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Cited by 278Neuroendocrine regulation and behaviorMaternal Mental Health During Pregnancy and PostpartumInfant Health and Development

The maternal brain and its plasticity in humans

Open access
Kim, Pilyoung, Strathearn, Lane, Swain, James E.·2016·Hormones and Behavior
DOI 10.1016/j.yhbeh.2015.08.001PMC PMC4724473
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Abstract

Early mother-infant relationships play important roles in infants’ optimal development. New mothers undergo neurobiological changes that support developing mother-infant relationships regardless of great individual differences in those relationships. In this article, we review the neural plasticity in human mothers’ brains based on functional magnetic resonance imaging (fMRI) studies. First, we review the neural circuits that are involved in establishing and maintaining mother-infant relationships. Second, we discuss early postpartum factors (e.g., birth and feeding methods, hormones, and parental sensitivity) that are associated with individual differences in maternal brain neuroplasticity. Third, we discuss abnormal changes in the maternal brain related to psychopathology (i.e., postpartum depression, posttraumatic stress disorder, substance abuse) and potential brain remodeling associated with interventions. Last, we highlight potentially important future research directions to better understand normative changes in the maternal brain and risks for abnormal changes that may disrupt early mother-infant relationships.

AI snapshot

Written from the paper’s full text.

TL;DR

This review synthesizes human fMRI evidence that the maternal brain undergoes structural and functional plasticity across the postpartum period, shaped by birth and feeding methods, hormones, stress, childhood adversity, and psychopathology. It proposes that normative maternal adaptation involves reward/motivation, emotion regulation, empathy, and executive circuits, while PPD, PTSD, and substance abuse reflect maladaptive plasticity that may be targets for intervention.

Key findings

  • Longitudinal structural imaging from the first to third/fourth months postpartum showed growth in reward/motivation regions (striatum, amygdala, hypothalamus, substantia nigra), sensory/empathy regions (superior temporal gyrus, thalamus, insula, pre- and post-central gyri), and emotion-regulation regions (inferior and medial frontal gyri, ACC); no neural regions showed grey matter reduction, and greater midbrain growth was associated with stronger positive maternal emotions about the baby.
  • At one month postpartum, vaginal delivery and exclusive breastfeeding were each associated with greater neural responses to own-baby cries versus control cries in overlapping motivation, sensory, and cognitive/emotional control regions; the vaginal-versus-cesarean functional difference disappeared by three to four months postpartum.
  • PPD affects 15–20% of pregnancies, with high-risk rates as high as 50–80%; PPD was associated with dampened amygdala/insula responses to negative or infant distress stimuli, whereas PTSD in mothers more than one year postpartum was associated with heightened fear-circuitry responses (amygdala, anterior insula) and altered prefrontal regulation.
  • In a preliminary Mom Power intervention imaging study, parenting treatment (n=14) versus treatment-as-usual (n=15) showed increased activity to own versus other infant stimuli in amygdala, precuneus, dorsal ACC, and dorsolateral PFC (p < 0.001, uncorrected), with activity inversely related to parenting stress in empathy regions.

Methods

  • Narrative review of functional magnetic resonance imaging (fMRI) studies in human mothers, with some structural imaging and genetic/hormonal studies, focused on neural circuits supporting mother-infant relationships and individual differences in maternal brain plasticity.
  • The paper reviews task-based studies using infant cry sounds, infant images/videos, and mother-infant interaction tasks, and discusses factors including birth method, feeding method, oxytocin/testosterone/estrogen, stress and childhood adversity, maternal behavior, and psychopathology.
  • No primary sample or new data are reported; the authors also propose an over-simplistic model of maternal brain function based on task-based imaging studies.

Limitations

  • The authors state their proposed model is “necessarily over-simplistic” and that the reviewed studies largely use block designs and region-focused analyses rather than connectivity, so circuit physiology and connectivity remain poorly described.
  • The authors state that existing human maternal brain findings are primarily cross-sectional and correlative, so causal or temporal conclusions cannot be drawn; they call for prospective and longitudinal studies across pregnancy and postpartum.
  • The text makes evident additional limitations: some cited studies have small samples (e.g., n=8 in one PPD study; n=12 in an early postpartum study; n=14 and n=15 in the intervention study), and the field lacks sufficient structural, at-risk-population, psychopathology-specific, naturalistic-stimulus, and multimodal/machine-learning work.

