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Becoming a mother: An integrative model of adaptations for motherhood during pregnancy and the postpartum period.

Periodic Reporting for period 2 - BEMOTHER (Becoming a mother: An integrative model of adaptations for motherhood during pregnancy and the postpartum period.)

Berichtszeitraum: 2022-04-01 bis 2023-09-30

During pregnancy, a woman experiences extraordinary adaptations that prepare her for the challenges of motherhood. While there is extensive evidence regarding the transformations that the body of a pregnant woman goes through, our understanding of the changes in her brain remains limited.

In 2017, our group was the first to show pronounced, systematic, and enduring changes occurring in the brain's social cognition network during pregnancy. These groundbreaking findings opened the door to new questions that are now being explored through the BEMOTHER project. Specifically, BEMOTHER aims to:

a) Determine when the brain changes in pregnant women begin and how they evolve throughout pregnancy.
b) Characterize the progression of psychological and behavioral adjustments associated with maternal-infant bonding and their connection to observed changes in the brain.
c) Assess the influence of environmental and psychological factors on maternal adaptations by including a group of non-pregnant same-sex partners.
d) Identify metabolomic biomarkers that may mediate the development of neural, psychological, and behavioral adaptations.
e) Identify neural and hormonal factors that can predict the development of postpartum mental conditions.

Answering these questions will allow us to achieve the overreaching goal of developing an integrated model of the adaptations that occur during pregnancy and the postpartum period.

In this sense, BEMOTHER is poised to make significant contributions across multiple domains of knowledge. In the field of reproductive neuroscience, it aims to shed light on the intricate mechanisms underlying the physiological adaptations of motherhood. By comprehensively examining the neural and hormonal changes involved in maternal-infant bonding, BEMOTHER can advance our understanding of matrescence—the psychological and behavioral aspects of becoming a mother.

Furthermore, the project aims to contribute to the field of neuroplasticity by investigating the enduring effects of brain reorganization induced by pregnancy and identifying metabolomic biomarkers associated with these changes. Such insights could enhance our comprehension of neurodevelopmental and neurodegenerative processes.

Finally, BEMOTHER has the potential to uncover neural and hormonal factors associated with the development of mental health problems in the postpartum period. This knowledge can help identify individuals at risk and facilitate early interventions.

In summary, the BEMOTHER project encompasses diverse investigations that hold the promise of making significant advancements in a surprisingly understudied field. By unraveling the brain adaptations during pregnancy, BEMOTHER will deepen our understanding of motherhood, neuroplasticity, and mental health, benefiting both women and their infants.
In the initial phase of BEMOTHER, our primary focus has been on participant recruitment and ensuring that the experimental sessions adhere to predetermined standards of quality and quantity for effective data acquisition.

As we reach the mid-term of the project, we have successfully recruited 322 nulliparous women who are planning to conceive. Among them, 127 participants have already completed a comprehensive pregnancy and postpartum session, which represents 92% of our original target. Additionally, we have successfully recruited 56 same-sex partners, nearly reaching our initial goal of 60.

We have also been able to collect all the intended measures, including neuroimaging, psychological assessments, behavioral data, and metabolomics measurements for each session. This encompasses one pre-pregnancy session, two intra-pregnancy sessions, and three postpartum sessions as per our planned protocol.

Regarding neuroimaging data, we have acquired over 1,300 functional and structural scans MRI scans, that will allow us to characterize the evolution of the morphometric, tractographic, neuroplastic, and connectivity variables over pregnancy and the postpartum period. This an outstanding achievement in itself, since it represents the world’s largest neuroimaging dataset on the neural reorganization of a woman’s transition to motherhood. Right now, we are beginning the analyses of the first four data points of our neuroimaging data (i.e. before pregnancy, 18 and 36 weeks of pregnancy, and 1 month postpartum).

We have also successfully gathered all the originally planned neuropsychological measures, ensuring a comprehensive assessment of our participants. These measures encompass: a) demographical and obstetric data, as well as physical and psychological health measures, b) a complete neuropsychological evaluation, including general and social cognition measures, psychiatric data, as well as mother-infant bonding measures.

Lastly, we have also successfully conducted metabolomics analyses, specifically focusing on determining the concentrations of approximately 100 steroid hormones and metabolites in urine samples. This comprehensive set of steroid hormones includes the primary metabolites of progestogens, estrogens, androgens, and corticosteroids.
BEMOTHER’s aim is to provide an integrative model that characterizes the dynamics of the neuroanatomical and neurofunctional reorganization during pregnancy and the postpartum period, as well as the hormonal factors underlying such reorganization. The overall aim is to understand how such a reorganization can be associated with the development of the psychological and behavioral adaptations that are implemented during the postpartum period to secure an adaptive maternal-infant bonding.

In order to achieve these objectives, BEMOTHER follows the Research Domain Criteria (RDoC). The RDoC offers an efficient framework to characterize the normal and pathological implementation of the adaptations for motherhood. The RDoC is an innovative framework for the development and integration of research across multiple domains and levels of analysis in order to achieve an understanding of mental disorders, allowing a better approach to treatment and prevention. There are strong reasons to support the need to begin with a descriptive, correlational, but also experimental, study in humans. BEMOTHER is poised to be an outstanding implementation of this approach.

BEMOTHER represents a change of paradigm in the field of reproductive neuroscience, because it overcomes the gross neuroanatomical and neurofunctional differences between the human brain and the brains of the standard animal models, as well as their heterogeneity in pregnant hormonal profiles and maternal repertoire timing. In addition, BEMOTHER will provide the necessary neural, psycho-behavioral and metabolomic data associated with the adaptations for motherhood that will pave the way to allow the identification of the specific targets for a mechanistic approach. In sum, BEMOTHER is poised to make a groundbreaking impact on a surprisingly understudied field that has relied until now solely in animal models.