̽��ֱ�� of Cambridge - pregnancy

Mother’s gut microbiome during pregnancy shapes baby’s brain development

jg533 — Tue, 20 Aug 2024 23:30:03 +0000

Researchers have compared the development of the fetal brain in mice whose mothers had no bacteria in their gut, to those whose mothers were given Bifidobacterium breve orally during pregnancy, but had no other bacteria in their gut.

Nutrient transport to the brain increased in fetuses of mothers given Bifidobacterium breve, and beneficial changes were also seen in other cell processes relating to growth.

Bifidobacterium breve is a ‘good bacteria’ that occurs naturally in our gut, and is available as a supplement in probiotic drinks and tablets.

Obesity or chronic stress can alter the gut microbiome of pregnant women, often resulting in fetal growth abnormalities. ̽��ֱ��babies of up to 10% of first-time mothers have low birth weight or fetal growth restriction. If a baby hasn't grown properly in the womb, there is an increased risk of conditions like cerebral palsy in infants and anxiety, depression, autism, and schizophrenia in later life.

These results suggest that improving fetal development - specifically fetal brain metabolism - by taking Bifidobacterium breve supplements while pregnant may support the development of a healthy baby.

̽��ֱ��results are published today in the journal Molecular Metabolism.

“Our study suggests that by providing ‘good bacteria’ to the mother we could improve the growth and development of her baby while she’s pregnant,” said Dr Jorge Lopez-Tello, a researcher in the ̽��ֱ�� of Cambridge’s Centre for Trophoblast Research, first author of the report.

He added: “This means future treatments for fetal growth restriction could potentially focus on altering the gut microbiome through probiotics, rather than offering pharmaceutical treatments - with the risk of side effects - to pregnant women.”

“ ̽��ֱ��design of therapies for fetal growth restriction are focused on improving blood flow pathways in the mother, but our results suggest we’ve been thinking about this the wrong way - perhaps we should be more focused on improving maternal gut health,” said Professor Amanda Sferruzzi-Perri, a researcher in the ̽��ֱ�� of Cambridge’s Centre for Trophoblast Research and senior author of the report, who is also a Fellow of St John’s College, Cambridge.

She added: “We know that good gut health - determined by the types of microbes in the gut - helps the body to absorb nutrients and protect against infections and diseases.”

̽��ֱ��study was carried out in mice, which allowed the effects of Bifidobacterium breve to be assessed in a way that would not be possible in humans - the researchers could precisely control the genetics, other microorganisms and the environment of the mice. But they say the effects they measured are likely to be similar in humans.

They now plan further work to monitor the brain development of the offspring after birth, and to understand how Bifidobacterium breve interacts with the other gut bacteria present in natural situations.

Previous work by the same team found that treating pregnant mice with Bifidobacterium breve improves the structure and function of the placenta. This also enables a better supply of glucose and other nutrients to the developing fetus and improves fetal growth.

“Although further research is needed to understand how these effects translate to humans, this exciting discovery may pave the way for future clinical studies that explore the critical role of the maternal microbiome in supporting healthy brain development before birth,” said Professor Lindsay Hall at the ̽��ֱ�� of Birmingham, who was also involved in the research.

While it is well known that the health of a pregnant mother is important for a healthy baby, the effect of her gut bacteria on the baby’s development has received little attention.

Reference

Lopez-Tello, J, et al: ‘Maternal gut Bifidobacterium breve modifies fetal brain metabolism in germ-free mice.’ Molecular Metabolism, August 2024. DOI: 10.1016/j.molmet.2024.102004

A study in mice has found that the bacteria Bifidobacterium breve in the mother’s gut during pregnancy supports healthy brain development in the fetus.

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CamFest Speaker Spotlight: Dr Carmel McEniery

zs332 — Fri, 01 Mar 2024 10:15:55 +0000

Dr Carmel McEniery is a Senior Research Associate in the Division of Experimental Medicine and Immunotherapeutics at the ̽��ֱ�� of Cambridge and principal investigator on the Cambridge POPPY study into pre-eclampsia. She will be taking part in an event which will explore the puzzling relationship between pregnancy, pre-eclampsia and women’s long-term cardiovascular health.

