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July 3, 2023

Protecting the Future

How Early Mental Health Care for Moms-to-Be Protect the Future of Their Children

Dr. Lana du Plessis

Joy and excitement are part of the experience of having a new baby, but unfortunately so are anxiety and depression. It is believed that 50% of new mothers have at least minor depressive symptoms during pregnancy that go untreated.  The reasons for anxiety and depression are due to the additional financial burden, time constraints to get things done, and the stress of being a parent. Apart from this, rapid hormonal and immune changes in the mother’s body play a major role.

Approximately 1 in 5 women are affected by major depressive episodes during pregnancy and the year after birth. Even non-pregnant women (1 in 20) experience major depressive episodes during their childbearing years. Major depressive episodes during pregnancy can lead to complications in pregnancy and childbirth.  Data indicates that depression in mothers increases the risk of heart and other health problems for the mother and child. For instance, women with postpartum depression are 70% more likely to develop heart problems within 5 years of giving birth.

Mothers-to-be that have anxiety and depression are also more likely to have babies with lower birth weights, poorer health, and emotional and behavioural difficulties.

If a mother experiences stress during pregnancy, the child is at risk of attention‐deficit disorder, conduct disorder, autistic spectrum disorder, anxiety, depression and/or asthma. The mother is also at risk of preterm labour. The most severe effect is schizophrenia, which is linked to extreme stress in the first trimester (1).

What are the mechanisms for these symptoms?

Early abuse of the mother during pregnancy,  is associated with changed brain structure and less cortical grey matter in the newborn. This early trauma may affect the mother’s natural biology and alter the development of her baby’s brain and may lead to depression and other problems for the child later in life.

It has been suggested that prenatal anxiety or depression alters the function of the placenta and allows more cortisol to pass through to the baby. Higher maternal cortisol is linked to altered brain function in the child, including heightened symptoms of sadness, anxiety, and loneliness, especially in girls.

In recent studies to understand the effect of stress during embryonic neural stem cell development, it was discovered that specific genes historically associated with psychiatric disorders, nerve signalling, and brain and nerve development all displayed over-methylation during stress (2-4).

Medication and Psychotherapy are helpful, and mothers experiencing symptoms of stress, anxiety or depression should get help when they feel overwhelmed. There is no shame in speaking about what they are experiencing.

During pregnancy and after, mothers must take care of themselves by eating healthy, doing something they enjoy with friends, doing yoga or exercise and going for a walk. During pregnancy, mothers are encouraged to frequently visit their healthcare provider for prenatal care, and they should also discuss their mental health status and feelings with their provider. There are excellent screening tools for depression, and these should form routine diagnoses in pregnancy.

If we can get mothers to monitor and speak up about their mental health during pregnancy, healthcare professionals can assist more effectively and help reduce stress, and even prevent childhood neuro-development problems.

Good mental health is important for moms-to-be as well as for their developing baby’s future health.

Be safe and reach out to your loved ones or a professional if you need help.

References

  1. Semra W, et al. The relationship between prematurity and maternal mental health during the first postpartum year. Journal of Neonatal Nursing, Volume 29, Issue 3, 2023, Pages 511-518.
  2. V. Lemaire, et al. Prenatal stress produces learning deficits associated with an inhibition of neurogenesis in the hippocampus. PNAS. September 26, 2000, 97 (20) 11032-11037.
  3. https://edoc.ub.uni-muenchen.de/25120/
  4. https://www.frontiersin.org/articles/10.3389/fncel.2015.00207.

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