Does a mother's mental health affect her fetus? (Part 1) – interview with Catherine Monk | VIEWPOINT



I think the bottom line is that we need to be paying attention to women's emotional well-being during pregnancy as much as we do to their physical well-being and by doing so we can help not only women but potentially their future children so doctor monk I'm so happy to have you here talking about your research in early development maybe you can start by saying a little bit about what kind of work you do what kinds of questions you're trying to answer sure sure and thank you for having me here so our work falls under the rubric of the developmental origins of health and disease and by development we are really starting with the fetus and our main question is understanding the risk for what we call psychopathology another way to call that is really having mental health problems so I I know this is probably not how people are used to thinking about it but we are going all the way back to the fetal period so the developmental origins of the disease of mental health disease and and finding how some of the early factors influencing the risk for having poor mental health outcomes may start in utero and we actually think that a risk factor is what's called an exposure that happens to the fetus in utero and that exposure is the mother's mental health problems and so really crucially what this suggests is that there are three possible pathways by which mental illness may travel in families so we all think about genes of risk that likely happen in families and we are pretty used to thinking about a child that grows up in a very very dysfunctional home say with an alcoholic parent an abusive parent a very very depressed parent has risk for mental health problems hard way to grow up mm-hmm and we're pushing back the time frame to say there's a third pathway so the mother's mental health problems while she's pregnant can get transmitted to the fetus and put that child at risk for future mental health problems so you're doing research on pregnant women and they're there they're there this the fetus in utero so how do you do that kind of research right I always like to say how do you ask the fetus questions and we are limited it's it's not as easy as you and I having a conversation obviously but again there is this developing brain and there is some fetal behavior and we can probe that fetal behavior so some of the ways that the fetus gives us an answer and his or her behavior is heart rate reactivity so two stimuli and also movement reactivated stimuli so we can see individual differences and how fetuses respond to stimuli just the way we can see in a child temperament at three or four years old some kids are less or more reactive even four months old and now we're pushing the time back so in heart rate reactivity to stimuli or movement reactivity we can see differences in how fetuses are developing so what are some of the factors that you're seeing impacting the the reactivity the behavior really of the fetus right so we've been focused on actually you know this maternal experience of distress specifically having significant depression or stress or anxiety during your pregnancy and that that actually seems to be associated with differences in how the fetus is developing so let me let me take a few steps back and walk you through this so some researchers going way back to 1967 did a very interesting study again asking the fetus questions and getting the answer and fetal heart rate and what they did believe it or not was tell a pregnant woman towards the end of her pregnancy that she was in a room it had just about half the amount of oxygen needed for her life but that her baby would probably live and you can imagine this is a life-threatening shock uh-huh well her heart rate went right up because they were monitoring her and at the same time the fetuses heart rate went way up so that tells us that the woman is having an emotional experience there was no change in the air in the room just the thought that this may hurt my baby she had a reaction and so did her fetus so we've learned from that paradigm and we don't give the women a stress that's life-threatening thankfully we're not allowed to do things like that anymore but we do give women as pregnant women a stressor in our lab it's a cognitive challenge and what we've seen is that fetuses whose mothers have significant anxiety and stress in their lives when their mothers are doing this task and feeling nervous themselves their heart rate goes up so what is the task well it's called a Stroup color word matching task okay and it's been around for almost 50 years in psychology it's really a task where you read words color words but in a different color than the word itself okay but because we all read so automatically as adults if you see the word blue in red ink you punch down blue but the right answer is the color of the letters and when we do the task we have someone in a white coat letting them know they're not working fast enough the computer tells them when they get it wrong so it's a performance anxiety and interestingly the women on average do show physiologic and psychological stress reactivity but what's really amazing is that fetuses differentiate themselves so it's only the fetuses of highly anxious and stressed or depressed women that show this heart rate increase during that stress or in the lab mm-hmm and then their heart rate goes down when the women are in recovery so what we think is happening is again like a temperament in a baby these fetuses are more reactive to stimuli it's a little complicated here but what the stimuli is is that again the mother's life is the fetuses life it's the fetuses experiences when she has a reaction she's getting stressed her heart rates beating faster that's sound and vestibular stimuli for the fetus so some of these fetuses are reacting to their world changing and some of the other fetuses of the women who don't have distress in their lives their fetuses their heart rates don't change so you're seeing a really strong correlation then between the kind of calmness of the fetus and the emotional condition that the mother is in so when you say stress anxiety is is it like they have to commute a long way to work what are the factors that are that you've identified that are really having this kind of an impact right that's such an important question because we all have stress in our lives and you know I'm not the only one doing research in this area there are many different labs across the world and none of us want to be giving pregnant women something else to worry about and frankly we all and we all have a bit of stress in our lives and many people think fetuses need to feel a little stress because they need to get inoculated the world out there has ups and downs so we're really talking about a serious depression we're really talking about feeling overwhelmed by life that you can't handle things or you know there are many people anxiety disorders are one of the most common mental health problems and so just anticipatory something's gonna wrong I don't I or rethinking over and over past things that didn't go well so it's really people who are quite women I should say who are quite troubled and their emotional well-being mm-hmm but it is on a continuum and we don't there's not you know a certain cut point where we can say yes this woman is affecting the fetus and this woman isn't fetuses differ in their sensitivity we're still learning a lot about this mm-hmm I think the bottom line is that we need to be paying attention to women's emotional well-being during pregnancy as much as we do to their physical well-being and by doing so we can help not only women but potentially their future children so that's what I wanted to ask you so there's a fetus some are more reactive in the in though in the womb some are less reactive so so what what what what are the are you seeing differences in babies and young children after they've been born right based on what you'd observed in their in their physical state in the womb yeah another key question so first I'll cite research from other labs or they've followed children without that Glover is one of the primary people and one of the major findings is that I actually I'll tell you too is that children exposed in utero to either significant maternal anxiety or depression now anxiety is really associated with risk and six and seven year old children showing emotional problems themselves particularly ADHD and then when girls have been followed anxiety and depression and their mothers and pregnancy when these girls go into the puberty period they're much more at risk for depression so there are these long term outcomes in terms of what we've seen in my lab because I I stopped around age two with the kids and we don't quite have our data yet for age two but we have done follow-up studies the first is that we see these babies who are as fetuses are more reactive they actually do go on at four months old to have a more reactive temperament and that is to a novel mobile being put in front of them fake crying and move more and fuss more and then going back in time but looking at the brain directly instead of behavior we've seen that having greater fetal heart rate reactivity as I described is associated with differences in what's called functional brain connectivity and we get that by having a newborn resting being asleep and going into our MRI scanner and so we can look at different areas of the brain and how much they are communicating and what we've seen in these newborns is that a part of the brain it's very associated with fear reactions and detecting stimuli and no trying to tell if it's or at least having a reaction if it's if it's going to be a bad or good experience called the amygdala is more strongly connected to a part of the brain called the prefrontal cortex and that actually is more the part of the brain that helps us decide if it's something to be worried about or not now obviously as a newborn we don't we imagine not there's certainly not verbal thinking going on but the brain is getting connected and we see that fetuses who have more reactive heart rate as newborns just resting in the scanner they have this part of the brain that amygdala the prefrontal cortex that is more intensely connected as if they're already ready to be aware of stimuli out in the world so the amygdala is the part of the brain deep inside that is thought to be associated with kind of emotional reactions fight or flight instincts is that correct absolutely that's right part of the limbic system and and key to our having emotional experiences so when you are explaining that the that in these infants who had higher reactivity in the womb that their that their amygdala is somehow more more active it's actually that was the second part of our finding which we didn't go into is through some complex statistical analyses and I should really cite my colleague on this Jonathan Posner and Jack Cooke Shaw and his lab they were actually able to see that it was the amygdala the activity of the amygdala just as you've anticipated that was driving this greater connectivity so that's exactly right hey everyone thanks for watching part one of our discussion with dr. Katherine monk if you enjoyed what you saw remember to like the video or leave us a comment and if you want to see more please check out part two

