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Copyright © 2017 Connexion Psychological Practice Ltd.


"Anxious or depressed mothers-to-be are at increased risk of having children who will experience sleep problems in infancy and toddlerhood, finds a study that published this month in Early Human Development.


We have long known that a child’s sleep is vital to his or her growth, but the origins of problems affecting it remained unclear. Now, we have evidence that these patterns may be set early on, perhaps even before birth," said Thomas O'Connor, Ph.D., the study's lead author. associate professor of Psychiatry at the University of Rochester Medical Centre. “This is another piece in the unfolding mystery of just how much the prenatal environment may shape a child’s health and development for years to come.”


The survey-based study, part of the Avon Longitudinal Study of Parents and Children (ALSPAC), assessed pregnant women living in Avon, England, who were due to give birth in a 21-month window. More than 14,000 women – an estimated 85 to 90 percent of those eligible – responded to questionnaires that gauged how depressed or anxious they were at multiple points early on in, late in, and after their pregnancy. Later on, the women were then asked to report on their child’s sleep habits at 6, 18 and 30 months, detailing how long the child slept (a consolidated daytime and nighttime total), how often the child awoke, and if he or she exhibited any of seven common forms of sleep problems, such as having nightmares, refusing to go to bed or having trouble falling asleep.


Surprisingly, babies born to mothers classified as anxious or depressed while pregnant dozed just as long as their unstressed-pregnancy counterparts – about 12 hours.


However, this sleep was less sweet; children born to mothers who were depressed or anxious during pregnancy experienced more sleep problems. For instance, mothers classified as clinically anxious 18 weeks into pregnancy, compared to their non-anxious counterparts, were about 40 percent more likely to have an 18-month-old who refused to go to bed, woke early, and kept crawling out of bed. The child’s rocky relationship with sleep often persisted until he or she was 30 months old.


A similar effect was found in children born to mothers who were depressed during pregnancy.


These prenatal mood disturbances worked as reliable predictors of children’s sleep problems even when investigators controlled data for other factors already linked with poor sleep quality in children, including a mother’s level of postnatal anxiety or depression, her smoking habit, or her social class.


“This problematic sleep is notable; it may be part of the reason why mood-disturbed pregnancies are linked to children’s behavioral disorders, like depression, hyperactivity and anxiety, later on down the road,” O’Connor said. “It remains to be seen if the sleep problems we witnessed may play an active, causal role in priming the path for these children’s emotional and cognitive problems in later life, or if both conditions merely fall out of the same stressful pregnancies.”


Related studies now show that stress, which is associated with increased exposure stress hormones, like cortisol, may disrupt a child’s formation of a bundle of nerve cells in the brain – called the suprachiasmatic nucleus – which act as a signalling system that tunes the body’s internal clock. This signalling system helps to properly regulate daily rhythms of waking, sleeping, even hunger – that is, if its formation has not been disrupted.


This could explain why sound sleep doesn’t come easily to kids whose signalling systems may not be properly calibrated, O’Connor said. However, more research is needed to monitor this signalling pathway more closely, watching for biological hints as to why sleep and behavioural disturbances so often crop up together.


In the meantime, pregnant women concerned about how their own mood-disturbance may harm their unborn baby’s sleeping habits, development and emotional health may want to consider psychological treatment, O’Connor said. Several evidence-based therapies exist, and unlike medication, none of them are suspect in the least for causing adverse effects to baby.


“Given prenatally, psychological interventions could instil a whole host of benefits that may carry-over to the child,” O’Connor said. “Still, more clinical research is needed to see how we can best promote healthy pregnancies and healthy babies.”


The ALSPAC study, part of the WHO-initiated European Longitudinal Study of Pregnancy and Childhood, is funded by the Welcomed Trust, the National Institutes of Health and the United Kingdom’s Department of Health, Department of the Environment, and Medical Research Council.



What is the first trimester of pregnancy (week 1-week 12)?

During the first trimester your body undergoes many changes. Hormonal changes affect almost every organ system in your body. These changes can trigger symptoms even in the very first weeks of pregnancy. Your period stopping is a clear sign that you are pregnant. Other changes may include:

  • Extreme tiredness

  • Tender, swollen breasts. Your nipples might also stick out.

  • Upset stomach with or without throwing up (morning sickness)

  • Cravings or distaste for certain foods

  • Mood swings

  • Constipation (trouble having bowel movements)

  • Need to pass urine more often

  • Headache

  • Heartburn

  • Weight gain or loss

As your body changes, you might need to make changes to your daily routine, such as going to bed earlier or eating frequent, small meals. Fortunately, most of these discomforts will go away as your pregnancy progresses. And some women might not feel any discomfort at all! If you have been pregnant before, you might feel differently this time around. Just as each woman is different, so is each pregnancy.



What is the second trimester of pregnancy (week 13-week 28)?

Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months.


You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move!

