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Tartour AI, Chivese T, Eltayeb S, Elamin FM, Fthenou E, Seed Ahmed M, Babu GR. Prenatal psychological distress and 11β-HSD2 gene expression in human placentas: Systematic review and meta-analysis. Psychoneuroendocrinology 2024; 166:107060. [PMID: 38677195 DOI: 10.1016/j.psyneuen.2024.107060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/10/2024] [Accepted: 04/18/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND The placenta acts as a buffer to regulate the degree of fetal exposure to maternal cortisol through the 11-Beta Hydroxysteroid Dehydrogenase isoenzyme type 2 (11-β HSD2) enzyme. We conducted a systematic review and meta-analysis to assess the effect of prenatal psychological distress (PPD) on placental 11-β HSD2 gene expression and explore the related mechanistic pathways involved in fetal neurodevelopment. METHODS We searched PubMed, Embase, Scopus, APA PsycInfo®, and ProQuest Dissertations for observational studies assessing the association between PPD and 11-β HSD2 expression in human placentas. Adjusted regression coefficients (β) and corresponding 95% confidence intervals (CIs) were pooled based on three contextual PPD exposure groups: prenatal depression, anxiety symptoms, and perceived stress. RESULTS Of 3159 retrieved records, sixteen longitudinal studies involving 1869 participants across seven countries were included. Overall, exposure to PPD disorders showed weak negative associations with the placental 11-β HSD2 gene expression as follows: prenatal depression (β -0.01, 95% CI 0.05-0.02, I2=0%), anxiety symptoms (β -0.02, 95% CI 0.06-0.01, I2=0%), and perceived stress (β -0.01 95% CI 0.06-0.04, I2=62.8%). Third-trimester PPD exposure was more frequently associated with lower placental 11-β HSD2 levels. PPD and placental 11-β HSD2 were associated with changes in cortisol reactivity and the development of adverse health outcomes in mothers and children. Female-offspring were more vulnerable to PPD exposures. CONCLUSION The study presents evidence of a modest role of prenatal psychological distress in regulating placental 11-β HSD2 gene expression. Future prospective cohorts utilizing larger sample sizes or advanced statistical methods to enhance the detection of small effect sizes should be planned. Additionally, controlling for key predictors such as the mother's ethnicity, trimester of PPD exposure, mode of delivery, and infant sex is crucial for valid exploration of PPD effects on fetal programming.
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Affiliation(s)
- Angham Ibrahim Tartour
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar.
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Safa Eltayeb
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Fatima M Elamin
- Office of Research Ethics and Integrity, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Eleni Fthenou
- Qatar Biobank for Medical Research, Qatar Foundation, Doha, Qatar
| | - Mohammed Seed Ahmed
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
| | - Giridhara Rathnaiah Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, P. O. Box:2713, Doha, Qatar
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Byg LM, Bilenberg N, Glintborg D, Andersen MS, Wesselhoeft R. The longitudinal relationship between prenatal maternal cortisol and preschool internalising problems. Psychoneuroendocrinology 2024; 168:107141. [PMID: 39059226 DOI: 10.1016/j.psyneuen.2024.107141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/02/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
INTRO Prenatal exposure to synthetic glucocorticoids may increase the risk of emotional symptoms in childhood partly by reducing fetal growth. We explored if physiological levels of prenatal maternal cortisol were associated with internalising problems in boys and girls and if this was mediated by birth weight. METHODS Mother-child dyads from the prospective Odense Child Cohort (n=1162) were included if maternal serum cortisol (3rd trimester), offspring birth weight, and Child Behaviour Checklist (CBCL) assessments in preschool age were available. Crude and adjusted associations between cortisol and internalising problems were determined in linear mixed models stratified by offspring sex. Covariates included parental psychiatric history, parity, maternal age, education, smoking during pregnancy, and gestational age at birth. In the presence of significant associations, we evaluated the potential mediating role of birth weight. RESULTS The study sample included 601 boys and 561 girls and internalising problems were assessed at mean ages 2.3 (±0.4) and 5 (±0.5) years. In the crude analysis, cortisol was positively associated with internalising problems in boys (p-value 0.017) and in girls (p-value < 0.0001). In the adjusted analyses, there was no statistically significant association between cortisol and offspring internalising problems in boys or girls (all p-values > 0.15). There was no mediation by birth weight. DISCUSSION Maternal serum cortisol was positively associated with offspring internalising problems in boys and girls, but there was no association following adjustment for potential confounders and no mediation through birth weight. Maternal third-trimester cortisol levels do not predict preschool offspring internalising problems in our study.
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Affiliation(s)
- Lars Meinertz Byg
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Niels Bilenberg
- Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Dorte Glintborg
- Department of Endocrinology and Metabolism, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Marianne Skovsager Andersen
- Department of Endocrinology and Metabolism, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Rikke Wesselhoeft
- Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
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Wu J, Zhou F, Wang Y, Niu Y, Zhang C, Meng Y, Hao Y, Yu W, Liu H, Li C, Zhang S, Chen S, Xia X, Wu Y, Huang H. Associations between maternal early pregnancy depression and longitudinal fetal growth. J Affect Disord 2024; 362:808-815. [PMID: 39029680 DOI: 10.1016/j.jad.2024.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 07/04/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND The impacts of maternal depression during mid-to-late pregnancy on fetal growth have been extensively investigated. However, the association between maternal depression during early pregnancy and fetal intrauterine growth are less clear. METHODS A prospective study comprised 23,465 eligible pregnant women and their offspring was conducted at a hospital-based center in Shanghai. Prenatal depression was assessed used using Patient Health Questionnaire (PHQ-9) before 14 gestational weeks. Differences in fetal growth trajectory of different maternal depressive statuses during three periods (16-23, 24-31, and 32-41 gestational weeks) were compared using a multilevel model with fractional polynomials. RESULTS Women with depressive symptoms during early pregnancy had higher longitudinal fetal trajectories, with an estimated increase in fetal weight (β = 0.33; 95 % CI, 0.06-0.61), compared to those without depressive symptoms. Increases in fetal abdominal circumference among women with depressive symptoms were observed before 23 gestational weeks. Offspring born to mothers with early pregnancy depression had a significantly higher birth weight of 14.13 g (95 % CI, 1.33-27.81 g) and an increased risk of severe large size for gestational age (adjusted odds ratio [aOR], 1.64; 95 % CI, 1.32-2.04) and macrosomia (aOR, 1.21; 95 % CI, 1.02-1.43). LIMITATIONS Self-rated scale was used to assess depressive symptoms rather than clinical diagnosis. And Long-term effects of early pregnancy depression on offspring were not explored. CONCLUSIONS The study revealed an association between maternal depression during early pregnancy and increased fetal biometrics, higher birth weight, and an elevated risk of severe large size for gestational age and macrosomia.
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Affiliation(s)
- Jiaying Wu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Fangyue Zhou
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yishu Wang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yujie Niu
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chen Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Yicong Meng
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yanhui Hao
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Wen Yu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Han Liu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Cheng Li
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Siwei Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Siyue Chen
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Xian Xia
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
| | - Yanting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Reproduction and Development, Shanghai, China; Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China.
| | - Hefeng Huang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China; Shanghai Key Laboratory of Reproduction and Development, Shanghai, China; Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China; Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Eckermann HA, Lugones M, Abdala D, Roge H, de Weerth C. Maternal early life and prenatal stress in relation to birth outcomes in Argentinian mothers. Dev Psychobiol 2024; 66:e22502. [PMID: 38807271 DOI: 10.1002/dev.22502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/15/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024]
Abstract
Environmental influences before and during pregnancy significantly impact offspring development. This study investigates open research questions regarding the associations between maternal early life stress (ELS), prenatal psychosocial stress, prenatal hair cortisol (HC), and birth outcomes in Argentinian women. Data on ELS, prenatal life events, HC (two samples representing first and second half of pregnancy), and birth outcomes were collected from middle-class Argentinian women (N = 69) upon delivery. Linear mixed models indicated that HC increased from the first half to the second half of pregnancy with considerable variability in the starting values and slopes between individuals. Mothers who experienced more ELS, were taller, or more educated, tended to show lower increases in HC. Older age was positively related to HC increases. Our data did not suggest an interaction between ELS and prenatal life events in relation to HC. We found that the change in HC was most likely negatively associated with birth weight. Our data are most compatible with either a weak or the absence of an association between ELS or prenatal life events and absolute values of HC. Mothers with stronger increases in hair cortisol tended to have newborns with slightly lower birth weight. Hence, ELS and birthweight may either have been related to changes in cortisol exposure during pregnancy or to factors that influence accumulation or retention of cortisol in hair.
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Affiliation(s)
- Henrik Andreas Eckermann
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Micaela Lugones
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Daniel Abdala
- Department of Neonatology, Hospital Español de Mendoza, Mendoza, Argentina
| | - Horacio Roge
- Department of Neonatology, Hospital Español de Mendoza, Mendoza, Argentina
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
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Raz S. Comprehensive assessment of memory function, inhibitory control, neural activity, and cortisol levels in late pregnancy. Ann N Y Acad Sci 2024; 1535:42-61. [PMID: 38622960 DOI: 10.1111/nyas.15142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
A considerable proportion of women subjectively perceive a detriment to their cognitive capacity during pregnancy, with decreased memory functions being the most frequently self-reported concerns. However, objective investigation of these perceived cognitive deficits has yielded inconsistent results. This study focused on memory functions during late pregnancy using multiple tasks designed to assess various memory indices, for example, working memory, learning rate, immediate recall, proactive and retroactive interference, delayed recall, retrieval efficiency, visuospatial constructional ability, recognition, and executive function. Additionally, sustained attention and inhibitory control were examined using a combined recognition stop-signal task. Electrophysiological brain activity during this task was recorded using a 128-channel electroencephalographic-event-related potential system. Salivary cortisol levels were assessed both prior to and following the experimental session. In contrast to the widely held belief, results demonstrated that women in late pregnancy did not exhibit a decline in their performance across the various memory tests. In terms of accuracy, there was not a single task in which poorer performance was found for pregnant women. The quality of memory performance was comparable, and in some cases even superior, among women in the pregnancy group. On the stop-signal task, pregnant women exhibited significantly better performance, and their electrophysiological data revealed greater centrally distributed P300 amplitude to "stop" signs, which may signify an enhanced neural efficiency in the domains of inhibitory executive control. Endocrine results revealed that pregnant women exhibited significantly lower levels of salivary cortisol, suggesting an attenuation of hypothalamic-pituitary-adrenocortical axis activity, which may contribute to the optimization of fetal development and growth.
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Affiliation(s)
- Sivan Raz
- Department of Behavioral Sciences, The Center for Psychobiological Research, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
- Department of Psychology, Tel Hai College, Upper Galilee, Israel
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Thompson WD, Reynolds RM, Beaumont RN, Warrington NM, Tyrrell J, Wood AR, Evans DM, McDonald TJ, Hattersley AH, Freathy RM, Lawlor DA, Borges MC. Maternal plasma cortisol's effect on offspring birth weight: a Mendelian Randomisation study. BMC Pregnancy Childbirth 2024; 24:65. [PMID: 38225564 PMCID: PMC10789047 DOI: 10.1186/s12884-024-06250-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Observational studies and randomized controlled trials have found evidence that higher maternal circulating cortisol levels in pregnancy are associated with lower offspring birth weight. However, it is possible that the observational associations are due to residual confounding. METHODS We performed two-sample Mendelian Randomisation (MR) using a single genetic variant (rs9989237) associated with morning plasma cortisol (GWAS; sample 1; N = 25,314). The association between this maternal genetic variant and offspring birth weight, adjusted for fetal genotype, was obtained from the published EGG Consortium and UK Biobank meta-analysis (GWAS; sample 2; N = up to 406,063) and a Wald ratio was used to estimate the causal effect. We also performed an alternative analysis using all GWAS reported cortisol variants that takes account of linkage disequilibrium. We also tested the genetic variant's effect on pregnancy cortisol and performed PheWas to search for potential pleiotropic effects. RESULTS The estimated effect of maternal circulating cortisol on birth weight was a 50 gram (95% CI, -109 to 10) lower birth weight per 1 SD higher log-transformed maternal circulating cortisol levels, using a single variant. The alternative analysis gave similar results (-33 grams (95% CI, -77 to 11)). The effect of the cortisol variant on pregnancy cortisol was 2-fold weaker than in the original GWAS, and evidence was found of pleiotropy. CONCLUSIONS Our findings provide some evidence that higher maternal morning plasma cortisol causes lower birth weight. Identification of more independent genetic instruments for morning plasma cortisol are necessary to explore the potential bias identified.
