A Science based view of In Utero impacts of Maternal Stress.

Stanislav Grof was a Czech psychiatrist and psychotherapist and one of the principal developers of transpersonal psychology. He theorised that what happens to us before birth, such as our mother’s emotional state, the atmosphere in the family, tension, safety, or the lack of it, can leave deep imprints in the nervous system.They may exist as implicit imprints - emotional tones, bodily sensations, or deep emotional patterns that later appear in life as reactions we cannot easily explain.

Until recently this was theory however, in more recent research Papadopoulou (2019) et., al. found the following (see reference below):

1.        In Utero Stress Exposures:

• Intrauterine life events have a significant impact on the epigenetic profiles of embryos, more so than stressful exposures during adult life.

• Early stages of embryonic development are highly sensitive to environmental insults, which can adversely affect brain plasticity and lead to lasting effects on adult psychopathology.

• Maternal stress, anxiety, and depression during pregnancy are associated with low birth weight (LBW) and future health problems. LBW is considered a marker of early-life adversities.

  
  

2.        Genetic and Epigenetic Factors:

• Genetic and epigenetic factors, such as DNA methylation and histone acetylation, influence the stress response system and brain development in embryos.

• Genes like NR3C1 and NR3C2, which encode glucocorticoid and mineralocorticoid receptors, play a critical role in regulating the hypothalamic-pituitary-adrenal (HPA) axis activity.

•  Alterations in these genes can lead to stress vulnerability and behavioural abnormalities.

• Maternal stress during pregnancy can lead to epigenetic changes in the NR3C1 gene, affecting its expression and altering the HPA axis reactivity in newborns.

  
  

3.        Impact of Maternal Stress on Mitochondria:

• Maternal stress during pregnancy can affect mitochondrial protein expression in pathways related to mitochondrial biogenesis and energy production in the prefrontal cortex and hippocampus of offspring.

• Maternal psychosocial stress has been linked to changes in mitochondrial DNA copy number in the placenta, which may influence infant temperament and development.

4.        Imprinted Genes and Development:

• Imprinted genes like IGF2 and MEST play crucial roles in placental and embryonic growth, as well as fetal metabolism and differentiation. ​

• Maternal stress can alter the methylation of these genes, potentially affecting fetal growth and development.

  
  

5.        Individuality and Stress Response:

• Early-life stress, including maternal deprivation, nutritional deprivation, and chemical exposure during critical developmental periods, can lead to phenotypic differences later in life.

• Adaptation to stress is influenced by genetic predisposition, early-life environment, and late-life environment, which collectively shape individual stress responses.

  
  

These findings highlight the profound influence of maternal stress and environmental factors on the genetic, epigenetic, and mitochondrial profiles of embryos, that can have long-term consequences for their health and development into adulthood.

Additionally, research by Michael Meaney (2001) demonstrated how early environmental conditions can alter gene expression related to stress regulation. Other studies suggest that elevated maternal stress during pregnancy may influence the infant’s later sensitivity to stress.

Why is this important information for couple therapists to be aware of?

1.        Couple therapy can be highly emotive and stressful for couples – we need to consider this when working with pregnant couples.  There is no doubt their experiences in the counselling room are impacting their baby;

2.        When working with adults we need to bear in mind that these In Utero experiences may be playing a part in this person’s responses to the therapist, the therapy process and their interactions with their partner.

What does this mean for our practice?

For pregnant couples, consider:

·      What informed consent should we obtain, this will include providing the couple with psycho-education about the potential risks to the baby of engaging in therapy;

·      When might couple therapy be contraindicated due to the stress burden on baby?

·      What might be needed for safe practice? This might include some an agreement about how arousal might be managed – slowing therapy down, taking time out to engage in relaxation or mindfulness practices within the session to maintain a level of regulation and safety for the mother and the baby.

·      Behavioural management regarding expressions of anger and frustration.

What these studies tell us is that careful assessment and management is vital in cases where pregnant women are involved. Perhaps a safer way to proceed might be to negotiate for the couple to limit treatment to psychoeducation and skill development and to leave therapeutic intervention until after baby is born and the parents can attend without the child present to reduce exposure to parental stress.

Something to consider.

References

Meaney MJ (2001). "Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations"  Annu. Rev. Neurosci. 24: 1161–92. doi:10.1146/annurev.neuro.24.1.1161. PMID 11520931.

Papadopoulou, Z., Vlaikou, A.-M., Theodoridou, D., Markopoulos, G. S., Tsoni, K., Agakidou, E., Drosou-Agakidou, V., Turck, C. W., Filiou, M. D., & Syrrou, M. (2019). ​ Stressful newborn memories: Pre-conceptual, in utero, and postnatal events. ​ Frontiers in Psychiatry, 10, 220. https://doi.org/10.3389/fpsyt.2019.00220