UTSpeaks: Raising babies (1 - Professor Maralyn Foureur)


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Is there an ideal way for parents and health carers to ensure babies get the best start in life?

All agree that every precious baby deserves the best possible start in life. But what is the best possible start and when does that start begin – before or after birth? With all that we already know and understand about pregnancy and infant development, do we truly understand the obstacles and opportunities at the heart of raising a child to its full potential?

This public lecture traces the journey of a child from the moments before conception to its first years as an infant. It considers the complex influences at work on mother and child such as fear, anxiety, social expectations and intergenerational parenting experiences. Insights will be offered based on cutting-edge research from which all would-be parents, infant care professionals and wider community would benefit.

Professor Maralyn Foureur
Maralyn is Professor of Midwifery at UTS and for the Central Coast and Northern Sydney Local Health Networks. She has led research in innovative models of midwifery care and the development of midwifery practice and education. Her research includes how birth unit design impacts on women and staff stress, communication, and ultimately birth outcomes. Maralyn co-leads the consortium called Birth After Caesarean Interventions which undertakes research promoting normal birth and raising the rate of vaginal birth after caesarean section.

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  • But I am going to begin this shared conversation between myself, Cathrine and you by presenting a few research examples from perinatal animal research. Three studies in particular I thought might provide an interesting snapshot of what is happening in the field of epigenetics which is particularly pertinent to pregnancy and childbirth.I’m going to examine the experiences of the Agouti mouse, stressed pregnant rats and genetically engineered mice. And then return ultimately to studies in human mothers
  • Let me introduce you to the Agouti mouse- a particular strain of mouse described over a century ago and cloned in 1992 as a mouse model of obesity –the mouse has a genetic mutation of its Agouti gene - that is ultimately lethal – the mouse is bright orange in colour and is (CLICK) prone to obesity, diabetes and cancer. All of her babies inherit this genetic mutation and therefore all of her babies are orange and prone to obesity, diabetes and cancer, unless there is an intervention.
  • these same genetic changes and behavioural changes were passed on to the next generation and so on it goes.The message in this study for me was that stress in pregnancy can have quite serious EPIGENETIC effects on the unborn baby that are played out in that baby’s life and then her baby’s life in turn.I wondered if there was some intervention that could stop this intergenerational transfer of DNA mutation
  • Fortunately I found another study that lifted my mood a little – a fascinating piece of research where mice were genetically engineered to have a memory defect in that they were completely unable to negotiate a simple maze to locate food.step 2 was that these genetically modified mice were then placed in an enriched environment for some time and ultimately their memory improved to the point that they could negotiate the maze – so they overcame their genetic deficit.But step 3 is what was amazing – when these genetically deficient mice had babies- their babies also had the same memory defective gene- but it didn’t affect them at all- they had the same improved memory of their mothers- so the memory defective gene had been silenced.Mm so whats the message here? –the quality of the social environment beyond infancy is capable of shifting patterns of gene expression with consequences for the functioning of the individual– both within and across generationsthe genes can be silenced.The brain is amazingly changeable like plasticine which is what is meant by the plasticity of the brain.I wanted to return to the stressed mother rats and find an intervention that would silence their altered DNA
  • So what have we encountered so far in relation to animal research?There are similar findings in a range of studies conducted with many other mammalsSo Of what relevance is this to human mothers and their babies?
  • It seems to me that there are common findings in the animal and human research that we may need to pay attention to – and we have just begun to examine the wealth of evidence that currently exists. Around nutrition, emotions, stressors of all sorts and toxins
  • There are many associations identified between stressful perinatal experiences and later life events- these include life challenges such as diabetes which is increasing dramatically, cardiovascular disease, autism spectrum disorders from mild AHDH to Autism, schizophrenia and psychotic disorders-drug dependency and suicidality
  • UTSpeaks: Raising babies (1 - Professor Maralyn Foureur)

