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  • Periodic Report Summary 1 - CARRYING (Infant Responses to Maternal Carrying in Human as Early Biomarker and Prognosis Estimator of Child Psychopathology: a Study on Autism Spectrum Disorders and Perinatal Brain Disorders in Early Infancy)

Periodic Report Summary 1 - CARRYING (Infant Responses to Maternal Carrying in Human as Early Biomarker and Prognosis Estimator of Child Psychopathology: a Study on Autism Spectrum Disorders and Perinatal Brain Disorders in Early Infancy)

In this project we aim to understand the psycho-physiological aspects of mother-infant interaction and their paramount influence on typical and atypical development. Mother-infant bonding is the earliest and most critical social relationship of mammalian infants. To promote this bond, infants have innate behaviors to seek maternal proximity and protest upon separation via communication with the mother vocally and through body movement. However, the physiological mechanisms regulating these infant behaviors remain largely undefined. As a model to study very early mother infant interaction we study the maternal and filial contribution during maternal carrying. In a pioneering study (Esposito et al., 2013) we have shown in rodent pups and human infants a specific calming response to maternal carrying. This calming response is a coordinated set of central, motor, and cardiac regulations and is a conserved component of mammalian mother-infant interactions. Here we aimed (i) to assess how the calming response to maternal carrying influence the efficiency of typical and adaptive mother-infant interaction; and (ii) to investigate how an adaptive maternal carrying is hindered within atypical mother-infant dyads, since the atypical characteristics may hinder the smooth development of an adaptive mother-infant interaction. We started considering mother-infant interactions within infants’ atypical development, such as Autism Spectrum Disorders and cerebral palsy, however we soon discovered that the available information about these developmental disorders were not enough to have a stable background to start from in order to interpret our TR data. After detailed analysis of videos taken during early infancy of children with developmental disabilities and discussion with several experts in the field, we decided to focus more on children with intact Central Nervous System. However, since the project aimed to study the calming responses in atypical context, we started to study what would happen in the situation where the caregiver has some special clinical condition. For this reason we focused on post partum depression that represents a relatively common condition in mothers, affecting typically 10-15% in high-income countries but up to 50% of mothers in low- and middle-income countries (~52million people worldwide yearly), and it has been associated with altered parent-infant interactions. This negative impact is both at the level of the quality of life of the people involved (social costs) and also at the level of medical treatments for the community (economical costs).

Achieved Goals
This first phase of the project focused on typical mother-infant dyads has been performed and the post-immediate (from 30 seconds to 10 minutes) responses to maternal carrying and its efficacy in further relaxing the infant (and consequently benefit the mother) have been investigated. Twenty-six infants have been from 1 to 6 months of age, both in laboratory and in families’ homes. In particular, to measure the hypothesized post-immediate (from 30 seconds to 10 minutes) infant calming effect to maternal carrying, the cardiac function (electrocardiogram ECG-wifi holter), vocalization and motor behaviour of human infants have been monitored during behavioural tasks that consist of two repetitions of the following conditions: lying in a crib for 5 minutes (CRIB), held by the mother who is sitting on a chair for 5 minutes (HOLDING), or held by the mother who is walking continuously for 1 to 10 minutes (CARRYING). Results show that to calmer physiological states (high IBI and high rMSSD) correspond a calmer infant’s state (sleeping) and a specific maternal activity (CARRYING condition). While to non-calm physiological states (low IBI and low rMSSD) correspond infant’s alert state (awake crying) and the CRIB condition. In between we find the middle states such as the infant awake but calm and the HOLDING condition. Results are confirmed when considering a continuous long carrying which lasts to 10 minutes. The amount of infants’ movement and cry decrease continuously throughout all the 10-minute carrying, while the physiological calmness continuously increases. Furthermore, during the 10-minutes carrying it emerged that the sympathetic activation is null at the beginning while after some minutes it increases sharply. This finding support the hypothesis that after an initial activation of the parasympathetic nervous system the calming response is sustained also by a sympathetic activation. This findings and the hypothesis are consistent with results from mouse models which show that the absence of a sympathetic arousal, pharmacologically blocked by the metoprolol, hinder a sustained state of physiological calmness. Also, the second step of the project has been performed and the influence of atypical characteristics within mother-infant dyads on the development of an adaptive maternal response to infants has been investigated. For this part of the project we analysed data collected at NIH (USA). Between 4 and 20 weeks postpartum, mothers completed the Beck Depression Inventory (BDI-II; Beck, Steer, & Brown, 1996). Of mothers with high BDI scores, 30 were diagnosed as having had major or minor depression within the then lifetime of the child and were included into the depressed group. Of mothers with low-BDI scores, mothers not diagnosed with any depressive disorder were selected into the non-depressed group. Thus, 30 clinically depressed (70% male infants, 53.3% firstborns) and 30 non-depressed mothers (67.7% male infants, 60% firstborns) provided data. Infants and mothers were visited in their home, and mothers were asked to behave as they normally would and to ignore the presence of the researcher. Infants and mothers were audio/video recorded continuously for a minimum of 50 min. Maternal behaviors during infant cry were then coded and analyzed. Analysis revealed that non-depressed mothers fed, rocked, and touched their infants for relatively more time than clinically depressed mothers. Clinically depressed mothers were non interactive for relatively more time than non-depressed mothers. Furthermore, during infant cry non-depressed were overall more active than clinically depressed mothers. Also, applying predictive models (tree based models) it emerged that the clinical diagnosis of the mother was the best predictor of maternal behaviors during their infant’s crying. Clinically depressed mothers engaged in less caregiving overall during their infants’ crying.

Future Steps
More data about the typical development dyads will be collected and the manuscript in preparation for both the typical and the atypical developmental dyads will be published in international journals.
Furthermore, to increase our knowledge about typical TR development, mice TR response data will be re-analyzed and interpret to comprehend the ontogeny of the TR and which behavioral and physiological characteristics of both mothers and infants contribute to achieve the best possible fit during maternal transport.

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Life Sciences
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