From the womb into the world:Protecting the fetal brain from maternal stress during pregnancy

No other period in a child's life matches the speed of brain development than the first nine months in the womb. Rapid growth goes hand in hand with enormous potential, but also with great vulnerability. This policy-focused review focuses on maternal mental health as a key factor for fetal brain development. Already during pregnancy, the fetal brain wires differently when exposed to maternal stress, and children prenatally exposed to stress have a higher risk of developing neurodevelopmental disorders. Maternal prenatal stress is preventable, treatable, and tractable by policy. Research-based, policy recommends: (1) screening for maternal mental health issues throughout pregnancy, (2) encourage talking about prenatal mental health, (3) evidence-based interventions for pregnant women with mental health issues, (4) avoiding stress-inducing communication towards pregnant women, and (5) stimulating positive postnatal parenting. Investing in healthy pregnancies will improve fetal brain growth, and, ultimately lead to a healthier next generation

Does mindful parenting mediate the association between maternal anxiety during pregnancy and child behavioral/emotional problems?

Objectives Maternal anxiety during pregnancy is a risk factor for child behavioral/emotional problems. Knowledge about explanatory factors mediating this link is scarce. Maternal anxiety during pregnancy may be an indicator of adverse postnatal environmental conditions, including maternal anxiety and poor parenting, possibly affecting child behavior. This study investigated whether maternal anxiety and mindful parenting in early childhood mediate the association between maternal anxiety during pregnancy and child behavioral/emotional problems. Methods This study was based on a sample of 118 mother-child dyads who participated in a cohort study that followed participants from pregnancy until 4 years after birth. At 21 weeks’ gestation and when the child was 4 years old, mothers completed questionnaires to assess state anxiety (State-Trait Anxiety Inventory) and general anxiety (Symptom Checklist-90 anxiety subscale). At age 4 years, mothers reported mindful parenting (Interpersonal Mindfulness in Parenting Scale) and child behavioral/emotional problems (Child Behavior Checklist). Results Maternal state anxiety during pregnancy was positively associated with child internalizing problems and negatively with mindful parenting. Maternal general anxiety during pregnancy was related with more child internalizing and externalizing problems but not with mindful parenting. The association between maternal state anxiety during pregnancy and child internalizing problems was sequentially mediated via concurrent maternal general anxiety and mindful parenting. Conclusions These findings suggest that maternal anxiety during pregnancy continues into early childhood and, because of this, it subsequently affects child internalizing behavior via poor mindful parenting. Replication studies are needed before developing interventions for tackling maternal anxiety during pregnancy and promoting mindful parenting

Prenatal hair cortisol concentrations during the COVID-19 outbreak:Associations with maternal psychological stress and infant temperament

Background:  Maternal psychological stress during pregnancy, including stress resulting from disasters and trauma, has been linked to temperamental difficulties in offspring. Although heightened cortisol concentrations are often hypothesized as an underlying mechanism, evidence supporting this mechanism is not consistent, potentially because of methodological issues and low stress in the population.  Aim:  To address these issues, this preregistered study investigated the following associations between: 1) prenatal psychological stress and hair cortisol, as a biomarker for chronic stress, during the COVID-19 outbreak (i.e., as a major worldwide psychological stressor), and 2) maternal hair cortisol during the COVID-19 outbreak and later infant temperamental negative affectivity and orienting/regulation. Additionally, we explored whether associations were different for women with low versus high socioeconomic status (SES; maternal education and annual household income) and at different stages of pregnancy.  Method:  Pregnant women (N = 100) filled out online questionnaires during the first COVID-19 lockdown. Six months later, when most mothers were still pregnant or had just given birth, maternal hair samples were collected during home visits. When infants were six months old, mothers reported on their infant's temperament.  Results:  Although hierarchical regression analyses revealed no associations between prenatal COVID-19 psychological stress and hair cortisol during the COVID-19 outbreak, SES proved to be a moderator in this association. Only pregnant women with higher levels of SES, not lower levels, showed a positive association between work-related and social support-related COVID-19 worries and hair cortisol. Finally, prenatal hair cortisol was not associated with later infant temperamental negative affectivity and orienting/regulation.  Conclusion:  Although the COVID-19 outbreak proved to be a major psychological stressor worldwide, the physiological impact of the crisis might be different for pregnant women with higher SES as compared to lower SES

