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Willford JA, Kaufman JM. Through a teratological lens: A narrative review of exposure to stress and drugs of abuse during pregnancy on neurodevelopment. Neurotoxicol Teratol 2024; 105:107384. [PMID: 39187031 DOI: 10.1016/j.ntt.2024.107384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 08/28/2024]
Abstract
Teratological research shows that both prenatal stress and prenatal substance exposure have a significant impact on neurodevelopmental outcomes in children. Using human research, the purpose of this narrative review is to explore the degree to which these exposures may represent complex prenatal and postnatal risks for the development of cognition and behavior in children. An understanding of the HPA axis and its function during pregnancy as well as the types and operationalization of prenatal stress provide a context for understanding the direct and indirect mechanisms by which prenatal stress affects brain and behavior development. In turn, prenatal substance exposure studies are evaluated for their importance in understanding variables that indicate a potential interaction with prenatal stress including reactivity to novelty, arousal, and stress reactivity during early childhood. The similarities and differences between prenatal stress exposure and prenatal substance exposure on neurodevelopmental outcomes including arousal and emotion regulation, cognition, behavior, stress reactivity, and risk for psychopathology are summarized. Further considerations for teratological studies of prenatal stress and/or substance exposure include identifying and addressing methodological challenges, embracing the complexity of pre-and postnatal environments in the research, and the importance of incorporating parenting and resilience into future studies.
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Affiliation(s)
- Jennifer A Willford
- Slippery Rock University, Department of Psychology, 1 Morrow Way, Slippery Rock, PA 16057, United States of America.
| | - Jesse M Kaufman
- Slippery Rock University, Department of Psychology, 1 Morrow Way, Slippery Rock, PA 16057, United States of America
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2
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Rosen-Carole CB, Greenman S, Wang H, Sonawane S, Misra R, O'Connor T, Järvinen K, D'Angio C, Young BE. Association between maternal stress and premature milk cortisol, milk IgA, and infant health: a cohort study. Front Nutr 2024; 11:1270523. [PMID: 38533463 PMCID: PMC10964987 DOI: 10.3389/fnut.2024.1270523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/06/2024] [Indexed: 03/28/2024] Open
Abstract
Background Maternal stress is pervasive in the neonatal intensive care unit (NICU). Maternal stress is associated with changes in human milk (HM) immunomodulatory agents, which may impact neonatal health. We sought to determine the association between maternal stress, HM immunoglobulin A (IgA) and cortisol, and to assess how these milk components correlate with infant immune and neurodevelopmental outcomes. We then compared how these associations persist over time. Methods The study design involved a cohort study of exclusively breastfeeding mothers and their singleton moderately preterm (28-34 weeks) infants admitted to the NICU. We collected maternal serum, maternal saliva, and first-morning whole milk samples, and administered maternal stress questionnaires at 1 and 5 weeks postpartum. We analyzed the samples for HM IgA (using a customized immunoassay in skim milk) and for HM and salivary cortisol (using a chemiluminescent immunoassay). Infant illness was assessed using the Score for Neonatal Acute Physiology II (SNAP II) and SNAP II with Perinatal Extension (SNAPPE II), and infant neurodevelopment were assessed using the Test of Infant Motor Performance. We analyzed changes in HM IgA and cortisol over time using paired t-tests. Furthermore, we performed correlation and regression analyses after adjusting for gestational age (GA), corrected GA, and infant days of life. Results In our study, we enrolled 26 dyads, with a mean maternal age of 28.1 years, consisting of 69% white, 19% Black, and 8% Hispanic. Cortisol: Salivary and HM cortisol were closely associated in week 1 but not in week 5. Though mean salivary cortisol remained stable over time [2.41 ng/mL (SD 2.43) to 2.32 (SD 1.77), p = 0.17], mean HM cortisol increased [1.96 ng/mL (SD 1.93) to 5.93 ng/mL (SD 3.83), p < 0.001]. Stress measures were inversely associated with HM cortisol at week 1 but not at week 5. IgA: HM IgA decreased over time (mean = -0.14 mg/mL, SD 0.53, p < 0.0001). High maternal stress, as measured by the Parental Stressor Scale: neonatal intensive care unit (PSS:NICU), was positively associated with HM IgA at week 5 (r = 0.79, P ≤ 0.001). Higher IgA was associated with a lower (better) SNAP II score at week 1 (r = -0.74, p = 0.05). No associations were found between maternal stress, salivary cortisol, HM cortisol, or HM IgA and neurodevelopment at discharge (as assessed using the TIMP score). Furthermore, these relationships did not differ by infant sex. Conclusion Maternal stress showed associations with HM cortisol and HM IgA. In turn, HM IgA was associated with lower measures of infant illness.
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Affiliation(s)
- Casey B. Rosen-Carole
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Susan Greenman
- Swedish First Hill Family Medicine, Seattle, WA, United States
| | - Hongyue Wang
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Sharvari Sonawane
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Ravi Misra
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Tom O'Connor
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Kirsi Järvinen
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Carl D'Angio
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Bridget E. Young
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
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Matvienko-Sikar K, Butler E, Keeffe LO, Dijk WV, Hayes CB, Huizink AC, Kearney PM, Costelloe SJ, Curtin S, Foley K, McCarthy FP, Mahony SO, Khashan A, Murray DM. Prenatal maternal cortisol, stress and anxiety, and childhood obesity at 5 years: a nested case-control study. J Reprod Infant Psychol 2023:1-15. [PMID: 38018852 DOI: 10.1080/02646838.2023.2288298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Paediatric obesity is a global public health issue. Prenatal maternal mental health is potentially implicated in the development of childhood obesity. This study examined associations between prenatal maternal cortisol, self-reported stress, anxiety and depression in the second trimester, and childhood overweight and obesity at 5 years of age. METHODS A nested case-control study was conducted using data from the Irish prospective longitudinal birth cohort SCOPE BASELINE. Cases were children with overweight or obesity, operationalised as having a BMI z-score above +2 standard deviations. Controls were children with a BMI z-score between -0.5 and 0.5 standard deviations at 5 years of age. Two to one matching by sex was conducted. Thirty-eight cases and 83 sex-matched controls were included. Maternal serum cortisol concentration and self-reported stress, anxiety and depression were measured at 15 ± 1 and 20 ± 1 weeks gestation. Conditional logistic regression analyses were conducted to examine associations between prenatal maternal cortisol and self-reported stress, anxiety and depression, and childhood overweight and obesity. RESULTS Despite some evidence for associations between anxiety and depression, and child BMI z-scores in univariate analyses, adjusted models indicated no associations between prenatal maternal stress (OR: 1.02, 95% CI: 0.94-1.12), anxiety (OR: 1.03, 95% CI: 0.97-1.09), depression (OR: 1.04, 95% CI: 0.91-1.19), or cortisol concentration (OR: 0.99, 95% CI: 0.99-1.00) and child BMI z-score. CONCLUSION Our findings do not provide support for associations between foetal exposure during the second trimester of pregnancy and maternal cortisol, stress and anxiety, and childhood overweight or obesity at 5 years of age.
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Affiliation(s)
| | - Emma Butler
- School of Population Health, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Linda O' Keeffe
- School of Public Health, University College Cork, Cork, Ireland
| | - Willeke V Dijk
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- VU Medical Center, Amsterdam, Netherlands
| | - Catherine B Hayes
- Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Anja C Huizink
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Sean J Costelloe
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Ireland
| | - Sinead Curtin
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Ireland
| | - Kelly Foley
- Department of Clinical Biochemistry, Cork University Hospital, Cork, Ireland
| | - Fergus P McCarthy
- Department of Obstetrics and Gynaecology, University College Cork, Cork Ireland
- INFANT Maternal and Child Health Research Centre, Cork, Ireland
| | - Siobhain O Mahony
- Department of Anatomy, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Ali Khashan
- School of Public Health, University College Cork, Cork, Ireland
- INFANT Maternal and Child Health Research Centre, Cork, Ireland
| | - Deirdre M Murray
- INFANT Maternal and Child Health Research Centre, Cork, Ireland
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
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Payne LA, Seidman LC, Ren B, Greenfield SF. COVID-Related Distress Is Associated with Increased Menstrual Pain and Symptoms in Adult Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:774. [PMID: 36613098 PMCID: PMC9819102 DOI: 10.3390/ijerph20010774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic resulted in heightened stress for many individuals, with women reporting more stress than men. Although a large body of evidence has demonstrated that stress, in general, can impact the menstrual cycle, it is not yet clear if COVID-specific stress would impact women's menstrual health. The current study explored the relationship between COVID-related stress and distress and menstrual variables (menstrual pain, number and severity of menstrual symptoms, and menstrual pain interference) in a sample of reproductive-age adult women. Seven-hundred fifteen women completed the initial survey and were re-contacted to complete the same survey three months later. Of those recontacted, 223 completed the follow-up survey. Results indicated that COVID-related stress and distress was associated with higher levels of menstrual pain, more frequent and more severe menstrual symptoms, and greater menstrual pain interference, even after accounting for age, hormonal use, bodily pain, and pain catastrophizing. Our findings suggest that women experience unique vulnerabilities that directly impact their health and functioning, and both research and clinical care should address these symptoms through careful assessment and treatment of menstrual pain and symptoms, particularly during and after periods of high stress and distress.
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Affiliation(s)
- Laura A. Payne
- McLean Hospital, Belmont, MA 02478, USA
- Harvard Medical School, Boston, MA 02115, USA
| | | | - Boyu Ren
- McLean Hospital, Belmont, MA 02478, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Shelly F. Greenfield
- McLean Hospital, Belmont, MA 02478, USA
- Harvard Medical School, Boston, MA 02115, USA
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Hlisníková H, Nagyová M, Kolena B, Mlynček M, Trnovec T, Petrovičová I. The Joint Effect of Perceived Psychosocial Stress and Phthalate Exposure on Hormonal Concentrations during the Early Stage of Pregnancy: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101561. [PMID: 36291497 PMCID: PMC9601203 DOI: 10.3390/children9101561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022]
Abstract
Phthalates alter the hormonal balance in humans during pregnancy, potentially affecting embryonic and fetal development. We studied the joint effect of exposure to phthalates, quantified by urinary phthalate metabolite concentration, and perceived psychological stress on the concentration of hormones in pregnant women (n = 90) from the Nitra region, Slovakia, up to the 15th week of pregnancy. We used high-performance liquid chromatography, tandem mass spectrometry (HPLC-MS/MS), and electro-chemiluminescence immunoassay to determine urinary concentrations of phthalates and serum concentrations of hormones, respectively. We used Cohen perceived stress scale (PSS) to evaluate the human perception of stressful situations. Our results showed that mono(carboxy-methyl-heptyl) phthalate (cx-MiNP) and a molar sum of di-iso-nonyl phthalate metabolites (ΣDiNP) were negatively associated with luteinizing hormone (LH) (p ≤ 0.05). Mono(hydroxy-methyl-octyl) phthalate (OH-MiNP) and the molar sum of high-molecular-weight phthalate metabolites (ΣHMWP) were positively associated with estradiol (p ≤ 0.05). PSS score was not significantly associated with hormonal concentrations. When the interaction effects of PSS score and monoethyl phthalate (MEP), cx-MiNP, ΣDiNP, and ΣHMWP on LH were analyzed, the associations were positive (p ≤ 0.05). Our cross-sectional study highlights that joint psychosocial stress and xenobiotic-induced stress caused by phthalates are associated with modulated concentrations of reproductive hormones in pregnant women.
