A new study published this month in the American Economic Review has found that “family ruptures” and stress can impact the mental health of future generations - in utero, i.e., before someone is even born, highlighting the importance of improved maternal mental health care, even during the preconception phase.
Researchers believe this is the first economic study of its kind pointing to a link between fetal stress exposure and mental illness in adulthood. The only other studies they know of that can relate was a study published in 2011 and another forthcoming demonstrating the effects of malnutrition in utero on mental and learning disabilities in adulthood.
There have been other studies, however, apart from economics that have shown that prenatal stress results in mental illness in adulthood, in particular depression and Attention Deficit Hyperactivity Disorder (ADHD). Also, a 2008 study on the effects in utero of stress related to the Six-Day Arab-Israel War demonstrated that children of mothers exposed to the stress of this war during pregnancy had a higher likelihood of developing schizophrenia by age 30.
For this study, researchers focused on ADHD, anxiety, and depression. The most impactful result they found, and what captured headlines from this study recently, was the effect prenatal exposure to the death of a maternal relative can have on an unborn child’s mental health future. A fetus exposed to the stress from its mother caused by the death of a loved one has been shown to increase the “take-up” of medications by 25 per cent for ADHD during childhood and 13 per cent in anti-anxiety and depression medications by these children in adulthood.
Researchers showed how the death of a relative up to three generations apart during pregnancy can affect the mental health of a child into adulthood. What happens is, the mother undergoes a physiological response which causes an increase in the level of the stress hormone, cortisol which the fetus becomes exposed to in utero.
The economic impact of mental illness in terms of the pharmaceutical industry is estimated to total $9.6 billion in medication to treat depression in the United States. It was also found ADHD medication has increased five fold from 2003 to 2013 and that one in seven male children take medication for ADHD.
Researchers were able to determine that a relative’s passing during a woman’s pregnancy may result in a financial burden as well as an emotional burden. Economically speaking, an eight per cent decrease in the consumption of prescription drugs to treat depression can be valued at $800 per year.
Given these statistics and the growing rate of mental conditions such as depression and anxiety, the authors of the study assert that it is imperative that we understand the specific causes of mental illness both for social and economic reasons. That’s why they decided to focus on in utero exposure to maternal stress as one very important causal factor.
The researchers used data from Sweden for their study from the outcomes of four generations of children’s mental health between 1973 and 2011. In addition the effects of the death of a loved one during pregnancy, researchers also found that hospitalizations and complications including low birth weight and pre-term births increased for newborns of mothers who experienced family ruptures during pregnancy.
“The presence of such a causal link may point to novel avenues for curbing high and rapidly rising private and social costs associated with mental illness,” note the authors of the study. “Specifically, if a mother’s stress during pregnancy harms her unborn child’s mental health later in life, measures that help reduce stress during pregnancy may come at low costs relative to their social benefits.”
The authors point to better maternity and paternity leaves following childbirth that may help to reduce stress and the importance of allowing women to take time off work during pregnancy as well. They also report that low-income women are already exposed to greater stress due to their low socioeconomic status so any added stress such as the death of a loved one would increase the cortisol in their body and the likelihood of their child developing a mental illness in childhood and throughout adulthood, perpetuating the “intergenerational transmission of this disadvantage.”
“Future research might explore these conjectures in more detail by examining the effects of specific interventions that reduce pregnant women’s stress levels on their children’s mental health,” note the study authors, “especially among low-income populations.”
Petra Persson, Maya Rossin-Slater, (April 2018), American Economic Review, Family Ruptures, Stress, and the Mental Health of the Next Generation, https://www.aeaweb.org/articles?id=10.1257/aer.20141406
Patricia Tomasi is a mom, maternal mental health advocate, journalist, and speaker. She writes regularly for the Huffington Post Canada, focusing primarily on maternal mental health after suffering from severe postpartum anxiety twice. You can find her Huffington Post biography here. Patricia is also a Patient Expert Advisor for the North American-based, Maternal Mental Health Research Collective and is the founder of the online peer support group - Facebook Postpartum Depression & Anxiety Support Group - with over 1500 members worldwide. Blog: www.patriciatomasiblog.wordpress.com