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Integrity signals

Registry

Crossref · 10.1016/j.yhbeh.2015.08.001

Cites

186 of 186 references verified0 citation errors · 0 not checkable

Statistics

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Claims the paper makes

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  • Premisecitation

    Responses to infants form a model motivational system using dopamine and oxytocin-rich pathways.

    “Both animal and human research (Numan and Woodside, 2010; Strathearn et al., 2009a) suggests that responses to infants form a model motivational system using dopamine (DA) and oxytocin (OT)-rich pathways.”
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    Natural reward-related stimuli, including food, sex, and faces of one's sexual partner or child, activate the brain's reward system.

    “Natural reward-related stimuli, including food, sex, and faces of one’s sexual partner or child, activate the brain’s “reward” system (Aharon et al., 2001; Delgado et al., 2000; Melis and Argiolas, 1995; Stoeckel et al., 2008; Strathearn et al., 2008).”
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    In response to infant stimuli, infant cry and smiles activate the amygdala.

    “In response to infant stimuli, infant cry and smiles activate the amygdala (Barrett et al., 2012; Seifritz et al., 2003; Swain et al., 2008), which has often been interpreted as a sign of emotional salience (Seifritz et al., 2003; Strathearn and Kim, 2013) or positive emotion associated with attachment (Leibenluft et al., 2004).”
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    A mother's positive feelings towards her unborn fetus and her perception of her fetus are associated with greater maternal sensitivity to the infant's signals and more affectionate vocalizations and touch.

    “Such reward pathways may be relevant very early in the postpartum period, as a mother’s positive feelings towards her unborn fetus, as well as her perception of her fetus, have been associated with greater maternal sensitivity to the infant’s signals and more affectionate vocalizations and touch (Keller et al., 2003; Keren et al., 2003).”
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  • Premisecitation

    Increased responses to baby cry in postpartum anxiety circuits including the basal ganglia and orbitofrontal cortex diminish over the first 4 months postpartum.

    “This matches apparent increased responses to baby cry in postpartum anxiety circuits including the basal ganglia and orbitofrontal cortex that diminish over the first 4 months postpartum (Swain et al., 2014b; Swain et al., 2015).”
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    Interpretationnone given

    After birth, the brain and body of mothers undergo dynamic changes to support the establishment and maintenance of maternal caregiving behaviors.

    “After birth, the brain and body of mothers undergo dynamic changes to support the establishment and maintenance of maternal caregiving behaviors.”
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    Premisecitation

    Sensitive caregiver responses to infant cues involve complex thoughts and behaviors and are likely the result of complex and highly plastic neural networks involved in emotional responses, attention/executive function, reward/motivation, and sensorimotor circuits.

    “Such behaviors are likely the result of complex and highly plastic neural networks involved in generating and organizing emotional responses (Kober et al., 2008), as well as dissociable and volitional attention and executive function, reward and motivation, and sensorimotor circuits (Buckner et al., 2008; Seeley et al., 2007; Sripada et al., 2014).”
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    Premisecitation

    In mothers, increased amygdala activation to infant stimuli can be associated with more positive responses to one's own infant, whereas in typical adults it is interpreted as a more negative response.

    “Thus, while increased activation of the amygdala to infant stimuli is interpreted as a more negative response to infants among typical adults (Riem et al., 2011), in mothers, it can be associated with more positive responses to one’s own infant (Barrett et al., 2012).”
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    Premisecitation

    Parental anxiety peaks immediately after childbirth and then begins to diminish during the first three to four months postpartum.

    “Indeed, parental anxiety peaks immediately after childbirth and then begins to diminish during the first three to four months postpartum (Feldman et al., 1999; Kim et al., 2013; Leckman et al., 1999).”
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    Premisecitation

    In rodents, changes in the neural structure and function during the early postpartum period have been observed consistently to support maternal motivation and to enhance processing of sensory information that is specialized to detect and respond to infants' calls.

