The impact of psychological distress during pregnancy on the developing fetus: biological mechanisms and the potential benefits of mindfulness interventions

Abstract

Abstract:The in utero environment plays an essential role in shaping future growth and development. Psychological distress during pregnancy has been shown to perturb the delicate physiological milieu of pregnancy, and has been associated with negative repercussions in the offspring, including adverse birth outcomes, long-term defects in cognitive development, behavioral problems during childhood and high baseline levels of stress-related hormones. Fetal epigenetic programming, involving epigenetic processes, may help explain the link between maternal prenatal stress and its negative effects on the child. Given the potential long-term effects of early-life stress on a child's health, it is crucial to minimize maternal distress during pregnancy. A number of recent studies have examined the usefulness of mindfulness-based programs to reduce prenatal psychological stress and improve maternal psychological health, and these are reviewed here. Overall, the findings are promising, but more research is needed with large studies using randomized controlled study designs. It remains unclear whether or not such interventions could also improve child health outcomes, and whether these changes are modulated at the epigenetic level during fetal development. Further studies in this area are needed.

Opening windows of opportunities: Evidence for interventions to prevent or treat depression in pregnant women being associated with changes in offspring's developmental trajectories of psychopathology risk

“…Thus, an important next step in this line of research is to propose and test mediational models. These would include not only studies of experimental interventions designed to change any of the potential pregnancy-related mediators (e.g., reducing pregnant women's stress reactivity and enhancing their coping skills; see Isgut, Smith Alicia, Reimann Eduardo, Kucuk, & Ryan, 2017; Richter et al, 2012, for two examples) but also postnatal functioning of the mother, her quality of parenting the infant, the stress context of child rearing (Hammen, 2002), quality of her relationship with the child's father/her romantic partner, and so forth. A review of the literature on mediation studies for child depression treatments proposed a ladder of evidence, based on various research design features (Maric, Wiers, & Prins, 2012).…”

An Epigenetics-Based, Lifestyle Medicine–Driven Approach to Stress Management for Primary Patient Care: Implications for Medical Education

“…88 These adaptations are thought to be carried out by epigenetic changes that alter fetal HPA axis development, 88,89 immune system function, 16,[90][91][92] and nervous system development. 91,92 Distress in pregnancy is also associated with defects in fetal cognitive development and subsequent childhood behavioral problems, exemplifying epigenetically modifiable relationships between prenatal stress and fetal phenotype outcomes. Fetal alcohol syndrome also has an epigenetic impact through DNA methylation of POMC (Proopiomelanocortin) neurons, which are regulators of HPA axis, immunity, and energy homeostasis, thus further exemplifying the relationship between perinatal stress and phenotype outcomes.…”

Older Adult Caregivers’ Experiences in an Online, Interactive Mindfulness Intervention

“…24 Mindfulness meditation as a practice refers to focusing one’s attention on the emergence of thoughts, emotions and body sensations while observing them as they arrive and pass. 25 Trait mindfulness and mindfulness interventions demonstrate changes in underlying biological mechanisms that contribute to mindfulness benefits, 26 such as reducing the connection between the amygdala and other regions of the brain that drive stress reactivity, decreasing respiratory rates and potentially normalizing diurnal cortisol secretion among those with high cortisol levels. 27,28 Further, mindfulness interventions have been found to counteract the sympathetic fight or flight response by increasing parasympathetic nervous system activation.…”