Researchers at the Center for Mental Health Innovation at Oregon Health & Science University (OHSU) have discovered why increased adiposity, or the amount of body fat, during pregnancy is linked to a higher risk of mental disorders and a greater lack of affection in children. Although there was evidence of a relationship between obesity during pregnancy and the mental health of offspring, the reasons are not well understood and this is the first study to demonstrate the link between two key hormones associated with fat mass – adiponectin and leptin – and the behavior of children.
Researchers tested whether concentrations of adiponectin and leptin in pregnant women’s blood or in the umbilical cord could predict the development of mental disorders in babies. Leptin, a hormone that regulates appetite, and adiponectin, a hormone that regulates glucose levels and fat breakdown, are essential for fetal development.
“The link between maternal metabolic status during pregnancy and offspring mental health is relatively new, and there is very little research explaining this connection,” said Elinor Sullivan, a professor of psychiatry at the OHSU School of Medicine and senior author of the study. “It is thought that metabolic status may influence the intrauterine environment, which may shape the fetal brain and its development.”
“Identifying new biomarkers gives us the opportunity to predict very early on which children are at risk for common mental disorders, such as ADHD and anxiety, so that we can offer targeted early interventions.” Biomarkers, or measurable characteristics in the body, can serve as an early warning system for underlying diseases or conditions, and are a valuable tool for better understanding a person’s health.
New biomarkers of risk for mental disorders in children
Led by Sullivan and Hanna Gustafsson, the researchers collected data from a cohort of 305 pregnant women and their children, taking blood samples from the pregnant woman in the second trimester and a cord blood sample at birth. The children were assessed at 6 months of age, at which time the researchers conducted standard behavioral tests to examine behaviors used to regulate emotions, which are strong risk indicators for mental disorders in early childhood.
The results of the study have been published in the journal Brain, Behavior, and Immunity and show that lower levels of the hormone adiponectin in the mother’s bloodstream and higher concentrations of the hormone leptin in the cord blood may be new biomarkers of the risk of mental disorders in children.
The researchers note that identifying these biomarkers could have great potential for early intervention in children at risk for a variety of mental disorders, and suggest that identifying children at risk may be possible earlier than previously thought, even before birth. Furthermore, these biomarkers can be measured in a clinical setting using standard, low-cost tools, and can be assessed using a single, easily interpreted test.
“It is believed that the metabolic state [de la embarazada] may influence the intrauterine environment, which may shape the fetal brain and its development”
The new focus of the research team will be to test interventions aimed at reducing the risk of mental disorders in children and supporting parents during the perinatal period. There is promising evidence that teaching parents practical skills during pregnancy can help support both the health of the pregnant woman and the child – for example, teaching how to swaddle and soothe a crying baby, providing information about typical infant crying patterns and offering mindfulness techniques to manage their own emotions when caring for an infant.
“Weight can be a complex and sensitive topic for pregnant women, and our goal as clinicians is to help patients take the best possible care of themselves and their developing baby,” said Dr. Jamie Lo, an associate professor of obstetrics and gynecology at the OHSU School of Medicine who specializes in maternal-fetal medicine. “These findings present an opportunity to intervene early in pregnancy and potentially improve health outcomes in children.”
Dr. Lo also emphasizes the importance of access to quality prenatal care that includes nutrition and healthy lifestyle counseling during pregnancy and before conception, which is critical to optimizing the health of pregnant women and their babies.
Looking ahead, Sullivan notes that more research is needed to better understand the nature of these associations and whether behavioral health outcomes persist into childhood. The research team plans to follow study subjects until they turn 5 years old to determine how these factors may predict long-term risk and clinical diagnosis.
“While this is an exciting first step, we have much more to learn, including the role that social determinants of health might play,” Sullivan said. “We look forward to continuing our research and supporting better care for parents and their children.”