    “In rodents, changes in the neural structure and function during the early postpartum period have been observed consistently to support maternal motivation and to enhance processing of sensory information that is specialized to detect and respond to infants’ calls (Fleming et al., 2002; Numan, 2007).”
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    Interpretationnone given

    Maternal adaptation to the role of motherhood and performance of associated behaviors for sensitive moment-to-moment responses to infant cues can be expected to depend on certain brain systems that need to be plastic to specific circumstances and adapt to environmental cues.

    “Maternal adaptation to the role of motherhood and performance of associated behaviors for sensitive moment-to-moment responses to infant cues can be expected to depend on certain brain systems that need to be plastic to specific circumstances, and adapt to environmental cues.”
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    Premisecitation

    Activation of the medial and lateral PFC and ACC is consistently observed among new mothers in response to an infant's cry, to videos of a distressed infant, and to one's own child greater than to familiar/unknown faces.

    “Activation of the medial and lateral PFC and ACC are consistently observed among new mothers in response to an infant’s cry (Laurent and Ablow, 2012; Lorberbaum et al., 2002), to videos of a distressed infant (Noriuchi et al., 2008), and to one’s own child greater than to familiar/unknown faces (Leibenluft et al., 2004) were observed among new mothers.”
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    Premisecitation

    In human mothers, structural growth was also observed in areas involved in processing sensory information and empathy, including the superior temporal gyrus, thalamus, insula, and pre- and post-central gyri, and in regions associated with regulating emotions, such as the inferior and medial frontal gyri and the ACC.

    “Structural growth was also observed in areas involved in processing sensory information and empathy, including the superior temporal gyrus, thalamus, insula, and pre- and post-central gyri. Finally, regions associated with regulating emotions, such as the inferior and medial frontal gyri and the ACC, also showed structural increases.”
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    • cites Kim et al., 2010a

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    Premisecitation

    Vaginal delivery provides critical sensory stimulation that increases release of OT and helps to establish maternal behaviors.

    “Vaginal delivery provides critical sensory stimulation that increases release of OT and helps to establish maternal behaviors (Morgan et al., 1992).”
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    Premisecitation

    Among non-parent women, administration of OT was associated with reduced responses in the amygdala to negative emotional images that were stressful, as well as stimuli that depict infants either crying or laughing.

    “Among non-parent women, administration of OT was associated with reduced responses in the amygdala to negative emotional images that were stressful (Rupp et al., 2012), as well as stimuli that depict infants either crying (Riem et al., 2011) or laughing (Riem et al., 2013).”
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    Interpretationreasoning

    Differences in maternal neural responses to infants are influenced by mothers' own childhood experiences, which contribute to baseline differences in terms of neural structure and functions.

    “Therefore, the findings suggest that differences in maternal neural responses to infants are influenced by mothers’ own childhood experiences, which contribute to baseline differences in terms of neural structure and functions.”
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    Premisecitation

    Exposure to childhood adversity may result in abnormal development of the OT system in the offspring, as well as lead to poorer quality of parenting behavior later in adulthood.

    “Although OT plays a role in stimulating the onset and maintenance of maternal behavior, exposure to childhood adversity may result in abnormal development of the OT system in the offspring, as well as lead to poorer quality of parenting behavior later in adulthood (Champagne and Meaney, 2001; Champagne, 2011; Champagne and Meaney, 2007).”
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    Interpretationreasoning

    Individual differences in hormonal levels, including testosterone, estrogen, and OT, may influence maternal neural responses to infants and, in turn, behavioral sensitivity to infants.

    “Taken together, these studies suggest that individual differences in hormonal levels, including testosterone, estrogen, and OT, may influence maternal neural responses to infants and, in turn, behavioral sensitivity to infants.”
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    Premisecitation

    High quality of maternal care in childhood was associated with increased grey matter volumes in regions involved in regulation of emotions and social and sensory information processing, including the superior frontal gyrus, the OFC, the superior and middle temporal gyri, and the fusiform gyrus, and with higher levels of neural responses to infants' cry sounds in these same regions.

    “High quality of maternal care in childhood was associated with increased grey matter volumes in regions involved in regulation of emotions and social and sensory information processing, including the superior frontal gyrus, the OFC, the superior and middle temporal gyri, and the fusiform gyrus. Furthermore, higher levels of neural responses to infants’ cry sounds were found in these same regions.”
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    • cites Kim et al., 2010b

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    Premisecitation

    Mothers with the AA genotype of the OT receptor gene, which has been associated with greater receptor expressions, showed significantly higher levels of positive parenting as well as greater neural responses to images of their own children compared to mothers with the GA and GG genotypes.

