygdala deals with emotions and stress responses, while the prefrontal cortex handles behavior, speech, and reasoning. It can also calm down the amygdala's reaction to things.
So, the thought is that right from the start, babies of moms who are more depressed have a weaker link in their brain between the amygdala and the prefrontal cortex. This might be an early hint that they struggle a bit with controlling their emotions. Other scientists are finding similar connections between moms feeling upset during pregnancy and this weakening of connections between these two brain areas. We're also noticing the same thing in studies with animals.
How does a mom's anxious or sad feelings get passed on to the baby?
We have some clues. One big clue is hormones. In animal studies, when babies are exposed to really high levels of the stress hormone cortisol in the womb, their amygdala (a part of the brain linked to emotions) is more active after they're born, and they act more anxious.
In studies with humans, there's a bunch of information too. In one study, they checked cortisol levels in a mom's blood and compared it to the cortisol in the fluid around the baby (that's what the baby is surrounded by in the womb). They found that in moms who are less anxious, there's not much connection between the cortisol in their blood and what the baby is exposed to. But in more anxious moms, there's a strong connection. This hints that when a mom is anxious, it might change how the placenta works, affecting how much cortisol reaches the fluid around the baby. The tricky part in this research is that it might not be about how much cortisol is in the mom's blood, but what level the baby is exposed to through the placenta and fluid.
A few teams, including ours, found an enzyme in the placenta that usually stops cortisol from going to the baby, and how it works changes based on how anxious moms are. In people, when moms are anxious, it seems to "turn off" the gene that manages this protective enzyme. So, more cortisol gets to the baby. Having too much cortisol in the womb is linked to fewer nerve cells forming and differences in how brain cells move and connect. All these things can raise the chance of the baby having anxiety or ADHD.
Other groups discovered that when these placental receptors get turned off, it messes with how hormones work, and this is linked to changes in kids' behavior, like being more anxious. Now, we're starting to see how all these pieces fit together and make sense in studies from different labs.
Is there a specific time when a baby's brain is more affected by signals from hormones or the immune system during development?
This is an area where we still have a lot to learn. Some experts think that if a mom feels stressed early in pregnancy, it could have stronger effects because it might impact the very basic parts of the baby's growing brain. This could increase the chance of issues like schizophrenia. If the stressful event happens later, the effects might be more subtle, and the risk of conditions like ADHD or anxiety could go up.
But these ideas are just starting to take shape. We're just beginning to understand when moms feel stressed during pregnancy and how it affects the baby, whether it's from a long-lasting stress like always being poor or a sudden stress like a famine.
Should this change how we take care of pregnant women's health?
Definitely. Pregnancy is a big time of change, not just physically but also mentally. It's a good time to check in on the woman and her family, and to say that just like we care about physical health, we care about mental health too. How the woman is feeling is like the environment for the baby.
Now, doctors are starting to routinely check for feelings of sadness or nervousness during pregnancy, but we could do more of that. At the very least, we could seriously consider that we have more than one patient – both the mom and the baby.
Sometimes, there's a bit too much focus on the baby's health, especially in risky pregnancies. We need to pay attention to the mom too because she might be dealing with physical and emotional problems. Some pregnant women want to make positive changes in their life, like exercising more or getting help for past emotional issues, not just for the baby but for themselves. As doctors, we should care about a woman's mental health, whether she's pregnant or not. And when we take care of her during pregnancy, we're also taking care of her future child.
How did scientists start studying if a mom's feelings could affect her baby?
Scientists had pregnant women do a color-word matching test in the lab, a common thinking challenge. Although they expected the babies' heart rate to change, the results didn't show anything significant for all women combined.
What did researchers find when they asked pregnant women about their feelings and separated them into anxious and non-anxious groups?
What did teams find regarding an enzyme in the placenta and cortisol exposure?
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me thinking about my future babies.