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Affiliation(s)
- W D Thompson
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
- Academic Rheumatology, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham, NG5 1PB, United Kingdom.
| | - R M Reynolds
- Centre for Cardiovascular Science, The Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - R N Beaumont
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - N M Warrington
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Frazer Institute, University of Queensland, Brisbane, Australia
| | - J Tyrrell
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - A R Wood
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - D M Evans
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
- Frazer Institute, University of Queensland, Brisbane, Australia
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - T J McDonald
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- Academic Department of Blood Sciences, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - A H Hattersley
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - R M Freathy
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - D A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - M C Borges
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health, Bristol Medical School, University of Bristol, Bristol, UK
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Panisch LS, Murphy HR, Wu Q, Brunner JL, Duberstein ZT, Arnold MS, Best M, Barrett ES, Miller RK, Qiu X, O’Connor TG. Adverse Childhood Experiences Predict Diurnal Cortisol Throughout Gestation. Psychosom Med 2023; 85:507-516. [PMID: 37199406 PMCID: PMC10524578 DOI: 10.1097/psy.0000000000001218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are associated with negative prenatal and perinatal health outcomes and may, via these pathways, have intergenerational effects on child health and development. We examine the impact of ACEs on maternal salivary cortisol, a key measure of prenatal biology previously linked with pregnancy-related health outcomes. METHODS Leveraging assessments across three trimesters, we used linear mixed-effects models to analyze the influence of ACEs on maternal prenatal diurnal cortisol patterns in a diverse cohort of pregnant women (analytic sample, n = 207). Covariates included comorbid prenatal depression, psychiatric medications, and sociodemographic factors. RESULTS Maternal ACEs were significantly associated with flatter diurnal cortisol slopes (i.e., less steep decline), after adjusting for covariates, with effects consistent across gestation (estimate = 0.15, standard error = 0.06, p = .008). CONCLUSIONS ACEs experienced before pregnancy may have a robust and lasting influence on maternal prenatal hypothalamic-pituitary-adrenal activity throughout gestation, a key biological marker associated with perinatal and child health outcomes. The findings suggest one route of intergenerational transmission of early adverse experiences and underscore the potential value of assessing prepregnancy adverse experiences for promoting perinatal and maternal and child health.
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Affiliation(s)
- Lisa S. Panisch
- Wayne State University School of Social Work, 5447 Woodward Ave., Detroit, MI, 48202, USA
| | - Hannah R. Murphy
- Translational Biomedical Science, University of Rochester School of Medicine & Dentistry, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
| | - Qiuyi Wu
- Biostatistics and Computational Biology, University of Rochester Medical Center, Saunders Research Building, 265 Crittenden Blvd., Box 630, Rochester, NY 14642
| | - Jessica L. Brunner
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
| | - Zoe T. Duberstein
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, New York, 14627, USA
| | - Molly S. Arnold
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, New York, 14627, USA
| | - Meghan Best
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
| | - Emily S. Barrett
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, New Jersey, 08854, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd., Piscataway, New Jersey, 08854, USA
| | - Richard K. Miller
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
| | - Xing Qiu
- Biostatistics and Computational Biology, University of Rochester Medical Center, Saunders Research Building, 265 Crittenden Blvd., Box 630, Rochester, NY 14642
| | - Thomas G. O’Connor
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, New York, 14642, USA
- Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, New York, 14627, USA
- Neuroscience, University of Rochester, 601 Elmwood Avenue, Box 603, KMRB G.9602, Rochester, New York, 14642, USA
- Psychiatry, University of Rochester, 300 Crittenden Blvd., Rochester, New York, 14642, USA
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Shriyan P, Sudhir P, van Schayck OC, Babu GR. Association of high cortisol levels in pregnancy and altered fetal growth. Results from the MAASTHI, a prospective cohort study, Bengaluru. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 14:100196. [PMID: 37461746 PMCID: PMC7614758 DOI: 10.1016/j.lansea.2023.100196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/09/2023] [Accepted: 03/28/2023] [Indexed: 07/20/2023]
Abstract
Background The role of maternal stress levels on mothers' mental health and fetal growth has been previously studied. However, the evidence linking cortisol exposure during pregnancy to growth outcomes in infants is sparsely available from lower and middle-income countries. We aim to investigate the association of serum cortisol levels in pregnancy with infant birth outcomes and postpartum depressive symptoms in a public health facility in India. Methods The current study is a part of the maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI) prospective cohort. We assessed the relationship between maternal exposure to serum cortisol and adverse neonatal outcomes and postpartum depressive symptoms. Serum cortisol levels in stored blood samples were measured in 230 pregnant women as a biomarker for stress during pregnancy. Pregnant women between 18 and 45 years of age were recruited for the study, presenting at ≥14 weeks of gestation and providing voluntary written informed consent. The Edinburgh Postnatal Depression Scale assessed postpartum depressive symptoms, and detailed infant anthropometric measurements were carried out at birth. Findings We found that higher levels (>17.66 μg/L) are significantly associated with low birth weight (OR = 2.28; 95% CI 1.21-4.32) and lower weight for length (OR = 2.16; 95% CI 1.07-4.35). The odds of developing postpartum depressive symptoms in pregnant women with higher mean cortisol cut-off levels is 2.3-fold [OR: 2.33, 95% CI (1.17, 4.64)] compared than women with lower cortisol levels. No significant association was found between serum cortisol and infants' birth weight for gestational age, head circumference, the sum of skinfold thickness, and crown-rump length. Interpretation Our results support the hypothesis that higher maternal cortisol levels may adversely impact birth weight, weight for length in newborns, and postpartum depressive symptoms in mothers. Funding This study was supported by the India Alliance Senior Fellowship [Grant No. IA/CPHS/20/1/505278] awarded to Giridhara R. Babu.
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Affiliation(s)
- Prafulla Shriyan
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka, 560023, India
| | - Paulomi Sudhir
- Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Onno C.P. van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Giridhara R. Babu
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka, 560023, India
- Clinical and Public Health Research Fellowship, The Wellcome Trust/DBT India Alliance, New Delhi, 110025, India
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Deer LK, Su C, Thwaites NA, Davis EP, Doom JR. A framework for testing pathways from prenatal stress-responsive hormones to cardiovascular disease risk. Front Endocrinol (Lausanne) 2023; 14:1111474. [PMID: 37223037 PMCID: PMC10200937 DOI: 10.3389/fendo.2023.1111474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/10/2023] [Indexed: 05/25/2023] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of death globally, with the prevalence projected to keep rising. Risk factors for adult CVD emerge at least as early as the prenatal period. Alterations in stress-responsive hormones in the prenatal period are hypothesized to contribute to CVD in adulthood, but little is known about relations between prenatal stress-responsive hormones and early precursors of CVD, such as cardiometabolic risk and health behaviors. The current review presents a theoretical model of the relation between prenatal stress-responsive hormones and adult CVD through cardiometabolic risk markers (e.g., rapid catch-up growth, high BMI/adiposity, high blood pressure, and altered blood glucose, lipids, and metabolic hormones) and health behaviors (e.g., substance use, poor sleep, poor diet and eating behaviors, and low physical activity levels). Emerging evidence in human and non-human animal literatures suggest that altered stress-responsive hormones during gestation predict higher cardiometabolic risk and poorer health behaviors in offspring. This review additionally highlights limitations of the current literature (e.g., lack of racial/ethnic diversity, lack of examination of sex differences), and discusses future directions for this promising area of research.
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Affiliation(s)
- LillyBelle K. Deer
- Department of Psychology, University of Denver, Denver, CO, United States
| | - Chen Su
- Department of Psychology, University of Denver, Denver, CO, United States
| | | | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, United States
- Department of Psychiatry & Human Behavior, University of California, Irvine, Irvine, CA, United States
| | - Jenalee R. Doom
- Department of Psychology, University of Denver, Denver, CO, United States
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Payne-Sturges D, De Saram S, Cory-Slechta DA. Cumulative Risk Evaluation of Phthalates Under TSCA. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:6403-6414. [PMID: 37043345 DOI: 10.1021/acs.est.2c08364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The U.S. Environmental Protection Agency (EPA) is currently conducting separate Toxic Substances Control Act (TSCA) risk evaluations for seven phthalates: dibutyl phthalate (DBP), butyl benzyl phthalate (BBP), di(2-ethylhexyl) phthalate (DEHP), diisobutyl phthalate (DIBP), dicyclohexyl phthalate (DCHP), di-isodecyl phthalate (DIDP), and diisononyl phthalate (DINP). Phthalates are highly abundant plastic additives used primarily to soften materials and make them flexible, and biomonitoring shows widespread human exposure to a mixture of phthalates. Evidence supports biological additivity of phthalate mixture exposures, including the enhancement of toxicity affecting common biological targets. Risk estimates based on individual phthalate exposure may not be protective of public health. Thus, a cumulative risk approach is warranted. While EPA initially did not signal that it would incorporate cumulative risk assessment (CRA) as part of its current risk evaluation for the seven phthalates, the agency recently announced that it is reconsidering if CRA for phthalates would be appropriate. Based on our review of existing chemical mixtures risk assessment guidance, current TSCA scoping documents for the seven phthalates, and pertinent peer-reviewed literature, we delineate a CRA approach that EPA can easily implement for phthalates. The strategy for using CRA to inform TSCA risk evaluation for existing chemicals is based upon integrative physiology and a common adverse health outcome algorithm for identifying and grouping relevant nonchemical and chemical stressors. We recommend adjustments for how hazard indices (HIs) or margins of exposure (MOEs) based on CRA are interpreted for determining "unreasonable risk" under TSCA.
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Affiliation(s)
- Devon Payne-Sturges
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 255 Valley Drive, College Park, Maryland 20742, United States
| | - Sulakkhana De Saram
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 255 Valley Drive, College Park, Maryland 20742, United States
| | - Deborah A Cory-Slechta
- University of Rochester School of Medicine, Box EHSC, Rochester, New York 14642, United States
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11
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Duffy KA, Sammel MD, Johnson RL, Kim DR, Wang EY, Ewing G, Hantsoo L, Kornfield SL, Bale TL, Epperson CN. Maternal adverse childhood experiences impact fetal adrenal volume in a sex-specific manner. Biol Sex Differ 2023; 14:7. [PMID: 36803442 PMCID: PMC9936707 DOI: 10.1186/s13293-023-00492-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/02/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The mechanisms by which parental early life stress can be transmitted to the next generation, in some cases in a sex-specific manner, are unclear. Maternal preconception stress may increase susceptibility to suboptimal health outcomes via in utero programming of the fetal hypothalamic-pituitary-adrenal (HPA) axis. METHODS We recruited healthy pregnant women (N = 147), dichotomized into low (0 or 1) and high (2+) adverse childhood experience (ACE) groups based on the ACE Questionnaire, to test the hypothesis that maternal ACE history influences fetal adrenal development in a sex-specific manner. At a mean (standard deviation) of 21.5 (1.4) and 29.5 (1.4) weeks gestation, participants underwent three-dimensional ultrasounds to measure fetal adrenal volume, adjusting for fetal body weight (waFAV). RESULTS At ultrasound 1, waFAV was smaller in high versus low ACE males (b = - 0.17; z = - 3.75; p < .001), but females did not differ significantly by maternal ACE group (b = 0.09; z = 1.72; p = .086). Compared to low ACE males, waFAV was smaller for low (b = - 0.20; z = - 4.10; p < .001) and high ACE females (b = - 0.11; z = 2.16; p = .031); however, high ACE males did not differ from low (b = 0.03; z = .57; p = .570) or high ACE females (b = - 0.06; z = - 1.29; p = .196). At ultrasound 2, waFAV did not differ significantly between any maternal ACE/offspring sex subgroups (ps ≥ .055). Perceived stress did not differ between maternal ACE groups at baseline, ultrasound 1, or ultrasound 2 (ps ≥ .148). CONCLUSIONS We observed a significant impact of high maternal ACE history on waFAV, a proxy for fetal adrenal development, but only in males. Our observation that the waFAV in males of mothers with a high ACE history did not differ from the waFAV of females extends preclinical research demonstrating a dysmasculinizing effect of gestational stress on a range of offspring outcomes. Future studies investigating intergenerational transmission of stress should consider the influence of maternal preconception stress on offspring outcomes.