    “Supporting the importance of OT in the central brain for parenting, mothers with the AA genotype, which has been associated with greater receptor expressions, showed significantly higher levels of positive parenting as well as greater neural responses to images of their own children compared to mothers with the GA and GG genotypes (Michalska et al., 2014).”
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    Premisenone given

    Mothers with an insecure/dismissing type of adult attachment show a diminished OT response to mother-infant interaction, which is associated with reduced activation in the hypothalamus and the ventral striatum.

    “Previous studies have shown that mothers with an insecure/dismissing type of adult attachment show a diminished OT response to mother-infant interaction, which is associated with reduced activation in the hypothalamus and the ventral striatum.”
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    Interpretationreasoning

    Reward-related neural responses to one's own infant were associated with enhanced neural connectivity for attention and social information processing, which may further support synchronous mother-infant interactions.

    “Thus, reward-related neural responses to one’s own infant were associated with enhanced neural connectivity for attention and social information processing, which may further support synchronous mother-infant interactions.”
    Quote in the paperSubstantial claim

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    Premisecitation

    When intrusive and synchronous mothers were compared, intrusive mothers showed greater responses in the amygdala to their own babies, whereas synchronous mothers showed greater activation in the NAcc.

    “When intrusive and synchronous mothers were compared, intrusive mothers showed greater responses in the amygdala to their own babies, whereas synchronous mothers showed greater activation in the NAcc.”
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    • cites Atzil et al., 2011 source

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    Interpretationreasoning

    Greater activation in the dorsal ACC may contribute to more sensitive processing of social cues, which may be further associated with highly synchronous behaviors among mothers interacting with their own infants.

    “Thus, greater activation in the dorsal ACC may contribute to more sensitive processing of social cues, which may be further associated with highly synchronous behaviors among mothers interacting with their own infants.”
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    • Rests on an assumption: The dorsal ACC is involved in integrating affective and social processes as well as regulating social pain such as social rejection.

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    Interpretationreasoning

    These studies suggest reduced neural responses across an array of limbic and cortical structures to negative emotional stimuli and infant distress cues, which may be associated with increased risks for mood dysregulation and maternal insensitivity.

    “These studies suggest reduced neural responses across an array of limbic and cortical structures to negative emotional stimuli and infant distress cues, which may be associated with increased risks for mood dysregulation and maternal insensitivity.”
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    Premisecitation

    Women with postpartum depression demonstrated an absence or disengagement of dorsomedial prefrontal cortex-amygdala connectivity while viewing fearful and threatening faces, whereas healthy mothers had intact dorsomedial prefrontal cortex-amygdala connectivity.

    “In a single such study, women with PPD demonstrated an absence or disengagement of dorsomedial PFC- amygdala connectivity while viewing fearful and threatening faces, whereas healthy mothers had intact dorsomedial PFC-amygdala connectivity to fearful and threatening faces. (Moses-Kolko et al., 2010).”
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    Premisecitation

    In mothers attending to non-infant negative emotional stimuli, postpartum depression versus healthy status and greater postpartum depression severity were associated with reduced activity in the amygdala to fearful and threatening faces or negatively valenced words.

    “Two existing studies (Moses-Kolko et al., 2010; Silverman et al., 2007) of mothers attending to non-infant negative emotional stimuli found that PPD versus healthy status and greater PPD severity was associated with reduced activity in the amygdala to fearful and threatening faces or negatively valenced words.”
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    Premisecitation

    Drugs of abuse such as cocaine stimulate dopamine pathways in similar brain regions.

    “Likewise, drugs of abuse such as cocaine stimulate DA pathways in similar brain regions (Kufahl et al., 2005).”
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    Premisecitation

    Mothers with addictions may be less able to respond appropriately to their children's cues, finding them less intrinsically rewarding or salient and more stress-provoking.

    “Unlike many mothers who find engaging with their own children to be a uniquely rewarding experience, mothers with addictions may be less able to respond appropriately to their children’s cues, finding them less intrinsically rewarding or salient and more stress-provoking (Rutherford et al., 2011).”
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    Interpretationcitation

    Postpartum depression is associated with dampened neural response, whereas PTSD among mothers is associated with heightened neural responses to infants in the emotion regulation circuits.