As your body changes to make room for your growing baby, you may have:

  • Body aches, such as back, abdomen, groin, or thigh pain

  • Stretch marks on your abdomen, breasts, thighs, or buttocks

  • Darkening of the skin around your nipples

  • A line on the skin running from belly button to pubic hairline

  • Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. Patches often match on both sides of the face. This is sometimes called the mask of pregnancy

  • Numb or tingling hands, called carpal tunnel syndrome

  • Itching on the abdomen, palms, and soles of the feet. (Call your doctor if you have nausea, loss of appetitevomitingjaundice or fatigue combined with itching. These can be signs of a serious liver problem.)

  • Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.)



What is the third trimester trimester of pregnancy (week 29-week 40)?

You're in the home stretch! Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Don't worry, your baby is fine and these problems will lessen once you give birth.


Some new body changes you might notice in the third trimester include:

  • Shortness of breath

  • Heartburn

  • Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.)

  • Hemorrhoids

  • Tender breasts, which may leak a watery pre-milk called colostrum (kuh-LOSS-struhm)

  • Your belly button may stick out

  • Trouble sleeping

  • The baby "dropping," or moving lower in your abdomen

  • Contractions, which can be a sign of real or false labor


As you near your due date, your cervix becomes thinner and softer (called effacing). This is a normal, natural process that helps the birth canal to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited - the final countdown has begun!

How will my baby develop week by week?


First Trimester (week 1-week 12)


At 4 weeks:

  • Your baby's brain and spinal cord have begun to form.

  • The heart begins to form.

  • Arm and leg buds appear.

  • Your baby is now an embryo and one-fifth of an inch long.


At 8 weeks:

  • All major organs and external body structures have begun to form.

  • Your baby's heart beats with a regular rhythm.

  • The arms and legs grow longer, and fingers and toes have begun to form.

  • The sex organs begin to form.

  • The eyes have moved forward on the face and eyelids have formed.

  • The umbilical cord is clearly visible.

  • At the end of 8 weeks, your baby is a fetus and looks more like a human. Your baby is nearly 1 inch long and weighs less than 1/8 of an ounce.


At 12 weeks:

  • The nerves and muscles begin to work together. Your baby can make a fist. 

  • Eyelids close to protect the developing eyes. They will not open again until the 28th week.

  • Head growth has slowed, and your baby is much longer. Now, at about 3 inches long, your baby weighs almost an ounce.


Second Trimester (week 13-week 28)


At 16 weeks:

  • The external sex organs show if your baby is a boy or girl. A woman who has an ultrasound in the second trimester or later might be able to find out the baby's sex.

  • Muscle tissue and bone continue to form, creating a more complete skeleton.

  • Skin begins to form. You can nearly see through it.

  • Meconium (mih-KOH-nee-uhm) develops in your baby's intestinal tract. This will be your baby's first bowel movement.

  • Your baby makes sucking motions with the mouth (sucking reflex).

  • Your baby reaches a length of about 4 to 5 inches and weighs almost 3 ounces.


At 20 weeks:

  • Your baby is more active. You might feel slight fluttering.

  • Your baby is covered by fine, downy hair called lanugo (luh-NOO-goh) and a waxy coating called vernix. This protects the forming skin underneath.

  • Eyebrows, eyelashes, fingernails, and toenails have formed. Your baby can even scratch itself.

  • Your baby can hear and swallow.

  • Now halfway through your pregnancy, your baby is about 6 inches long and weighs about 9 ounces.


At 24 weeks:

  • Bone marrow begins to make blood cells.

  • Taste buds form on your baby's tongue.

  • Footprints and fingerprints have formed.

  • Real hair begins to grow on your baby's head.

  • The lungs are formed, but do not work.

  • The hand and startle reflex develop.

  • Your baby sleeps and wakes regularly.

  • If your baby is a boy, his testicles begin to move from the abdomen into the scrotum. If your baby is a girl, her uterus and ovaries are in place, and a lifetime supply of eggs have formed in the ovaries.

  • Your baby stores fat and has gained quite a bit of weight. Now at about 12 inches long, your baby weighs about 1½ pounds.



Third Trimester (week 29-week 40)


At 32 weeks:

  • Your baby's bones are fully formed, but still soft.

  • Your baby's kicks and jabs are forceful.

  • The eyes can open and close and sense changes in light.

  • Lungs are not fully formed, but practice "breathing" movements occur.

  • Your baby's body begins to store vital minerals, such as iron and calcium.

  • Lanugo begins to fall off.

  • Your baby is gaining weight quickly, about one-half pound a week. Now, your baby is about 15 to 17 inches long and weighs about 3 to 33⁄4 pounds


At 36 weeks:

  • The protective waxy coating called vernix gets thicker.

  • Body fat increases. Your baby is getting bigger and bigger and has less space to move around. Movements are less forceful, but you will feel stretches and wiggles.

  • Your baby is about 16 to 19 inches long and weighs about 6 to 6½ pounds.


Weeks 37-40:

  • By the end of 37 weeks, your baby is considered full term. Your baby's organs are ready to function on their own.

  • As you near your due date, your baby may turn into a head-down position for birth. Most babies "present" head down.

  • At birth, your baby may weigh somewhere between 6 pounds 2 ounces and 9 pounds 2 ounces and be 19 to 21 inches long. Most full-term babies fall within these ranges. But healthy babies come in many different sizes.



Source: http://www.medicinenet.com/pregnancy/article.htm