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Affiliation(s)
- Korrina A. Duffy
- grid.430503.10000 0001 0703 675XDepartment of Psychiatry, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO USA ,grid.430503.10000 0001 0703 675XDepartment of Psychiatry, University of Colorado – Anschutz Medical Campus, 1890 N. Revere Court, Aurora, CO 80045 USA
| | - Mary D. Sammel
- grid.430503.10000 0001 0703 675XDepartment of Psychiatry, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO USA ,grid.430503.10000 0001 0703 675XDepartment of Biostatistics and Informatics, University of Colorado School of Public Health – Anschutz Medical Campus, Aurora, CO USA
| | - Rachel L. Johnson
- grid.430503.10000 0001 0703 675XDepartment of Biostatistics and Informatics, University of Colorado School of Public Health – Anschutz Medical Campus, Aurora, CO USA
| | - Deborah R. Kim
- grid.25879.310000 0004 1936 8972Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Eileen Y. Wang
- grid.25879.310000 0004 1936 8972Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Grace Ewing
- grid.266826.e0000 0000 9216 5478University of New England College of Osteopathic Medicine, Biddeford, ME USA
| | - Liisa Hantsoo
- grid.21107.350000 0001 2171 9311Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Sara L. Kornfield
- grid.25879.310000 0004 1936 8972Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Tracy L. Bale
- grid.430503.10000 0001 0703 675XDepartment of Psychiatry, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO USA
| | - C. Neill Epperson
- grid.430503.10000 0001 0703 675XDepartment of Psychiatry, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO USA ,grid.430503.10000 0001 0703 675XDepartment of Family Medicine, University of Colorado School of Medicine – Anschutz Medical Campus, Aurora, CO USA
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12
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Hahn-Holbrook J, Davis EP, Sandman CA, Glynn LM. Maternal prenatal cortisol trajectories predict accelerated growth in infancy. Psychoneuroendocrinology 2023; 147:105957. [PMID: 36371954 PMCID: PMC10710294 DOI: 10.1016/j.psyneuen.2022.105957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022]
Abstract
Higher maternal cortisol in pregnancy has been linked to childhood obesity. Much of the previous research has been limited in that cortisol in pregnancy is only measured at one time-point, precluding the ability to examine critical timing effects of prenatal maternal cortisol. To fill this gap, this longitudinal study measured maternal plasma cortisol at 15, 19, 25, and 31 weeks of pregnancy, and assessed infant body mass index percentile (BMIP)1 at birth, 3, 6, 12, and 24 months in 189 mother-infant pairs. Three distinct patterns of maternal cortisol in pregnancy (typical, steep, and flat trajectories) were identified using general growth mixture modeling (GGMM)2 and then used to predict child growth patterns using multilevel modeling. Infants of mothers who had flat cortisol trajectories, characterized by relatively high cortisol in early gestation that plateaus by mid-gestation, experienced more rapid increases in BMIP from birth to 6 months, and had higher BMIPs at 3 and 6 months, than infants whose mothers had the typical slow cortisol rise over gestation, or steep (rapidly accelerating) trajectories. These results suggest that it is not just the total amount of maternal cortisol in pregnancy that shapes early infant growth, but instead the timing and trajectory of prenatal cortisol exposure. To better understand the early origins of obesity risk, future research is needed to investigate the factors that shape mothers' prenatal cortisol trajectories.
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Affiliation(s)
- Jennifer Hahn-Holbrook
- Department of Psychology, University of California, 5200 Lake Rd, Merced, CA 95343, the United States of America.
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, 2155 S Race St, Denver, CO 80210, the United States of America; Department of Pediatrics, University of California, Irvine, CA 333 The City Blvd. West, Suite 800, Orange, CA 92868-4482, the United States of America.
| | - Curt A Sandman
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA UCI School of Medicine Medical Education, 1001 Health Sciences Road, Irvine, CA 92697-4089, the United States of America.
| | - Laura M Glynn
- Department of Psychology, Chapman University, One University Drive, Orange, CA 92866, the United States of America.
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13
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Arleevskaya M, Takha E, Petrov S, Kazarian G, Renaudineau Y, Brooks W, Larionova R, Korovina M, Valeeva A, Shuralev E, Mukminov M, Kravtsova O, Novikov A. Interplay of Environmental, Individual and Genetic Factors in Rheumatoid Arthritis Provocation. Int J Mol Sci 2022; 23:ijms23158140. [PMID: 35897715 PMCID: PMC9329780 DOI: 10.3390/ijms23158140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 02/05/2023] Open
Abstract
In this review, we explore systemization of knowledge about the triggering effects of non-genetic factors in pathogenic mechanisms that contribute to the development of rheumatoid arthritis (RA). Possible mechanisms involving environmental and individual factors in RA pathogenesis were analyzed, namely, infections, mental stress, sleep deprivation ecology, age, perinatal and gender factors, eating habits, obesity and smoking. The non-genetic factors modulate basic processes in the body with the impact of these factors being non-specific, but these common challenges may be decisive for advancement of the disease in the predisposed body at risk for RA. The provocation of this particular disease is associated with the presence of congenital loci minoris resistentia. The more frequent non-genetic factors form tangles of interdependent relationships and, thereby, several interdependent external factors hit one vulnerable basic process at once, either provoking or reinforcing each other. Understanding the specific mechanisms by which environmental and individual factors impact an individual under RA risk in the preclinical stages can contribute to early disease diagnosis and, if the factor is modifiable, might be useful for the prevention or delay of its development.
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Affiliation(s)
- Marina Arleevskaya
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 420008 Kazan, Russia;
- Correspondence: ; Tel.: +7-89172-886-679; Fax: +7-843-238-5413
| | - Elena Takha
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
| | - Sergey Petrov
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, 420008 Kazan, Russia
| | - Gevorg Kazarian
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
| | - Yves Renaudineau
- Department of Immunology, CHU Toulouse, INSERM U1291, CNRS U5051, University Toulouse IIII, 31000 Toulouse, France;
| | - Wesley Brooks
- Department of Chemistry, University of South Florida, Tampa, FL 33620, USA;
| | - Regina Larionova
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
| | - Marina Korovina
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 420008 Kazan, Russia;
| | - Anna Valeeva
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
| | - Eduard Shuralev
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, 420008 Kazan, Russia
| | - Malik Mukminov
- Central Research Laboratory, Kazan State Medical Academy, 420012 Kazan, Russia; (E.T.); (S.P.); (G.K.); (R.L.); (M.K.); (A.V.); (E.S.); (M.M.)
- Institute of Environmental Sciences, Kazan (Volga Region) Federal University, 420008 Kazan, Russia
| | - Olga Kravtsova
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 420008 Kazan, Russia;
| | - Andrey Novikov
- Mathematical Center, Sobolev Instiute of Mathematics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia;
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14
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Trans- and Multigenerational Maternal Social Isolation Stress Programs the Blood Plasma Metabolome in the F3 Generation. Metabolites 2022; 12:metabo12070572. [PMID: 35888696 PMCID: PMC9320469 DOI: 10.3390/metabo12070572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 11/21/2022] Open
Abstract
Metabolic risk factors are among the most common causes of noncommunicable diseases, and stress critically contributes to metabolic risk. In particular, social isolation during pregnancy may represent a salient stressor that affects offspring metabolic health, with potentially adverse consequences for future generations. Here, we used proton nuclear magnetic resonance (1H NMR) spectroscopy to analyze the blood plasma metabolomes of the third filial (F3) generation of rats born to lineages that experienced either transgenerational or multigenerational maternal social isolation stress. We show that maternal social isolation induces distinct and robust metabolic profiles in the blood plasma of adult F3 offspring, which are characterized by critical switches in energy metabolism, such as upregulated formate and creatine phosphate metabolisms and downregulated glucose metabolism. Both trans- and multigenerational stress altered plasma metabolomic profiles in adult offspring when compared to controls. Social isolation stress increasingly affected pathways involved in energy metabolism and protein biosynthesis, particularly in branched-chain amino acid synthesis, the tricarboxylic acid cycle (lactate, citrate), muscle performance (alanine, creatine phosphate), and immunoregulation (serine, threonine). Levels of creatine phosphate, leucine, and isoleucine were associated with changes in anxiety-like behaviours in open field exploration. The findings reveal the metabolic underpinnings of epigenetically heritable diseases and suggest that even remote maternal social stress may become a risk factor for metabolic diseases, such as diabetes, and adverse mental health outcomes. Metabolomic signatures of transgenerational stress may aid in the risk prediction and early diagnosis of non-communicable diseases in precision medicine approaches.
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15
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Payne-Sturges DC, Puett R, Cory-Slechta DA. Both parents matter: a national-scale analysis of parental race/ethnicity, disparities in prenatal PM 2.5 exposures and related impacts on birth outcomes. Environ Health 2022; 21:47. [PMID: 35513869 PMCID: PMC9074320 DOI: 10.1186/s12940-022-00856-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/12/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Most U.S. studies that report racial/ethnic disparities in increased risk of low birth weight associated with air pollution exposures have been conducted in California or northeastern states and/or urban areas, limiting generalizability of study results. Few of these studies have examined maternal racial/ethnic groups other than Non-Hispanic Black, non-Hispanic White and Hispanic, nor have they included paternal race. We aimed to examine the independent effects of PM2.5 on birth weight among a nationally representative sample of U.S. singleton infants and how both maternal and paternal race/ethnicity modify relationships between prenatal PM2.5 exposures and birth outcomes. METHODS We used data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), a longitudinal nationally representative cohort of 10,700 U.S. children born in 2001, which we linked to U.S.EPA's Community Multi-scale Air Quality (CMAQ)-derived predicted daily PM2.5 concentrations at the centroid of each Census Bureau Zip Code Tabulation Area (ZCTA) for maternal residences. We examined relationships between term birthweight (TBW), term low birthweight rate (TLBW) and gestational PM2.5 pollutant using multivariate regression models. Effect modification of air pollution exposures on birth outcomes by maternal and paternal race was evaluated using stratified models. All analyses were conducted with sample weights to provide national-scale estimates. RESULTS The majority of mothers were White (61%). Fourteen percent of mothers identified as Black, 21% as Hispanic, 3% Asian American and Pacific Islander (AAPI) and 1% American Indian and Alaskan Native (AIAN). Fathers were also racially/ethnically diverse with 55% identified as White Non-Hispanic, 10% as Black Non-Hispanic, 19% as Hispanic, 3% as AAPI and 1% as AIAN. Results from the chi-square and ANOVA tests of significance for racial/ethnic differences indicate disparities in prenatal exposures and birth outcomes by both maternal and paternal race/ethnicity. Prenatal PM2.5 was associated with reduced birthweights during second and third trimester and over the entire gestational period in adjusted regression models, although results did not reach statistical significance. In models stratified by maternal race and paternal race, one unit increase in PM2.5 was statistically significantly associated with lower birthweights among AAPI mothers, -5.6 g (95% CI:-10.3, -1.0 g) and AAPI fathers, -7.6 g (95% CI: -13.1, -2.1 g) during 3rd trimester and among births where father's race was not reported, -14.2 g (95% CI: -24.0, -4.4 g). CONCLUSIONS These data suggest that paternal characteristics should be used, in addition to maternal characteristics, to describe the risks of adverse birth outcomes. Additionally, our study suggests that serious consideration should be given to investigating environmental and social mechanisms, such as air pollution exposures, as potential contributors to disparities in birth outcomes among AAPI populations.