    “While PDD was associated with dampened neural response, PTSD among mothers is associated with heightened neural responses to infants in the emotion regulation circuits.”
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    Premisecitation

    Addiction problems in mothers are associated with a range of major parenting difficulties, often resulting in child abuse and neglect.

    “Addiction problems in mothers are associated with a range of major parenting difficulties, often resulting in child abuse and neglect (Mayes et al., 1997; Strathearn and Mayes, 2010).”
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    Interpretationreasoning

    Drugs of abuse may co-opt the brain circuitry critical for maternal caregiving.

    “This finding raises the possibility that drugs of abuse may co-opt the brain circuitry critical for maternal caregiving.”
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    Premisecitation

    In mothers viewing child separation versus free play videos, IPV-PTSD mothers activated an unrestrained fear-circuitry that was associated with higher subjective ratings of stress.

    “In this study of mothers viewing child separation vs. free play videos, IPV-PTSD mothers activated an “unrestrained” fear-circuitry that was associated with higher subjective ratings of stress.”
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    • cites Schechter et al., 2012 source

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    Premisecitation

    The described circuitry in women with IPV-PTSD compared to healthy mothers included heightened activity in bilateral anterior entorhinal cortex, left caudate, left insula, and reduced frontocortical activity in superior frontal gyrus and bilateral superior parietal lobes.

    “The circuitry described included heightened activity in emotion regulation and empathy regions -- bilateral anterior entorhinal cortex, left caudate, left insula, and reduced frontocortical activity (superior frontal gyrus and bilateral superior parietal lobes) in women with IPV-PTSD compared to healthy mothers.”
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    Premisecitation

    PTSD symptoms were inversely correlated with superior frontal gyrus activity and positively associated with caudate activity.

    “PTSD symptoms were inversely correlated with superior frontal gyrus activity and positively associated with caudate activity.”
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    Interpretationreasoning

    These findings highlight the importance of the emotion regulation region and limbic activation for dissociation, PTSD symptoms, and other domains of cognitive function that affect maternal sensitivity and child outcome.

    “These findings highlight the importance of the emotion regulation region and limbic activation for dissociation, PTSD symptoms and other domains of cognitive function that affect maternal sensitivity and child outcome.”
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    Premisecitation

    Epidemiological studies have linked addiction in adulthood to prior adverse early childhood experiences, with increased risk and severity related to the number of adverse factors experienced.

    “Epidemiological studies have linked addiction in adulthood to prior adverse early childhood experiences (Anda et al., 2006; Dube et al., 2003b), with increased risk/severity related to the number of adverse factors experienced, such as childhood abuse, domestic violence, and parental addiction.”
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    Premisecitation

    Parenting difficulties that result from addiction can lead to the perpetuation of childhood abuse and neglect, thus continuing the cycle of childhood adversity and addiction.

    “Parenting difficulties that result from addiction can lead to the perpetuation of childhood abuse and neglect (Dube et al., 2003a), thus continuing the cycle of childhood adversity and addiction.”
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    Premisecitation

    Growing up in a negative home environment and with childhood neglect is significantly correlated with higher levels of parenting stress in adulthood and an increased display of problematic parenting behaviors.

    “Furthermore, growing up in a negative home environment and with childhood neglect is significantly correlated with higher levels of parenting stress in adulthood and an increased display of problematic parenting behaviors (Harmer et al., 1999).”
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    Interpretationreasoning

    There is increasing evidence of intergenerational effects, whereby mothers who abuse drugs have often experienced grossly inadequate caregiving environments during their own childhood, perhaps further accentuating neglectful or abusive care of their children that is associated with substance abuse.

    “Taken together, there appears to be increasing evidence of intergenerational effects, whereby mothers who abuse drugs have often experienced grossly inadequate caregiving environments during their own childhood, perhaps further accentuating neglectful or abusive care of their children that is associated with substance abuse..”
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    Interpretationcitation

    Mothers more than one year postpartum who have PTSD have a neurobiology resembling that in non-postpartum populations, characterized by hyperactivity within the fear circuitry (amygdala and anterior insula) and alternatively decreased or increased dissociative-type voluntary ventromedial prefrontal cortex/ventral anterior cingulate cortex regulation of subcortical activity.

