Dr. Magryta: The first two thousand days for your new love, part 2
Stress and Women’s Ability to Conceive, or The Healthy Mind is Key.
When it comes to the prospect of becoming a mother, chronic stress can wreak havoc on hormonal balance and stress responses which is critical for conception and development. I have found that mothers-to-be are more motivated than the general population to be healthy for their prospective newborn.
To understand how stress affects a pregnancy, we need to understand what happens when someone is chronically stressed.
Chronic stress is the number one cause of altered hormonal function and subsequent fatigue with poor feelings. Humans and mammals in general are capable of responding to acute stress with a robust adrenal gland response that releases the hormone cortisol, as well as the sympathetic nervous system’s release of epinephrine to stimulate physiologic changes that we call the fight-or-flight response. This is a good thing when you need to flee from a predator or win a race.
However, if you are always running away from that same predator, sooner or later this beneficial function will break down and disease will ensue. This is exactly what happens when parents go through a prolonged state of domestic stress or there is workplace or family drama that is unremitting.
The science: When you are exposed to a short stressful event, the brain releases a hormone called corticotropin releasing factor, CRF, which in turn stimulates the anterior pituitary gland to release adrenocorticotropic hormone which stimulates the adrenal gland to release cortisol. Cortisol is responsible for activating pathways that help us stop digesting food and wasting energy while simultaneously cranking up our ability to run, think and survive.
CRF also increases the serotonin signaling pathways that keep us alert and hyper in order to get away from the stress. CRF changes the intestines’ permeability, our response to pain, our appetite, our food behaviors and increases our inflammatory pathways. You can clearly see how all of these changes in the short run are advantageous.
Now, lets change the dynamic to the chronically stressed mother-to-be. CRF continues to be released for too long, over-stimulating the adrenal gland’s hormones. Now these previously beneficial properties are causing anxiety from continued hyper-alertness, food sensitivities/allergies from intestinal permeability, fibromyalgia symptoms from abnormal pain sensing, reduced desire to eat, psychological pleasure eating and fatigue from stressed adrenal glands and cellular mitochondrial energy centers. This is not a good place to be.
The most dangerous part of this messed up scenario is the toll that the CRF has taken on the gut. The chronic stimulation has opened up pores in the intestinal lining allowing food proteins, neuroactive compounds and metabolites to cross into a place that they are forbidden. This gives these substances access to the whole immune system as well as to our brain. We believe that this is the major factor involved in damaging the brain.
Think about this — chronic stress opens the gut lining to the passage of forbidden proteins that cause the symptoms that we perceive as anxiety, depression, fatigue and malaise! We know that this is reversible, because animal studies have shown us that fecal transplants have temporarily cured these same symptoms. I have personally seen hundreds of young men and women throw away their anti-depressants after they clean up their diet, work on stress and fix micronutrient/gut function.
How does this apply to the prepregnant mother or pregnant mother?
The data is clear that chronic stress and in turn mental disease are associated with many negative outcomes for mom and baby.
Anxiety regarding a current pregnancy (“pregnancy anxiety”) is associated with shorter gestation and has adverse implications for preterm birth, fetal neurodevelopment and child outcomes. (Schetter et. al. 2012)
Chronic strain and depressive symptoms in mothers during pregnancy are associated with lower birth weight with many potential adverse consequences. (Schetter et. al. 2012)
Amniotic fluid of chronically stressed mother’s contains higher levels of stress hormones than that of unstressed women. (La Marca-Ghaemmaghami et. el. 2017)
Chronic prenatal stress affects the offspring by altering gene expression and increasing newborn and childhood stress responses. (G. Turecki et. al. 2016)
The hormonal pathways involved in stress mediation and resolution are critical to a healthy pregnancy. Mothers-to-be and even young females not interested in pregnancy must considered stress management as a part of a healthy existence. Learning how to handle stress before it peaks is key. It will go a long way toward avoiding potential negative impacts on your offspring.
Next week: epigenetics and pregnancy and then management techniques.
Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at firstname.lastname@example.org
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