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Affiliation(s)
- Devon C Payne-Sturges
- School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, 255 Valley Drive, College Park, MD, 20742, USA.
| | - Robin Puett
- School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, 255 Valley Drive, College Park, MD, 20742, USA
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16
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Associations between maternal awakening salivary cortisol levels in mid-pregnancy and adverse birth outcomes. Arch Gynecol Obstet 2022; 306:1989-1999. [PMID: 35320387 DOI: 10.1007/s00404-022-06513-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/06/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Elevated levels of maternal cortisol have been hypothesized as the intermediate process between symptoms of depression and psychosocial stress during pregnancy and adverse birth outcomes. Therefore, we examined associations between cortisol levels in the second trimester of pregnancy and risks of three common birth outcomes in a nested case-control study. METHODS This study was embedded in the PRIDE Study (n = 3,019), from which we selected all cases with preterm birth (n = 64), low birth weight (n = 49), and small-for-gestational age (SGA; n = 65), and 260 randomly selected controls, among the participants who provided a single awakening saliva sample in approximately gestational week 19 in 2012-2016. Multivariable linear and logistic regression was performed to assess the associations between continuous and categorized cortisol levels and the selected outcomes. RESULTS We did not observe any associations between maternal cortisol levels and preterm birth and low birth weight. However, high cortisol levels (≥ 90th percentile) seemed to be associated with SGA (adjusted odds ratio 2.1, 95% confidence interval 0.9-4.8), in particular among girls (adjusted odds ratio 3.7, 95% confidence interval 1.1-11.9, based on eight exposed cases) in an exploratory analysis. CONCLUSION The results of this study showed no suggestions of associations between maternal awakening cortisol levels in mid-pregnancy and adverse birth outcomes, except for an increased risk of SGA.
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17
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Sex-specific association of high maternal psychological stress during pregnancy on newborn birthweight. PLoS One 2022; 17:e0262641. [PMID: 35051242 PMCID: PMC8775189 DOI: 10.1371/journal.pone.0262641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/03/2022] [Indexed: 02/06/2023] Open
Abstract
Birthweight is an important predictor of newborn health and has been linked to maternal psychological stress during pregnancy. However, it is unclear whether prenatal stress affects birthweight similarly for both male and female infants. We used a well-established pregnancy cohort to investigate the impact of high maternal psychological stress during pregnancy on birthweight as a function of infant sex. Overall, 5702 mother-newborn pairs were analysed. Of these, 198 mothers reported high levels of stress using the Psychological Stress Measure (nine-items version; PSM-9). Maternal psychological stress was assessed between the 24th and 28th week of gestation and analyses were performed jointly and independently as a function of neonatal sex (separate analyses for male and female infants). Newborns exposed to high maternal psychological stress during pregnancy (a score above 26 measured using the PSM-9 questionnaire, corresponding to >97.5th percentile) were compared to newborns of mothers who reported lower stress. ANCOVAs revealed that high levels of maternal stress during pregnancy were linked to infant birthweight as a function of infant sex. Male infants of mothers who reported high levels of stress had a greater birthweight whereas female infants had a lower birthweight under the same conditions, in comparison to mothers who did not report greater levels of stress. Although the effect size is small, these results underline the possibility that male and female fetuses may use different strategies when adapting to maternal adversity and highlight the need to consider infant sex as a moderator of the association between maternal psychological stress during pregnancy and infant birthweight.
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18
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Caparros-Gonzalez RA, Lynn F, Alderdice F, Peralta-Ramirez MI. Cortisol levels versus self-report stress measures during pregnancy as predictors of adverse infant outcomes: a systematic review. Stress 2022; 25:189-212. [PMID: 35435113 DOI: 10.1080/10253890.2022.2059348] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Systematically review existing evidence to (1) identify the association between self-report stress and cortisol levels measured during pregnancy; and, (2) assess their association with adverse infant outcomes to determine which is the better predictor. A systematic review was conducted in accordance with PRISMA guidelines. Search terms focused on pregnancy, psychological stress and cortisol. Nine electronic databases were searched, in addition to reference lists of relevant papers. Eligibility criteria consisted of studies that included measurement of self-reported psychological stress, cortisol and assessed their associations with any infant-related outcome. Further limits included studies published in English or Spanish with human female participants. A meta-regression was not feasible due to differences in study samples, measurement tools employed, types of cortisol assessed and outcomes reported. A narrative synthesis was provided. 28 studies were eligible for inclusion. Convergent validity between self-report measures and cortisol was reported by three studies (range r = 0.12-0.41). Higher levels of self-report stress were significantly associated with intrauterine growth restriction (fetal biparietal diameter, low fetal head circumference, abdominal circumference), low gestational age at birth, low anthropometric measures (birth length, head circumference, length of the neonate), poor infant neurodevelopment (cognitive development) and potentially pathogenic gut microbiota (Clostridiaceae Clostridium, Haemophilus) in six studies. Higher cortisol levels were significantly associated with intrauterine growth restriction (fetal biparietal diameter, low fetal head circumference, abdominal circumference), low gestational age at birth, low infant birth weight, poor infant neurodevelopment (attention scores on the Network Neurobehavioral Scale) and low levels of potentially protective gut microbiota (Lactobacillus, Slackia and Actinobaculum) in 13 studies. Of the studies that assessed which type of measure was a better predictor of infant outcomes (n = 6), there was agreement that cortisol levels were statistically better at predicting adverse outcomes than self-reported stress. Self-report stress measures appear to be modest predictors of adverse infant outcomes in comparison to cortisol. A number of methodological limitations need to be addressed in future studies to help understand the relationship between cortisol and self-reported stress and how they are related to adverse infant outcomes.
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Affiliation(s)
- Rafael A Caparros-Gonzalez
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Fiona Lynn
- Medical Biology Center, School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Zou H, Tao Z, Zhou Y, Zhang Z, Zhang C, Li L, Yang J, Wang Y, Huang W, Wang J. Perceived Stress Positively Relates to Insomnia Symptoms: The Moderation of Resilience in Chinese Pregnant Women During COVID-19. Front Psychiatry 2022; 13:856627. [PMID: 35573361 PMCID: PMC9092980 DOI: 10.3389/fpsyt.2022.856627] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/24/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The government's COVID-19 pandemic response lockdown strategy had a negative psychological and physical impact on individuals, which necessitated special care to pregnant women's mental health. There has been no large-scale research on the underlying relationship between perceived stress and insomnia symptoms in pregnant Chinese women up to this point. During the COVID-19 pandemic, we wanted to see if there was an association between perceived stress and insomnia symptoms, as well as the moderating impact of resilience for Chinese pregnant women. METHODS This cross-sectional study examined 2115 pregnant women from central and western China using multi-stage sampling methodologies. A systematic questionnaire was used to collect information on sleep quality, perceived stress, and resilience using the Insomnia Severity Index, Perceptual Stress Scale, and Connor and Davidson Resilience Scale. To assess the moderating influence of resilience, hierarchical regressions were used. RESULTS During the COVID-19 pandemic, 18.53% of respondents (N = 2115) reported experiencing sleeplessness. In pregnant women, perceived stress was positively linked with insomnia symptoms (p < 0.001). Furthermore, resilience significantly attenuated the influence of perceived stress on insomnia symptoms in Chinese expectant mother (βinteraction = -0.0126, p < 0.001). CONCLUSION Pregnant women with strong resilience were less influenced by perceived stress than those with poor resilience. The findings of this study might give empirical proof that health care professionals should identify the relevance of reducing perceived stress in pregnant women with poor resilience and provide better treatment and support when necessary.
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Affiliation(s)
- Hongyu Zou
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China.,School of Psychology, South China Normal University, Guangzhou, China
| | - Zhen Tao
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Zhiguo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Chunyan Zhang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Linling Li
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Jiezhi Yang
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Yanni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Wei Huang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Jianhong Wang
- Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
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La Marca-Ghaemmaghami P, Zimmermann R, Haller M, Ehlert U. Cortisol and estriol responses to awakening in the first pregnancy trimester: Associations with maternal stress and resilience factors. Psychoneuroendocrinology 2021; 125:105120. [PMID: 33385739 DOI: 10.1016/j.psyneuen.2020.105120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 11/08/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Little is known about the maternal cortisol awakening response (CAR) in the first pregnancy trimester. Similarly unknown is how the CAR in early gestation relates to other steroid hormones, such as estriol. Maternal estriol in blood and urine is used to monitor fetal well-being since it is produced by the fetoplacental unit from fetal precursors. Low levels have been associated with maternal-fetal complications. We were recently able to show that estriol is measurable in maternal saliva from 6 weeks' gestation onwards. However, its pattern following morning awakening and potential links with salivary cortisol in early gestation is relatively unknown. In this prospective study, we explored the cortisol and estriol responses to morning awakening in first-trimester pregnant women, the potential association of these endocrine variables with maternal stress and resilience factors, and their predictive value for the further pregnancy course. METHODS Fifty-one women with an uncomplicated, singleton pregnancy responded to questionnaires measuring chronic and pregnancy-specific stress, emotional support, and daily uplifts at 6 weeks' gestation. At 8 and 10 weeks, the women collected saliva samples immediately, 30, and 60 min after morning awakening. After 12 weeks, 40 women reported on the further pregnancy course, of whom 6 had developed complications. RESULTS In response to morning awakening, cortisol levels increased significantly at 10 weeks (p = .04), while estriol levels decreased significantly at both 8 and 10 weeks (p < .001). A stronger cortisol increase was linked to a stronger estriol decrease at 8 (p = .03), but not at 10 weeks. Then, perceived emotional support at 6 weeks was negatively associated with cortisol baseline at 8 (p = .01) and positively with estriol baseline at 10 weeks (p = .03). Moreover, higher pregnancy-specific stress was related to a lower estriol baseline at 8 weeks (p = .047). Furthermore, compared to healthy women, those with complications at follow-up had already reported less emotional support (p = .03) and fewer daily uplifts (p = .03) at 6 weeks. These women also seemed to lack a significant estriol response to morning awakening at 8 weeks (p > .10). DISCUSSION These findings advance our knowledge of cortisol and estriol secretion following morning awakening and encourage the investigation of E3 in addition to cortisol when researching prenatal stress and its consequences for maternal and fetal health.
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Affiliation(s)
- Pearl La Marca-Ghaemmaghami
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, Zurich 8050, Switzerland.
| | - Roland Zimmermann
- Department of Obstetrics, University Hospital of Zurich, Frauenklinikstrasse 10, Zurich 8091, Switzerland.
| | - Marina Haller
- Department of Psychological Methods, Evaluation and Statistics, University of Zurich, Binzmuelestrasse 14/Box 27, Zurich 8050, Switzerland.
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, Zurich 8050, Switzerland.