    “Mothers, more than one year postpartum, who have PTSD, have a neurobiology which resembles that in non-postpartum populations, characterized by hyperactivity within the fear circuitry (amygdala and anterior insula) and alternatively decreased or increased (dissociative-type) voluntary ventromedial PFC/ventral ACC regulation of subcortical activity.”
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    Interpretationreasoning

    Given the apparent plasticity of the maternal brain in adaptive mental health and psychopathological maladaptation, brain changes are likely occurring when parenting interventions are applied.

    “Given the apparent plasticity of the maternal brain in adaptive mental health and psychopathological maladaptation, brain changes are likely occurring when parenting interventions are applied.”
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    Interpretationown data

    Heightened intrusive and anxious responses that accompany subsyndromal affective symptoms in very early (3 weeks) postpartum mothers, associated with medial prefrontal cortex and lenticular nucleus activity to infant cry, may change over time and serve an adaptive role that fails in the development of syndromal depression.

    “Heightened intrusive/anxious responses that accompany subsyndromal affective symptoms in very early (3 weeks) postpartum mothers, associated with medial PFC and lenticular nucleus activity to infant cry, may change over time and serve an adaptive role that fails in the development of syndromal depression.”
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    Interpretationreasoning

    Mothers with syndromal level depression have blunted amygdala and insula activity to negative emotional stimuli and infant distress stimuli, which is the opposite of that described in non-postpartum depressed samples.

    “Mothers with syndromal level depression have blunted amygdala and insula activity to negative emotional stimuli and infant distress stimuli, which is the opposite of that described in non-postpartum depressed samples.”
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    Premisecitation

    Infants of mothers with mental health problems are at increased risk for developmental delays, cognitive and functional impairments, physical symptoms and injuries, as well as behavioral and emotional problems in affected pre-school and school age children.

    “The importance of such interventions is underlined by a growing body of research demonstrating that infants of mothers with mental health problems are at increased risk for developmental delays, cognitive and functional impairments, physical symptoms and injuries, as well as behavioral and emotional problems in the affected pre-school and school age children (Bagner et al., 2010; Bureau et al., 2”
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    Interpretationreasoning

    Detecting neural endophenotypes of disrupted maternal care may guide earlier interventions and improve the mental and physical health of mother and offspring.

    “Detecting neural endophenotypes of disrupted maternal care may guide earlier inventions and improve the mental and physical health of mother and offspring.”
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    Premisecitation

    Continuous symptom spectra may overlap across defined psychopathologies and may better align with neurobiological systems.

    “Alternately, as proposed in the National Institute of Mental Health’s Research Domain Criteria (RDoC) (Cuthbert, 2014) continuous symptom spectra, which may overlap across defined psychopathologies, may better align with neurobiological systems.”
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  • May combine two claims.

    Premisecitation

    Animal evidence suggests mixed findings on reduced neurogenesis in the hippocampus but increased synaptic density in the prefrontal cortex during the postpartum period.

    “animal evidence suggests mixed findings on reduced neurogenesis in the hippocampus but increased synaptic density in the prefrontal cortex during the postpartum period (Leuner et al., 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Leuner et al., 2010 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Negative environments such as living in poverty, being a single or teenage mother, and high marital conflicts are significant risk factors for maternal insensitivity toward infants and for psychopathology.

    “Third, negative environments such as living in poverty, being a single or teenage mother, and high marital conflicts are significant risk factors for maternal insensitivity toward infants and for psychopathology (Magnuson and Duncan, 2002; Sturge-Apple et al., 2006).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Magnuson and Duncan, 2002

      Not checked in the free run.

    • cites Sturge-Apple et al., 2006

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Training-induced increased grey matter volumes have been associated with increased activation in the hippocampus.

    “While training-induced increased grey matter volumes have been associated with increased activation in the hippocampus (Hamzei et al., 2012),”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hamzei et al., 2012 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Verbal recall memory declines during pregnancy and the postpartum period.

    “For example, verbal recall memory declines during pregnancy and the postpartum period (Glynn, 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Glynn, 2010 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Multimodal approaches that use machine learning methods promise diagnostic and prognostic models for healthy maternal adaptation versus psychopathology that may not be possible with any one method.

