Sunday, October 12, 2008

What does the state of the economy have to do with your unborn baby?

Last week, Tara Parker-Pope wrote an article in the New York Times about the unlikely connection between a failing economy and better health status. While this correlation is not always present, Parker-Pope points to certain situations in which mental well-being and health status actually improve during an economic downturn. In developing countries, laborers might have more time to spend with their families and to breastfeed their children. In industrialized countries, particularly in well-to-do families, if one earner loses their job or has a lighter work load, he or she could have more time to spend at home with their children, improving their mental well-being. Aside from spending quality time with family members, families usually eat healthier when money is tight and time is plentiful since they prepare food at home instead of dining out.

Because I believe in the fetal origins hypothesis, I believe that if there is a situation in which people might be healthier, and some of those people will be women of childbearing age, the result will be healthier children in the future. When I read Parker-Pope's article, I was reminded a conference I attended in June, hosted by the New York City Regional Perinatal Forum. One of the presenters, Dr. Michael Lu of UCLA, urged providers and perinatal health centers to consider a life course perspective when treating their patients: consider pre-conception and inter-conception health status, as well as health status during pregnancy, as important factors that affect the pregnancy as well as the future health status of the fetus.

Dr. Lu presented various research that indicates that chronic stress, which never "turns off" (as opposed to acute or major stress), creates "wear and tear" on bodily organs and systems. This "wear and tear" is in the form of stress hormones, which cross the placenta. Chronic maternal stress, including life events and pregnancy-related stress, elevate corticotrophin-releasing hormone (CRH), and adrenocorticotropin hormone (ACTH), cortisol, epinephrine, and norepinephrine. These hormonal changes make the hypocampus section of the brain (responsible for learning and memory) less sensitive and the amygdala section of the brain (responsible for anxiety) more sensitive, in addition to down-regulating certain receptors and impairing hormonal feedback mechanisms.

Research studies hypothesize and prove to varying extents, that these excess hormones can lead to decreased birth weight, preterm delivery, depressed immune systems, increased glucose intolerance (i.e. gestational diabetes), and reduce the effectiveness of fertility treatments. Some even speculate that excess amounts of CRH and cortisol in the fetal brain can alter the infant's termperement, increase ADHD, and increase depressive sypmtoms.

I am getting just as stressed writing this, as I am sure you are reading this. But don't fret. These research contributions are important to decifer because maternal stress can be modified. First of all, if you are pregnant or trying to become pregnant and the economic downturn means you have more time on your hands, harness this time to reduce stress and hormone levels. Relax, bond with family members, cook healthy food, and exercise.

In fact, one research study indicates that eating healthier food during pregnancy actually reduces pregnancy- related stress levels. This could be due to the fact that women feel empowered and in control of their health or because healthy food can decrease inflmmation. Low-mercury fish or fish oil supplements (i.e. cod liver oil, DHA/EPA supplements) and LOTS of fruits, vegetables, and whole grains provide the necessary omega-3 fatty acids and antioxidants to combat the effects of stress hormones.

If the economic downturn is making you more stressed, learn how to deal with the stress. Mindfullness-based stress reduction, yoga, and breathing techniques can all be incorporated into a busy day to help reduce stress hormones- and still make sure to eat a salad with dinner. In fact, I attented a mindfullness-based stress reduction class yesterday at the 92nd Street Y and learned some great techniques. I am figuring out unique ways to apply them to pre-pregnant, pregnant, and postpartum women and I will hopefully post about this again soon.

You can find some of the references for this post here, here, here, here, and here (full text subscriptions required).

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