10 Replies to “Does a mother's mental health affect her fetus? (Part 1) – interview with Catherine Monk | VIEWPOINT”

  1. Does Monk have any suggestions for books on the subject? I started getting interested in neonatal environment after reading some of Sopalsky's work on glucocorticoids but would prefer something more specifically focused. I mean I'll check out the articles but I like to really dive in on these things.

  2. Hello! Have you tested mothers who are drug users and pregnant? Then they give up their child for adoption? And their adoptive parents deal with behavioral issues

  3. My sister-in-law was very stressed out and anxious during her 1st pregnancy. Her 1st kid is a bit of an anxious child. My sister-in-law was much more calm and less worried during her 2nd pregnancy. Her 2nd child is much more self-assured. My sister-in-law was worried and stressed again during her 3rd pregnancy (though not as much as her 1st). Her 3rd kid is less emotionally balanced than the 2nd, but more-so than the 1st. Is all of this anecdotal? Yes. Is it correlative? Absolutely. Does it, nevertheless, suggest certain conclusions? Potentially. If the mother is experiencing more stress hormones than normal, it makes sense that the child within her would also experience those hormones. This doesn't have to be about "crazy" women, just about the daily stresses that all human beings experience. The take-away is this- if you are a pregnant woman, do your best to stay calm and emotionally stable, for the good of your pre-born infant. Remember, you're emoting for two! 😀

  4. To speak to some of the comments – The fetal origins of adult disease (FOAD) has been making tremendous discoveries and strides since WWII and includes a study of women exposed to the extreme stress of WWII during the Dutch Hunger winter. While initial studies focused on nutritional stress it's since been found that emotional stress has just as strong of an effect on babies and children. Prenatal stress can affect birth size and risk for chronic diseases such as heart disease, obesity, and diabetes in adults. And boys develop in the womb too – so it's not just a need to care for and support women but to care for famiiies and children. Studies by Antonio Madrid have shown that stress in this time frame is a risk factor for asthma and that helping mothers heal from difficult or traumatic events during this early time frame can often cure asthma in their kids. Thanks so much for this great interview!

    Veronique Mead, MD, MA

  5. Fascinating conversation. I think a lot of people aren't going to like the realization that working pregnant women is probably a bad idea. And also single pregnant women is likely a bad idea since a provider male is not present. This is going to be a contentious area in our current hyper PC environment…

  6. So if a woman who is genetically disposed for depression, gets pregnant and gets depressed, has a baby ( that is probably also genetically disposed of depression) when that baby grows up and gets depressed it's mostly because of fetal development stressors? I need to see a little more causation and less correlation

  7. Of course. Moral of the story: Don't have sex with a bat shit crazy.

    Bat shit crazy parents have an even greater effect on the mental well being of the child after they are born also.

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