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Affiliation(s)
- Henrieta Hlisníková
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 94974 Nitra-Chrenová, Slovakia
- Correspondence: ; Tel.: +421-37-6408-716
| | - Miroslava Nagyová
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 94974 Nitra-Chrenová, Slovakia
| | - Branislav Kolena
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 94974 Nitra-Chrenová, Slovakia
| | - Miloš Mlynček
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University in Nitra, 94974 Nitra-Chrenová, Slovakia
| | - Tomáš Trnovec
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 83101 Bratislava, Slovakia
| | - Ida Petrovičová
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 94974 Nitra-Chrenová, Slovakia
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LE G, M P, MA M, KE B, MP V, JM R, C B, S E, PD W. Prospective association between maternal allostatic load during pregnancy and child mitochondrial content and bioenergetic capacity. Psychoneuroendocrinology 2022; 144:105868. [PMID: 35853381 PMCID: PMC9706402 DOI: 10.1016/j.psyneuen.2022.105868] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/06/2022] [Accepted: 07/11/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Mitochondria are multifunctional energy-producing and signaling organelles that support life and contribute to stress adaptation. There is a growing understanding of the dynamic relationship between stress exposure and mitochondrial biology; however, the influence of stress on key domains of mitochondrial biology during early-life, particularly the earliest phases of intra-uterine/prenatal period remains largely unknown. Thus, the goal of this study was to examine the impact of fetal exposure to stress (modeled as the biological construct allostatic load) upon mitochondrial biology in early childhood. METHODS In n = 30 children (range: 3.5-6 years, 53% male), we quantified mitochondrial content via citrate synthase (CS) activity and mtDNA copy number (mtDNAcn), and measured mitochondrial bioenergetic capacity via respiratory chain enzyme activities (complexes I (CI), II (CII), and IV (CIV)) in platelet-depleted peripheral blood mononuclear cells (PBMCs). In a cohort of healthy pregnant women, maternal allostatic load was operationalized as a latent variable (sum of z-scores) representing an aggregation of early-, mid- and late-gestation measures of neuroendocrine (cortisol), immune (interleukin-6, C-reactive protein), metabolic (homeostasis model assessment of insulin resistance, free fatty acids), and cardiovascular (aggregate systolic and diastolic blood pressure) systems, as well as an anthropometric indicator (pre-pregnancy body mass index [BMI]). RESULTS An interquartile increase in maternal allostatic load during pregnancy was associated with higher mitochondrial content (24% and 15% higher CS and mtDNAcn), and a higher mitochondrial bioenergetic capacity (16%, 23%, and 25% higher CI, CII and CIV enzymatic activities) in child leukocytes. The positive association between maternal allostatic load during pregnancy and child mitochondrial content and bioenergetic capacity remained significant after accounting for the effects of key pre- and post-natal maternal and child covariates (p's < 0.05, except CI p = 0.073). CONCLUSION We report evidence that prenatal biological stress exposure, modeled as allostatic load, was associated with elevated child mitochondrial content and bioenergetic capacity in early childhood. This higher mitochondrial content and bioenergetic capacity (per leukocyte) may reflect increased energetic demands at the immune or organism level, and thus contribute to wear-and-tear and pathophysiology, and/or programmed pro-inflammatory phenotypes. These findings provide potential mechanistic insight into the cellular processes underlying developmental programming, and support the potential role that changes in mitochondrial content and bioenergetic functional capacity may play in altering life-long susceptibility for health and disease.
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Affiliation(s)
- Gyllenhammer LE
- Development, Health and Disease Research Program, University of California, School of Medicine, Irvine, CA, USA,Department of Pediatrics, University of California, School of Medicine, Irvine, CA, USA
| | - Picard M
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, USA,Department of Neurology, Merritt Center, Columbia Translational Neuroscience Initiative, Columbia University Irving Medical Center, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - McGill MA
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Boyle KE
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Lifecourse Epidemiology of Adiposity and Diabetes Center, Aurora, Colorado, USA
| | - Vawter MP
- Department of Psychiatry and Human Behavior, University of California, School of Medicine, Irvine, CA, USA
| | - Rasmussen JM
- Development, Health and Disease Research Program, University of California, School of Medicine, Irvine, CA, USA,Department of Pediatrics, University of California, School of Medicine, Irvine, CA, USA
| | - Buss C
- Development, Health and Disease Research Program, University of California, School of Medicine, Irvine, CA, USA,Department of Pediatrics, University of California, School of Medicine, Irvine, CA, USA.,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
| | - Entringer S
- Development, Health and Disease Research Program, University of California, School of Medicine, Irvine, CA, USA,Department of Pediatrics, University of California, School of Medicine, Irvine, CA, USA.,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
| | - Wadhwa PD
- Development, Health and Disease Research Program, University of California, School of Medicine, Irvine, CA, USA,Department of Pediatrics, University of California, School of Medicine, Irvine, CA, USA.,Department of Psychiatry and Human Behavior, University of California, School of Medicine, Irvine, CA, USA,Department of Obstetrics and Gynecology, University of California, School of Medicine, Irvine, CA, USA,Department of Epidemiology, University of California, School of Medicine, Irvine, CA, USA
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Lundholm C, Rejnö G, Brew B, Smew AI, Saltvedt S, Almqvist C. Associations Between Maternal Distress, Cortisol Levels, and Perinatal Outcomes. Psychosom Med 2022; 84:288-296. [PMID: 35067648 DOI: 10.1097/psy.0000000000001049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Stress during pregnancy may decrease gestational age at birth and birth size. We aimed to investigate the associations between maternal subjective stress measures, salivary cortisol, and perinatal outcomes. METHODS A cohort of pregnant women (n = 1693) was recruited from eight antenatal care clinics in Stockholm, Sweden. Questionnaires on subjective distress (perceived stress, worry, depression symptoms, sleep quality) and saliva samples for cortisol measurement (morning and evening) were collected in early and late pregnancy. Perinatal outcomes were birth weight, birth length, gestational age, and birth weight for gestational age. We used linear regression to estimate associations adjusted for maternal characteristics. RESULTS All associations between subjective distress and cortisol levels were close to null and nonsignificant, for example, exp(β) = 1.001 (95% confidence interval = 0.995 to 1.006) for the morning cortisol level and perceived stress in early pregnancy. Likewise, most associations between distress (subjective and cortisol) and perinatal outcomes were weak and not statistically significant, for example, β = 1.95 (95% confidence interval = -4.16 to 8.06) for perceived stress in early pregnancy and birth weight. An exception was a statistically significant association between birth weight for gestational age and depression symptoms in early pregnancy, with somewhat higher weight with more symptoms (β = 0.08; 95% CI = 0.04 to 0.13). The results were similar for stress in early and late pregnancy. CONCLUSIONS We found no association between subjective distress and cortisol measures irrespective of when in pregnancy the measures were taken. Furthermore, we found no evidence for a longitudinal association between psychological measures of stress or cortisol with lower birth weight, birth weight for gestational age, or gestational age.
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Affiliation(s)
- Cecilia Lundholm
- From the Department of Medical Epidemiology and Biostatistics (Lundholm, Rejnö, Brew, Smew, Almqvist), Karolinska Institutet; Obstetrics and Gynaecology Unit (Rejnö), Södersjukhuset, Stockholm, Sweden; National Perinatal Epidemiology and Biostatistics Unit, Centre for Big Data Research in Health and School of Women and Children's Health (Brew), University of New South Wales, Sydney, Australia; Department of Women's and Children's Health (Saltvedt), Karolinska Institutet; Obstetrics and Gynaecology Unit (Saltvedt) and Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital (Almqvist), Karolinska University Hospital, Stockholm, Sweden
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Li J, Du Y, Liu Y, Du J, Zhang R, Qu P, Yan H, Wang D, Dang S. Maternal exposure to life events during pregnancy and congenital heart disease in offspring: a case-control study in a Chinese population. BMC Pregnancy Childbirth 2021; 21:677. [PMID: 34615495 PMCID: PMC8496089 DOI: 10.1186/s12884-021-04154-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
Background Previous studies have suggested that maternal stress could increase the risk of some adverse pregnancy outcomes, but evidence on congenital heart disease (CHD) is limited. We aimed to explore the association between maternal exposure to life events during pregnancy and CHD in offspring. Methods The data was based on an unmatched case-control study about CHD conducted in Shaanxi province of China from 2014 to 2016. We included 2280 subjects, 699 in the case group and 1581 in the control group. The cases were infants or fetuses diagnosed with CHD, and the controls were infants without any birth defects. The life events were assessed by the Life Events Scale for Pregnant Women, and were divided into positive and negative events for synchronous analysis. A directed acyclic graph was drawn to screen the confounders. Logistic regression was employed to estimate the odds ratio and 95% confidence interval for the effects of life events on CHD. Results After controlling for the potential confounders, the pregnant women experiencing the positive events during pregnancy had lower risk of CHD in offspring than those without positive events (OR = 0.38, 95%CI: 0.30 ~ 0.48). The risk of CHD in offspring could increase by 62% among the pregnant women experiencing the negative events compared to those without (OR = 1.62, 95%CI: 1.29 ~ 2.03). Both effects showed a certain dose-response association. Besides, the positive events could weaken the risk impact of negative events on CHD. Conclusion It may suggest that maternal exposure to negative life events could increase the risk of CHD in offspring, while experiencing positive events could play a potential protective role. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04154-0.
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Affiliation(s)
- Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi Province, China
| | - Yujiao Du
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi Province, China
| | - Yini Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi Province, China
| | - Jiaoyang Du
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi Province, China
| | - Ruo Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi Province, China
| | - Pengfei Qu
- Assisted Reproduction Center, Northwest Women's and Children's Hospital of Xi'an Jiaotong University, Xi'an, 710003, Shaanxi Province, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi Province, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi Province, China.
