Increasing Parity is Associated with Cumulative Effects on Memory

BACKGROUND: The purpose of this investigation was to determine if reproductive experience is associated with cumulative effects on human memory performance during pregnancy and if these effects persist into the postpartum period. METHODS: Verbal recall memory performance was assessed in 254 women four times during pregnancy and at 3 months postpartum. The relation between parity and memory function was evaluated with hierarchical linear modeling and analysis of covariance (ANCOVA). RESULTS: The data indicate that the previously documented adverse effects of pregnancy on memory performance are compounded with successive pregnancies. During gestation and postpartum, multiparity was associated with poorer memory function, and these effects did not appear to be due to differences in maternal demographics, depressive symptoms, or sleep quality. CONCLUSIONS: Animal models demonstrate that the effects of reproduction on brain structure and function are both cumulative and enduring. However, little is known about the influence of reproductive experience on the human female brain. These findings provide evidence that in humans, reproduction is associated with striking and perhaps persisting changes in cognitive function

Maternal, Environmental, and Social Context Predicts Diarrheal Infection Incidence in Young Children in Sundarbans, India

Diarrheal infection is the third leading cause of childhood mortality in India and is responsible for 13% of all deaths per year in children under 5 years of age (Lakshaminarayan & Jayalakshmy, 2015). The Sundarbans in West Bengal is amongst the poorest regions of India and is the epitome of abject deprivation and the acute struggle against geographical and socioeconomic challenges. The incidence of diarrhea in this region is considerably high; about 42,000 reported cases occur per month, and one in five diarrhea cases are reported as severe (with blood in stool). In addition, 37% of children hospitalized for ailments were admitted due to diarrhea (Kanjilal et al., 2013). However, little research has been conducted to determine whether maternal characteristics and behaviours correlate with this incidence in India, though some studies have found certain family characteristics to be protective in other areas such as sub-Saharan Africa (c.f. Boschi-Pinto et al., 2006). The objective of the current study was to investigate sociodemographic, psychological and environmental factors associated with diarrheal infection in children in West Bengal. A structured interview was administered in Bengali to women who were mothers to children aged five and under in 150 households in the village of Sonakhali of Ramchandrakhali in West Bengal. Door to door data collection was carried out on a random sample of the entire village. Information regarding demographic and socioeconomic characteristics of the mother were obtained as well as information about diarrheal incidence during the prior year in children five and under. A validated Bengali version of the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988) was administered which assesses perceptions of overall social support, as well as particular support from significant others, family, and friends. In addition, mothers were asked to answer questions regarding their beliefs about the causes and methods of prevention of diarrhea. Among children five and under, 75% of males and 73% of females had at least one incidence of diarrhea in the past year (mean = 2.7). Predictors of incidence included household income, religion, type of home, and perceived social support (all p\u27s\u3c .05). There were no significant associations between the age of the mother, mother\u27s age at marriage, caste, education level and incidence of diarrhea. Notably, the effects of social support remained after adjusting for income, religion, and type of house. These findings suggest that further understanding the epidemiology of childhood diarrhea should not be limited to the thorough examination of environmental factors, but also requires focus on the role of the mother and her psychological states and social context

Mode of Delivery and Infant Cognitive Development

The rate of nonindicated cesarean births is increasing each year within the United States. Although cesarean delivery can function as a life- saving intervention, emerging evidence suggests that it may also be associated with deleterious developmental consequences for the child. Here we test the hypothesis that mode of delivery is associated with cognitive development during infancy. 229 pregnant women were recruited and their infants’ cognitive development was assessed at 6, 12 and 24 months with the Bayley Scales of Infant Development. Medical charts were reviewed by obstetric nurses to determine prenatal medical risk and birth outcomes, including mode of delivery. Infants who were delivered vaginally (n = 163) exhibited better performance on the mental development index of the Bayley at 6, 12, and 24 months (M= 98.56, 96.20, and 98.79 respectively) compared to those delivered by cesarean (n =66 ; M= 94.38, 89.64, 90.83 respectively; all F’s \u3e 7.97 and all p’s \u3c .005). These group differences remained even after consideration of potential covariates and third variable explanations in ANCOVA models including: 1. Whether the birth was spontaneous or induced 2. Length of gestation 3. A range of demographic factors including maternal age, socioeconomic status and postpartum depressive symptoms. The benefits of cesarean delivery when medically indicated are undisputed. However, these findings suggest that in the case of nonindicated cesarean delivery, practitioners should carefully consider the potential short and long-term costs and benefits of this intervention

The Contribution of Racism-Related Stress and Adversity to Disparities in Birth Outcomes: Evidence and Research Recommendations