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21
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Kotz J, Marriott R, Reid C. The EPDS and Australian Indigenous women: A systematic review of the literature. Women Birth 2021; 34:e128-e134. [DOI: 10.1016/j.wombi.2020.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 12/20/2019] [Accepted: 02/04/2020] [Indexed: 12/14/2022]
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Silva PS, Hooper HB, Manica E, Merighe GKF, Oliveira SA, Traldi AS, Negrão JA. Heat stress affects the expression of key genes in the placenta, placental characteristics, and efficiency of Saanen goats and the survival and growth of their kids. J Dairy Sci 2021; 104:4970-4979. [PMID: 33551154 DOI: 10.3168/jds.2020-18301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 11/09/2020] [Indexed: 01/18/2023]
Abstract
Heat stress is detrimental during gestation; however, the effects of heat stress on goat placental characteristics and kid survival remain unclear. The objective of this study was to evaluate the effects of heat stress at final gestation on cortisol concentration, placenta characteristics, and the expression of genes related to placenta. Forty-six primiparous and multiparous Saanen goats were subjected to control (CT; under a thermoneutral environment: air temperature between 12°C and 25°C and the relative humidity from 45 to 73%, n = 23) or heat stress (HS; under a climatic chamber: air temperature at 37°C and the relative humidity at 60 to 70% from 0800 to 1600 h, n = 23) from the last 60 d of pregnancy until the first colostrum suckling. The heat challenge imposed on HS goats during the prepartum period increased their rectal temperature, respiratory frequency, and cortisol levels in plasma and amniotic fluid versus CT goats. In the placenta, HS treatment also increased the expression of the HSPA1A gene. Heat-stressed goats also showed significantly lower expression of HSD11B2 and greater expression of MC2R and NR3C1 than CT goats, suggesting that heat stress decreased the effectiveness by which the HSD11B2 enzyme converts cortisol to cortisone and increased placental responsiveness to cortisol. The HS goats took longer to release the placenta with lighter placental cotyledons, and HS goats had a lower ratio between the kid's weight at birth and placenta weight than CT goats. There was no treatment effect on the kids' survival or weights at birth, but the kids from goats subjected to HS presented lesser cortisol concentration and greater mortality rates at weaning than kids from CT goats. Finally, the overexpression of HSPA1A by HS goats suggests a protective response of placenta. However, the heat stress negatively affected the placenta's expulsion length, placental cotyledons number, weight and area, the ratio between kid's weight and placenta weight, and cortisol signaling. Indeed, the upregulation of MC2R and NR3C1 and downregulation of HSD11B2 on placenta caused by heat stress were associated with greater cortisol concentrations in the amniotic fluid of HS goats. Although HS and CT kids had adequate weights and survival rate during the first weeks of life, the heat stress increased the mortality at weaning of HS kids versus CT kids, suggesting that the heat stress effect persists and can change the ability of kids to respond to weaning challenge.
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Affiliation(s)
- P S Silva
- Department of Basic Sciences, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, São Paulo, 13635-900, Brazil
| | - H B Hooper
- Department of Basic Sciences, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, São Paulo, 13635-900, Brazil
| | - E Manica
- Department of Basic Sciences, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, São Paulo, 13635-900, Brazil
| | - G K F Merighe
- Department of Basic Sciences, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, São Paulo, 13635-900, Brazil
| | - S A Oliveira
- Department of Basic Sciences, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, São Paulo, 13635-900, Brazil
| | - A S Traldi
- Department of Animal Reproduction, Faculty of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga, São Paulo, 13635-900, Brazil
| | - J A Negrão
- Department of Basic Sciences, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, São Paulo, 13635-900, Brazil.
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23
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Talbot J, Charron V, Konkle ATM. Feeling the Void: Lack of Support for Isolation and Sleep Difficulties in Pregnant Women during the COVID-19 Pandemic Revealed by Twitter Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020393. [PMID: 33419145 PMCID: PMC7825552 DOI: 10.3390/ijerph18020393] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/31/2022]
Abstract
Pregnant women face many physical and psychological changes during their pregnancy. It is known that stress, caused by many factors and life events such as the COVID-19 pandemic, can negatively impact the health of mothers and offspring. It is the first time social media, such as Twitter, are available and commonly used during a global pandemic; this allows access to a rich set of data. The objective of this study was to characterize the content of an international sample of tweets related to pregnancy and mental health during the first wave of COVID-19, from March to June 2020. Tweets were collected using GetOldTweets3. Sentiment analysis was performed using the VADER sentiment analysis tool, and a thematic analysis was performed. In total, 192 tweets were analyzed: 51 were from individuals, 37 from companies, 56 from non-profit organizations, and 48 from health professionals/researchers. Findings showed discrepancies between individual and non-individual tweets. Women expressed anxiety, depressive symptoms, sleeping problems, and distress related to isolation. Alarmingly, there was a discrepancy between distress expressed by women with isolation and sleep difficulties compared to support offered by non-individuals. Concrete efforts should be made to acknowledge these issues on Twitter while maintaining the current support offered.
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Affiliation(s)
- Joey Talbot
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Valérie Charron
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Anne TM Konkle
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Brain and Mind Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence:
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24
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Wei Q, Shi H, Ma X, Shi Y, Zhang Y, Wang L. The impact of maternal stress on offspring birth weight and the mediating effect of dietary patterns: the Shanghai Maternal-Child Pairs Cohort study. J Affect Disord 2021; 278:643-649. [PMID: 33038709 DOI: 10.1016/j.jad.2020.09.077] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 07/24/2020] [Accepted: 09/18/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Maternal stress and nutrition during pregnancy are two of the most commonly studied factors in the context of fetal development. However, few investigators have considered the combined effects of stress and diet in pregnant women and their offspring. AIMS To determine the impact of maternal stress on offspring birth weight, and the potential mediating role of maternal dietary patterns. METHODS A total of 3542 pregnant women and their singleton live births were recruited from Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC). Maternal stress was assessed using the Life Event Scale for Pregnant Women (LESPW) in early and late pregnancy. Food frequency questionnaire (FFQ) was performed to evaluate maternal diet in late pregnancy. Multiple linear regression was conducted to estimate the associations between maternal stress and child birth weight. Logistic regression was performed to calculate the association between maternal stress and small for gestational age (SGA)/large for gestational age (LGA). The bootstrap method was used to investigate the mediating effects of maternal dietary patterns. RESULTS Maternal subjective events stress (β = 0.367) and total stress (β = 0.079) in early pregnancy, and positive objective life events stress (β = 0.275) in late pregnancy, were positively associated with birth weight. Maternal dietary pattern of "high-fat and sugar" mediated the associations between subjective events stress and total stress during early pregnancy and birth weight. An increased risk for LGA was observed among women exposed to relatively higher stress during early pregnancy (OR, 1.416; 95% CI, 1.035-1.937). No statistically significant associations were found between maternal stress during late pregnancy and child birth weight or SGA/LGA. CONCLUSIONS Maternal life events stress during early pregnancy significantly increases neonatal birth weight and risk for LGA, which may mediate by a "high-fat and sugar" dietary pattern. LIMITATIONS The lack of biological markers limits the explanation of the mechanism. The assessment of diet used food intake frequency to evaluate dietary characteristics, which may miss information of energy intake.
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Affiliation(s)
- Qian Wei
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
| | - Xuemei Ma
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Yuyang Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Yunhui Zhang
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Ling Wang
- Shanghai Medical College of Fudan University, Shanghai, CN.
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25
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Riis JL, Granger DA, Woo H, Voegtline K, DiPietro JA, Johnson SB. Long-Term Associations Between Prenatal Maternal Cortisol and Child Neuroendocrine-Immune Regulation. Int J Behav Med 2020; 27:267-281. [PMID: 31506880 DOI: 10.1007/s12529-019-09814-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Advancing understanding of the developmental origins of neuroendocrine-immune (NEI) functioning is key to elucidating the biological mechanisms involved in health and disease risk across the lifespan. This study examined whether prenatal maternal hypothalamic-pituitary-adrenal (HPA) activity moderates child NEI relations and explored the consistency of this moderating effect across gestation. METHODS Pregnant women participated in five prenatal study visits from 24 to 38 weeks gestation. At each visit, women provided a saliva sample. In a 5-year follow-up study, children (nfemale = 25, nmale=20) provided four saliva samples and participated in behavioral assessments and challenge tasks. Prenatal maternal saliva samples were assayed for cortisol. Child saliva samples were assayed for cortisol and cytokines (IL-1β, IL-6, IL-8, TNFα) as indices of HPA and inflammatory activity. Multilevel mixed-effects models examined the moderation of child NEI relations by prenatal maternal cortisol. RESULTS Among males, average prenatal maternal cortisol did not moderate child NEI relations. Among females, average prenatal maternal cortisol moderated some child NEI relations with higher prenatal cortisol associated with more positive cortisol-cytokine relations at age five. When examined by gestational time point, there were more significant NEI moderation effects by maternal cortisol from later gestation (≥ 30 weeks) than earlier. CONCLUSIONS The findings suggest prenatal maternal HPA activity may moderate child NEI functioning. Additional research conducted with more heterogeneous and larger samples is needed to fully understand these relations. Furthering our knowledge of NEI development has important research and clinical implications, particularly for understanding and addressing conditions with inflammatory pathophysiologies, such as depression and cardiovascular disease.
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Affiliation(s)
- Jenna L Riis
- School of Social Ecology, University of California, Irvine, Irvine, CA, USA.
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, USA.
| | - Douglas A Granger
- School of Social Ecology, University of California, Irvine, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Han Woo
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Janet A DiPietro
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sara B Johnson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
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26
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Peterson AK, M. Toledo-Corral C, Chavez TA, Naya CH, Johnson M, Eckel SP, Lerner D, Grubbs BH, Farzan SF, Dunton GF, Bastain TM, Breton CV. Prenatal Maternal Cortisol Levels and Infant Birth Weight in a Predominately Low-Income Hispanic Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6896. [PMID: 32967301 PMCID: PMC7559007 DOI: 10.3390/ijerph17186896] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 12/22/2022]
Abstract
Infant birth weight influences numerous health outcomes throughout the life course including childhood obesity and metabolic morbidities. Maternal experience of stress, both before and during pregnancy, has been hypothesized to influence fetal growth and birth outcomes. However, these associations currently are not fully understood, due to conflicting results in the published literature. Salivary cortisol is often used as a biological biomarker to assess the diurnal pattern of the hypothalamic-pituitary-adrenal axis (HPA-axis) functioning. Cortisol metrics include both the total cortisol concentration secreted during waking hours, reflected by the area under the curve (AUC), and cortisol dynamics, which include the diurnal cortisol slope (DCS) and the cortisol awakening response (CAR). This study examined the association of these cortisol metrics measured during the third trimester of pregnancy and infant birth weight among 240 mother-infant dyads participating in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort study, which is predominately comprised of Hispanic low-income women. There were no significant associations with the maternal biological stress response and infant birth weight in this study. More research is needed in larger studies to better understand how the biological stress response influences birth weight in populations facing health disparities.
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Affiliation(s)
- Alicia K. Peterson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
| | - Claudia M. Toledo-Corral
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
- Department of Health Sciences, California State University Northridge, Northridge, CA 91330, USA
| | - Thomas A. Chavez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
| | - Christine H. Naya
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
| | - Mark Johnson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
| | - Sandrah P. Eckel
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
| | | | - Brendan H. Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Shohreh F. Farzan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
| | - Genevieve F. Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Theresa M. Bastain
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
| | - Carrie V. Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (A.K.P.); (C.M.T.-C.); (T.A.C.); (C.H.N.); (M.J.); (S.P.E.); (S.F.F.); (G.F.D.); (T.M.B.)
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Johnston RC, Faulkner M, Carpenter PM, Nael A, Haydel D, Sandman CA, Wing DA, Davis EP. Associations Between Placental Corticotropin-Releasing Hormone, Maternal Cortisol, and Birth Outcomes, Based on Placental Histopathology. Reprod Sci 2020; 27:1803-1811. [PMID: 32219714 PMCID: PMC7396307 DOI: 10.1007/s43032-020-00182-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/13/2020] [Indexed: 01/21/2023]
Abstract
Preterm birth remains the leading cause of neonatal morbidity and mortality, with complex biochemical pathways requiring continued understanding and assessment. The objective of this study is to assess the associations between maternal cortisol and placental corticotropin-releasing hormone (placental CRH) concentrations with birth outcomes when stratified by placental histopathology. We conducted an analysis of 112 singleton pregnancies who received betamethasone between 23 and 34 weeks' gestation. Maternal blood and saliva were collected prior to betamethasone administration and samples assayed for plasma cortisol (pCort), salivary cortisol (sCort), and placental CRH levels. Placental findings were characterized as inflammatory, maternal vascular underperfusion (MVU), or no pathology, and compared for the outcomes of placental CRH, pCort, and sCort levels, gestational age at birth (GAB), and birthweight percentiles (BWP). Thirty-six subjects were characterized as inflammatory, 38 as MVU, and 38 without placental abnormalities. Histopathology groups differed significantly on placental CRH levels, GAB, and BWP. Post hoc tests suggested that the MVU group had higher placental CRH than the inflammatory or no pathology groups, and despite delivering earlier than the other two groups, the inflammatory group had infants with significantly higher BWP. No differences existed between groups in terms of mean plasma or sCort levels. Higher placental CRH and pCort levels were associated with earlier GAB in the overall sample, but when split by group, these associations remained significant only among the MVU group. Higher placental CRH was also associated with lower BWP in the overall sample but did not remain significant when split by group. Higher sCort was associated with lower BWP only in the MVU group. There is differentiation of placental CRH, cortisol, and birth outcomes when evaluated by placental histopathology. This highlights the importance of evaluating birth outcomes within the context of placental histopathology.
