CONNECTING MATERNAL BIPOLAR DISORDER & CHILDREN: INVESTIGATING THE PRENATAL ENVIRONMENT’S EFFECT ON NEWBORN BRAIN ACTIVITY

By Disha Srivastava

Pregnancy is typically an exciting time in a woman's life, but for women with mental illness, this is not always the case. According to the Psychiatric Disorders During Pregnancy, pregnant women with mood disorders such as bipolar disorder face a greater risk of complications as they are less likely to get appropriate prenatal care and more likely to engage in risk taking behavior.


As per the definition used by authors Rusner, Berg & Begley, bipolar disorders are severe mood disorders characterized by lifelong mood fluctuations that vary between phases of depressive, hypomanic, manic, or mixed episodes. Manic episodes are defined as periods of heightened or elevated moods, while hypomanic episodes are similar, but not as extreme in intensity. Most women are diagnosed with bipolar disorder between the ages of 18 and 30, which overlaps with the time when many women experience pregnancies, childbirth, and postpartum. 

According to the Psychiatric Disorders During Pregnancy, studies suggest that up to 20% of women suffer from mood and anxiety disorders during their pregnancy. Moreover, a study found that 70.8% of women with bipolar disorder experienced at least one hypomanic, depressive, or manic episode during their pregnancy. A literature review conducted by Rusner et al found only 9 credible studies that assessed bipolar disorder in pregnancy and childbirth. While this was a comprehensive review, the authors highlighted how studies focusing on bipolar disorder and pregnancy complications are limited and more studies need to be conducted, especially on fetal abnormalities outcomes among mothers with bipolar disorders.

The Women’s Mental Health Program, established under the Department of Psychiatry and Behavioral Sciences at Emory University, focuses on studying the mental health of mothers during pregnancies and postpartum periods. In particular, they investigate the effect of psychiatric medications on infants and the wellbeing of infants born to mothers with mental illness. One of their current active studies, entitled “Prenatal Environment on Resting Brain Activity in Newborns of Mothers with Bipolar Disorder,” seeks to examine neurological areas related to emotional reactivity and regulation of newborns born to mothers with bipolar disorder. According to Chantal Henry,  emotional reactivity refers to the emotional response one might have to their environment and emotion regulation is the ability to regulate and effectively respond to an emotional event. More specifically, researchers wish to understand how the mother’s mental health during pregnancy can influence neural connections in their baby’s brain.

Researchers are using functional MRI scans in order to examine the functional aspects of the newborn brain and possibly detect abnormalities. During the scan, mothers will be asked to complete questionnaires about their mood, medication use, stress, and their experience during labor and delivery of the baby. Through this, researchers will be able to assess the level at which these external factors may have affected the prenatal environment. Specifically, researchers will be able to correlate potential environmental factors relating to maternal mental health to emotional responses in their newborn’s brain. Although the research is ongoing, its repercussions are large and will provide an insight into the importance of how neural activity in areas associated with emotion in newborns can affect their future.

By studying the neural connection among babies born to mothers with bipolar disorder, the study can contribute to our understanding of how a mother's mental health affects prenatal neurological development, as well as predict possible future effects on the newborn. In connections to how authors Gordovez and McMahon stated that bipolar disorders are one of the most heritable mental disorders, this study could possibly provide a lens for understanding early markers for bipolar disorder. By assessing emotional reactivity and regulation, researchers are potentially opening up pathways for earlier detection, diagnosis, and treatment.



References 

Gordovez, F. J., & McMahon, F. J. (2020). The genetics of bipolar disorder. Molecular Psychiatry, 25(3), 544–559. https://doi.org/10.1038/s41380-019-0634-7 

Henry, C. (2012). Emotional dysfunction as a marker of bipolar disorders. Frontiers in Bioscience, E4(7), 2622–2630. https://doi.org/10.2741/e578 

Psychiatric Disorders During Pregnancy. MGH Center for Women's Mental Health. (2018, May 29). https://womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/. 

Research Studies. Emory Women's Mental Health Program (WMHP) - Research Studies. http://womensmentalhealth.emory.edu/Programs/index2.html. 

Rusner, M., Berg, M., & Begley, C. (2016). Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes. BMC Pregnancy and Childbirth, 16(1). https://doi.org/10.1186/s12884-016-1127-1 

Disha is a junior from Foster City, California, majoring in psychology. She joined EURJ in order to learn and present the current research at Emory. Some of her other involvements include being an advising fellow for Emory’s Matriculate, a research curator for Emory’s Autism Awareness Organization, and a tutor for EduMate, NYC. She enjoys rewatching The Office, listening to music, and is always looking for new horror movies to watch!