Frontal alpha asymmetry in response to stressor moderates the relation between parenting hassles and child externalizing problems

Inequitable urban environments are associated with toxic stress and altered neural social stress processing that threatens the development of self-regulation. Some children in these environments struggle with early onset externalizing problems that are associated with a variety of negative long-term outcomes. While previous research has linked parenting daily hassles to child externalizing problems, the role of frontal alpha asymmetry (FAA) as a potential modifier of this relationship has scarcely been explored. The present study examined mother-child dyads, most of whom were living in low socioeconomic status households in an urban environment and self-identified as members of racial minority groups. Analyses focused on frustration task electroencephalography (EEG) data from 67 children (mean age = 59.0 months, SD = 2.6). Mothers reported the frequency of their daily parenting hassles and their child’s externalizing problems. Frustration task FAA moderated the relationship between parenting daily hassles and child externalizing problems, but resting FAA did not. More specifically, children with left frontal asymmetry had more externalizing problems as their mothers perceived more hassles in their parenting role, but parenting hassles and externalizing problems were not associated among children with right frontal asymmetry. These findings lend support to the motivational direction hypothesis and capability model of FAA. More generally, this study reveals how individual differences in lateralization of cortical activity in response to a stressor may confer differential susceptibility to child behavioral problems with approach motivation (i.e., left frontal asymmetry) predicting externalizing problems under conditions of parental stress

The COVID-19 outbreak increases maternal stress during pregnancy, but not the incidence of postpartum depression

The COVID-19 pandemic affects society and may especially have an impact on mental health of vulnerable groups, such as perinatal women. This prospective cohort study compared perinatal symptoms of depression and stress during and before the pandemic. Pregnancy-specific stress increased significantly in women during the pandemic. We found no increase in depressive symptoms during pregnancy nor an increase in incidence of postnatal depression during the pandemic. Clinicians should be aware of increased stress in pregnant women and offer adequate care

Maternal mindfulness and anxiety during pregnancy affect infants’ neural responses to sounds

Maternal anxiety during pregnancy has been consistently shown to negatively affect offspring neurodevelopmental outcomes. However, little is known about the impact of positive maternal traits/states during pregnancy on the offspring. The present study was aimed at investigating the effects of the mother’s mindfulness and anxiety during pregnancy on the infant’s neurocognitive functioning at 9 month of age. Mothers reported mindfulness using the Freiburg Mindfulness Inventory and anxiety using the Symptom Checklist at ±20.7 weeks of gestation. Event-related brain potentials (ERPs) were measured from 79 infants in an auditory oddball paradigm designed to measure auditory attention - a key aspect of early neurocognitive functioning. For the ERP-responses elicited by standard sounds, higher maternal mindfulness was associated with lower N250 amplitudes (p<.01, η²=.097), whereas higher maternal anxiety was associated with higher N250 amplitudes (p<.05, η²=.057). Maternal mindfulness was also positively associated with the P150 amplitude (p<.01, η²=.130). These results suggest that infants prenatally exposed to higher levels of maternal mindfulness devote fewer attentional resources to frequently occurring irrelevant sounds. The results show that positive traits and experiences of the mother during pregnancy may also affect the unborn child. Emphasizing the beneficial effects of a positive psychological state during pregnancy may promote healthy behavior in pregnant women

Implementing EEG hyperscanning setups.