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Mahrer NE, Guardino CM, Hobel C, Dunkel Schetter C. Maternal Stress Before Conception Is Associated with Shorter Gestation. Ann Behav Med 2021; 55:242-252. [PMID: 32686836 PMCID: PMC7980768 DOI: 10.1093/abm/kaaa047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Stress in pregnancy predicts adverse birth outcomes. Stressors occurring prior to conception may also pose risk for the mother and child. The few published studies on preconception stress test a single stress measure and examine only linear associations with birth outcomes. PURPOSE Guided by findings in the prenatal stress literature, the current study aimed to (i) identify latent factors from a set of preconception stress measures and (ii) examine linear and curvilinear associations between these stress factors and length of gestation. METHODS Study 1 utilized a sample of 2,637 racially/ethnically diverse women to develop a measurement model of maternal stress from assessments of seven acute and chronic stress measures. Factor analysis revealed three latent factors representing stressors (life events, financial strain, interpersonal violence, discrimination), stress appraisals (perceived stress, parenting stress), and chronic relationship stress (family, partner stress). Study 2 examined the associations of these three latent preconception stress factors with the length of gestation of a subsequent pregnancy in the subset of 360 women who became pregnant within 4.5 years. RESULTS Controlling for prenatal medical risks, there was a significant linear effect of stress appraisals on the length of gestation such that more perceived stress was associated with shorter gestation. There was a curvilinear effect of stressors on the length of gestation with moderate levels associated with longer gestation. CONCLUSIONS These results have implications for research on intergenerational origins of developmental adversities and may guide preconception prevention efforts. Findings also inform approaches to the study of stress as a multidimensional construct.
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Affiliation(s)
- N E Mahrer
- Department of Psychology, University of California, Los Angeles, CA, USA
- Psychology Department, University of La Verne, CA, USA
| | - C M Guardino
- Department of Psychology, Dickinson College, PA, USA
| | - C Hobel
- Department of Obstetrics and Gynecology, Cedars-Sinai, CA, USA
| | - C Dunkel Schetter
- Department of Psychology, University of California, Los Angeles, CA, USA
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10
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Epstein CM, Houfek JF, Rice MJ, Weiss SJ. Integrative Review of Early Life Adversity and Cortisol Regulation in Pregnancy. J Obstet Gynecol Neonatal Nurs 2021; 50:242-255. [PMID: 33524324 DOI: 10.1016/j.jogn.2020.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To synthesize published findings on the relationship between early life adversity and hypothalamic-pituitary-adrenal axis cortisol parameters in pregnant women. DATA SOURCES We searched PubMed, CINAHL, and PsycINFO databases using variants and combinations of the keywords early life adversity, pregnancy, hypothalamic-pituitary-adrenal axis, and cortisol. STUDY SELECTION We selected articles that included pregnant participants, included measures of cortisol and early life adversity, were published in English in a peer-reviewed journal, and were of sufficient methodologic quality. Date of publication was unrestricted through May 2020. DATA EXTRACTION Twenty-five articles met the inclusion criteria and were evaluated for quality and risk of bias. Sources of cortisol included saliva, hair, plasma, and amniotic fluid. DATA SYNTHESIS We categorized findings according to four physiologically distinct cortisol output parameters: diurnal (daily pattern), phasic (in response to an acute stressor), tonic (baseline level), and pregnancy-related change. Preliminary evidence suggests that early adversity may be associated with elevated cortisol awakening response (diurnal) and blunted response to acute stressors (phasic), irrespective of other psychosocial symptoms or current stress. For women with high levels of current stress or psychological symptoms, early adversity was associated with higher baseline (tonic) cortisol levels. CONCLUSION Early life adversity in women is linked with alterations in cortisol regulation that are apparent during pregnancy. Researchers should examine how variations in each cortisol parameter differentially predict pregnancy health risk behaviors, maternal mental health, and neonatal health outcomes.
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Psychological stress and cortisol during pregnancy: An ecological momentary assessment (EMA)-Based within- and between-person analysis. Psychoneuroendocrinology 2020; 121:104848. [PMID: 32927180 PMCID: PMC7895320 DOI: 10.1016/j.psyneuen.2020.104848] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although the linkage between psychological stress and cortisol is believed to mediate the association of stress with health outcomes, several studies have been unable to demonstrate this association. We suggest this inability may be a consequence of limitations in the measurement approach and/or reliance on analytic strategies that focus on associations across, rather than within individuals. The link between psychological stress and cortisol is of particular interest in the context of pregnancy and fetal development. Using an ecological momentary assessment (EMA) design, we examined the association between psychological stress and cortisol at the between- and the within-person level. METHODS 152 participants completed a 4-day long EMA protocol serially in early, mid and late pregnancy to provide momentary stress appraisals (average of 150 measures/subject) and saliva samples (average of 55 samples/subject) for quantification of cortisol. The association between stress and cortisol was estimated using linear mixed models. RESULTS After accounting for the effects of key determinants of variation in cortisol, momentary stress was significantly and positively associated with cortisol at the within-person level (B = .030, p = .031), but not at the between-person level. No association was evident for traditional retrospective measures of stress with cortisol at either the between- or the within-person level. CONCLUSIONS Our study highlights the value of EMA methods and linear mixed-modeling approaches in linking maternal psychological and physiological states across pregnancy. These findings may have important implications for the development of personalized risk identification and "just-in-time" intervention strategies to optimize maternal and child health.
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Werner A, Wu C, Zachariae R, Nohr EA, Uldbjerg N, Hansen ÅM. Effects of antenatal hypnosis on maternal salivary cortisol during childbirth and six weeks postpartum-A randomized controlled trial. PLoS One 2020; 15:e0230704. [PMID: 32357152 PMCID: PMC7194394 DOI: 10.1371/journal.pone.0230704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/05/2020] [Indexed: 11/29/2022] Open
Abstract
Background Cortisol has been used to capture psychophysiological stress during childbirth and postpartum wellbeing. We explored the effect of a brief antenatal training course in self-hypnosis on salivary cortisol during childbirth and 6 weeks postpartum. Methods In a randomized, controlled trial conducted at Aarhus University Hospital Skejby Denmark during the period January 2010 until October 2010, a total of 349 healthy nulliparous women were included. They were randomly allocated to a hypnosis group (n = 136) receiving three one-hour lessons in self-hypnosis with additional audio-recordings, a relaxation group (n = 134) receiving three one-hour lessons in various relaxation methods with audio-recordings for additional training, and a usual care group (n = 79) receiving ordinary antenatal care only. Salivary cortisol samples were collected during childbirth (at the beginning of the pushing state, 30 minutes, and 2 hours after childbirth), and 6 weeks postpartum (at wake up, 30 minutes after wake up, and evening). Cortisol concentrations were compared using a linear mixed-effects model. Correlations between cortisol concentrations and length of birth, experienced pain and calmness during birth were examined by a Spearman rank correlation test. Findings During childbirth, week correlations were found between cortisol concentrations 30 minutes after childbirth and length of birth. In the beginning of the pushing state and 2 hours after childbirth, we found a tendency towards higher cortisol concentrations in the hypnosis group compared to the other two groups (hypnosis versus relaxation p = 0.02 and 0.03, hypnosis versus usual care p = 0.08 and 0.05). No differences were observed in cortisol concentrations between the groups 30 minutes after childbirth (hypnosis versus relaxation p = 0.08, hypnosis versus usual care 0.10) or 6 weeks postpartum (hypnosis versus relaxation: p = 0.85, 0.51, and 0.68, hypnosis versus usual care: p = 0.85, 0.93, and 0.96). Conclusion Antenatal hypnosis training may increase the release of cortisol during childbirth with no long-term consequences. Further research is needed to help interpret these findings.
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Affiliation(s)
- Anette Werner
- Institute of Clinical Research, Research Unit of Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- * E-mail:
| | - Chunsen Wu
- Institute of Clinical Research, Research Unit of Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Robert Zachariae
- Department of Oncology, Unit for Psychooncology and Health Psychology, Aarhus University Hospital, Aarhus, Denmark
- Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Ellen A. Nohr
- Institute of Clinical Research, Research Unit of Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Niels Uldbjerg
- Department of Gynecology and Obstetrics, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Onchonga D, MoghaddamHosseini V, Keraka M, Várnagy Á. Prevalence of fear of childbirth in a sample of gravida women in Kenya. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 24:100510. [PMID: 32217359 DOI: 10.1016/j.srhc.2020.100510] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/07/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of the study was to determine the prevalence of fear of childbirth (FOC) using a sample of gravida women in Kenya, a developing country where it is not fully acknowledged. MATERIALS AND METHODS This were a cross-sectional study on gravida women visiting health facilities to receive routine antenatal care. The study applied multistage sampling to enrol eligible expectant women. A researcher-developed questionnaire was used alongside Wijma Delivery Expectancy/Experience Questionnaire (version A) to collect respondents' demographic characteristics and to measure their fear of childbirth levels, respectively. RESULTS Approximately 29.5% had low, 40.4% moderate, 22.1% high, and 8% recorded severe FOC levels. Comparing by parity, the prevalence of severe FOC was higher on primigravida at 13.8% than multigravida, 8.0%. The results revealed a significant relationship between marital status (p = 0.045), parity (p = 0.000), literacy status (p = 0.000), regular check-up of pregnancy at health facilities (p = 0.003), having trust in healthcare providers (p = 0.000), and physical activity for gravida women with fear of childbirth (p = 0.000). CONCLUSION From the findings, special attention on the identified predictors of fear of childbirth during prenatal sessions would help in managing fear of childbirth before they give birth.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary.
| | - Vahideh MoghaddamHosseini
- Department of Midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran; Non-Communicable Diseases Research Centre, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Ákos Várnagy
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
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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: 12] [Impact Index Per Article: 3.0] [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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Garcia-Flores V, Romero R, Furcron AE, Levenson D, Galaz J, Zou C, Hassan SS, Hsu CD, Olson D, Metz GAS, Gomez-Lopez N. Prenatal Maternal Stress Causes Preterm Birth and Affects Neonatal Adaptive Immunity in Mice. Front Immunol 2020; 11:254. [PMID: 32174914 PMCID: PMC7054386 DOI: 10.3389/fimmu.2020.00254] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
Maternal stress is a well-established risk factor for preterm birth and has been associated with adverse neonatal outcomes in the first and subsequent generations, including increased susceptibility to disease and lasting immunological changes. However, a causal link between prenatal maternal stress and preterm birth, as well as compromised neonatal immunity, has yet to be established. To fill this gap in knowledge, we used a murine model of prenatal maternal stress across three generations and high-dimensional flow cytometry to evaluate neonatal adaptive immunity. We report that recurrent prenatal maternal stress induced preterm birth in the first and second filial generations and negatively impacted early neonatal growth. Strikingly, prenatal maternal stress induced a systematic reduction in T cells and B cells, the former including regulatory CD4+ T cells as well as IL-4- and IL-17A-producing T cells, in the second generation. Yet, neonatal adaptive immunity gained resilience against prenatal maternal stress by the third generation. We also show that the rate of prenatal maternal stress-induced preterm birth can be reduced upon cessation of stress, though neonatal growth impairments persisted. These findings provide evidence that prenatal maternal stress causes preterm birth and affects neonatal immunity across generations, adverse effects that can be ameliorated upon cessation.
