Health Discoveries Winter 2022 | Page 14

“ How do we give our research legs so that it can walk out into the community and be able to help the people that we really are passionate about helping ? You have to go out and have these conversations with the people who need this information .”

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
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