The Maternal Brain in Context: Systemic Physiological Changes Across Pregnancy.
Hannah Grotzinger1, Magdalena Martínez-García1, Eliza C Miller2
1Department of Psychological and Brain Sciences and Ann S. Bowers Women's Brain Health Initiative, University of California, Santa Barbara, California, USA; email: hgrotzinger@ucsb.edu, egjacobs@ucsb.edu.
Annual Review of Neuroscience
|April 2, 2026
Summary
Pregnancy triggers significant maternal brain remodeling, influenced by hormonal shifts and changes in immune, cardiovascular, and microbiome systems. This review explores these interconnected adaptations for a holistic understanding.
Area of Science:
- Neuroscience
- Reproductive Biology
- Immunology
Background:
- Pregnancy involves profound physiological adaptations in maternal immune regulation and vascular systems.
- Longitudinal studies reveal significant maternal nervous system remodeling linked to hormonal changes during pregnancy.
- Understanding maternal brain adaptations requires an integrative approach considering multiple physiological systems.
Purpose of the Study:
- To review the impact of endocrine, cardiovascular, microbiome, and immune systems on the maternal brain.
- To elucidate the biological pathways shaping the maternal brain during pregnancy and postpartum.
- To identify neural adaptations in both normative and adverse pregnancy outcomes.
Main Methods:
- Literature review synthesizing findings from longitudinal human studies.
- Integrative analysis of peripheral system changes (endocrine, cardiovascular, immune, microbiome) and their neural correlates.
- Focus on normative and adverse pregnancy contexts.
Main Results:
- Pregnancy induces coordinated adaptations across peripheral systems and the maternal brain.
- Gonadal hormone production correlates with observed nervous system remodeling.
- Interactions between immune, cardiovascular, and microbiome factors significantly influence maternal brain function.
Conclusions:
- A holistic, integrative approach is crucial for understanding maternal brain plasticity during pregnancy.
- Further research into these interconnected systems will illuminate mechanisms underlying maternal brain health and disease.
- Identifying these pathways is key to addressing adverse pregnancy outcomes and supporting maternal well-being.
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