    “Such multimodal approaches that use machine learning methods promise diagnostic and prognostic models for healthy maternal adaptation vs. psychopathology (Orru et al., 2012) that may not be possible with any one method.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Orru et al., 2012 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning

    Dysfunctions in the regulation of the emotion network may be associated with postpartum depression, whereas the reward/motivation network may be more associated with substance abuse.

    “For instance, dysfunctions in the regulation of the emotion network may be associated with postpartum depression, whereas the reward/motivation network may be more associated with substance abuse.”
    Quote in the paperNot a substantial claim
48 of 48

  • The paper relies on this without support.

    Maternal caregiving plays a critical role for infant survival and optimal development.

    “Maternal caregiving plays a critical role for infant survival and optimal development.”

  • The paper relies on this without support.

    Testosterone is metabolized into estradiol, which can subsequently increase OT levels.

    “This finding is not surprising given that testosterone is metabolized into estradiol, which can subsequently increase OT levels.”

  • The paper relies on this without support.

    Synchronous maternal behaviors are more sensitive parenting behaviors and are associated with positive infant outcomes.

    “Synchronous maternal behaviors, including coordination of gaze, touch, and vocalizations with infants, are interpreted as more sensitive parenting behaviors and are associated with positive infant outcomes.”

  • The paper relies on this without support.

    The dorsal ACC is involved in integrating affective and social processes as well as regulating social pain such as social rejection.

    “The dorsal ACC is involved in integrating affective and social processes as well as regulating social pain such as social rejection.”

  • The paper relies on this without support.

    Little is known about within-circuit connectivity of cortical brain regions that can directly modulate limbic reactivity to infants and other emotional cues in postpartum women.

    “Little is known about within-circuit connectivity of cortical brain regions that can directly modulate limbic reactivity to infants and other emotional cues in postpartum women.”

  • The paper relies on this without support.

    Our understanding of neural regions involved in parenting is still limited to inform the development of specific intervention strategies.

    “Our understanding on neural regions involved in parenting is still limited to inform the development of specific intervention strategies”

  • The paper relies on this without support.

    The field lacks studies examining specific links between neural regions or networks and behaviors throughout pregnancy and the postpartum period.

    “the field also lacks studies examining specific links between neural regions/networks and behaviors throughout pregnancy and the postpartum period.”

  • The paper relies on this without support.

    Many women rapidly resume substance use after childbirth, with resultant adverse effects on their parenting capacity and their children's development.

    “Many women rapidly resume substance use after childbirth, with resultant adverse effects on their parenting capacity and their children’s development.”
8 of 8

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Postpartum depression affects 10 to 20% of new mothers and between 4 and 26% of new fathers, and can be drastically higher for caregivers with histories of depression and stress hormone dysregulation.

    “One particularly significant cause of dysregulation is postpartum depression, which affects 10 to 20% of new mothers and between 4 and 26% of new fathers-and can be drastically higher for caregivers with histories of depression and stress hormone dysregulation”

    From Malleability, plasticity, and individuality: How children learn and develop in context<sup>1</sup> (2019) · cites this paper as Kim et al., 2016

    Section 4.1 (page not specified) reports PPD in 15–20% of pregnancies and rates as high as 50–80% in high-risk groups that include people with previous major depressive episodes or abnormal stress hormone regulation. It does not give the claimed 4–26% prevalence for new fathers, and its 15–20% figure is not the claimed 10–20% of new mothers. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • During the first months of life, the caregiver coregulates both the infant's and his or her own emotional arousal and physical needs.

    “During that time, the caregiver coregulates both the infant's and his/her own emotional arousal and physical needs”

    From Malleability, plasticity, and individuality: How children learn and develop in context<sup>1</sup> (2019) · cites this paper as Kim et al., 2016

    Section 2.2 (page not provided) says mothers respond to infant distress while managing their own distress. Section 2.1 (page not provided) describes meeting infants’ physical and psychological needs during the early postpartum months. The paper does not say caregivers regulate their own physical needs, and its discussion focuses on mothers rather than caregivers generally. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Relational pattern making involves emotional responses, executive functions, reward and motivation systems, and sensorimotor systems, and occurs through sequences of attunement, mis-attunement, and re-attunement.

