Maternal Psychological Factors and Onset of Functional Gastrointestinal Disorders in Offspring, Baldassarre et al, 2021

Andy

Retired committee member
Background/Objectives:
Functional gastrointestinal disorders (FGIDs) are a heterogeneous group of conditions of unclear etiology. The biopsychosocial model approach to FGIDs posits that early-life stressors may trigger a cascade of complex interactions between genetic predisposition and risk factors eventually leading to the occurrence of FGIDs. The relationship between psychological disposition of the mother and FGIDs occurrence is poorly understood. We conducted a study to investigate if parental psychological factors may contribute to the onset of FGIDs in offspring.

Methods:
We performed a prospective cohort study of parent-infant pairs who completed a battery of self-reported psychological questionnaires and a validated Rome III questionnaire for the diagnosis of Infant and Toddler FGIDs. The Edinburgh Postpartum Depression Scale (EPDS) was used to examine postpartum depression (PPD) symptoms; the Maternity Blues Questionnaire (MBQ) was applied to measure maternity blues severity; The Symptoms Checklist Revised (SCL90-R) was used to assess the presence of relevant psychiatric symptoms; adult attachment style in mothers was assessed in a continuous way through the 5 dimensions of the Attachment Style Questionnaire (ASQ).

Results:
Out of the 360 eligible mothers, 200 were enrolled, 113 completed the three-month follow-up and were included in the final analysis. PPD symptoms prevalence was 20.4%, 20%, 13.2% and 13.1% respectively at 3 days, 1 week, 1 month and 3 months after delivery. 40.4% of mothers suffered from severe blues according to the MBQ. Relevant psychiatric symptoms (SCL90-R) were present in 7.8% and 10.9% of mothers, respectively at 1 week and 3 months after delivery. 48.7% of mothers showed a secure attachment pattern measured through the RQ. At 1-month follow-up, infant regurgitation was diagnosed in 26 (23%) of infants, infantile colic in 31 (27.4%), dyschezia in 17 (15%) and functional constipation in 9 (8%). At 3-month follow-up, FGIDs prevalence was respectively 16 (19.3%), 11 (13.3%), 4 (4.8%) and 11 (13.3%). A significant positive association between PPD symptoms starting 3 days after delivery and the presence of infantile colic on setting 1 month after birth was found (p = 0.028), as well as between PPD symptoms occurrence 7 days after delivery and infantile regurgitation beginning 1 month after birth (p = 0.042). Higher prevalence of infantile colic was found in offspring of mothers suffering from PPD symptoms from 3 days after delivery (54.5 vs 19.8; p = 0.001). No significant association was found between FGIDs and psychiatric symptoms and maternity blues at any timepoint. On the other hand, mothers of infants with regurgitation with an onset 1 month after birth have higher insecurity score in avoidant and fearful ASQ-related attachment dimensions (respectively, p = 0.03, p = 0.042, p = 0.03).

Conclusions:
Maternal psychological factors might contribute to the onset of infant FGIDs in offspring. Early screening of postpartum depression symptoms and early implementation of psychological interventions within the postpartum period might promote the health of mother-infant dyad.
Paywall, https://journals.lww.com/jpgn/Abstract/9000/Maternal_Psychological_Factors_and_Onset_of.95739.aspx
 
It is possible that mothers with problems have babies with colic, though a baby with colic could just as easily be the cause of the mother's problems!

But how on earth can they say that the babies have functional gastrointestinal disorders?

It is the type of research that closes doors on finding ways to help people. The gut is affected by stress hormones and babies do get stressed when their mother is not calm but calling it functional and blaming the mother takes us nowhere.
 
On the other hand, mothers of infants with regurgitation with an onset 1 month after birth have higher insecurity score in avoidant and fearful ASQ-related attachment dimensions (respectively, p = 0.03, p = 0.042, p = 0.03).

But which came first the chicken or the egg?

As a woman who hasn't had children and not spent a huge amount of time with babies, I ask have you heard an infant suffering from colic? Seen them wriggling about and drawing their legs up in pain? Of course the mother (& father) would be stressed and worried, particularly if it happens after every feed!
 
Feeding/eating problems is such a potentially stressful issue for parents. Feeding your child is part of your identity as a parent. When I worked with swallowing issues with adults with cerebral palsy, it was obviously necessary to work closely with parents/carers but at times you needed to address issues relating to previous medical intervention that had occurred twenty or thirty years before.

Blaming parents sets parents and children up potentially for a life time of stress and anxiety, that could have been totally avoidable. How many adults with physical disability die of aspiration pneumonia as their condition changes with age because their carers had been made afraid in early childhood of admitting there were any difficulties?

[added - it might not be an enormous number, but I would guesstimate maybe in England overall perhaps three or four preventable deaths a year]
 
Last edited:
Well, I'm very glad that when one of mine had infant colic and the other some regurgitation, nobody tried psychologising me. Both were regarded as biological problems they would grow out of, which of course they did.
 