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Affiliation(s)
- Robert C Johnston
- University of California, Irvine, Orange, CA, 92868, USA.
- Austin Maternal Fetal Medicine, 12200 Renfert Way, Suite G-3, Austin, TX, 78758, USA.
| | - Megan Faulkner
- University of California, Irvine, Orange, CA, 92868, USA
| | - Philip M Carpenter
- University of California, Irvine, Orange, CA, 92868, USA
- University of Southern California, Los Angeles, CA, 90033, USA
| | - Ali Nael
- University of California, Irvine, Orange, CA, 92868, USA
- Children's Hospital Orange County, Orange County, CA, 92868, USA
| | - Dana Haydel
- Texas Children's Hospital, Houston, TX, 77030, USA
| | - Curt A Sandman
- University of California, Irvine, Orange, CA, 92868, USA
- University of Denver, Denver, CO, 80208, USA
| | - Deborah A Wing
- University of California, Irvine, Orange, CA, 92868, USA
| | - Elysia Poggi Davis
- University of California, Irvine, Orange, CA, 92868, USA
- University of Denver, Denver, CO, 80208, USA
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28
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Amiel Castro RT, Ehlert U, Dainese SM, Zimmerman R, La Marca-Ghaemmaghami P. Psychological predictors of gestational outcomes in second trimester pregnant women: associations with daily uplifts. Arch Gynecol Obstet 2020; 301:869-874. [PMID: 32200420 DOI: 10.1007/s00404-020-05506-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE We investigated whether pregnancy/birth anxiety is associated with shorter gestation while maternal chronic stress and depressive symptoms are associated with lower birth weight; we also examined whether experiencing daily uplifts prenatally may contribute to a more favorable birth outcome. METHODS Thirty-four healthy second trimester pregnant women responded to questions regarding their experience of pregnancy/birth anxiety, chronic stress, depressive symptoms, and daily uplifts. Information on birth outcome was obtained from medical records. RESULTS Maternal pregnancy/birth anxiety, depression, and stress were unrelated to birth outcomes. Daily uplifts were associated with gestational age at birth (B = 2.0, p = 0.01), neonatal weight (B = 46.9, p = 0.00), and size (B = 10.6, p = 0.01). Our results suggest that pregnancy/birth anxiety is not associated with shorter gestation as well as depression and stress seem to not predict lower birth weight. CONCLUSION We expand the literature by showing that experiencing daily uplifts during mid-gestation may further fetal development.
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Affiliation(s)
- R T Amiel Castro
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Binzmühlestrasse 14/26, 8050, Zürich, Switzerland
| | - U Ehlert
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Binzmühlestrasse 14/26, 8050, Zürich, Switzerland
| | - S M Dainese
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Binzmühlestrasse 14/26, 8050, Zürich, Switzerland
| | - R Zimmerman
- Department of Obstetrics, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - P La Marca-Ghaemmaghami
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Binzmühlestrasse 14/26, 8050, Zürich, Switzerland.
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29
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Meyer JS, Novak MA. Assessment of prenatal stress-related cortisol exposure: focus on cortisol accumulation in hair and nails. Dev Psychobiol 2020; 63:409-436. [PMID: 32783213 DOI: 10.1002/dev.22021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/02/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022]
Abstract
Prenatal stress adversely affects offspring development. Although cortisol is hypothesized to be a key mediator of stress-induced developmental deficits, determining the amount of fetal cortisol exposure produced by maternal stress has proved challenging. Current approaches, such as measuring cortisol concentrations in maternal plasma, saliva, or urine, amniotic fluid, fetal plasma, or cord blood, all have significant limitations for assessing cumulative fetal cortisol exposure over time. A recently emerging approach is to measure cortisol concentrations in maternal hair and/or newborn hair or nail samples. Maternal hair cortisol potentially shows long-term production across each trimester of pregnancy, whereas neonatal hair or nail cortisol is thought to reflect mainly third trimester hormone accumulation. This review first describes fetal adrenocortical development, placental cortisol metabolism, and the various sources of fetal cortisol exposure across pregnancy. We then summarize the results obtained from "classical" methods of assessing prenatal cortisol exposure prior to the advent of hair and nail cortisol measurement. Lastly, we discuss the initial development and validation of the hair cortisol methodology, its subsequent application to studies of chronic stress, and recent findings regarding maternal and neonatal hair or nail cortisol concentrations in relation to prenatal stress and other variables of interest.
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Affiliation(s)
- Jerrold S Meyer
- Department of Psychological and Brain Sciences, Neuroscience and Behavior Program, University of Massachusetts, Amherst, MA, USA
| | - Melinda A Novak
- Department of Psychological and Brain Sciences, Neuroscience and Behavior Program, University of Massachusetts, Amherst, MA, USA
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Maternal Antioxidant Status in Early Pregnancy and Development of Fetal Complications in Twin Pregnancies: A Pilot Study. Antioxidants (Basel) 2020; 9:antiox9040269. [PMID: 32218124 PMCID: PMC7222178 DOI: 10.3390/antiox9040269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 01/08/2023] Open
Abstract
Twin pregnancies are increasing due to the rise in mothers' childbearing age and have a higher risk of fetal growth restriction (FGR) and prematurity. Therefore, early prediction of these events is important. Our aim was to analyze in the first trimester of pregnancy a possible association between antioxidants, including melatonin, in maternal plasma and the development of fetal complications in twin pregnancies. A single-center, prospective, and observational study was performed in 104 twin-pregnant women. A blood sample was extracted between the 9th and the 11th week of gestation, and plasma was obtained. Antioxidants (thiols, reduced glutathione, phenolic compounds, catalase, superoxide dismutase) and oxidative damage biomarkers (carbonyl groups and malondialdehyde) were assessed by spectrophotometry, and global scores were calculated from these parameters (Antiox-S, Prooxy-S). Melatonin and cortisol were evaluated by a competitive immunoassay. In the first trimester of pregnancy, Antiox-S was significantly lower in women who developed FGR compared to those with normal fetal growth; plasma melatonin was significantly lower in women with preterm compared to those with full-term births and exhibited a positive correlation with birth weight. Maternal cortisol showed a negative correlation with birth weight. We conclude that, for twin gestations, maternal plasma antioxidant status and melatonin could be potential biomarkers to be included in algorithms to predict FGR and preterm labor.
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Aker A, McConnell RER, Loch-Caruso R, Park SK, Mukherjee B, Rosario ZY, Vélez-Vega CM, Huerta-Montanez G, Alshawabkeh AN, Cordero JF, Meeker JD. Interactions between chemicals and non-chemical stressors: The modifying effect of life events on the association between triclocarban, phenols and parabens with gestational length in a Puerto Rican cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 708:134719. [PMID: 31785910 PMCID: PMC6957748 DOI: 10.1016/j.scitotenv.2019.134719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/27/2019] [Accepted: 09/27/2019] [Indexed: 04/13/2023]
Abstract
BACKGROUND Phenols and parabens are common additives to consumer products. There is evidence of adverse birth outcomes in association with prenatal exposure to these chemicals, in addition to psychosocial factors. We previously reported an increase in gestational length with bisphenol-A, methylparaben and propylparaben, and a decrease in gestational length with triclocarban. OBJECTIVES We examined the modifying effect of psychosocial stress on the association between chemicals and gestational length in up to 752 women among a pregnancy cohort study. METHODS Urinary biomarkers were measured at up to three time points in pregnancy. Multiple linear regression models were conducted to investigate the association between gestational length and the interaction between average exposure biomarkers and LES. Multiple linear regression models regressing the exposure biomarkers in relation to gestational length were also stratified by LES, Negative LES, and Positive LES, based on the subjective ratings of events. Results were transformed into the change in gestational length for an inter-quartile-range difference in the exposure. RESULTS Of the four psychosocial stress measures, only the life events score (LES) was a significant modifier. Associations between triclocarban, bisphenol-S, methyl- and propylparaben in relation to gestational length were stronger among women with negative Total LES scores. Among women with negative Total LES scores, bisphenol-S and triclocarban were associated with a 3-5 day decrease in gestational length [(-3.15; 95% CI: -6.06, -0.24); (-4.68; 95% CI: -8.47, -0.89)], whereas methylparaben and propylparaben were associated with a 2-3 day increase in gestational length [(2.21; 95% CI: 0.02, 4.40); (2.92; 95% CI: 0.58, 5.26)]. Significant interactions were driven by negative life events, but the association with triclocarban was driven by few positive life events. CONCLUSIONS Associations between exposure biomarkers and gestational length were stronger in the presence of negative life events. This provides evidence that stress makes the body more vulnerable to chemical exposure.
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Affiliation(s)
- Amira Aker
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Rafael E Rios McConnell
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Rita Loch-Caruso
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Sung Kyun Park
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Zaira Y Rosario
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | - Carmen M Vélez-Vega
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA
| | | | | | - José F Cordero
- College of Public Health, Athens, University of Georgia, GA, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA.
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Casey T, Sun H, Suarez-Trujillo A, Crodian J, Zhang L, Plaut K, Burgess HJ, Dowden S, Haas DM, Ahmed A. Pregnancy rest-activity patterns are related to salivary cortisol rhythms and maternal-fetal health indicators in women from a disadvantaged population. PLoS One 2020; 15:e0229567. [PMID: 32126104 PMCID: PMC7053712 DOI: 10.1371/journal.pone.0229567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 02/09/2020] [Indexed: 12/22/2022] Open
Abstract
Irregular rest-activity patterns can disrupt metabolic and hormonal physiology and potentially lead to disease. Little is known regarding rest-activity patterns during gestation and their association with hormonal rhythms and health in pregnant women. We conducted a pilot study to determine if 24 h rest-activity was related to saliva cortisol rhythms and maternal-fetal health in an economically disadvantaged population. Primiparous women wore a wrist actigraphy device for a week to record activity during gestational weeks 22 (G22; n = 50) and 32 (G32; n = 46) and postpartum week one (PPW1; n = 39). Participants collected saliva samples every 4 hr over a 24 hr period during G22 (n = 22), G32 (n = 20) and 24–48 hr postnatal (n = 20), and cortisol concentrations were measured with ELISA. Circadian rhythmicity was assessed using autocorrelation coefficient (r24) and cosinor analysis. Blood glucose levels, body mass index (BMI), gestational disease data, and gestational age of infant at birth were abstracted from medical charts. Time of cortisol peak (acrophase) during G22 was related with acrophase of activity (r = 0.66; p = 0.001) and blood glucose levels (r = 0.58; p = 0.006). During G22, minutes of wake after sleep onset was positively related to cortisol mesor and AUC (p <0.05). Rest-activity r24, R2, and mesor during G32 were positively (p<0.05) associated with gestational age of infant at birth. Across all three time points r24 of activity was related with cortisol amplitude (r = 0.33; p = 0.01). Findings support a relationship between rest-activity patterns and saliva cortisol rhythms during pregnancy. The association of less robust activity rhythms with earlier gestational age of infant at birth indicates a potential link between circadian system disruption and maternal-fetal health outcomes.