Why seven in ten women experience pregnancy sickness

cjb250 — Wed, 13 Dec 2023 16:00:10 +0000

A Cambridge-led study has shown why many women experience nausea and vomiting during pregnancy – and why some women, including the Duchess of Cambridge, become so sick they need to be admitted to hospital.

Newborn babies at risk from bacteria commonly carried by mothers

cjb250 — Wed, 29 Nov 2023 16:00:11 +0000

Streptococcus agalactiae (known as Group B Streptococcus, or GBS) is present in the genital tract in around one in five women. Previous research by the team at the ̽��ֱ�� of Cambridge and Rosie Hospital, Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust, identified GBS in the placenta of around 5% of women prior to the onset of labour. Although it can be treated with antibiotics, unless screened, women will not know they are carriers.

GBS can cause sepsis, a life-threatening reaction to an infection, in the newborn. Worldwide, GBS accounts for around 50,000 stillbirths and as many as 100,000 infant deaths per year.

In a study published today in Nature Microbiology, the team looked at the link between the presence of GBS in the placenta and the risk of admission of the baby to a neonatal unit. ̽��ֱ��researchers re-analysed data available from their previous study of 436 infants born at term, confirming their findings in a second cohort of 925 pregnancies.

From their analysis, the researchers estimate that placental GBS was associated with a two- to three-fold increased risk of neonatal unit admission, with one in 200 babies admitted with sepsis associated with GBS – almost 10 times the previous estimate. ̽��ֱ��clinical assessment of these babies using the current diagnostic testing identified GBS in less than one in five of these cases.

In the USA, all pregnant women are routinely screened for GBS and treated with antibiotics if found to be positive. In the UK, women who test positive for GBS are also treated with antibiotics – however, only a minority of pregnant women are tested for GBS, as the approach in the UK is to obtain samples only from women experiencing complications, or with other risk factors.

There are a number of reasons why women in the UK are not screened, including the fact that detecting GBS in the mother is not always straightforward and only a small minority of babies exposed to the bacteria were thought to become ill. A randomised controlled trial of screening for GBS for treatment with antibiotics is currently underway in the UK.

Dr Francesca Gaccioli from the Department of Obstetrics & Gynaecology at the ̽��ֱ�� of Cambridge said: “In the UK, we’ve traditionally not screened mothers for GBS, but our findings – that significantly more newborns are admitted to the neonatal unit as a result of GBS-related sepsis than was previously thought – profoundly changes the risk/benefit balance of universal screening.”

To improve detection, the researchers have developed an ultrasensitive PCR test, which amplifies tiny amounts of DNA or RNA from a suspected sample to check for the presence of GBS. They have filed a patent with Cambridge Enterprise, the ̽��ֱ�� of Cambridge’s technology transfer arm, for this test.

Professor Gordon Smith, Head of Obstetrics & Gynaecology at the ̽��ֱ�� of Cambridge, said: “Using this new test, we now realise that the clinically detected cases of GBS may represent the tip of the iceberg of complications arising from this infection. We hope that the ultra-sensitive test developed by our team might lead to viable point-of-care testing to inform immediate neonatal care.”

When the researchers analysed serum from the babies’ umbilical cords, they found that over a third showed greatly increased levels of several cytokines – protein messengers release by the immune system. This suggests that a so-called ‘cytokine storm’ – an extreme immune response that causes collateral damage to the host – was behind the increased risk of disease.

̽��ֱ��research was funded by the Medical Research Council and supported by the National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre.

Reference
Gaccioli, F, Stephens, K & Sovio, U et al. Placental Streptococcus agalactiae DNA is associated with neonatal unit admission and fetal pro-inflammatory cytokines in term infants. Nature Microbiology; 29 Nov 2023; DOI: 10.1038/s41564-023-01528-2

One in 200 newborns is admitted to a neonatal unit with sepsis caused by a bacteria commonly carried by their mothers – much greater than the previous estimate, say Cambridge researchers. ̽��ֱ��team has developed an ultra-sensitive test capable of better detecting the bacteria, as it is missed in the vast majority of cases.