Like a stuck record spinning round round. Without Marshall's team peptic ulcers would still be stuck in the psychosomatic void of failure, saying the exact same things as this nonsense here, exact same as the old nonsense there:

peptic-ulcers-psychosomatic.jpg
 
Don’t you just love the way research seems to be conducted now in psychology?
So the results show “No significant association was found between FGIDs and psychiatric symptoms and maternity blues at any timepoint.”
And they state in the conclusion that “Maternal psychological factors might contribute to the onset of infant FGIDs in offspring.”

Dammit - the pesky results don’t show what we wanted them to - never mind, we can still suggest that we know better.....
 
Out of the 360 eligible mothers, 200 were enrolled, 113 completed the three-month follow-up and were included in the final analysis.
Likely selection bias.

A significant positive association between PPD symptoms starting 3 days after delivery and the presence of infantile colic on setting 1 month after birth was found (p = 0.028), as well as between PPD symptoms occurrence 7 days after delivery and infantile regurgitation beginning 1 month after birth (p = 0.042). Higher prevalence of infantile colic was found in offspring of mothers suffering from PPD symptoms from 3 days after delivery (54.5 vs 19.8; p = 0.001).
Cherry picking

No significant association was found between FGIDs and psychiatric symptoms and maternity blues at any timepoint.
Null result.

Maternal psychological factors might contribute to the onset of infant FGIDs in offspring.
Sticking with the planned conclusion despite a null result, with a spin that will inevitably make mothers feel guilty and reduce the need for proper biological investigation of the causes of the conditions (which could lead to a better understanding of them, and treatments, and a whole lot less stress on the parents and the baby)

Early screening of postpartum depression symptoms and early implementation of psychological interventions within the postpartum period might promote the health of mother-infant dyad.
Statement of the obvious - surely these things should be done regardless of whether a baby has colic or not. And it doesn't take anything fancy with psychologists - having a midwife visit every new mother in her home a couple of times during the first 6 weeks or so goes a long way to being a safety net to catch and prevent early childhood issues.
 
It reminds me of something i read as of late. Right before the turn of the century, there was a major ice storm in Montreal and area. Dozens died frozen in their house, due to power outage. Researchers at McGill University saw this as an opportunity to study pre-natal maternal stress effects on the offspring.
Long-term effects
Project Ice Storm (Projet Verglas) was created to monitor the long-term effect of prenatal stress. Researchers at McGill University set up the project in the immediate aftermath of the disaster, finding 178 families to participate; some of the women were still pregnant at the start of the investigation. "The goal of the current study is to understand the long-term effects of the prenatal exposure to stress on the physical growth and functioning, cognitive development, and behaviour of the Project Ice Storm children by studying developmental trajectories through age 13.[20]

https://www.mcgill.ca/projetverglas/icestorm
 
Last edited:
surely these things should be done regardless of whether a baby has colic or not. And it doesn't take anything fancy with psychologists - having a midwife visit every new mother in her home a couple of times during the first 6 weeks or so goes a long way to being a safety net to catch and prevent early childhood issues.
Yes to this! Why do we need to prove that neglecting people in distress or treating people badly "causes health problems" in order to justify not doing these things? If a person doesn't develop some sort of health problem as a result of such poor treatment, does that make it okay? Surely, its about having some basic standards of care.

Its like when people draw on "neuroscience evidence" to advise people how to bring up a child. Yes, studies with animals show that early stimulus deprivation (like being locked up and kept in the dark) can slow neural development. But surely we don't need science to tell us that its not okay to keep babies/toddlers locked up and in the dark :facepalm:
 
One inescapable conclusion from the systematic pattern of arguing that there may be a relation (and that relation must be causal and in the preferred direction no matter how many straws have to be grasped to pretend this is a serious argument) no matter what to every null result is an admission that the process of EBM is so unreliable that nothing can be concluded unless it validates the assumptions. They don't even trust their own process when it invalidates their assumptions, literally thinking "well, that can't be right, it's not the answer I want".

In a nutshell: with unlimited mulligans, you can hit a hole-in-one every time if you only count the times it worked. Also another time-honored EBM process: just build the green and dig the hole at the exact spot the ball rested (or draw the bull's eye around wherever the bullet hit). Magical evidence-based perfect hit ratio!

Seriously it's important to step back and appreciate this: they don't trust the process when it gives them answers they don't want, arguing the assumption must be right regardless. The complete opposite of the scientific method. Beyond the fact that it's just a system to produce whatever results are fashionable, everyone involved explicitly distrusts the process, dismissing the outcomes unless they give exactly what they planned to argue.

Sometimes there is a meme that is just too perfect not to use:
78c560ee402d0d6f79c699e1d655c7a7.jpg
 
Back
Top Bottom