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The neurobiological impact of traumatic birth on postpartum mental health and the offspring

We know that pregnancy, delivery, and the succeeding weeks involve enormous and unique changes in the body of mothers, mostly derived from a surge in hormone levels, but also coinciding with a time frame of stress and life changes. Recently, we knew that the brain of pregnant women also experiences substantial structural modifications that are thought to facilitate maternal-to-child bonding. However, between 4% and 20% of women who give birth will perceive their delivery in such a stressful way that they will present psychological consequences resulting in what we call traumatic birth. Why is this so important? Because these sequelae may also hinder elaborating the maternal role and influence the neurodevelopment of the child. Despite the relevant consequences of these problems, little is known about the mechanisms through which traumatic birth may cause mental problems such as depression or anxiety after delivery. We know that large magnitude stress is also able to transform and modify our brain and, theoretically, it could modify the natural brain transformation processes that happen during pregnancy and delivery. Thus, we hypothesize that traumatic birth interferes with the normal biological changes of maternity, causing a deviation in the hormonal profile, and subsequently in the structure and functioning of the brain. These alterations, ultimately, increase the risk of postpartum mental health conditions, dificult the mother-to-child bonding, and subsequently influence the normal development of the infant.

How are we planning to test this hypothesis? We will evaluate 45 dyads of mother and child who have experienced a traumatic birth and 45 control dyads. Participant mothers will be evaluated at 8 weeks after delivery: we will ask them to answer clinical questionnaires and they will get a brain scan to determine alterations in brain volume and connectivity. Hair samples and saliva will be collected to study the hormonal profile, and we will retrieve information about the level of pain and the existence of relevant events that happened during delivery. We will also enquire about the subjective perception that mothers had during the delivery, and we will evaluate the development of the normal reactions and reflexes of the child.
We will use all this information to find out which of these elements are different in mothers and babies with traumatic birth in comparison to mothers and babies without traumatic birth. As we know that personality and past history of mental disorders may also influence mental health during the postpartum, we will control for these variables.

Who will benefit from this study? Understanding the mechanisms through which traumatic birth influences mental health may help clinicians to anticipate situations at risk for traumatic birth or to prevent its consequences. Because maternity is socially considered as a joyful life event, women suffering from the consequences of traumatic birth, may feel guilty and forced to cover their psychological trouble. These are important barriers to seek for help. Uncovering the mechanisms of this problem will shed light on its causes and will help to destigmatize many women who are struggling with postpartum mental health conditions.

Funding

Fundació La Marató TV3, 2022 call. 180.330 €

Principal Investigator

Daniel Bergé, Hospital del Mar Research Institute

Links

Information of the study at the Hospital del Mar Research Institute website

Screening questionnaire