Chair:
Kathy Ayala, Graduate Student, Interdepartmental Neuroscience Program, Yale University, Yale Child Study Center, New Haven, CT, United States
Presenters:
- Cristin M. Holland, PhD, OTR/L, Assistant Professor of Rehabilitation and Regenerative Medicine, Columbia University, New York, United States
- Kristin Voegtline, PhD, Assistant Professor of Obstetrics and Gynecology and Population Health Sciences, Weill Cornell Medicine, New York, United States
- Marisa Spann, PhD, MPH, Herbert Irving Associate Professor of Medical Psychology, Columbia University, Vagelos College of Physicians and Surgeons, New York, United States
- Helena Rutherford, PhD, Associate Professor in the Child Study Center, Yale University, New Haven, United States
Symposium Description:
The prenatal period is a critical window of dyadic development, with dynamic fetal and maternal systems interactions. Fetal neurobehavior, indexed by movement, heart rate, and heart rate variability, provides an early indicator of child development. Simultaneously, maternal behavioral, psychological, and neural changes may reflect growing sensitivity to the developing child and emerging caregiving. The proposed symposium brings together four presentations that explore different aspects, and directions, of this bidirectional development using diverse methodologies including psychological assessment, fetal monitoring, and neuroimaging. In the first presentation, Dr. Cristin Holland will describe findings from a pilot study exploring how occupational engagement during pregnancy, defined as active involvement in daily activities and tasks, may impact fetal heart rate variability. In the second presentation, Dr. Kristin Voegtline will present data from a pregnant population showing that maternal psychological “uplifts”, particularly those related to fetal activity, are associated with fetal heart rate. The second half of the symposium highlights novel approaches to studying maternal-fetal dynamics using neuroimaging. In the third presentation, Dr. Marisa Spann will showcase a maternal-fetal hyperscanning paradigm using functional near-infrared spectroscopy and fetal movement monitoring to examine how simultaneous fetal activity relates to maternal prefrontal cortex activation. In the fourth presentation, Dr. Helena Rutherford will present evidence linking fetal movement with maternal neural response to infant cues, using event-related potentials. Together, these four studies demonstrate the value of multimodal approaches to investigate prenatal development, for mother and child, as a dynamic, bidirectional process.
List of abstracts and presenters:
PREGNANCY, MEANINGFUL ACTIVITY PARTICIPATION, AND FETAL WELL-BEING: INTEGRATING OCCUPATIONAL SCIENCE WITH PRENATAL PROGRAMMING
1Cristin M. Holland, PhD, OTR/L,
1Columbia University, Rehabilitation and Regenerative Medicine (Programs in Occupational Therapy), New York, NY, USA
Neurodevelopmental trajectories are shaped by the interplay of genetics and environmental exposures starting in utero. Fetal neurobehavior, an index of fetal health and well-being, is influenced by the maternal environment. For example, physical activity during pregnancy influences fetal heart rate and movement. However, research on activity participation during pregnancy and its impacts on fetal well-being has mainly remained restricted to duration and intensity of exercise-type activity. Other aspects of activity participation, or engagement in occupation (e.g., daily roles, tasks, or activities individuals need or want to do), are not well-considered, despite evidence that meaningful activity participation contributes to overall health and well-being. Pregnancy is a period of rapid change for the pregnant individual and development for the offspring, so it is important to understand how maternal engagement or changes in occupations during this period may impact the fetus. This presentation will describe a pilot study recruiting 2nd and 3rd trimester pregnant individuals to complete questionnaires on meaningful activity participation and engage in a standardized maternal-fetal physiology protocol. Preliminary analyses show pregnant individuals endorsed low perceptions of meaningful activity participation and indicate potential that participants with higher meaningful activity participation may have fetuses who demonstrate lower heart rate variability. This study serves as a first step in integrating occupational engagement concepts from occupational science and/or occupational therapy with the developmental origins of health and disease model (i.e., prenatal programming) to understand how engagement in valued occupations during pregnancy may have intergenerational impacts on developing offspring in the fetal period.
THE EMOTIONAL EXPERIENCE OF PREGNANCY AND FETAL HEART RATE
Kristin M. Voegtline, PhD1,2, Sylvie Lauzon, CNM, RN, MSPH3 & Supriya Dhaurali, MS3
1Weill Cornell Medicine, Department of Obstetrics and Gynecology, New York, NY, USA
2Weill Cornell Medicine, Department of Population Health Sciences, New York, NY, USA
3Johns Hopkins University, Department of Pediatrics, Baltimore, MD, USA
The foundation of individual differences in neurobehavior does not originate at term nor at birth; it is measurable in the fetus during gestation. Prior work suggests maternal psychological state may be an important calibrator of fetal neurobehavioral development. Ninety-six pregnant women completed the 41-item Pregnancy Experiences Scale, reporting on the uplifts and hassles of pregnancy, at 36 weeks gestation. Fetal heart rate and variability was collected continuously for 50 minutes using the Monica AN24 (Monica Healthcare Ltd) on a subset of women (n=84, 88% of participants had useable fetal data) via five disposable electrodes arrayed on the maternal abdominal wall in standard configuration that detect and extract the fetal electrocardiogram from the larger maternal electrocardiogram signal. Unadjusted analysis revealed a positive association between the intensity of pregnancy uplifts and fetal heart rate. In line with prior studies, we also found ‘how much the baby moves’ to be the chief pregnancy uplift endorsed. A multivariate regression model showed both the intensity of pregnancy uplifts as well as the specific uplift of maternal perception of how much the baby moved were significantly associated with higher fetal heart rate, controlling for maternal heart rate and fetal sex. Findings suggest an overall positive valence towards pregnancy, and specifically positive valence towards fetal movement, may be associated with individual differences in fetal autonomic control in late gestation. Future research requires a dyadic approach to understand mechanisms underlying these associations.