In the UK, we’ve traditionally not screened mothers for GBS, but our findingsprofoundly changes the risk/benefit balance of universal screening

Francesca Gaccioli

Arteida MjESHTRI

Pregnant woman holding her stomach

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Risk of premature birth from smoking while pregnant more than double previous estimates

cjb250 — Wed, 27 Sep 2023 23:01:31 +0000

̽��ֱ��study, published today in the International Journal of Epidemiology, also found that smoking meant that the baby was four times more likely to be small for its gestational age, putting it at risk of potentially serious complications including breathing difficulties and infections.

But the team found no evidence that caffeine intake was linked to adverse outcomes.

Women are currently recommended to stop smoking and limit their caffeine intake during pregnancy because of the risk of complications to the baby. For example, smoking during pregnancy is associated with an increased risk of fetal growth restriction, premature birth and low birthweight, though it has also been linked to a reduced risk of preeclampsia (high blood pressure during pregnancy).

High caffeine intake has also been shown to be associated with lower birthweights and possibly fetal growth restriction. Caffeine is more difficult to avoid than cigarette smoke as is found in coffee, tea, chocolate, energy drinks, soft drinks, and certain medications.

Studies looking at the links between smoking, caffeine and adverse pregnancy outcomes tend to rely on self-reported data to estimate exposure, which is not always reliable. A more objective measure is to look at levels of metabolites in the blood – chemical by-products created when substances such as tobacco and caffeine are processed in the body.

Researchers at the ̽��ֱ�� of Cambridge and the Rosie Hospital, part of Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust, recruited more than 4,200 women who attended the hospital between 2008 and 2012 as part of the Pregnancy Outcome Prediction (POP) study. ̽��ֱ��team analysed blood samples taken from a subset of these women four times during their pregnancies.

To assess exposure to cigarette smoke, the team looked at levels of the metabolite cotinine, which can be detected in blood, urine, and saliva. Only two out of three women with detectable levels of cotinine in every blood sample were self-reported smokers, showing that this measure is a more objective way of assessing smoking behaviour.

A total of 914 women were included in the smoking analysis. Of these, 78.6% were classified as having no exposure to smoking while pregnant, 11.7% as having some exposure and 9.7% as having consistent exposure.

Compared to women who were not exposed to smoking while pregnant, those with consistent exposure were 2.6 times more likely to experience spontaneous preterm birth – more than double the previous estimate of 1.27 from a meta-analysis of studies – and 4.1 times as likely to experience fetal growth restriction.

Babies born to smokers were found to be on average 387g lighter than babies born to non-smokers – that is, more than 10% smaller than the weight of an average newborn. This increases the risk that the baby will have a low birth weight (2.5kg or less), which in turn is linked to an increased risk of developmental problems as well as poorer health in later life.

Unlike in previous studies, however, the team found no evidence that smoking reduced the risk of pre-eclampsia.

Professor Gordon Smith, Head of the Department of Obstetrics and Gynaecology at the ̽��ֱ�� of Cambridge, said: “We’ve known for a long time that smoking during pregnancy is not good for the baby, but our study shows that it’s potentially much worse than previously thought. It puts the baby at risk of potentially serious complications from growing too slowly in the womb or from being born too soon.

“We hope this knowledge will help encourage pregnant mums and women planning pregnancy to access smoking-cessation services. Pregnancy is a key time when women quit and if they can remain tobacco free after the birth there are lifelong benefits for them and their child.”

Smoking cessation is offered routinely to all pregnant women and the NHS has local smoking cessation services for anyone, pregnant or not. Further information is available on the NHS website.

To assess caffeine intake, they researchers looked for the metabolite paraxanthine, which accounts for 80% of caffeine metabolism and is both less sensitive to recent intake and more stable throughout the day.

915 women were included in the caffeine analysis. Of these women, 12.8% had low levels of paraxanthine throughout pregnancy (suggesting low caffeine intake), 74.0% had moderate levels and 13.2% had high levels. There was little evidence of an association between caffeine intake and any of the adverse outcomes.

̽��ֱ��work was supported by the National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre and the Medical Research Council.

Reference
Selvaratnam, RJ et al. Objective measures of smoking and caffeine intake and the risk of adverse pregnancy outcome. International Journal of Epidemiology; 28 Sept 2023; DOI: 10.1093/ije/dyad123

Cambridge researchers have found that women who smoke during pregnancy are 2.6 times more likely to give birth prematurely compared to non-smokers – more than double the previous estimate.