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Affiliation(s)
- Valeria Garcia-Flores
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, United States
- Detroit Medical Center, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Florida International University, Miami, FL, United States
| | - Amy-Eunice Furcron
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Dustyn Levenson
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Jose Galaz
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Chengrui Zou
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Sonia S. Hassan
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
- Office of Women's Health, Integrative Biosciences Center, Wayne State University, Detroit, MI, United States
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Chaur-Dong Hsu
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, United States
| | - David Olson
- Department of Obstetrics and Gynecology, Pediatrics, and Physiology, University of Alberta, Edmonton, AB, Canada
| | - Gerlinde A. S. Metz
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| | - Nardhy Gomez-Lopez
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U. S. Department of Health and Human Services, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, United States
- Department of Immunology, Microbiology and Biochemistry, Wayne State University School of Medicine, Detroit, MI, United States
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Matvienko-Sikar K, Cooney J, Flannery C, Murphy J, Khashan A, Huizink A. Maternal stress in the first 1000 days and risk of childhood obesity: a systematic review. J Reprod Infant Psychol 2020; 39:180-204. [PMID: 32046507 DOI: 10.1080/02646838.2020.1724917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: Maternal stress is associated with adverse child outcomes. Conception to 2-years postpartum (the first 1000 days) is a developmentally sensitive period for stress exposure. The role of maternal stress in the first 1000 days on child obesity risk is unclear. This review systematically examines the relationship between maternal stress across the first 1000 days and child obesity risk. Methods: The Cochrane Library, MEDLINE, PsycINFO, EMBASE, CINAHL, and Maternity and Infant Care were searched from inception to June 2018. Eligible studies included women who experienced maternal stress in the first 1000 days; an included a measure of maternal stress and of child anthropometrics. Results: Sixteen studies met inclusion criteria, the majority of these examined prenatal stress exposure. Inconsistent effects were observed for psychological and physiological stress responses, on child weight outcomes. Environmental stress exposures, including natural disaster and bereavement, were more consistently associated with increased obesity risk. Conclusion: This review does not provide support for the effects of psychological or physiological maternal stress on child weight outcomes; there is some evidence of associations between environmental stress exposures and greater childhood adiposity. Variation in conceptualisation and measurement of stress, timing of stress exposure, and limited examination of stress-related behaviours were noted.
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Affiliation(s)
| | - Jennifer Cooney
- School of Applied Psychology, University College Cork , Cork, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork , Cork, Ireland
| | - Jennifer Murphy
- School of Public Health, University College Cork , Cork, Ireland
| | - Ali Khashan
- School of Public Health, University College Cork , Cork, Ireland.,Irish Centre for Fetal and Neonatal Transnational Research (INFANT) Centre, Cork University Maternity Hospital , Cork, Ireland
| | - Anja Huizink
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam , Amsterdam, The Netherlands
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Jia S, Wei X, Ma L, Wang Y, Gu H, Liu D, Ma W, Yuan Z. Maternal, paternal, and neonatal risk factors for neural tube defects: A systematic review and meta-analysis. Int J Dev Neurosci 2019; 78:227-235. [PMID: 31563704 DOI: 10.1016/j.ijdevneu.2019.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Neural tube defects [NTDs] are severe congenital anomalies. The etiology of NTDs is not fully known, and studies on the potential risk factors of NTDs present inconsistent results. Thus, we conducted a systematic review and meta-analysis to investigate the maternal, paternal, and neonatal risk factors for NTDs. STUDY DESIGN We systematically reviewed relative original studies published through October 6, 2018 available in Pubmed, Embase and the Cochrane Library without restrictions for language. The selected studies measured maternal, paternal, and neonatal risk factors and examined their associations with NTDs. A meta-analysis, including subgroup analysis and sensitivity analysis, was conducted to estimate the pooled effect measures. Two reviewers independently extracted data using a predesigned data collection form. RESULTS Forty-five studies were eligible for inclusion in the meta-analysis, and twelve potential risk factors were analyzed. The factors that were associated with NTDs risk included stressful life events [odds ratio [OR],1.61; 95% confidence interval [CI], 1.24-2.08; p < 0.001; I2 = 59.2%], low maternal education level [OR, 1.42; 95% CI, 1.19-1.70; p < 0.001; I2 = 47.7%], pregestational diabetes [OR, 2.24; 95% CI, 1.21-4.12; p < 0.010; I2 = 56.3%], low paternal age [OR, 1.41; 95% CI, 1.10-1.81; p = 0.007; I2 = 0.0%], low birth weight [OR, 5.53; 95% CI, 1.95-15.70; p = 0.001; I2 = 98.5%], and neonatal female gender [OR, 1.54; 95% CI, 1.10-2.14; p = 0.012; I2 = 67.8%]. CONCLUSION Stressful life events, pregestational diabetes, low birth weight, and neonatal female gender are risk factors associated with NTDs. Low maternal education level and low paternal age are factors that are moderately associated with NTDs. Further cohort studies are required to verify the factors associated with NTDs and control the risk of this severe birth defect.
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Affiliation(s)
- Shanshan Jia
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Xiaowei Wei
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Ling Ma
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
- Department of Pathophysiology, Basic Science College, China Medical University, Shenyang, PR China
| | - Yanfu Wang
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Hui Gu
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Dan Liu
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Wei Ma
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
| | - Zhengwei Yuan
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical University, Shenyang, PR China
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Sun Y, Huang K, Hu Y, Yan S, Xu Y, Zhu P, Tao F. Pregnancy-specific anxiety and elective cesarean section in primiparas: A cohort study in China. PLoS One 2019; 14:e0216870. [PMID: 31091276 PMCID: PMC6519904 DOI: 10.1371/journal.pone.0216870] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/30/2019] [Indexed: 01/17/2023] Open
Abstract
The purpose of this study was to investigate the association between pregnancy-specific anxiety and elective cesarean section, and identify the critical period in which pregnancy-specific anxiety will affect the elective cesarean section. Primiparous women in the 1st trimester of pregnancy were invited to participate in the cohort. General information on maternal socio-demographic characteristics and environmental exposure were collected using questionnaires. Pregnancy-specific anxiety was assessed by using pregnancy-specific anxiety questionnaire in the 1st, 2nd and 3rd trimester, respectively. Delivery modes and pregnancy complications were abstracted from medical notes. Structural equation modeling (SEM) was adopted to examine the relationship between pregnancy-specific anxiety and elective cesarean section. Results indicated the overall elective cesarean section rate in this study was 45%. Among 1 874 pregnant women, 30.9% women experienced anxiety at least once during pregnancy, and 6.9% women suffered from anxiety in all three trimesters. Anxiety in the 2nd trimester was a significant predictor for elective cesarean section. Young maternal age and low educational level had indirect effects on women’s choice of elective caesarean section through affecting pregnancy-specific anxiety. More attention should be paid to maternal psychological problems, and professional counseling needs to be strengthened to protect women from pregnancy-specific anxiety.
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Affiliation(s)
- Yuanfang Sun
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui Province, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui Province, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, Anhui Province, China
- * E-mail:
| | - Yabin Hu
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui Province, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Center, Ma'anshan, China
| | - Yeqing Xu
- Ma'anshan Maternal and Child Health Center, Ma'anshan, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui Province, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, Anhui Province, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, Anhui Province, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, Anhui Province, China
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Al-Hashimi FJG, Kareem Alalaf S, Al Tawil NG. Screening for depression during pregnancy using the Kurdish version of the Edinburgh Postnatal Depression Scale in Erbil city. Health Care Women Int 2019; 41:240-254. [PMID: 30865576 DOI: 10.1080/07399332.2019.1571592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We aimed to determine any difference in the prevalence rate of depression during the three trimesters of pregnancy and its association with certain obstetric risk factors. In total, 1000 pregnant women attending primary health centers in the city of Erbil, Kurdistan, Iraq were assessed for depression using the Edinburgh Postnatal Depression Scale. Women in the first and second trimesters had a significantly higher probability of depression than those in the third trimester. Screening early in pregnancy and following pregnant women in each trimester may help to identify those who are susceptible to depression and enable appropriate intervention.
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Affiliation(s)
| | - Shahla Kareem Alalaf
- Department of Obstetrics and Gynecology, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
| | - Namir G Al Tawil
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
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Chatterjee A, Thompson JW, Svensson K, Tamayo Y Ortiz M, Wright R, Wright R, Tellez-Rojo M, Baccarelli A, Cantoral A, Schnaas L, Oken E. Maternal antenatal stress has little impact on child sleep: results from a prebirth cohort in Mexico City. Sleep Health 2018; 4:397-404. [PMID: 30241653 PMCID: PMC6152833 DOI: 10.1016/j.sleh.2018.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 01/28/2023]
Abstract
STUDY OBJECTIVES Maternal antenatal stress may influence offspring development and behavior, but any association with child sleep is unknown. METHODS From 2007 to 2011, we recruited pregnant women in Mexico City to the Programming Research in Obesity, Growth, Environment, and Social Stressors prebirth cohort. Mothers completed the Perceived Stress Scale (PSS, a 4-item questionnaire assessing past-month stress) and the Crisis in Family Systems measure assessing negative life events (NLEs; how many domains among the 11 assessed in which the mother experienced a stressful event in the prior 6 months)-with higher scores reflecting higher stress-and provided 5 timed salivary samples per day on 2 consecutive days, from which we derived cortisol area under the curve, slope, and awakening response. At age 4-6 years, children's sleep was estimated using accelerometry over a 7-day period. We performed secondary analysis of associations of antenatal maternal stress with child sleep duration and efficiency (time asleep/time in bed) using linear regression adjusted for maternal and child characteristics. RESULTS Among 594 mother-child dyads, mean antenatal PSS score was 5.2 (SD = 3.2) out of 16, and mean NLE was 3.2 (SD = 2) out of 11; child sleep duration was 7.7 hours (SD = 0.7), and sleep efficiency was 79% (SD = 6). There was no association between any of the stress measures-PSS, NLE, or salivary cortisol-and sleep duration or sleep efficiency in adjusted or unadjusted models. CONCLUSIONS Among mother-child dyads in a Mexico City cohort, antenatal stress was not associated with important changes in child sleep at 4-6 years.