Hyperscanning refers to obtaining simultaneous neural recordings from more than one person (Montage et al., 2002 [1]), that can be used to study interactive situations. In particular, hyperscanning with Electroencephalography (EEG) is becoming increasingly popular since it allows researchers to explore the interactive brain with a high temporal resolution. Notably, there is a 40-year gap between the first instance that simultaneous measurement of EEG activity was mentioned in the literature (Duane and Behrendt, 1965 [2]), and the first actual description of an EEG hyperscanning setup being implemented (Babiloni et al., 2006 [3]). To date, specific EEG hyperscanning devices have not yet been developed and EEG hyperscanning setups are not usually described with sufficient detail to be easily reproduced. Here, we offer a step-by-step description of solutions to many of these technological challenges. Specifically, we describe and provide customized implementations of EEG hyperscanning setups using hardware and software from different companies: Brain Products, ANT, EGI, and BioSemi. •Necessary details to set up a functioning EEG hyperscanning protocol are provided.•The setups allow independent measures and measures of synchronization between the signals of two different brains.•Individual electrical Ground and Reference is obtained in all discussed systems

The risk and protective factors of heightened prenatal anxiety and depression during the COVID-19 lockdown

While pregnant women are already at-risk for developing symptoms of anxiety and depression, this is heightened during the COVID-19 pandemic. We compared anxiety and depression symptoms, as indicators of psychological distress, before and during COVID-19, and investigated the role of partner, social network and healthcare support on COVID-19-related worries and consequently on psychological distress. A national survey, conducted during the first lockdown in The Netherlands, assessed COVID-19 experiences and psychological distress (N = 1421), whereas a comparison sample (N = 1439) was screened for psychological distress in 2017–2018. During COVID-19, the percentage of mothers scoring above the questionnaires’ clinical cut-offs doubled for depression (6% and 12%) and anxiety (24% and 52%). Women reported increased partner support during COVID-19, compared to pre-pandemic, but decreased social and healthcare support. Higher support resulted in lower COVID-19-related worries, which in turn contributed to less psychological distress. Results suggest that a global pandemic exerts a heavy toll on pregnant women’s mental health. Psychological distress was substantially higher during the pandemic than the pre-pandemic years. We identified a protective role of partner, social, and healthcare support, with important implications for the current and future crisis management. Whether increased psychological distress is transient or persistent, and whether and how it affects the future generation remains to be determined

Differences between human auditory event-related potentials (AERP) measured at 2 and 4 months after birth

Infant auditory event-related potentials (AERP) show a series of marked changes during the first year of life. These AERP changes indicate important advances in early development. The current study examined AERP differences between 2- and 4-month-old infants. An auditory oddball paradigm was delivered to infants with a frequent repetitive tone and three rare auditory events. The three rare events included a shorter than the regular inter-stimulus interval (ISI-deviant), white noise segments, and environmental sounds. The results suggest that the N250 infantile AERP component emerges during this period in response to white noise but not to environmental sounds, possibly indicating a developmental step towards separating acoustic deviance from contextual novelty. The scalp distribution of the AERP response to both the white noise and the environmental sounds shifted towards frontal areas and AERP peak latencies were overall lower in infants at 4 compared to at 2 months of age. These observations indicate improvements in the speed of sound processing and maturation of the frontal attentional network in infants during this period

Automated brain masking of fetal functional MRI with open data

Fetal resting-state functional magnetic resonance imaging (rs-fMRI) has emerged as a critical new approach for characterizing brain development before birth. Despite the rapid and widespread growth of this approach, at present, we lack neuroimaging processing pipelines suited to address the unique challenges inherent in this data type. Here, we solve the most challenging processing step, rapid and accurate isolation of the fetal brain from surrounding tissue across thousands of non-stationary 3D brain volumes. Leveraging our library of 1,241 manually traced fetal fMRI images from 207 fetuses, we trained a Convolutional Neural Network (CNN) that achieved excellent performance across two held-out test sets from separate scanners and populations. Furthermore, we unite the auto-masking model with additional fMRI preprocessing steps from existing software and provide insight into our adaptation of each step. This work represents an initial advancement towards a fully comprehensive, open-source workflow, with openly shared code and data, for fetal functional MRI data preprocessing