SYNCHRONIZING DOPPLER ULTRASOUND AND FNIRS TO UNDERSTAND SIGNALS OF FETAL WELL-BEING
Marisa N. Spann, Ph.D., M.P.H.,1 Sanjana Inala, M.P.H.,1 Eric Morgan, M.S.,2 Xuejun Hao, Ph.D.,1† & Dustin Scheinost, Ph.D.2†
1Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
2MindWare Technologies, Westerville, OH, USA
3Yale University School of Medicine, New Haven, CT, USA
†co-senior author
Fetal neurobehavior (indexed by fetal motion) has been linked to central nervous system development and sleep regulation. Observations of fetal movements, quality and quantity, have provided insights into environmental influences and pregnancy complications such as preterm labor and stillbirth. Early dyadic interactions between mother and fetus may be essential to predict birth outcomes. We propose a neurobiological hyperscanning approach to evaluate the interaction between the maternal-fetal dyad to understand the interrelationship between fetal activity and maternal neural response. We collected longitudinal assessments of dyadic development to determine associations between fetal neurobehavior and maternal neural response. Seven healthy pregnant women underwent longitudinal fetal ultrasound and maternal functional near‐infrared spectroscopy (fNIRS) in the third trimester. Fetal motion was acquired using Toitu MT-610 and fNIRS data was acquired using NIRSport2/2.10. Analysis of the fNIRS data was conducted using Homer3, and after processing, data was converted into oxy- and deoxygenated hemoglobin concentrations. A paired t-test was conducted comparing baseline to fetal motion epochs in relation to maternal prefrontal brain activity. We found a positive correlation between fetal neurobehavioral activity and maternal bilateral prefrontal cortex activity observed within dorsolateral and medial regions. As shown in prior postnatal fMRI studies, heightened prefrontal cortex activation in mothers is positively associated with parenting behaviors, such as maternal sensitivity, care, and responsiveness. The dyadic hyperscanning data may suggest there are patterns of recognition in the maternal brain that could potentially help interpret fetal well-being. This line of research suggests the need for more dyadic research in the fetal period.
A ROLE FOR FETAL MOVEMENT IN SHAPING MATERNAL NEURODEVELOPMENT
Helena JV Rutherford, Ph.D.,1, Kathy Ayala1, Lissa Falcioni2, Jeff Eilbott1, & Kristin Voegtline, Ph.D.3,4
1Yale University, Yale Child Study Center, 230 South Frontage Road, New Haven, CT, USA
2Yale New Haven Hospital, Maternal Fetal Medicine, 1 Long Wharf Drive, New Haven, CT, USA
3Weill Cornell Medical College, 1300 York Avenue, New York, NY, USA
4Johns Hopkins University, Department of Pediatrics, Baltimore, MD
Emerging evidence suggests that the maternal brain undergoes significant change during pregnancy which may serve to prepare the individual for caregiving, including increased maternal responsiveness. We have proposed that fetal movement may play a role in shaping maternal neurodevelopment during pregnancy, including increasing responsiveness to infant cues. In the current study we examined links between fetal movement and neural responses to infant cues in 22 primiparous pregnant women. We recorded fetal movement via Doppler-based actocardiography assessing the total number and duration of fetal movements. We also recorded high dense-array EEG while women viewed distress and neutral infant faces and examined the P300 (attentional processing) and N170 (perceptual processing) ERP amplitudes elicited by those faces. For the P300, we found an interaction between fetal movement count and infant emotional expression, F(1,20)=8.88,p=.007,η2partial=.31, where higher fetal movement counts were associated with greater P300 responses to distress, r(22)=.54, p=.010, but not neutral, r(22)=-.01, p=.994, infant faces. We also found an interaction between fetal movement duration and infant emotional expression, F(1,20)=16.99,p<.001,η2partial=.46. Longer durations of fetal movement were associated with greater P300 responses to distress, r(22)=.53,p=.011, but not neutral, r(22)=-.16, p=.479, infant faces. Our findings were comparable when adjusting for gestational weeks, time between lab visits, psychological risk, and fetal sex. Findings were null with the N170. Our results provide the first evidence that fetal movement activity may contribute to maternal neurodevelopment; specifically, women with more active fetuses evidence heightened neural responding to infant distress consistent with greater allocation of attention to these salient infant cues.