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Affiliation(s)
- Avik Chatterjee
- Division of Global Health Equity, Department of Internal Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
| | - Jennifer W Thompson
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Suite 401E, Boston, MA 02215
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029
| | - Marcela Tamayo Y Ortiz
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México; Mexican Council for Science and Technology, National Institute of Public Health Mexico, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Robert Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029; Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Rosalind Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029; Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Martha Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Andrea Baccarelli
- Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Alejandra Cantoral
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Lourdes Schnaas
- National Institute of Perinatology, Calle Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, 11000 Ciudad de México, CDMX, Mexico
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Suite 401E, Boston, MA 02215
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21
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Cattane N, Richetto J, Cattaneo A. Prenatal exposure to environmental insults and enhanced risk of developing Schizophrenia and Autism Spectrum Disorder: focus on biological pathways and epigenetic mechanisms. Neurosci Biobehav Rev 2018; 117:253-278. [PMID: 29981347 DOI: 10.1016/j.neubiorev.2018.07.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/11/2018] [Accepted: 07/01/2018] [Indexed: 12/15/2022]
Abstract
When considering neurodevelopmental disorders (NDDs), Schizophrenia (SZ) and Autism Spectrum Disorder (ASD) are considered to be among the most severe in term of prevalence, morbidity and impact on the society. Similar features and overlapping symptoms have been observed at multiple levels, suggesting common pathophysiological bases. Indeed, recent genome-wide association studies (GWAS) and epidemiological data report shared vulnerability genes and environmental triggers across the two disorders. In this review, we will discuss the possible biological mechanisms, including glutamatergic and GABAergic neurotransmissions, inflammatory signals and oxidative stress related systems, which are targeted by adverse environmental exposures and that have been associated with the development of SZ and ASD. We will also discuss the emerging role of the gut microbiome as possible interplay between environment, immune system and brain development. Finally, we will describe the involvement of epigenetic mechanisms in the maintenance of long-lasting effects of adverse environments early in life. This will allow us to better understand the pathophysiology of these NDDs, and also to identify novel targets for future treatment strategies.
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Affiliation(s)
- Nadia Cattane
- Biological Psychiatry Unit, IRCCS Fatebenefratelli San Giovanni di Dio, via Pilastroni 4, Brescia, Italy
| | - Juliet Richetto
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Fatebenefratelli San Giovanni di Dio, via Pilastroni 4, Brescia, Italy; Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, 125 Coldharbour Lane, SE5 9NU, London, UK.
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22
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Roberts AL, Lyall K, Weisskopf MG. Maternal Exposure to Childhood Abuse is Associated with Mate Selection: Implications for Autism in Offspring. J Autism Dev Disord 2018; 47:1998-2009. [PMID: 28393290 DOI: 10.1007/s10803-017-3115-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Maternal experience of childhood abuse has been associated with offspring autism. To explore whether familial tendency towards autistic traits-presumably related to genetic predisposition-accounts for this association, we examined whether women who experienced childhood abuse were more likely to select mates with high levels of autistic traits, and whether parental autistic traits accounted for the association of maternal abuse and offspring autism in 209 autism cases and 833 controls. Maternal childhood abuse was strongly associated with high paternal autistic traits (severe abuse, OR = 3.98, 95% CI = 1.26, 8.31). Maternal and paternal autistic traits accounted for 21% of the association between maternal abuse and offspring autism. These results provide evidence that childhood abuse affects mate selection, with implications for offspring health.
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Affiliation(s)
- Andrea L Roberts
- Department of Society, Human Development and Health, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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23
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Rouse CE, Eckert LO, Babarinsa I, Fay E, Gupta M, Harrison MS, Kawai AT, Kharbanda EO, Kucuku M, Meller L, Mallett Moore T, Subelj M, Kochhar S, Tavares-Da-Silva F. Spontaneous abortion and ectopic pregnancy: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine 2017; 35:6563-6574. [PMID: 29150062 PMCID: PMC5714431 DOI: 10.1016/j.vaccine.2017.01.047] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/13/2017] [Indexed: 02/08/2023]
Affiliation(s)
| | | | - Isaac Babarinsa
- Sidra Medical and Research Center/Weill Cornell Medicine-Qatar/Women's Hospital, Doha, Qatar
| | - Emily Fay
- University of Washington, Seattle, WA, USA
| | | | | | - Alison Tse Kawai
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Merita Kucuku
- Department of Vaccines Control, National Agency for Medicines & Medical Devices, Albania
| | | | | | - Maja Subelj
- National Institute of Public Health, Ljubljana, Slovenia
| | - Sonali Kochhar
- Global Healthcare Consulting, India; Erasmus University Medical Center, Rotterdam, The Netherlands
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24
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Urech C, Scherer S, Emmenegger M, Gaab J, Tschudin S, Hoesli I, Berger T, Alder J. Efficacy of an internet-based cognitive behavioral stress management training in women with idiopathic preterm labor: A randomized controlled intervention study. J Psychosom Res 2017; 103:140-146. [PMID: 29167041 DOI: 10.1016/j.jpsychores.2017.10.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/29/2017] [Accepted: 10/25/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This randomized controlled trial aimed at evaluating the efficacy of an internet-based cognitive behavioral stress management program (IB-CBSM) for pregnant women with preterm labor (PTL) on birth outcome and stress-related psychological and biological parameters. METHODS 93 pregnant women with PTL (gestational age 18-32) were assigned to either the IB-CBSM (n=50) or a control group (CG) based on distraction (n=43). Participants in both groups worked through six weekly modules. Birth outcome measures included gestational age, neonatal weight and length at birth and the rate of preterm birth (PTB). Questionnaires assessed psychological wellbeing and the activity of the HPA-axis was measured with the cortisol awakening reaction (CAR), both before (T1) and after the intervention (T2). RESULTS Birth outcome and psychological wellbeing did not differ between IB-CBSM and CG. However, psychological wellbeing was higher after both interventions (PSS: ηp2=0.455, STAIX1: ηp2=0.455, STAIX2: ηp2=0.936, PRAT: ηp2=0.465, EPDS: ηp2=0.856). Cortisol levels were stable and did not alter differently between groups from T1 to T2. Higher cortisol levels were associated with lower gestational age at birth, whereas no significant correlations were found between weight and length at birth. CONCLUSIONS Although there were no significant differences between the two groups and birth outcome, psychological and biological parameters, both interventions (CBSM and CG) showed equivalent effects and proved to be beneficial with regard to psychosocial distress and well-being. Further research is needed to investigate CBSM and distraction interventions for pregnant women at risk for PTB together with a non-intervention control condition.
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Affiliation(s)
- Corinne Urech
- Clinic of Obstetrics and Gynecology, University Hospital Basel, Switzerland.
| | - Sandra Scherer
- Clinic of Obstetrics and Gynecology, University Hospital Basel, Switzerland
| | - Martina Emmenegger
- Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
| | - Jens Gaab
- Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
| | - Sibil Tschudin
- Clinic of Obstetrics and Gynecology, University Hospital Basel, Switzerland
| | - Irène Hoesli
- Clinic of Obstetrics and Gynecology, University Hospital Basel, Switzerland
| | - Thomas Berger
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Bern, Switzerland
| | - Judith Alder
- Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
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25
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Quintana-Domeque C, Ródenas-Serrano P. The hidden costs of terrorism: The effects on health at birth. JOURNAL OF HEALTH ECONOMICS 2017; 56:47-60. [PMID: 28968529 DOI: 10.1016/j.jhealeco.2017.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/02/2017] [Accepted: 08/30/2017] [Indexed: 05/05/2023]
Abstract
We study the effects of in utero exposure to terrorism in Spain on birth outcomes, focusing on terrorism perpetrated by ETA during the period 1980-2003. We find that in utero exposure to terrorism early in pregnancy, as measured by the number of bomb casualties in the mother's province of residence in the first trimester of pregnancy, has detrimental effects on birth outcomes: in terms of average birth weight (lower), prevalence of low birth weight (higher) and fraction of "normal" babies (lower). While our findings are robust to a host of potential threats to validity, they seem to be driven by exposure to a relatively large number of bomb casualties. Focusing on the deadliest ETA terrorist attack, the Hipercor bombing of 1987 in Barcelona, we find substantial effects on birth outcomes. We then attempt to assess the mechanisms at stake by presenting evidence suggesting that exposure to bomb casualties decreases self-reported health and increases smoking among women, but not among men. While exposure to terrorism during conception does not affect total fertility, there seems to be a compositional change: during bombing periods, those women who conceive are more likely to be married, and married women tend to have better birth outcomes, on average. In addition, we find that exposure to bomb casualties increases fetal deaths. Thus, we interpret our estimated negative effects on health at birth as providing lower bounds to the true effects of in utero exposure to terrorism.
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26
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Prevalence of Fear of Childbirth and Its Associated Factors in Primigravid Women: A Cross- Sectional Study. ACTA ACUST UNITED AC 2017. [DOI: 10.5812/semj.61896] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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27
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Bleker LS, Roseboom TJ, Vrijkotte TG, Reynolds RM, de Rooij SR. Determinants of cortisol during pregnancy - The ABCD cohort. Psychoneuroendocrinology 2017. [PMID: 28641158 DOI: 10.1016/j.psyneuen.2017.05.026] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Psychosocial stress during pregnancy has been proposed as a major contributor of glucocorticoid-mediated programming of the fetal hypothalamic-pituitary adrenal (HPA) axis, with later adverse health consequences. However, evidence linking maternal stress to maternal cortisol values during pregnancy is inconclusive. A possible explanation for this is that other maternal factors overshadow any potential effects of stress on cortisol levels. We studied a large cohort of pregnant women with extensive data on pregnancy characteristics to determine the respective contributions of biological, environmental and psychosocial stress factors to cortisol levels in pregnancy. METHODS We used data from 3039 women from the Amsterdam Born Children and their Development-study cohort. Serum cortisol was measured in blood, collected at the first prenatal visit, at different gestational ages (median=91days, range=40-256days), and at various time points during the day (median=11:45h, range=08:00-18:30h). We assessed associations between maternal serum cortisol in pregnancy and biological factors, lifestyle factors and stress factors, including depression, anxiety, pregnancy-related anxiety, work stress, parenting stress and fatigue. RESULTS In multivariable analysis, variables that were associated with higher cortisol levels in pregnancy were lower maternal age [1.5nmol/l, 95%CI (0.6-2.4)], being nulliparous [21.5 nmol/l (15.9-27.1)], lower pre-pregnancy body mass index (BMI) [1.3nmol/l (0.3-2.4)], higher C-reactive protein (CRP) [1.0nmol/l (0.4-1.5)], carrying a female fetus [9.2nmol/l (1.8-16.5)], non-smoking [14.2nmol/l (0.6-27.7)], sufficient sleep [8.5nmol/l (0.9-16.1)], and being unemployed [12.7nmol/l (2.2-23.2)]. None of the psychosocial stressors was significantly associated with serum cortisol levels in pregnancy. A total of 32% of all variance in cortisol was explained by gestational age, maternal age, time of day, parity, pre-pregnancy BMI, CRP, fetal sex, smoking behavior, self-reported sleep sufficiency, and employment. CONCLUSIONS Our data suggest that maternal cortisol during pregnancy is mainly affected by biological and lifestyle factors, but not by psychosocial factors. We suggest that psychosocial stress in pregnancy might program the fetus through other mechanisms than through altering maternal cortisol levels.
