Dr Emily Camm, The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
In this Q&A with Dr Emily Camm (The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia) she explains how a mother’s health and the quality of her diet and the air she breathed while pregnant can influence her child’s brain development. The changes can be long-term and cause problems during adulthood.
What inspired your interest in studying early life and neurodevelopment?
During my undergraduate science degree, I had an outstanding lecturer in fetal physiology, Professor Mary Wlodek, who inspired my interest in fetal development. At the same time, I was studying psychology with a focus on the neural basis for behaviour, learning, and memory.
The interaction between our genes and lifestyle plays an important role in determining who we are, and our risk of disease as adults. Through Professor Mary Wlodek teachings, I began to appreciate that the nutrition we received in the womb, our mother’s health while pregnant and the quality of the air she breathed can have a profound effect on our development as a baby and our health into adulthood.
Why is it important to study the impact of the environment on fetal development?
Extensive epidemiological, clinical, and experimental studies have clearly demonstrated that a poor prenatal environment or pregnancy complications alter fetal development and increase the risk of offspring neurological, psychological, and psychiatric disorders in later life.
Studying the pathways by which environmental exposures or pregnancy complications impact the fetal brain and offspring neurodevelopment is critical, so that effective public health messaging, preventative strategies and early interventions can be implemented to ensure children reach their full neurodevelopmental potential.
Tell us about your research exploring the link between low oxygen in the womb and memory function?
Low oxygen, or hypoxia, in the womb during pregnancy is a common complication of pregnancy. It occurs in various scenarios such as at high altitude, maternal smoking, preeclampsia, or placental insufficiency. Conditions such as preeclampsia and placental insufficiency affect up to 10% of pregnancies.
Over a series of studies, I demonstrated that hypoxia during pregnancy reduces the amount of oxygen that is delivered to the baby’s brain, which adversely affects not only the development and number of cells (neurons) that are produced but how they communicate with each other. I observed these changes primarily in the hippocampus, a brain region which is critical for learning and memory. Ultimately, alterations in cell development and number as a consequence of low oxygen in pregnancy will impact how the offspring’s brain functions and matures, which surfaces in adult life as problems with forming lasting memories.
What are the implications of the physiological changes on a child’s brain development?
Low oxygen in the womb during pregnancy triggers several physiological responses in the baby to ensure its survival. Blood from the fetal heart is preferentially pumped to vital organs, such as the brain, at the expense of other organs. Simultaneously, the baby’s heart rate and fetal breathing movements decrease, which assists in minimising the baby’s energy expenditure.
Whilst these physiological responses are aimed at maintaining blood flow and oxygen supply to essential organs in the face of an adverse environment, this does not ensure normal fetal development. These physiological adaptations slow the baby’s growth, which can lead to permanent changes in the structure and function of various organs, and eventually to disorders in postnatal life.
Depending on the stage of development, exposure to low oxygen may delay the proliferation, migration, or growth of cells (neurons) in the brain, or lead to an increase in cell death. The degree of insulation, or myelin, that wraps around the extensions of the neurons, called axons, may also be impaired. Combined, these alterations may lead to reduced numbers of cells within the brain, impaired cell-to-cell connections and communication, and ultimately impaired brain function.
How can our understanding of the long-term impacts of early life conditions affect medical treatment and care in the future?
Increasing knowledge that early life events program disease creates an exciting window of opportunity to halt the development of neurological disease and mental disorders before birth.
Experimental studies provide critical clues as to which pathways are implicated in early life conditions. This significant knowledge leads to new avenues for much needed treatment options or interventions designed to ameliorate the adverse effects of early life conditions on child neurodevelopmental outcomes, with a focus on pregnancy as a critical period in determining adult health.
Additionally, understanding the long-term impacts of a poor prenatal environment on brain health is also important in order to streamline early care pathways, enable multidisciplinary interventions and improved resource allocation to help children reach their full neurodevelopmental potential. Importantly, early diagnoses and interventions will not only improve long-term outcomes, but reduce the emotional and economic impact on the child and their family.
Dr Emily Camm will be speaking more about this research at the Environmental Impacts on Pregnancy and Offspring Outcomes: Lessons Learned and Avenues for Intervention on 29 September in London.