Maternal Stress Management Critical for Passing on Healthy Genes
Research has long confirmed the effects of maternal health on fetal development and outcomes. But scientific inquiry into the genesis of disease processes in an adult with no apparent risk factors has been uncharted territory until the last few decades.
The interrelationship between maternal stress and fetal “programming” was considered as early as the mid-1980’s, beginning with the suggested connection between poor nutrition in early life and adult disease. But the developmental origins of adult health and disease were not studied until the mid-1990’s, with little understanding of the etiology until the last two decades.
The placenta is a physiological connection, or fetomaternal organ, that also functions in endocrine regulation and through which epigenetic changes can take place.
“This epigenetic [from Greek, above, upon, over, or beyond conventional genetic], cellular memory involves the heritable transmission of gene expression patterns that persist through cell division, but do not involve an alteration in DNA sequence. Epigenetic processes act in a cell specific, temporally-regulated manner to direct development, differentiation, organogensis, and related processes. Some have compared epigenetic mechanisms to the software to orchestrate and/or modulate the DNA hardware” (Gheorge et al 2010).
In this article on gene expression in the placenta, Gheorge et al (2010), posit that maternal stress results in epigenetic responses in the fetus that can be responsible for adult health and disease. Maternal stress-induced sequelae can include: 1) immune dysfunction, 2) cortisol dysregulation later in life, and 3) increased risk of mental illness such as depression, among other psycho-cognitive disorders.
In a separate study, Oberlander et al (2008) test the hypothesis of epigenetic change by looking at prenatal exposure to maternal depression, neonatal methylation of human glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses. In a study of third trimester maternal depressed/anxious mood women, increased methylation of NR3C1 was found, which was associated with increased salivary cortisol stress response at 3 months of age when controlled for prenatal anti-depressant exposure, postnatal age, and postnatal maternal mood.
Already confirmed in animal models, this study showed that exposure to maternal stress in humans resulted in increased stress reactivity of the HPA (hypothalamic-pituitary-adrenal) axis in 3-month old infants.
Integrated Physical Therapy in Perinatal Care
The good news is physical therapists can effectively impact epigenetic effects and neuroendocrine regulation through integrated prenatal exercise prescription and patient counseling.
A 2013 study (Field et al) of 92 women found that 20 minutes of physical yoga postures once a week for 12 weeks yoga from 22 weeks gestation on, in addition to social support, lowered depression, anxiety, and anger scores among expectant mothers, as well as diminished leg and back pain, improved relationship scores, and lowered cortisol levels. A second randomized trial of 84 prenatally depressed women, conducted by the same researchers in 2012, found that yoga and massage therapy also reduced prenatal depression in twice weekly sessions of 20 minutes each.
Other researchers have also looked at yoga’s epigentic effects in the general population as well, finding that meditation preserves telomere (DNA material) integrity, facilitates normal circadian rhythm, reduces stress arousal, and reduces risk of premature aging, cancer, and related non-communicable sequelae.
Promising research on yoga’s epigenetic effects in the prenatal and general populations is available to physical therapists and all practitioners who specialize in perinatal care through Yoga as Medicine for Pregnancy, the integrative course that Ginger developed and teaches for Herman & Wallace Pelvic Rehabilitation Institute.
Perinatal care in Ginger’s course is based on the biopsychosocial yogic paradigm, a holistic person-centered approach that is supported to have long-standing positive effects for mother and baby. Yoga can be also used as more than meditation and relaxation, however; and Ginger shares yoga techniques that can be used for prenatal strength and conditioning, birth preparation and education, postpartum recovery and rehabilitation, and general fitness and wellness in the YPREG course. See Ginger’s recent posts on Why Every Expectant Mom Needs Yoga, Yoga in Physical Therapy Improves Postpartum Care, Yoga for Natural Childbirth.