We’ve known for a long time that smoking during pregnancy is not good for the baby, but our study shows that it’s potentially much worse than previously thought

Gordon Smith

Malte Mueller (Getty Images)

Pregnant woman smoking cigarette - stock illustration

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Thousands of pregnancies tracked in UK’s biggest study on pre-eclampsia

Anonymous — Wed, 19 Jul 2023 10:16:45 +0000

̽��ֱ��POPPY study (Preconception to pOst-partum study of cardiometabolic health in Primigravid PregnancY) is funded by Wellcome and is being led by a team from Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust (CUH) and the ̽��ֱ�� of Cambridge. ̽��ֱ��study is also being carried out in Glasgow and up to four other research centres in London.

In the first large scale study of its kind in the UK, women are being monitored before, during and after their first pregnancy to see what factors might be influencing the health of their placenta and their long-term cardiovascular risk. It’s hoped that by understanding this risk, the health of women who develop placental complications can also be improved over their lifetime.

Placental complications affect around 1 in 10 pregnancies and includes:

pre-eclampsia (high blood pressure with kidney/liver/brain involvement)
gestational hypertension (high blood pressure in pregnancy)
fetal growth restriction (baby being small).

These conditions can lead to serious complications for both mother and baby if not monitored or treated.

High blood pressure (hypertension), diabetes, autoimmune conditions, age and being obese before pregnancy are just some of the factors likely to increase the risk of pre-eclampsia and placental dysfunction, but it’s unclear exactly why and whether there are other causes.

In addition, women who experience placental complications are twice as likely to develop heart disease and diabetes later in life, compared with women who have a healthy pregnancy.

It’s not clear however whether placental complications cause heart disease and diabetes directly, or whether these conditions happen in women who already have some underlying and/or unknown health issues before pregnancy.

Women thought to be at high risk of developing pre-eclampsia are advised to take a 75 to 150mg daily dose of aspirin from the twelfth week of pregnancy until birth to reduce the risk of developing this condition. If a woman develops pre-eclampsia, the only way to cure it is to deliver the baby, normally at around 37 to 38 weeks of pregnancy, although this can be earlier in more severe cases.

Dr Bernadette Jenner is a medical registrar in obstetric medicine and clinical pharmacology at Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust (CUH) and is leading the POPPY study in Cambridge. She said:

“This study is going to be monitoring thousands of women from before they become pregnant for the first time and will track them through to birth and beyond to try and discover why some develop placental conditions and others don’t. We also hope to find out whether or not these conditions trigger longer-term health issues such as heart disease and diabetes.”

“We have a significant lack of understanding when it comes to placental conditions, especially when you consider how common they are, and the serious impact they can have on women and babies, which at times is life-threatening. To prevent pre-eclampsia and other placental conditions we need to know what really causes them and why. We have some big gaps in our knowledge and this study hopes to find answers.”

Professor Ian Wilkinson is leading the POPPY study and is a clinical pharmacologist and Professor of Therapeutics at the ̽��ֱ�� of Cambridge. He said:

“ ̽��ֱ��POPPY study is a world first and will help us to better understand why common complications of pregnancy adversely affect women’s long term cardiovascular health. This is the key to reducing this risk and may also allow us to prevent pregnancy complications before they occur.”

"Unfortunately, many women who suffer from pre-eclampsia, or one of the other placental complications, are not aware of the potential long term risks, and very few of them are actively followed up after birth - despite recommendations by NICE.”

“Therefore, whilst we await the findings of the POPPY study it is important that women who have experienced one of these complications are seen by a medical professional in the months after delivery to ensure that their blood pressure and other cardiovascular risk factors are checked and treated if necessary."

̽��ֱ��POPPY study is now open at Addenbrooke’s Hospital in Cambridge. Two more sites will be open soon at Glasgow Royal Infirmary NHS and Imperial College Healthcare NHS Trust, with further sites in London to start in the coming months.

Participants must be planning their first pregnancy and live in Glasgow, Cambridge or London where the study is taking place. Participation will involve monitoring alongside regular pregnancy checks and tests.

Find out how you can take part on the POPPY Study website.

Adapted from a press release by CUH

Up to 3,500 first time mums are due to take part in a study led by Cambridge researchers to understand why some will develop pre-eclampsia and placental complications during pregnancy and whether it effects their long-term health.