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Affiliation(s)
- Laura S Bleker
- Academic Medical Centre, Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, The Netherlands,.
| | - Tessa J Roseboom
- Academic Medical Centre, Department of Obstetrics Gynecology, Amsterdam, The Netherlands,; Academic Medical Centre, Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, The Netherlands
| | - Tanja G Vrijkotte
- Academic Medical Centre, Amsterdam Public Health research institute, Department of Public Health, Amsterdam, The Netherlands
| | - Rebecca M Reynolds
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
| | - Susanne R de Rooij
- Academic Medical Centre, Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam, The Netherlands,; Academic Medical Centre, Amsterdam Public Health research institute, Department of Public Health, Amsterdam, The Netherlands
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28
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El-Heis S, Crozier SR, Healy E, Robinson SM, Harvey NC, Cooper C, Inskip HM, Baird J, Godfrey KM. Maternal stress and psychological distress preconception: association with offspring atopic eczema at age 12 months. Clin Exp Allergy 2017; 47:760-769. [PMID: 28218994 DOI: 10.1111/cea.12910] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 01/16/2017] [Accepted: 02/09/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Perinatal maternal stress and low mood have been linked to offspring atopic eczema. OBJECTIVES To examine the relation of maternal stress/mood with atopic eczema in the offspring, focusing particularly on stress/psychological distress preconception. METHODS At recruitment in the UK Southampton Women's Survey, preconception maternal reports of perceived stress in daily living and the effect of stress on health were recorded; in a subsample, psychological distress was assessed (12-item General Health Questionnaire). Infants were followed up at ages 6 (n = 2956) and 12 (n = 2872) months and atopic eczema ascertained (based on UK Working Party Criteria for the Definition of Atopic Dermatitis). At 6 months post-partum, mothers were asked if they had experienced symptoms of low mood since childbirth and completed the Edinburgh Postnatal Depression Scale. RESULTS Preconception perceived stress affecting health [OR 1.21 (95% CI 1.08-1.35), P = 0.001] and stress in daily living [OR 1.16 (1.03-1.30), P = 0.014] were associated with an increased risk of offspring atopic eczema at age 12 months but not at 6 months, robust to adjustment for potentially confounding variables. Findings were similar for maternal psychological distress preconception. Low maternal mood between delivery and 6 months post-partum was associated with an increased risk of infantile atopic eczema at age 12 months, but no significant association between post-natal mood and atopic eczema was seen after taking account of preconception stress. CONCLUSION AND CLINICAL RELEVANCE Our data provide novel evidence linking maternal stress at preconception to atopic eczema risk, supporting a developmental contribution to the aetiology of atopic eczema and pointing to potentially modifiable influences.
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Affiliation(s)
- S El-Heis
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S R Crozier
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E Healy
- Dermatopharmacology, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S M Robinson
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - N C Harvey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - H M Inskip
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - K M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Institute of Developmental Sciences, University of Southampton, Southampton, UK
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Vlenterie R, Roeleveld N, van Gelder MMHJ. Single awakening salivary measurements provide reliable estimates of morning cortisol levels in pregnant women. Psychoneuroendocrinology 2016; 74:295-301. [PMID: 27701043 DOI: 10.1016/j.psyneuen.2016.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/31/2016] [Accepted: 09/15/2016] [Indexed: 11/28/2022]
Abstract
Mood disorders during pregnancy have been associated with adverse effects on maternal as well as fetal health. Since mood, anxiety, and stress disorders are related with elevated cortisol levels, salivary cortisol may be a useful biomarker. Although multiple samples are generally recommended, a single measurement of awakening salivary cortisol could be a simpler and more cost-effective method to determine whether women have elevated morning cortisol levels during a specific period of pregnancy. Therefore, the aim of this validation study among 177 women in the PRIDE Study was to examine whether one awakening salivary cortisol measurement will suffice to classify pregnant women as having normal or elevated cortisol levels compared to awakening salivary cortisol measurements on three consecutive working days. We calculated intraclass correlation coefficients (ICC) and Cohen's kappa statistics (κ) overall as well as in sub-analyses within strata based on maternal age, level of education, net household income, pre-pregnancy BMI, parity, complications during pregnancy, caffeine consumption, gestational week of sampling, and awakening time. The mean cortisol concentrations were 8.98ng/ml (SD 5.32) for day one, 8.62ng/ml (SD 4.55) for day two, and 8.39ng/ml (SD 4.58) for day three. The overall ICC was 0.86 (95% CI 0.82-0.89) while the κ was 0.75 (95% CI 0.64-0.86). For the ICCs calculated within sub-analyses, a maximum difference of 0.11 was observed between the strata. For the κ statistics, most strata did not differ more than 0.12, except for pre-pregnancy BMI, severe nausea, and extreme fatigue with differences up to 0.22. In conclusion, one awakening salivary cortisol measurement is as reliable for the classification of pregnant women into normal and elevated morning cortisol levels as salivary cortisol measurements on three consecutive working days.
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Affiliation(s)
- Richelle Vlenterie
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Department of Pediatrics, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Radboud REshape Innovation Center, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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30
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Rice MJ, Records K. Cardiac Response Rate Variability in Physically Abused Women of Childbearing Age. Biol Res Nurs 2016; 7:204-13. [PMID: 16552948 DOI: 10.1177/1099800405283567] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Physical abuse directly affects maternal and fetal/infant health, with documented reports of higher rates of pregnancy termination, neonatal death, and lower birth weights. Although the Centers for Disease Control and Prevention recommend repeated interviews of women of childbearing age to screen for abuse, the paper-and-pencil instruments available for such screening are adversely affected by the hesitancy of women to disclose physical abuse. Biophysical measures of physiological stress adaptations may hold potential for identifying physically abused childbearing women. This pilot investigation used a Latin square design to assess the effects of physically abusive trauma on the cardiac rate response of three clinical groups and one control group of childbearing-age women. Participants were screened using the Child-bearing Health Questionnaire. Cardiac response rates were measured during a standardized orthostatic challenge using a Tanito cardiac rate response monitor. Forty participants participated with an average age of 27. Multiple analyses of variance revealed that there were significant differences between cardiac rate responses at the 5-min interval. Post hoc testing using Dunnett’s t indicated that only the abused pregnant women had significantly higher cardiac responses to orthostatic challenges; differences were apparent at the 5-min testing period. The findings suggest that physical abuse may alter the vasovagal response beyond the attenuation associated with pregnancy. These findings support further testing with larger samples to identify vasovagal changes in abused pregnant women.
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Affiliation(s)
- Michael J Rice
- Washington State University, Intercollegiate College of Nursing, 2917 W. Ft. Wright Drive, Spokane, WA 99224, USA.
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31
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Talley P, Heitkemper M, Chicz-Demet A, Sandman CA. Male Violence, Stress, and Neuroendocrine Parameters in Pregnancy: A Pilot Study. Biol Res Nurs 2016; 7:222-33. [PMID: 16552950 DOI: 10.1177/1099800405283182] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Stress during pregnancy has been associated with a number of adverse outcomes. This study compared and correlated neuroendocrine parameters in women (n = 8) who self-reported battering during their pregnancy to those in women who did not (n = 8). Women who identified themselves as having a violent relationship with an intimate partner were recruited from a rural midwestern community. They were matched on age, self-reported ethnicity, parity, gestational age, and personal and family income with nonbattered controls. Midgestational measures of self-reported stress levels showed that battered women reported markedly higher levels of anxiety and depression. Neuroendocrine levels were not different between groups (battered vs. nonbattered); however, the relationships among hormones were different between groups. In nonbattered women, adrenocorticotropic hormone (ACTH) and cortisol levels were correlated but not in battered women. Beta endorphin and ACTH levels in battered women showed a significant linear relationship but not in nonbattered women. These results suggest that the maternal experience of stress alters the relationship of hypothalamic-pituitary-adrenal-placental axis hormones despite the lack of absolute differences in blood levels.
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Affiliation(s)
- Pam Talley
- Department of Family & Child Nursing, University of Washington, Seattle 98195, USA.
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Rodriguez A, Bohlin G, Lindmark G. A Longitudinal Study of Perceived Health during Pregnancy. J Health Psychol 2016; 4:129-47. [DOI: 10.1177/135910539900400209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Perceived health was studied longitudinally in a sample of 364 nulliparous women. Psychosocial, contextual, and biomedical factors were taken into account to predict medically relevant versus benign symptoms which were then used to predict perceived health over time. The results of structural equation modeling showed that pregnancy adjustment and medically relevant symptoms which were affected by social support, perceived stress, and negative affect predicted later perceived health. The outcomes of perceived health were examined during the third trimester in terms of medical care utilization and emergency room visits. Perceived health solely accounted for medical care utilization, while emergency room visits were accounted by medical care utilization and perceived stress.
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Affiliation(s)
| | | | - Gunilla Lindmark
- Department of Obstetrics and Gynaecology, Uppsala University, Sweden
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Sagrestano LM, Carroll D, Rodriguez AC, Nuwayhid B. Demographic, Psychological, and Relationship Factors in Domestic Violence During Pregnancy in a Sample of Low-Income Women of Color. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/j.1471-6402.2004.00148.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Research suggests that a significant number of women first experience domestic violence during pregnancy. The current study examines correlates of violence during pregnancy, first by comparing women who did and did not report violence, and second examining three subgroups of women who reported violence (violence initiated, violence persisted, violence ceased). Results indicated that controlling for demographics, more frequent violence was associated with less support and satisfaction with support from the baby's father, more negative interactions with the baby's father, and more verbal aggression in their relationships than those who did not report violence. Differences among subgroups of women reporting violence emerged only for the relationship variables. Implications for detecting violence in clinical settings are discussed.