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Affiliation(s)
- Theresa Casey
- Department of Animal Sciences, Purdue University, West Lafayette, IN, United States of America
- * E-mail:
| | - Hui Sun
- Department of Statistics, Purdue University, West Lafayette, IN, United States of America
| | - Aridany Suarez-Trujillo
- Department of Animal Sciences, Purdue University, West Lafayette, IN, United States of America
| | - Jennifer Crodian
- Department of Animal Sciences, Purdue University, West Lafayette, IN, United States of America
| | - Lingsong Zhang
- Department of Statistics, Purdue University, West Lafayette, IN, United States of America
- Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Karen Plaut
- Department of Animal Sciences, Purdue University, West Lafayette, IN, United States of America
| | - Helen J. Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Shelley Dowden
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, United States of America
| | - David M. Haas
- Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN, United States of America
| | - Azza Ahmed
- School of Nursing, Purdue University, West Lafayette, IN, United States of America
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Stoye DQ, Andrew R, Grobman WA, Adam EK, Wadhwa PD, Buss C, Entringer S, Miller GE, Boardman JP, Seckl JR, Keenan-Devlin LS, Borders AEB, Reynolds RM. Maternal Glucocorticoid Metabolism Across Pregnancy: A Potential Mechanism Underlying Fetal Glucocorticoid Exposure. J Clin Endocrinol Metab 2020; 105:5766073. [PMID: 32108902 PMCID: PMC7047583 DOI: 10.1210/clinem/dgz313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/21/2020] [Indexed: 01/01/2023]
Abstract
CONTEXT Across pregnancy, maternal serum cortisol levels increase up to 3-fold. It is not known whether maternal peripheral cortisol metabolism and clearance change across pregnancy or influence fetal cortisol exposure and development. OBJECTIVES The primary study objective was to compare maternal urinary glucocorticoid metabolites, as markers of cortisol metabolism and clearance, between the second and third trimester of pregnancy. Secondary objectives were to test associations of total maternal urinary glucocorticoid excretion, with maternal serum cortisol levels and offspring birth weight z score. DESIGN, PARTICIPANTS, AND SETTING A total of 151 women with singleton pregnancies, recruited from prenatal clinic at the Pittsburgh site of the Measurement of Maternal Stress (MOMS) study, had 24-hour urine collections during both the second and third trimesters. RESULTS Between the second and third trimester, total urinary glucocorticoid excretion increased (ratio of geometric means [RGM] 1.37, 95% CI 1.22-1.52, P < .001), and there was an increase in calculated 5β-reductase compared to 5α-reductase activity (RGM 3.41, 95% CI 3.04-3.83, P < .001). During the third trimester total urinary glucocorticoid excretion and serum cortisol were negatively correlated (r = -0.179, P = .029). Mean total urinary glucocorticoid excretion across both trimesters and offspring birth weight z score were positively associated (β = 0.314, P = .001). CONCLUSIONS The estimated activity of maternal enzymes responsible for cortisol metabolism change between the second and third trimester of pregnancy. Additionally, maternal peripheral metabolism and clearance of cortisol may serve as a novel mechanism affecting fetal cortisol exposure and growth.
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Affiliation(s)
- David Q Stoye
- MRC Centre of Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Ruth Andrew
- Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
| | - William A Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University, Chicago, Illinois
| | - Emma K Adam
- School of Education and Social Policy, Institute for Policy Research, Northwestern University, Evanston, Illinois
| | - Pathik D Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine, California
| | - Claudia Buss
- Development, Health and Disease Research Program, University of California, Irvine, California
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt–Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
| | - Sonja Entringer
- Development, Health and Disease Research Program, University of California, Irvine, California
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt–Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
| | - Gregory E Miller
- Department of Psychology, Institute for Policy Research, Northwestern University, Evanston, Illinois
| | - James P Boardman
- MRC Centre of Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Jonathan R Seckl
- Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
| | - Lauren S Keenan-Devlin
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University Health System, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Ann E B Borders
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University, Chicago, Illinois
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University Health System, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Rebecca M Reynolds
- MRC Centre of Reproductive Health, University of Edinburgh, Edinburgh, UK
- Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
- Correspondence: Rebecca M. Reynolds, MA, FRCP, PHD, Centre for Cardiovascular Science, Queen’s Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK. E-mail:
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Insights into sympathetic nervous system and GPCR interplay in fetal programming of hypertension: a bridge for new pharmacological strategies. Drug Discov Today 2020; 25:739-747. [PMID: 32032706 DOI: 10.1016/j.drudis.2020.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/07/2020] [Accepted: 01/29/2020] [Indexed: 12/18/2022]
Abstract
Cardiovascular diseases (CVDs) are the most common cause of death from noncommunicable diseases worldwide. In addition to the classical CVD risk factors related to lifestyle and/or genetic background, exposure to an adverse intrauterine environment compromises fetal development leading to low birth weight and increasing offspring susceptibility to develop CVDs later in life, particularly hypertension - a process known as fetal programming of hypertension (FPH). In FPH animal models, permanent alterations have been detected in gene expression, in the structure and function of heart and blood vessels, compromising cardiovascular physiology and favoring hypertension development. This review focuses on the role of the sympathetic nervous system and its interplay with G-protein-coupled receptors, emphasizing strategies that envisage the prevention and/or treatment of FPH through interventions in early life.
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Fassaie S, McAloon J. Maternal distress, HPA activity, and antenatal interventions: A systematic review. Psychoneuroendocrinology 2020; 112:104477. [PMID: 31753328 DOI: 10.1016/j.psyneuen.2019.104477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/05/2019] [Accepted: 10/11/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Elevated antenatal distress has been associated with negative outcomes for both mothers and, as a result, their infants. One mechanism hypothesised to underlie these associations is the maternal hypothalamic pituitary adrenal (HPA) axis. Though research has examined whether biopsychosocial antenatal interventions can reduce maternal HPA activity, only one review has summarized the nature of findings to date. The present study examined randomised control trials (RCTs) specifically; our primary aim was to assess the effectiveness of antenatal interventions in reducing HPA activity in pregnant women, our secondary aim was to examine whether antenatal interventions reduced maternal self-report of depression and/or anxiety. METHODS This study systematically reviewed RCTs that evaluated biopsychosocial interventions that reported subjective and objective markers of maternal distress in pregnant women within the clinical population. RESULTS Eight studies met inclusion criteria and women were in their second or third trimester. HPA-activity was primarily assessed through salivary cortisol (n = 7) and self-reported maternal distress was assessed using a variety of validated screening measures. Included trials demonstrated significant methodological heterogeneity and small sample sizes, poor treatment adherence, and poor reliability in cortisol measurement indicated low methodological quality. CONCLUSIONS Due to the high heterogeneity across studies, small sample sizes, and unreliable sampling methods, firm conclusions about the efficacy and effectiveness of antenatal interventions cannot be drawn. Despite this, interventions which targeted pregnancy-specific influencers of maternal mood were more likely to result in reduced depression and anxiety symptomatology as reported by mothers.
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Affiliation(s)
- Soha Fassaie
- Graduate School of Health, University of Technology Sydney, PO Box 123, Broadway NSW 2007, Australia
| | - John McAloon
- Graduate School of Health, University of Technology Sydney, PO Box 123, Broadway NSW 2007, Australia.
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Brabin B, Tinto H, Roberts SA. Testing an infection model to explain excess risk of preterm birth with long-term iron supplementation in a malaria endemic area. Malar J 2019; 18:374. [PMID: 31771607 PMCID: PMC6880560 DOI: 10.1186/s12936-019-3013-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/16/2019] [Indexed: 12/15/2022] Open
Abstract
Background In view of recent evidence from a randomized trial in Burkina Faso that periconceptional iron supplementation substantially increases risk of spontaneous preterm birth (< 37 weeks) in first pregnancies (adjusted relative risk = 2.22; 95% CI 1.39–3.61), explanation is required to understand potential mechanisms, including progesterone mediated responses, linking long-term iron supplementation, malaria and gestational age. Methods The analysis developed a model based on a dual hit inflammatory mechanism arising from simultaneous malaria and gut infections, supported in part by published trial results. This model is developed to understand mechanisms linking iron supplementation, malaria and gestational age. Background literature substantiates synergistic inflammatory effects of these infections where trial data is unavailable. A path modelling exercise assessed direct and indirect paths influencing preterm birth and gestation length. Results A dual hit hypothesis incorporates two main pathways for pro-inflammatory mechanisms, which in this model, interact to increase hepcidin expression. Trial data showed preterm birth was positively associated with C-reactive protein (P = 0.0038) an inflammatory biomarker. The malaria pathway upregulates C-reactive protein and serum hepcidin, thereby reducing iron absorption. The enteric pathway results from unabsorbed gut iron, which induces microbiome changes and pathogenic gut infections, initiating pro-inflammatory events with lipopolysaccharide expression. Data from the trial suggest that raised hepcidin concentration is a mediating catalyst, being inversely associated with shorter gestational age at delivery (P = 0.002) and positively with preterm incidence (P = 0.007). A segmented regression model identified a change-point consisting of two segments before and after a sharp rise in hepcidin concentration. This showed a post change hepcidin elevation in women with increasing C-reactive protein values in late gestation (post-change slope 0.55. 95% CI 0.39–0.92, P < 0.001). Path modelling confirmed seasonal malaria effects on preterm birth, with mediation through C-reactive protein and (non-linear) hepcidin induction. Conclusions Following long-term iron supplementation, dual inflammatory pathways that mediate hepcidin expression and culminate in progesterone withdrawal may account for the reduction in gestational age observed in first pregnancies in this area of high malaria exposure. If correct, this model strongly suggests that in such areas, effective infection control is required prior to iron supplementation to avoid increasing preterm births. Trial registration NCT01210040. Registered with Clinicaltrials.gov on 27th September 2010
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Affiliation(s)
- Bernard Brabin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L35QA, UK. .,Institute of Infection and Global Health, University of Liverpool, Liverpool, UK. .,Global Child Health Group, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Halidou Tinto
- Clinical Research Unit of Nanoro (URCN/IRSS), Nanoro, Burkina Faso
| | - Stephen A Roberts
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
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Wynne-Edwards KE, Lee K, Zhou R, Edwards HE. Sex differences in substrates and clearance products of cortisol and corticosterone synthesis in full-term human umbilical circulation without labor: Substrate depletion matches synthesis in males, but not females. Psychoneuroendocrinology 2019; 109:104381. [PMID: 31442935 DOI: 10.1016/j.psyneuen.2019.104381] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 07/02/2019] [Accepted: 07/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Antenatal impacts on the hypothalamus- pituitary-adrenal axis affect health throughout later life and the impacts on developing males and females often differ. The female fetus at full-term (sampled as scheduled Caesarian section without antecedent labor) both receives more cortisol in umbilical venous blood and adds more cortisol to umbilical arterial circulation than the male. The current study was designed to expand our knowledge of sex-specific, fetal, adrenal steroid synthesis and clearance pathways. METHODS Paired, full-term, arterial and venous umbilical cord samples were taken at the time of scheduled Caesarian delivery (N = 53, 33 male). Adrenal glucocorticoids (cortisol, corticosterone), cortisol precursor steroids (17-hydroxyprogesterone, 11-deoxycortisol), and cortisol and corticosterone metabolites (cortisone and 11-dehydrocorticosterone), as well as gonadal steroids (testosterone and androstenedione), were quantified by liquid chromatography coupled to tandem mass spectrometry. RESULTS Both sexes preferentially added corticosterone. Males added more testosterone than females. The female fetus had higher umbilical cord (arterial and venous) concentrations of cortisol, as well as higher total steroid molarity summed across the six adrenal steroids, than males. Depletion of substrate pools of 17-hydroxyprogesterone, 11-deoxycortisol, and cortisone could account for only 20% of net female cortisol synthesis. In contrast, increased fetal synthesis of cortisol was balanced by equivalent molar depletion of substrate pools when the fetus was male. CONCLUSIONS Preferential fetal corticosterone synthesis in both sexes, and higher concentrations of cortisol in females were confirmed. Differences in adrenal steroidogenesis pathway function in full-term males and females might underlie antenatal programming of hypothalamic-pituitary-adrenal axis function in later life.
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Affiliation(s)
- Katherine E Wynne-Edwards
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Kovid Lee
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Ruokun Zhou
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
| | - Heather E Edwards
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.