We have a significant lack of understanding when it comes to placental conditions, especially when you consider how common they are, and the serious impact they can have on women and babies, which at times is life-threatening

Bernadette Jenner

POPPY study | Dr Bernadette Jenner

Suhyeon Choi

Pregnant person holding her stomach

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Unborn babies use ‘greedy’ gene from dads to ‘remote-control’ mums into feeding them extra food

Anonymous — Tue, 11 Jul 2023 15:00:32 +0000

̽��ֱ��unborn baby ‘remote controls’ its mother’s metabolism so the two are in a nutritional tug of war. ̽��ֱ��mother’s body wants the baby to survive but needs to keep enough glucose and fats circulating in her system for her own health, to be able to deliver the baby, breastfeed and to reproduce again.

A new study from the ̽��ֱ�� of Cambridge published today examines how the placenta communicates with the mother through the release of hormones so she will accommodate her baby’s growth. ̽��ֱ��placenta is a vital organ that develops with the fetus in pregnant women and other female mammals to support the developing fetus. In pregnant mice, scientists selectively altered the signalling cells in the placenta that tell mothers to allocate nutrients to her developing fetuses.

Professor Amanda Sferruzzi-Perri, Professor in Fetal and Placental Physiology, a Fellow of St John’s College and co-senior author of the paper, said: “It’s the first direct evidence that a gene inherited from the father is signalling to the mother to divert nutrients to the fetus.”

Dr Miguel Constancia, MRC Investigator based at the Wellcome-MRC Institute of Metabolic Science and co-senior author of the paper, said: “ ̽��ֱ��baby’s remote control system is operated by genes that can be switched on or off depending on whether they are a ‘dad’s’ or ‘mum’s’ gene’, the so-called imprinted genes.

“Genes controlled by the father are ‘greedy’ and ‘selfish’ and will tend to manipulate maternal resources for the benefit of the fetuses, so to grow them big and fittest. Although pregnancy is largely cooperative, there is a big arena for potential conflict between the mother and the baby, with imprinted genes and the placenta thought to play key roles.”

̽��ֱ��findings by researchers from the Centre for Trophoblast Research at Cambridge’s Department of Physiology, Development and Neuroscience and the Medical Research Council Metabolic Diseases Unit, part of the Wellcome-MRC Institute of Metabolic Science, have been published in Cell Metabolism.

̽��ֱ��baby’s genes controlled by the father tend to promote fetal growth and those controlled by the mother tend to limit fetal growth.

Professor Sferruzzi-Perri explained: “Those genes from the mother that limit fetal growth are thought to be a mother’s way of ensuring her survival, so she doesn’t have a baby that takes all the nutrients and is too big and challenging to birth. ̽��ֱ��mother also has a chance of having subsequent pregnancies potentially with different males in the future to pass on her genes more widely.”

Researchers deleted the expression of an important imprinted gene called Igf2, which provides instructions for making a protein called ‘Insulin Like Growth Factor 2’. Similar to the hormone insulin, which is responsible for making and controlling glucose levels in our circulation, the gene promotes fetal growth and plays a key part in the development of fetal tissues including the placenta, liver and brain.

Dr Jorge Lopez-Tello, a lead author of the study based at the ̽��ֱ��’s Department of Physiology, Development and Neuroscience, said: “If the function of Igf2 from the father is switched off in signalling cells, the mother doesn’t make enough amounts of glucose and lipids – fats – available in her circulation. These nutrients therefore reach the fetus in insufficient amounts and the fetus doesn’t grow properly.”

̽��ֱ��scientists found that deleting Igf2 from the placenta’s signalling cells affects the production of other hormones that modulate the way the mother’s pancreas produces insulin, and how her liver and other metabolic organs respond.

“We found Igf2 controls the hormones responsible for reducing insulin sensitivity in the mother during pregnancy. It means the mother’s tissues don’t absorb glucose so nutrients are more available in the circulation to be transferred to the fetus,” said Professor Sferruzzi-Perri.

Babies with Igf2 gene defects can be overgrown or growth-stunted. “Until now, we didn’t know that part of the Igf2 gene’s role is to regulate signalling to the mother to allocate nutrients to the fetus,” added Professor Sferruzzi-Perri.