Currently, racial and ethnic differences in adverse birth outcomes and infant mortality are some of the largest and most persistent health disparities in the United States. This narrative review article synthesizes existing literature to present a conceptual model of how racism-related stress and adversity are critical determinants of such disparities. We describe how historical and ongoing racism has created conditions wherein women of color are disproportionately exposed to chronic, multilayered stress and adversity and how the biological consequences of exposure to these stressors confers risk for adverse birth outcomes. Next, we identify important priorities and considerations for future research, including the heterogeneity of racism-related stressors, biomarkers and mechanisms, chronicity and sensitive periods of exposure, developmental programming of lifespan health, resilience, and community-engaged research methodologies

The Influence of Unpredictable, Fragmented Parental Signals on the Developing Brain

Mental illnesses originate early in life, governed by environmental and genetic factors. Because parents are a dominant source of signals to the developing child, parental signals - beginning with maternal signals in utero - are primary contributors to children’s mental health. Existing literature on maternal signals has focused almost exclusively on their quality and valence (e.g. maternal depression, sensitivity). Here we identify a novel dimension of maternal signals: their patterns and especially their predictability/unpredictability, as an important determinant of children’s neurodevelopment. We find that unpredictable maternal mood and behavior presage risk for child and adolescent psychopathology. In experimental models, fragmented/unpredictable maternal care patterns directly induce aberrant synaptic connectivity and disturbed maturation of cognitive and emotional brain circuits, with commensurate memory problems and anhedonia-like behaviors. Together, our findings across species demonstrate that patterns of maternal signals influence brain circuit maturation, promoting resilience or vulnerability to mental illness

Maternal Programming: Application of a Developmental Psychopathology Perspective

The fetal phase of life has long been recognized as a sensitive period of development. Here we posit that pregnancy represents a simultaneous sensitive period for the adult female with broad and persisting consequences for her health and development, including risk for psychopathology. In this review, we examine the transition to motherhood through the lens of developmental psychopathology. Specifically, we summarize the typical and atypical changes in brain and behavior that characterize the perinatal period. We highlight how the exceptional neuroplasticity exhibited by women during this life phase may account for increased vulnerability for psychopathology. Further, we discuss several modes of signaling that are available to the fetus to affect maternal phenotypes (hormones, motor activity, and gene transfer) and also illustrate how evolutionary perspectives can help explain how and why fetal functions may contribute to maternal psychopathology. The developmental psychopathology perspective has spurred advances in understanding risk and resilience for mental health in many domains. As such, it is surprising that this major epoch in the female life span has yet to benefit fully from similar applications

Developmental Origins of the Human Hypothalamic-Pituitary-Adrenal Axis

Introduction: The developmental origins of disease or fetal programming model predicts that intrauterine exposures have life-long consequences for physical and psychological health. Prenatal programming of the fetal hypothalamic-pituitary-adrenal (HPA) axis is proposed as a primary mechanism by which early experiences are linked to later disease risk. Areas covered: This review describes the development of the fetal HPA axis, which is determined by an intricately timed cascade of endocrine events during gestation and is regulated by an integrated maternal-placental-fetal steroidogenic unit. Mechanisms by which stress-induced elevations in hormones of maternal, fetal, or placental origin influence the structure and function of the emerging fetal HPA axis are discussed. Recent prospective studies documenting persisting associations between prenatal stress exposures and altered postnatal HPA axis function are summarized, with effects observed beginning in infancy into adulthood. Expert commentary: The results of these studies are synthesized, and potential moderating factors are discussed. Promising areas of further research highlighted include epigenetic mechanisms and interactions between pre and postnatal influences

Response to “Cortisol in Human Milk: The Good, the Bad, or the Ugly?”

A response to Finken et al.\u27s Cortisol in Human Milk: The Good, the Bad, or the Ugly? , a critique of the authors\u27 previous article Cortisol in human milk predicts child BMI

One Size Doesn’t Fit All: Attitudes Towards Work Modify the Relation between Parental Leave Length and Postpartum Depression

The present study aimed to investigate the relationship between parental leave length and maternal depressive symptoms at six- and twelve-months postpartum and whether this relation was influenced by women’s attitudes towards leave, whether leave was paid or unpaid, and the reason they returned to work. The sample included 115 working women recruited during pregnancy as part of a larger longitudinal study. Analyses revealed that maternal attitudes toward leave influenced the association between leave length and depressive symptoms. Specifically, longer leaves were associated with increased depressive symptoms for women who missed their previous activities at work. Furthermore, women who missed work and had leave for 16 weeks or more, exhibited higher depressive symptoms at six- and twelve-months. Last, results also indicated that women who returned to work solely for monetary reasons exhibited more depressive symptoms at six-months postpartum than those who returned to work for other reasons. This study is among the first to show that women’s attitudes towards parental leave and their individual reasons for returning to work are important factors to consider that may have potential implications for parental leave policies