July 14, 2017

Brain-gnacy: How Giving Birth Changes Your Brain

If I asked you for the most apparent change in a pregnant woman, you would probably not answer ‘the brain’. Looking at all the physical changes in a woman’s body during pregnancy, it is understandable that the brain seems to be a supporting rather than a main actor in the 9 month-long play called pregnancy. Here is why – surprise – the brain is important for pregnancy and child birth.

The pregnant brain needs to coordinate physiological changes that on the one hand allow the baby to grow and on the other hand prepare the mother for the challenges of giving birth and motherhood. Female sex steroid hormones, like estrogens and progesterone are elevated during pregnancy and can act on the brain to induce changes that favor pregnancy, like increased appetite, a reduced stress response or the inhibition and accumulation of neuropeptides until they are needed [1].

Adapted from http://bit.ly/2dlW1si

Hungry All the Time? 
Growing new life inside one’s body means that a lot more energy is needed – to supply the fetus with nutrients and to build up energy reserves that can be used in the period of lactation after the child is born. Appetite is usually regulated so that energy intake is in balance with energy expenditure [2]. To allow for increased food intake, changes in the brain that suppress the sensation of satiety take place. While satiety is normally signaled by the hormone leptin, the pregnant brain develops a central resistance to leptin, which ultimately increases appetite and food intake [2]. So, in a sense, your brain acts like your grandma, stuffing you with food for the bad times!
 
YOUR BRAIN MAKES YOU HUNGRY


Stressless Superwomen
Since exposure of the fetus to high levels of stress hormones increases the risk for cardiovascular, metabolic and psychiatric diseases in later life, it is necessary to minimize the exposure of the fetus to stress [3]. This means that either everyone has to tip-toe around pregnant women, or we need to change the mother-to-be’s physiological response to stress. If only it were possible to reduce the levels of circulating stress hormones! Wait  that is exactly what’s happening. In pregnancy, changes in the maternal hypothalamic–pituitary–adrenal (HPA) axis occur which render mommy hyporesponsive to stressors. This process involves changes in several HPA components, but also higher brain regions and is reflected by reduced secretion of adrenocorticotropic hormone following stress [3].

PREGNANCY MAKES YOU (ALMOST) IMMUNE TO STRESS


Just On Time!
A normal pregnancy is estimated to last around 268 days, and more often than not, the due date is not too far off from what the gynecologist predicted. To prevent premature birth, the brain has to coordinate the availability and action of labor-inducing factors. For example, the neuropeptide oxytocin stimulates contractions of the uterus during birth. Throughout pregnancy, the hormonal environment changes in a way that keeps oxytocin-secreting neurons quiescent, while oxytocin continues to accumulate and its receptor expression increases [1]. This accumulation of oxytocin is believed to facilitate synchronized firing of neurons that then secrete pulses of oxytocin during birth. In concert, these stimulate contractions of the uterus and ultimately facilitate childbirth [1].

How to Be a Mommy
Let the brain do the job. Many mothers-to-be might have wondered at some point if they are capable of being a mom. Maternal love seems to be somewhat natural and unconditional everywhere in the world. You might have guessed it already, it is indeed the usual suspect who pulls the strings for maternal love: your brain.
After birth, maternal behavior needs to be initiated to ensure survival of the newborn. The medial preoptic area (mPOA), which has some control over the reward circuitry, has a central role in the regulation of maternal behavior. Priming of the mPOA by the changed endocrine environment during pregnancy is necessary for the fast initiation of maternal behavior right after childbirth [3]. During delivery, oxytocin is released and acts on receptors in the mPOA and other brain regions – and maternal behavior is induced [3].

Your Kid Lives On In You 
During pregnancy, cells from the fetus can cross the placenta and remain in the mother’s body sometimes for decades. These cells are mainly found in the bloodstream during and right after pregnancy, but can be found anywhere in the body as well. Some studies have even shown a migration of fetal cells to the maternal brain [4]. Different studies found positive or negative effects on maternal health, ranging from increased risk for autoimmune disease [5] to improved wound healing [6].
In a nutshell, your brain needs to adapt during pregnancy and changes a lot of processes in the body. Being the perfect host, the brain does everything in its powers to make pregnancy and being a mother possible.


by Juliane Schiweck, PhD Student AG Eickholt
this article appeared December 2016 in CNS Volume 9, Issue 4, From Cradle to Grave in the Brain

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