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Affiliation(s)
| | - Doris Carroll
- Department of Maternal-Fetal Medicine, University of Illinois at Chicago
| | | | - Bahij Nuwayhid
- Department of Maternal-Fetal Medicine, University of Illinois at Chicago
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Zilcha-Mano S, Langer E. Mindful Attention to Variability Intervention and Successful Pregnancy Outcomes. J Clin Psychol 2016; 72:897-907. [DOI: 10.1002/jclp.22294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 01/10/2016] [Accepted: 02/05/2016] [Indexed: 11/06/2022]
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Paiva SPC, Veloso CA, Campos FFC, Carneiro MM, Tilan JU, Wang H, Umans JG, Zukowska Z, Kitlinska J. Elevated levels of neuropeptide Y in preeclampsia: A pilot study implicating a role for stress in pathogenesis of the disease. Neuropeptides 2016; 55:127-35. [PMID: 26431933 PMCID: PMC4755897 DOI: 10.1016/j.npep.2015.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 09/20/2015] [Accepted: 09/20/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine if preeclampsia (PE) is associated with dysregulation of the neuropeptide Y (NPY) system. METHODS The study enrolled 114 subjects either with normal pregnancy (NP) or with PE. Systolic blood pressure (SBP) was collected from patients using a standard sphygmomanometer. The PE patients were divided into two groups based on the gestational age (GA) at delivery - placental PE (PLPE, GA <34 weeks) or maternal PE (MTPE, GA ≥34 weeks). NPY was measured in platelet rich plasma (PRP), platelet poor plasma (PPP) and in the serum of NP and PE patients utilizing radioimmunoassay. Serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) were measured in NP and PE subjects by ELISA. RESULTS SBP was higher in PE compared to NP. Circulating NPY in serum and PRP, as well as NPY content per 100,000 platelets, but not its concentrations in PPP, were elevated in PE, as compared to NP. The highest NPY concentrations were observed in sera and PRP of patients with MTPE. PE patients had also elevated levels of sFlt-1, as compared to NP, although no difference between PLPE and MTPL groups were observed. There was no increase in P1GF in PE patients. CONCLUSION Systemic NPY is elevated in PE patients, as compared to NP. This increase is observed in blood fractions containing platelets, suggesting accumulation of the peptide in these cells. NPY concentrations are particularly high in patients with MTPE, underlying differences in etiology between PLPE and MTPE. Our study implicates NPY as a potential target in antihypertensive therapies for PE patients.
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Affiliation(s)
- Sara P C Paiva
- Department of Physiology & Biophysics, Georgetown University Medical Center, Washington, DC, USA; Instituto de Ciências Biológicas e da Saúde, Centro Universitário de Belo Horizonte UNIBH, Belo Horizonte MG, Brazil; Hospital das Clínicas, Universidade Federal de Minas Gerais UFMG, Belo Horizonte Brazil
| | - Clara A Veloso
- Instituto de Ciências Biológicas e da Saúde, Centro Universitário de Belo Horizonte UNIBH, Belo Horizonte MG, Brazil
| | - Fernanda F C Campos
- Instituto de Ciências Biológicas e da Saúde, Centro Universitário de Belo Horizonte UNIBH, Belo Horizonte MG, Brazil
| | - Márcia M Carneiro
- Hospital das Clínicas, Universidade Federal de Minas Gerais UFMG, Belo Horizonte Brazil
| | - Jason U Tilan
- Department of Nursing, School of Nursing and Health Studies, Georgetown University, Washington, DC 20057, USA; Department of Human Science, School of Nursing and Health Studies, Georgetown University, Washington, DC 20057, USA
| | - Hongkun Wang
- Department of Biostatistics and Bioinformatics, Georgetown University Medical Center, Washington, DC, USA
| | - Jason G Umans
- Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC, USA; Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Zofia Zukowska
- Department of Physiology & Biophysics, Georgetown University Medical Center, Washington, DC, USA
| | - Joanna Kitlinska
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, DC, USA.
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O'Donnell MH, Behie AM. Effects of wildfire disaster exposure on male birth weight in an Australian population. EVOLUTION MEDICINE AND PUBLIC HEALTH 2015; 2015:344-54. [PMID: 26574560 PMCID: PMC4697771 DOI: 10.1093/emph/eov027] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 11/06/2015] [Indexed: 01/15/2023]
Abstract
Background and objectives: Maternal stress can depress birth weight and gestational age, with potential health effects. A growing number of studies examine the effect of maternal stress caused by environmental disasters on birth outcomes. These changes may indicate an adaptive response. In this study, we examine the effects of maternal exposure to wildfire on birth weight and gestational age, hypothesising that maternal stress will negatively influence these measures. Methodology: Using data from the Australian Capital Territory, we employed Analysis of Variance to examine the influence of the 2003 Canberra wildfires on the weight of babies born to mothers resident in fire-affected regions, while considering the role of other factors. Results: We found that male infants born in the most severely fire-affected area had significantly higher average birth weights than their less exposed peers and were also heavier than males born in the same areas in non-fire years. Higher average weights were attributable to an increase in the number of macrosomic infants. There was no significant effect on the weight of female infants or on gestational age for either sex. Conclusions and implications: Our findings indicate heightened environmental responsivity in the male cohort. We find that elevated maternal stress acted to accelerate the growth of male fetuses, potentially through an elevation of maternal blood glucose levels. Like previous studies, our work finds effects of disaster exposure and suggests that fetal growth patterns respond to maternal signals. However, the direction of the change in birth weight is opposite to that of many earlier studies.
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Affiliation(s)
- M H O'Donnell
- School of Archaeology and Anthropology, College of Arts and Social Sciences, the Australian National University, Canberra 0200, Australia
| | - A M Behie
- School of Archaeology and Anthropology, College of Arts and Social Sciences, the Australian National University, Canberra 0200, Australia
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Fleuriet KJ, Sunil T. Reproductive habitus, psychosocial health, and birth weight variation in Mexican immigrant and Mexican American women in south Texas. Soc Sci Med 2015; 138:102-9. [DOI: 10.1016/j.socscimed.2015.05.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
High levels of stress during pregnancy are associated with a number of adverse psychological and physiological outcomes for mother and child. These effects seem to be transmitted in part by one of the major stress-responsive systems, namely the hypothalamic-pituitary-adrenal (HPA) axis, which includes the hormone cortisol. However, as inconsistent study results indicate, methodology poses a substantial challenge to the investigation of stress during pregnancy. For example, although measures of maternal psychological stress and stress hormones are independently related to adverse pregnancy outcome, they seldom have been found to correlate with one another directly. Repeated measurement of psychological and biological responses to acute standardized stress challenges appears to reveal stronger associations. This article reviews the literature on experienced stress and stress hormones in pregnant women and presents studies that used standardized stress challenges (e.g., the Trier Social Stress Test, the cortisol response to morning awakening) to examine maternal stress reactivity more systematically. This review also takes a look at the few studies that examined the protective effects of psychological and psychosocial resources or stress interventions on experienced stress and stress hormones in pregnant women. Overall, results indicate that baseline stress hormone levels advance incrementally during gestation, presumably to prepare mother and fetus for delivery, while responses to acute stress appear to be increasingly attenuated. Moreover, the acute maternal stress response seems to be predictive of neonatal birth outcome and maternal well-being postpartum. Preliminary findings also suggest that much can be done toward coping with stress during pregnancy. Further research and a closer collaboration between science and clinical practice are required.
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Affiliation(s)
| | - Ulrike Ehlert
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Switzerland
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Moore Simas TA, Corvera S, Lee MM, Zhang N, Leung K, Olendzki B, Barton B, Rosal MC. Understanding multifactorial influences on the continuum of maternal weight trajectories in pregnancy and early postpartum: study protocol, and participant baseline characteristics. BMC Pregnancy Childbirth 2015; 15:71. [PMID: 25885002 PMCID: PMC4389494 DOI: 10.1186/s12884-015-0490-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 02/25/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Maternal and offspring immediate and long-term health are affected by pregnancy weight gain and maternal weight. This study was designed to determine feasibility of: 1) recruiting a socio-economically and racially/ethnically diverse sample of pregnant women into a longitudinal observational study, including consenting the women for serial biologic specimen evaluations; 2) implementing comprehensive assessments (including biologic, anthropometric, behavioral, cognitive/psychosocial and socio-demographic, and cultural measures) at multiple time points over the study period, including collecting biologic specimens at planned and unplanned pregnancy delivery times; and 3) retaining the sample for one year into the postpartum period. Additionally, the study will provide preliminary data of associations among hypothesized predictors, mediators and moderators of pregnancy and post-partum maternal and infant weight trajectories. The study was conceptualized under a Biopsychosocial Model using a lifespan approach. Study protocol and baseline characteristics are described. METHODS/DESIGN We sought to recruit a sample of 100 healthy women age 18-45 years, between 28-34 weeks gestation, with singleton pregnancies, enrolled in care prior to 17 weeks gestation. Women provide written consent for face-to-face (medical history, anthropometrics, biologic specimens), and paper-and-pencil assessments, at five time points: baseline (third trimester), delivery-associated, and 6-weeks, 3-months and 6-months postpartum. Additional telephone-based assessments (diet, physical activity and breastfeeding) administered baseline and three-months postpartum. Infant weights are collected until 1-year of life. We seek to retain 80% of participants at six-months postpartum and 80% of offspring at 12-months. 110 women were recruited. Sample characteristics include: mean age 28.3 years, BMI 25.7 kg/m(2), and gestational age at baseline visit of 32.5 weeks. One-third of cohort was non-white, over a quarter were Latina, and almost a quarter were non-US born. The cohort majority was multigravida, had graduated high school and/or had higher levels of education, and worked outside the home. DISCUSSION Documentation of study feasibility and preliminary data for theory-driven hypothesis of maternal and child factors associated with weight trajectories will support future large scale longitudinal studies of risk and protective factors for maternal and child health. This research will also inform intervention targets facilitating healthy maternal and child weight.
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Affiliation(s)
- Tiffany A Moore Simas
- Department of Obstetrics & Gynecology, Division of Research, University of Massachusetts Medical School/UMass Memorial Health Care, Memorial Campus - 119 Belmont Street, Worcester, MA, 01605, USA.
| | - Silvia Corvera
- Department of Medicine, Program in Molecular Medicine, University of Massachusetts Medical School, Biotech 2 - 373 Plantation Street, Worcester, MA, 01605, USA.
| | - Mary M Lee
- Department of Pediatrics, University of Massachusetts Medical School/UMass Memorial Health Care, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
| | - NingNing Zhang
- Department of Pediatrics, University of Massachusetts Medical School/UMass Memorial Health Care, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
| | - Katherine Leung
- Department of Obstetrics & Gynecology, Division of Research, University of Massachusetts Medical School/UMass Memorial Health Care, Memorial Campus - 119 Belmont Street, Worcester, MA, 01605, USA.
| | - Barbara Olendzki
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
| | - Bruce Barton
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
| | - Milagros C Rosal
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, University Campus - 55 Lake Avenue, Worcester, MA, 01655, USA.