    1. 1. UTSpeaks: Raising babies (part two)<br />23 August, 2011<br />
    2. 2. RAISING BABIES<br />Maralyn Foureur<br />Professor of Midwifery<br />University of Technology Sydney<br />
    3. 3. Aim of presentation<br />To explore how the early stages of<br /> life might influence a child’s future wellbeing<br />Peri-conception<br />Pregnancy<br />Birth<br />Early newborn/breastfeeding<br />What can we learn from available research evidence?<br />
    4. 4. What kind of evidence?<br />From a wide range of disciplines- Neuroscience, Neuro-biology, Neuro-architecture, Psycho-biology, Psycho-neuro-immunology, Epidemiology, Epigenetics – and more... <br />Aided by new tools: fMRI, PET scan, 4D Ultrasound imaging<br />New science of Epi-Genetics = Above the Genes<br />
    5. 5. Genes are being switched on or silenced by signals from outside the Gene sequence<br />Signals include<br />nutrition, emotions, stress, toxins<br />
    6. 6. What kinds of Research?<br />Unethical to manipulate the environment for human studies<br />Experiments with animals - first<br />Then search to find confirming evidence in humans<br />Look for naturally occurring ‘experiments’ or<br />Large population based–longitudinal (over time), observational studies<br />ALL FORMS OF RESEARCH HAVE SOME LIMITATIONS…<br />
    7. 7. Perinatal research examples<br />The Agouti Mouse<br />Stressed Pregnant Rats<br />Genetically Engineered Mice<br />Studies in Humans<br />
    8. 8. Study 1: The story of the agouti mouse and her babies<br />Prone to Obesity - Diabetes - Cancer<br />
    9. 9. The agouti gene can be silenced…<br />Pregnant Agouti fed a diet rich in soy extract, folate, B12…<br />-will have babies who<br /> still have the <br /> agouti gene but are<br /> otherwise normal<br />
    10. 10. Study 2: stressed pregnant rats…<br />Abused and neglected their pups<br />Pups developed epigenetic modifications to their DNA<br />Pups grew up to be poor mothers<br />
    11. 11. 3rd Generation effects<br />And passed on these changes to the next generation of offspring<br />
    12. 12. Study 3: Its not all bad news…Trans-generational effects on brain’s plasticity<br />1. Mice genetically engineered to have a memory defect<br />2. Placed in an enriched environment<br />Memory improved<br />3. Offspring of those mice - who had the same memory defective gene - also had an improved memory<br />
    13. 13. So what have we encountered so far?<br />Gene mutation can cause obesity, diabetes and cancer<br />Changes to diet can silence the gene mutation from being expressed <br />Maternal Stress during pregnancy can alter the structure of the DNA (gene expression) in the unborn offspring<br />The changes to the gene expression result in behavioural changes in the offspring<br />Changes to the gene expression can continue to occur across generations<br />An enriched environment can overcome changes in the genes<br />
    14. 14. Is there any confirmation of these epigenetic effects in human studies?<br />Naturally occurring ‘experiments’<br />Nutrition – famine<br />Cardiovascular disease, metabolic syndrome, neurodevelopmental disorders <br />Longitudinal studies<br />Longitudinal studies<br />Antenatal maternal mood disorders (depression) <br />Changes to the baby’s DNA<br />Increased salivary cortisol levels at 3 months of age<br />Upregulated stress responses<br />
    15. 15. There are common findings we may need to pay attention to…<br />The Fetus is sensitive to its mother’s nutrition and psycho-emotional state<br />The mother’s experiences are translated into chemical & electrical messages that flood her body and brain and may change her behaviour<br />and in turn- chemical and electrical messages flood the baby’s body and brain<br />and potentially shape its neuro-behavioural development<br />
    16. 16. Associations between stressful perinatal experiences and later life events<br />These include…<br /> Diabetes<br />Cardio vascular disease <br />Autism spectrum disorders<br />Schizophrenia<br />Psychotic disorders<br />Drug Dependency<br />Suicidality<br />
    17. 17. Is there a solution?<br />Secure mother-infant attachment-predicts long term resilience to physical and psychological distress<br />New Models of maternity care aim to reduce maternal stress and enhance mother-infant attachment<br />Studies of Birth Unit Design aim to contribute to reduced maternal stress<br />