Prenatal Risks for Future Mental Health Problems Flashcards Preview

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Flashcards in Prenatal Risks for Future Mental Health Problems Deck (39)
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1

Define foetal programming

How the environment in the womb can alter development of the foetus and have long-lasting effects on the child

2

Describe the Barker hypothesis

The intrauterine environment affects a child's risk of developing disease later in life - for example, CHD, T2 diabetes, stroke, and HTN develop due to developmental plasticity in response to undernutrition during foetal life

3

Describe the effect of birth weight on coronary heart disease risk

A child of low birth weight is twice as likely to die of CHD in their 70s as a child of normal birth weight

4

How many women are affected by postnatal depression?

1 in 10

5

How much is a woman's risk of psychosis increased in the month post-partum?

30x

6

State 2 risk factors for post-partum psychosis

Personal or family history of bipolar disorder

7

How much does the brain increase in size between 20 and 40 weeks gestation?

17x

8

How much does the brain increase in size between birth and 5 years of age?

4x

9

Name the steps involved in neural development

Proliferation, migration, differentiation, synaptogenesis, neural pruning

10

When does neural proliferation start and end?

Starts: 5 weeks gestation
Ends: 18 months after birth

11

Broadly, what occurs in the developing brain in the first and second half of gestation?

1st half: Migration
2nd half: Synaptogenesis

12

State some prenatal stresses associated with developmental and behavioural changes in the child

Maternal anxiety and depression, maternal daily hassles, pregnancy-specific anxiety, partner or family discord, experience of acute distress

13

Describe the association between maternal childhood trauma and pregnancy-related mental health issues (ALSPAC study)

A maternal history of sexual abuse preducts elevated anxiety and depression from pregnancy to 33 months post-partum. Early childhood trauma is associated with antenatal anxiety and depression

14

Describe the difference in prenatal mental health in LICs and HICs

Prenatal stress is more common in LICS/MICS, with 25% of expectant mothers experiencing symptoms of perinatal depression and anxiety compared to 15% in HICS. Explanations include higher rates of maternal and infant death, higher rates of interpersonal violence, natural disasters, and war

15

Name some developmental disorders associated with prenatal stress

Anxiety disorder, depressive disorder, ADHD, language impairment, sleep problems in infancy, difficult temperament, schizophrenia, autism spectrum disorder, intellectual disability

16

What period of development is associated with schizophrenia?

Altered migration of cells during the first half of gestation

17

Name some physical consequences to the child of maternal prenatal stress

Low birthweight, ambidextrosity, altered fingerprint pattern, decreased telomere length, asthma, altered microbiome, altered immune function

18

Name some conditions associated with not being right-handed

ADHD, schizophrenia, dyslexia

19

Describe the effect of pregnancy-related anxiety on the infant's gut microbiome

It is associated with fewer Enterobacteriaceae species in the microbiome of the newborn meconium

20

Describe some effects of prenatal stress on offspring in animal studies

Increased anxiety, reduced attention, learning deficits, reduced laterality, altered sexual behaviour with increased rates of homosexuality

21

What appears to mediate the effects of prenatal stress on offspring in animal studies?

The HPA axis and cortisol

22

What percentage of behavioural and emotional problems are likely to be attributable to antenatal anxiety, depression, or stress (ALSPAC)?

10-15%

23

How much does high prenatal anxiety influence the child's risk of developing a mental health disorder? (O'Donnell et al, 2014)

It doubles it - but only to 12.5%

24

Gene variants of which enzyme are associated with working memory and ADHD?

Catecholamine methyl transferase (COMT)

25

Describe the relationship between antenatal anxiety, working memory, and COMT (ALSPAC; O'Donnell et al, 2017)

Working memory is worse in children with the GG genotype of COMT, but only when their mothers had been anxious during pregnancy

26

Describe the relationship between antenatal anxiety, ADHD, and COMT (ALSPAC; O'Donnell et al, 2017)

Children with the GG genotype of COMT have higher ADHD socres, but only if their mothers suffered from perinatal anxiety

27

Describe the relationship between maternal anxiety and 11-betaHSD2 (O'Donnell et al, 2012)

Greater levels of maternal anxiety correlate with lower expression of 11-betaHSD2, allowing more cortisol to pass from mother to foetus - but only in Caucasian women; enzyme expression increases with antenatal stress in non-Caucasian women

28

Describe the relationship between cortisol and Bayley scales of infant development 2 (BSD-II) scores

Higher amniotic fluid cortisol correlates with a slight impairment to cognitive development on the BSD-II - but only in children with insecure attachment, showing that secure attachment can ameliorate the effects of high cortisol during pregnancy

29

Describe the brain changes in children associated with maternal stress during pregnancy (Sarkar et al, 2018)

During a rewarded continuous performance task, children of stressed mothers showed increased activation of the right cingulate gyrus and decreased activation of the left inferior frontal gyrus, right supramarginal gyrus, and left anterior cingulate cortex

30

Describe the brain changes in children associated with high amniotic fluid cortisol (Sarkar et al, 2018)

Antenatal amniotic fluid cortisol correlated with increased fMRI activation during sustained attention in the right temporal pole, right angerior cingulate cortex, and right caudate, with decreased activation in the left primary visual cortex, right cingulate cortex, and right insula