̽��ֱ��mice studied were smaller at birth and their offspring showed early signs of diabetes and obesity in later life.

Professor Sferruzzi-Perri said: “Our research highlights how important the controlled allocation of nutrients to the fetus is for the lifelong health of the offspring, and the direct role the placenta plays.

“ ̽��ֱ��placenta is an amazing organ. At the end of pregnancy, the placenta is delivered by the mother, but the memories of how the placenta was functioning leaves a lasting legacy on the way those fetal organs have developed and then how they’re going to function through life.”

̽��ֱ��next step is to understand how placental hormones are controlled by Igf2 and what those hormones are doing. Future research could help scientists discover new strategies to target the placenta to improve health outcomes for mums and babies.

Mice are used in research because the organisation of their DNA and their gene expression is similar to humans, with ninety-eight percent of human genes having a comparable gene in the mouse. They have similar reproductive and nervous systems to humans, and suffer from many of the same diseases such as obesity, cancer and diabetes.

Reference
Lopez-Tello, J et al. Fetal manipulation of maternal metabolism is a critical function of the imprinted Igf2 gene. Cell Metabolism; 11 July 2023; DOI: 10.1016/j.cmet.2023.06.007

Adapted from a press release from St John’s College Cambridge

A study in mice has found that fetuses use a copy of a gene inherited from their dad to force their mum to release as much nutrition as possible during pregnancy.

It’s the first direct evidence that a gene inherited from the father is signalling to the mother to divert nutrients to the fetus

Amanda Sferruzzi-Perri

Understanding Animal Research

Brown mouse

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Autistic people are more likely to experience depression and anxiety during pregnancy

cjb250 — Wed, 26 Oct 2022 07:00:17 +0000

In the study, led by researchers at the Autism Research Centre, 524 non-autistic people and 417 autistic people completed an online survey about their experience of pregnancy. Anyone who was pregnant at the time of responding or had previously given birth was eligible to take part.

̽��ֱ��study revealed that autistic parents were around three times more likely than non-autistic parents to report having experienced prenatal depression (9% of non-autistic parents and 24% of autistic parents) and anxiety (14% of non-autistic parents and 48% of autistic parents).

Autistic respondents also experienced lower satisfaction with pregnancy healthcare. Autistic respondents were less likely to trust professionals, feel that professionals took their questions and concerns seriously, feel that professionals treated them respectfully, and be satisfied with how information was presented to them in appointments. Furthermore, autistic respondents were more likely to experience sensory issues during pregnancy and more likely to feel overwhelmed by the sensory environment of prenatal appointments.

Dr Sarah Hampton, lead researcher on the study, said: “This study suggests that autistic people are more vulnerable to mental-health difficulties during pregnancy. It is imperative that effective mental-health screening and support is available for autistic people during pregnancy.”

Dr Rosie Holt, a member of the research team, added: “ ̽��ֱ��results also suggest that autistic people may benefit from accommodations to prenatal healthcare. These may include adjustments to the sensory environment of healthcare settings, as well as adjustments to how information is communicated during prenatal appointments.”

Dr Carrie Allison, Deputy Director of the Autism Research Centre and a member of the team, said: “We are grateful to members of the autistic community for providing feedback when we designed this research. It is vital that autistic people with lived experience help shape the research we do, and we keep their priorities as a clear focus.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the research team, said: “It is important that more research is conducted looking at the experiences of autistic new parents, who have been neglected in research. It is also important that this research is translated into health and social care policy and practice to ensure these parents receive the support and adaptations they need in a timely manner.”

Reference
Hampton, S, Allison, C, Baron-Cohen, S, & Holt, R (2022). Autistic People’s Perinatal Experiences I: A Survey of Pregnancy Experiences. Journal of Autism and Developmental Disorders

Autistic people are more vulnerable to depression and anxiety during pregnancy, according to new research from the ̽��ֱ�� of Cambridge. ̽��ֱ��results are published in the Journal of Autism and Developmental Disorders and have important implications for supporting autistic people during pregnancy.

This study suggests that autistic people are more vulnerable to mental health difficulties during pregnancy. It is imperative that effective mental health screening and support is available for autistic people during pregnancy

Sarah Hampton

PetraSolajova

Pregant woman

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