PASS IT ON
The lifelong effects of stress and trauma can begin before we ’ re born . Stroud , the director of the Center for Behavioral and Preventive Medicine at The Miriam Hospital , looks at ultrasounds , placental genetics , and infant behavior to understand how maternal depression and substance use affect the next generation . By finding new ways to identify who ’ s at risk , she says , “ we can design postnatal interventions that might mitigate some of the effects of prenatal exposures .”
Substance use often goes hand-in-hand with stressors like poverty and depression . Stroud ’ s lab measures the effects of those traumas alongside the impacts of e-cigarettes or marijuana on pregnant mothers and their babies . During pregnancy they use ultrasounds to record and code fetal behavior , like how and how much the baby is moving , to tease out associations with substance use or mood disorders . Though behavior changes are subtle compared to measurements like amniotic fluid level or birth weight , Stroud says it could become one more tool to help doctors determine “ which babies might be more at risk or are being affected more by substance use .”
Stroud ’ s lab follows infants up to six months to record stress response , levels of stress hormones , and other effects . She says they ’ ve seen diminished stress response in smoking-exposed babies , “ which suggests that they ’ re not mounting an adequate biological stress response to daily stressors , which may have implications for immune functioning and longer-term behavioral development .” In babies whose moms also used marijuana while pregnant , the stress response is even weaker .
“ One of the reasons we ’ re doing our studies is to provide information about safety and how [ substance use ] affects offspring ,” Stroud says . “ There is no other time in anyone ’ s life that people self quit at rates that they do during pregnancy .” While she and her team offer resources for anyone interested in quitting , they strive to be nonjudgmental . “ A lot of moms already feel badly about it ,” Stroud says .
Emotional sensitivity in a mother , even if she smokes during pregnancy , may bode well for her child , she adds . “ It can buffer the effects ,” Stroud says . “ There ’ s a lot of hopeful messages out there about resilience in parenting . … Postnatal environment is extremely important . The unfortunate problem is that sometimes pre- and postnatal environments are highly correlated .” But offering support to parents has the potential to change the story .
FROM THEORY TO PRACTICE
Parade , whose research focuses mostly on early childhood , believes supporting pregnant women could prevent child abuse . One of her projects will recruit women who have experienced trauma or adversity to a home visiting program that begins before their babies are born . The CDC-funded study builds on earlier work with the Rhode Island Department of Health and the state chapter of the American Academy of Pediatrics .
“ We developed a screening tool to identify women with a history of stress and trauma in the early postpartum period that we rolled out in a home visiting program called First Connections ,” says Parade , the director of Early Childhood Research at Bradley Hospital . Home visitors assess a family ’ s needs and refer them to additional services .
“ To prevent maltreatment from ever occurring ,” Parade wants to reach families even earlier . For her study she ’ ll investigate whether offering First Connections to women while they ’ re pregnant translates to safer homes for their kids . The program also provides more training and support for home visitors .
“ If you can build a strong relationship between a provider , like the home visitor , and the mother ,” she hypothesizes , “ that will trickle down to have a strong impact on the relationship between the mother and the child .” In yet another study , Parade is working with colleagues at Bradley and a local nonprofit to evaluate whether offering extra support and training to foster parents helps retention and prevents
14 HEALTH DISCOVERIES l WINTER 2022