    “Relational pattern making involves emotional responses, executive functions, reward and motivation systems, and sensorimotor systems; it occurs through sequences of attunement (sensing what others think and need), mis-attunement, and re-attunement”

    From Malleability, plasticity, and individuality: How children learn and develop in context<sup>1</sup> (2019) · cites this paper as Kim, Strathearn, & Swain, 2016

    Section 2, “Neurocognitive mechanisms underlying parental sensitivity” (page unavailable), links sensitive caregiver responses to emotional, executive-function, reward-and-motivation, and sensorimotor systems. The paper discusses attuned mother–infant behavior, but the passages do not describe relational pattern making as a sequence of attunement, mis-attunement, and re-attunement. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The emergence of different aspects of maternal behavior relies on experience-dependent changes within the maternal brain that enable the processing of sensory cues from the newborn.

    “the emergence of different aspects of maternal behavior relies on experience-dependent changes within the maternal brain that enable the processing of sensory cues from the newborn”

    From Neuromodulation of maternal circuits by oxytocin (2019) · cites this paper as Kim et al., 2016

  • New mothers undergo dramatic endocrinological and physiological changes supporting the establishment and maintenance of maternal caregiving, including changes throughout the central nervous system.

    “New mothers themselves undergo dramatic endocrinological and physiological changes supporting the establishment and maintenance of maternal caregiving, including changes throughout the central nervous system”

    From Neuromodulation of maternal circuits by oxytocin (2019) · cites this paper as Kim et al., 2016

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. Gaynes, 2005, Perinatal depression: prevalence, screening accuracy, and screening outcomes, Evid. Rep. Technol. Assess. (Summ.), 1
  2. Swain, 2011, Brain imaging of human parent–infant relationships, Arch. Womens Ment. Health, 14, s93
  3. Swain, 2014, Brain activity in empathy and approach-motivation domains for high-risk parents is increased by intervention and inversely related to parenting stress, Neuropsychopharmacology, 39, S523
  4. Swain, 2015, Functional brain activations of parents listening to their own baby-cry change over the early postpartum, Dev. Psychobiol.
  5. Vazquez, 2015, Women at risk for depression: prenatal depressive symptoms and afternoon ACTH levels predict post-partum depression, Arch. Gen. Psychiatry

Cited by

Sorted by citations

Related

Authors
Kim, P., Strathearn, L., & Swain, J. E.
Affiliations
  • University of Denver (US)
  • University of Iowa (US)
  • University of Michigan (US)
Corresponding author
Kim, Pilyoung
ORCID
Venue
Hormones and Behavior
Publisher
Elsevier BV
Published
2016-01
Volume
77
Pages
113-123
ISSN
0018-506X (ISSN-L)
DOI
10.1016/j.yhbeh.2015.08.001
PMC
PMC4724473
OpenAlex
W1132316397
Semantic Scholar
21e96b9f949aef121f1031097442a12308821974
Cited by
278
References
186
Citations by year
2026: 18 · 2025: 22 · 2024: 27 · 2023: 24 · 2022: 16 · 2021: 24 · 2020: 41 · 2019: 36 · 2018: 29 · 2017: 21 · 2016: 16 · 2015: 4
FWCI
3.64
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Hormones and Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Commons - DU (University of Denver) (submittedVersion)
Funders
  • National Institute of Child Health and Human Development (R21 HD078797, R01 HD065819)
  • National Institute on Drug Abuse (R01 DA026437)
  • National Center for Advancing Translational Sciences (UL1 TR000433)
  • Centers for Disease Control and Prevention (U49/CE002099)
  • Brain and Behavior Research Foundation
  • Klingenstein Third Generation Foundation
Topics
  • Social Sciences › Psychology › Social Psychology › Neuroendocrine regulation and behavior
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Health Professions › Pharmacy › Infant Health and Development
Keywords
maternal brain, neuroplasticity, mother-infant relationship, postpartum depression, post-traumatic stress disorder, maternal substance abuse, brain remodeling, parental sensitivity, maternal hormones, individual differences
MeSH terms
Brain, Female, Humans, Maternal Behavior, Mother-Child Relations, Neuronal Plasticity, Postpartum Period

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

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