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Mustonen P, Karlsson L, Kataja EL, Scheinin NM, Kortesluoma S, Coimbra B, Rodrigues AJ, Sousa N, Karlsson H. Maternal prenatal hair cortisol is associated with prenatal depressive symptom trajectories. Psychoneuroendocrinology 2019; 109:104383. [PMID: 31400561 DOI: 10.1016/j.psyneuen.2019.104383] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 11/15/2022]
Abstract
UNLABELLED Maternal prenatal cortisol levels have been inconsistently associated with self-reports of prenatal psychological distress (PD). Previous research has linked hair cortisol concentration (HCC) evaluating cumulatively the previous months with cross-sectional PD measures that usually cover the past week(s), which may lead to misleading conclusions on their relations. We aimed to investigate how maternal HCC relates to cumulative PD measures across pregnancy. METHODS Subjects (N = 595) were drawn from the FinnBrain Birth Cohort Study. Maternal HCC was measured from hair samples collected at gestational week (gwk) 24 (HCC1, n = 467) and at delivery (HCC2, n = 222). As HCC1 and HCC2 comprised mostly of different subjects, they were considered as independent populations. Maternal PD assessments at gwks 14, 24, and 34 were the Edinburgh Postnatal Depression Scale (EPDS), the anxiety subscale of the Symptom Checklist (SCL-90), the Pregnancy-Related Anxiety Questionnaire -Revised2 (PRAQ-R2), and a daily hassles scale. Cumulative PD comprised of the mean scores of two consecutive assessments (mean1 = gwks 14 and 24; mean2 = gwks 24 and 34). In addition, EPDS and SCL scores were modelled by using growth mixture modelling to identify symptom trajectory categories. Regression models were adjusted for age, body mass index, education and use of selective serotonin/serotonin-norepinephrine reuptake inhibitor medication. RESULTS In the adjusted regression model, higher HCC2 was related to the "consistently elevated" prenatal depressive symptoms trajectory in comparison to "consistently low" (β =.71, p =.021) and "low and increasing" (β =.82, p = .011) symptom trajectories. Additionally, the cumulative mean (mean 1) of daily hassles in relationships was associated with HCC1 (β = 0.25, p = .004). General or pregnancy-related anxiety symptoms were unrelated to HCC after adjustment for the covariates. CONCLUSIONS The assessment of cumulative or trajectory measures of PD can reveal important associations with maternal prenatal HCC, even though the associations are generally weak. Of the different dimensions of PD, prenatal trajectories of depressive symptoms were most consistently linked with end-pregnancy HCC levels.
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Affiliation(s)
- Paula Mustonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Susanna Kortesluoma
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Institute of Biomedicine, University of Turku, Finland
| | - Bárbara Coimbra
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
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Lipner E, Murphy SK, Ellman LM. Prenatal Maternal Stress and the Cascade of Risk to Schizophrenia Spectrum Disorders in Offspring. Curr Psychiatry Rep 2019; 21:99. [PMID: 31522269 PMCID: PMC7043262 DOI: 10.1007/s11920-019-1085-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Disruptions in fetal development (via genetic and environmental pathways) have been consistently associated with risk for schizophrenia in a variety of studies. Although multiple obstetric complications (OCs) have been linked to schizophrenia, this review will discuss emerging evidence supporting the role of prenatal maternal stress (PNMS) in the etiology of schizophrenia spectrum disorders (SSD). In addition, findings linking PNMS to intermediate phenotypes of the disorder, such as OCs and premorbid cognitive, behavioral, and motor deficits, will be reviewed. Maternal immune and endocrine dysregulation will also be explored as potential mechanisms by which PNMS confers risk for SSD. RECENT FINDINGS PNMS has been linked to offspring SSD; however, findings are mixed due to inconsistent and retrospective assessments of PNMS and lack of specificity about SSD outcomes. PNMS is also associated with various intermediate phenotypes of SSD (e.g., prenatal infection/inflammation, decreased fetal growth, hypoxia-related OCs). Recent studies continue to elucidate the impact of PNMS while considering the moderating roles of fetal sex and stress timing, but it is still unclear which aspects of PNMS (e.g., type, timing) confer risk for SSD specifically. PNMS increases risk for SSD, but only in a small portion of fetuses exposed to PNMS. Fetal sex, genetics, and other environmental factors, as well as additional pre- and postnatal insults, likely contribute to the PNMS-SSD association. Longitudinal birth cohort studies are needed to prospectively illuminate the mechanisms that account for the variability in outcomes following PNMS.
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Affiliation(s)
- Emily Lipner
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19106, USA
| | - Shannon K Murphy
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19106, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19106, USA.
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Cherak SJ, Malebranche ME, Wynne-Edwards K, Williamson T, Giesbrecht GF. Quantitative meta-analysis of maternal prenatal salivary cortisol and newborn birthweight does not identify effect of fetal sex. Psychoneuroendocrinology 2019; 106:117-121. [PMID: 30974325 DOI: 10.1016/j.psyneuen.2019.03.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/23/2019] [Accepted: 03/31/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Heightened concentration of maternal cortisol is a frequently proposed mechanism linking adverse maternal environments with poor birth outcomes, including birth weight. It is commonly hypothesized that prenatal exposures have sexually dimorphic effects on fetal development, however few studies have assessed the effects of fetal sex on the relationship between maternal cortisol and birth outcomes. METHODS In a previous systematic review and meta-analysis we obtained data from authors of included studies to calculate trimester-specific correlations between maternal prenatal salivary cortisol and newborn birth weight. Given that this data was well-poised to address the unknown effects of fetal sex on the relationship between maternal cortisol and birth outcomes, we contacted authors a second time with request to unblind sex into the correlations. An updated database search was conducted to identify potentially relevant articles published within 2018 and two additional articles were included. RESULTS AND DISCUSSION Eleven studies with a total of 2236 maternal-fetal dyads demonstrated negative correlations for both males, -0.15 (95% CI -0.24 to -0.06, I2 = 98.5%, p < 0.001) and females -0.21 (95% CI -0.25 to -0.17, I2 = 93.3%, p < 0.001). Sex difference were not statistically significant, p = 0.62. Despite greater exposure to cortisol and lower birth weight among females, the association did not differ by sex.
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Affiliation(s)
- Stephana J Cherak
- Department of Community Health Sciences, University of Calgary, 3820 Hospital Drive N.W., Calgary, AB, T2N 4Z6, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health, Heritage Medical Research Building, 3330 Hospital Drive N.W., Calgary, AB, T2N 4N1, Canada; O'Brien Institute for Public Health, University of Calgary, 3820 Hospital Drive N.W., Calgary, AB, T2N 4Z6, Canada.
| | - Mary E Malebranche
- O'Brien Institute for Public Health, University of Calgary, 3820 Hospital Drive N.W., Calgary, AB, T2N 4Z6, Canada; Department of General Internal Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, AB, T2N 4N1, Canada
| | - Katherine Wynne-Edwards
- Department of Comparative Biology and Experimental Medicine, University of Calgary, 33390 Hospital Drive N.W., T2N 4N1, Canada; Hotchkiss Brain Institute, University of Calgary, 33390 Hospital Drive N.W., T2N 4N1, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, 3820 Hospital Drive N.W., Calgary, AB, T2N 4Z6, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health, Heritage Medical Research Building, 3330 Hospital Drive N.W., Calgary, AB, T2N 4N1, Canada; Department of General Internal Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, AB, T2N 4N1, Canada
| | - Gerald F Giesbrecht
- Department of Community Health Sciences, University of Calgary, 3820 Hospital Drive N.W., Calgary, AB, T2N 4Z6, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health, Heritage Medical Research Building, 3330 Hospital Drive N.W., Calgary, AB, T2N 4N1, Canada; Department of Paediatrics, University of Calgary, 2888 Shaganappi Trail N.W., Calgary, AB, T3B 6A8, Canada; Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB, T2N 1N4, Canada
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Smith A, Twynstra J, Seabrook JA. Antenatal depression and offspring health outcomes. Obstet Med 2019; 13:55-61. [PMID: 32714436 DOI: 10.1177/1753495x19843015] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 03/18/2019] [Indexed: 12/11/2022] Open
Abstract
Background Depression is the most common mental disorder during pregnancy, with prevalence rates between 4% and 20%. The objective of this review was to synthesize the literature on the association between antenatal depression and offspring birth outcomes, as well as developmental, behavioral, and psychiatric outcomes. Methods A search of PubMed, Cochrane, and Medline databases was conducted for articles published until December 2017. Articles focusing on the effects of antenatal depression on the offspring were selected to be reviewed. Reference lists of all studies were examined for any missed articles. A total of 32 articles were included in this review. Results Antenatal depression is associated with preterm birth, excessive infant crying, and offspring mental health problems. Untreated antenatal depression is strongly associated with adverse effects on the infant nervous system. Conclusion Antenatal depression increases the likelihood of poor offspring health outcomes. Research should investigate whether medication use confounds this relationship.
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Affiliation(s)
- Alexandra Smith
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Jasna Twynstra
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada.,Department of Paediatrics, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
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Christian LM. At the forefront of psychoneuroimmunology in pregnancy: Implications for racial disparities in birth outcomes: PART 2: Biological mechanisms. Neurosci Biobehav Rev 2019; 117:327-333. [PMID: 30885813 DOI: 10.1016/j.neubiorev.2019.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/26/2019] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Abstract
As reviewed in Part 1 of this two part review, birth prior to full term is a substantial public health issue. In the US, ˜400,000 babies per year are born preterm (< 37 weeks), while>1 million are early term (37-386/7 weeks) and remarkable racial disparities in shortened gestation are observed among African Americans as compared to Whites. Biomechanisms linking stressor exposures with birth outcomes are increasingly being explicated. The current paper reviews the mechanistic role of maternal biological functioning in the link between behavioral exposures and birth outcomes. These include the inter-related roles of neuroendocrine function, inflammatory regulation, biological aging, and the microbiome. An integrative approach which addresses both behavioral and biological factors within the same study, carefully considers the role of race/ethnicity, and rigorously defines birth outcomes (e.g., spontaneous versus medically-indicated and inclusive of early term birth) is needed to move research in this field toward better mechanistic understanding and clinical application.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA; Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA.
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Maternal Lifetime Trauma and Birthweight: Effect Modification by In Utero Cortisol and Child Sex. J Pediatr 2018; 203:301-308. [PMID: 30197200 PMCID: PMC6398337 DOI: 10.1016/j.jpeds.2018.07.069] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/12/2018] [Accepted: 07/19/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate associations between maternal lifetime traumatic stress and offspring birthweight and examine modifying effects of third trimester cortisol and fetal sex. STUDY DESIGN Analyses included 314 mother-infant dyads from an ethnically mixed pregnancy cohort. Maternal lifetime trauma was reported via the Life Stressor Checklist-Revised. Fenton birthweight for gestational age z-scores (BWGA-z) were calculated. A 3-cm scalp-nearest maternal hair segment collected at birth was assayed to reflect cumulative third trimester cortisol secretion. Multivariable regression was used to investigate associations between maternal lifetime trauma and BWGA-z and examine 2- and 3-way interactions with cortisol and fetal sex. Because subjects with low or high cortisol levels could represent susceptible populations, varying coefficient models that relax the linearity assumption on cortisol level were used to assess the modification of maternal lifetime trauma associations with BWGA-z as a function of cortisol. RESULTS Women were primarily minorities (41% Hispanic, 26% black) with ≤12 years education (63%); 63% reported ≥1 traumatic event. Prenatal cortisol modified the association between maternal lifetime trauma and birthweight. Women with higher lifetime trauma and increased cortisol had significantly lower birthweight infants in males; among males exposed to the 90th percentile of cortisol, a 1-unit increase in trauma score was associated with a 0.19-unit decrease in BWGA-z (95% CI, -0.34 to -0.04). Associations among females were nonsignificant, regardless of cortisol level. CONCLUSIONS These findings underscore the need to consider complex interactions among maternal trauma, disrupted in utero cortisol production, and fetal sex to fully elucidate intergenerational effects of maternal lifetime trauma.
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Carlson NS. Current Resources for Evidence-Based Practice, November 2018. J Obstet Gynecol Neonatal Nurs 2018; 47:820-829. [PMID: 30312573 DOI: 10.1016/j.jogn.2018.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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