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Subjective Social Status, Mental and Psychosocial Health, and Birth Weight Differences in Mexican–American and Mexican Immigrant Women. J Immigr Minor Health 2015; 17:1781-90. [DOI: 10.1007/s10903-015-0178-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Maur DG, Pascuan CG, Genaro AM, Zorrilla-Zubilete MA. Involvement of Nitric Oxide, Neurotrophins and HPA Axis in Neurobehavioural Alterations Induced by Prenatal Stress. ADVANCES IN NEUROBIOLOGY 2015; 10:61-74. [PMID: 25287536 DOI: 10.1007/978-1-4939-1372-5_4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Several studies suggest that negative emotions during pregnancy generate adverse effects on the cognitive, behavioural and emotional development of the descendants. The psychoneuroendocrine pathways involve the transplacentary passage of maternal glucocorticoids in order to influence directly on fetal growth and brain development.Nitric oxide is a gaseous neurotransmitter that plays an important role in the control of neural activity by diffusing into neurons and participates in learning and memory processes. It has been demonstrated that nitric oxide is involved in the regulation of corticosterone secretion. Thus, it has been found that the neuronal isoform of nitric oxide synthase (nNOS) is an endogenous inhibitor of glucocorticoid receptor (GR) in the hippocampus and that nNOS in the hippocampus may participate in the modulation of hypothalamic-pituitary-adrenal axis activity via GR.Neurotrophins are a family of secreted growth factors consisting of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT3) and NT4. Although initially described in the nervous system, they regulate processes such as cell survival, proliferation and differentiation in several other compartments. It has been demonstrated that the NO-citrulline cycle acts together with BDNF in maintaining the progress of neural differentiation.In the present chapter, we explore the interrelation between nitric oxide, glucocorticoids and neurotrophins in brain areas that are key structures in learning and memory processes. The participation of this interrelation in the behavioural and cognitive alterations induced in the offspring by maternal stress is also addressed.
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Affiliation(s)
- Damian G Maur
- Department of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
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Bublitz MH, Parade S, Stroud LR. The effects of childhood sexual abuse on cortisol trajectories in pregnancy are moderated by current family functioning. Biol Psychol 2014; 103:152-7. [PMID: 25220484 DOI: 10.1016/j.biopsycho.2014.08.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 07/04/2014] [Accepted: 08/25/2014] [Indexed: 11/17/2022]
Abstract
The goal of this study was to understand the roles of maternal history of childhood sexual abuse (CSA) and current family functioning on the cortisol awakening response (CAR) in pregnancy. Participants were 185 pregnant women (ages 18-40) who completed items from the Adverse Childhood Experiences scale to measure child maltreatment history and the Family Assessment Device to measure current family functioning. Participants provided saliva samples at wake-up and 30min after wake-up at 25, 29, and 35 weeks gestation to measure CAR. A moderation effect was found such that participants with more severe CSA histories and poorer perceived family functioning had increasing CAR in pregnancy compared to participants with less severe CSA histories and better family functioning. These findings highlight the importance of considering stress in both childhood and current environments in predicting maternal cortisol in pregnancy.
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Affiliation(s)
- Margaret H Bublitz
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
| | - Stephanie Parade
- Bradley Research Center, E.P. Bradley Hospital, Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Laura R Stroud
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
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Antenatal depression and antidepressants during pregnancy: unraveling the complex interactions for the offspring. Eur J Pharmacol 2014; 753:257-62. [PMID: 25094036 DOI: 10.1016/j.ejphar.2014.07.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/18/2014] [Accepted: 07/24/2014] [Indexed: 02/01/2023]
Abstract
During pregnancy the risk for a woman to develop a depressive episode is as high as 20%. Antenatal depression is not harmless for the developing child as several changes, including neurodevelopmental alterations, have been reported. Sometimes it is unavoidable to treat a pregnant mother with antidepressants, especially when she is suicidal. Currently, selective serotonin reuptake inhibitors (SSRIs) are the pharmacological choice of antidepressant treatment. SSRIs do not cause gross teratogenic alterations and are generally considered safe for use in pregnancy. However, although SSRIs may relieve the maternal symptoms, they definitively cross the placenta partially influencing the neurodevelopment of the fetus. In this review an overview is given of the effects on the offspring of maternal antenatal depression and the putative neurodevelopmental effects of SSRI treatment during pregnancy. Although we primarily focus on human data, some animal data are discussed to describe possible mechanisms on how SSRIs are affecting underlying biological mechanisms associated with depression. In summary, maternal depression may have long-lasting effects on the offspring, whereas prenatal SSRI exposure also increases the risk for long-lasting effects. It remains to be determined whether the effects found after SSRI treatment in pregnant women are only due to the SSRI exposure or if the underlying depression is also contributing to these effects. The possibility of epigenetic alterations as one of the underlying mechanisms that is altered by SSRI exposure is discussed. However much more research in this area is needed to explain the exact role of epigenetic mechanisms in SSRI exposure during pregnancy.
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Christian LM, Iams J, Porter K, Leblebicioglu B. Self-rated health among pregnant women: associations with objective health indicators, psychological functioning, and serum inflammatory markers. Ann Behav Med 2014; 46:295-309. [PMID: 23765366 DOI: 10.1007/s12160-013-9521-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Biobehavioral correlates of self-rated health in pregnancy are largely unknown. PURPOSE The goals of this study were to examine, in pregnant women, associations of self-rated health with (1) demographics, objective health status, health behaviors, and psychological factors, and (2) serum inflammatory markers. METHODS In the second trimester of pregnancy, 101 women provided a blood sample, completed measures of psychosocial stress, health status, and health behaviors, and received a comprehensive periodontal examination. RESULTS The following independently predicted poorer self-rated health: (1) greater psychological stress, (2) greater objective health diagnoses, (3) higher body mass index, and (4) past smoking (versus never smoking). Poorer self-rated health was associated with higher serum interleukin-1β (p = 0.02) and marginally higher macrophage migration inhibitory factor (p = 0.06). These relationships were not fully accounted for by behavioral/psychological factors. CONCLUSIONS This study provides novel data regarding factors influencing subjective ratings of health and the association of self-rated health with serum inflammatory markers in pregnant women.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA,
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Roberts AL, Koenen KC, Lyall K, Ascherio A, Weisskopf MG. Women's posttraumatic stress symptoms and autism spectrum disorder in their children. RESEARCH IN AUTISM SPECTRUM DISORDERS 2014; 8:608-616. [PMID: 24855487 PMCID: PMC4025916 DOI: 10.1016/j.rasd.2014.02.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Maternal posttraumatic stress disorder (PTSD) may be associated with autism spectrum disorder (ASD) in offspring through multiple pathways: maternal stress may affect the fetus; ASD in children may increase risk of PTSD in mothers; and the two disorders may share genetic risk. Understanding whether maternal PTSD is associated with child's ASD is important for clinicians treating children with ASD, as PTSD in parents is associated with poorer family functioning. We examined the association of maternal PTSD with offspring ASD in a large US cohort (N ASD cases = 413, N controls = 42,868). Mother's PTSD symptoms were strongly associated with child's ASD (RR 4-5 PTSD symptoms=1.98, 95% CI=1.39, 2.81; RR 6-7 symptoms=2.89, 95% CI=2.00, 4.18). Clinicians treating persons with ASD should be aware of elevated risk of PTSD in the mother. Genetic studies should investigate PTSD risk alleles in relation to ASD.
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Affiliation(s)
- Andrea L. Roberts
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
| | - Karestan C. Koenen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Kristen Lyall
- Department of Nutrition, Harvard School of Public Health
- University of California, Department of Public Health Sciences, Davis, CA
| | - Alberto Ascherio
- Department of Nutrition, Harvard School of Public Health
- Department of Epidemiology, Harvard School of Public Health
| | - Marc G. Weisskopf
- Department of Epidemiology, Harvard School of Public Health
- Department of Environmental Health, Harvard School of Public Health
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Graignic-Philippe R, Dayan J, Chokron S, Jacquet AY, Tordjman S. Effects of prenatal stress on fetal and child development: A critical literature review. Neurosci Biobehav Rev 2014; 43:137-62. [DOI: 10.1016/j.neubiorev.2014.03.022] [Citation(s) in RCA: 179] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 02/19/2014] [Accepted: 03/31/2014] [Indexed: 12/13/2022]
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Zahran S, Breunig IM, Link BG, Snodgrass JG, Weiler S, Mielke HW. Maternal exposure to hurricane destruction and fetal mortality. J Epidemiol Community Health 2014; 68:760-6. [PMID: 24811774 DOI: 10.1136/jech-2014-203807] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The majority of research documenting the public health impacts of natural disasters focuses on the well-being of adults and their living children. Negative effects may also occur in the unborn, exposed to disaster stressors when critical organ systems are developing and when the consequences of exposure are large. METHODS We exploit spatial and temporal variation in hurricane behaviour as a quasi-experimental design to assess whether fetal death is dose-responsive in the extent of hurricane damage. Data on births and fetal deaths are merged with Parish-level housing wreckage data. Fetal outcomes are regressed on housing wreckage adjusting for the maternal, fetal, placental and other risk factors. The average causal effect of maternal exposure to hurricane destruction is captured by difference-in-differences analyses. RESULTS The adjusted odds of fetal death are 1.40 (1.07-1.83) and 2.37 (1.684-3.327) times higher in parishes suffering 10-50% and >50% wreckage to housing stock, respectively. For every 1% increase in the destruction of housing stock, we observe a 1.7% (1.1-2.4%) increase in fetal death. Of the 410 officially recorded fetal deaths in these parishes, between 117 and 205 may be attributable to hurricane destruction and postdisaster disorder. The estimated fetal death toll is 17.4-30.6% of the human death toll. CONCLUSIONS The destruction caused by Hurricanes Katrina and Rita imposed significant measurable losses in terms of fetal death. Postdisaster migratory dynamics suggest that the reported effects of maternal exposure to hurricane destruction on fetal death may be conservative.
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Affiliation(s)
- Sammy Zahran
- Department of Economics, Colorado State University, Fort Collins, Colorado, USA Department of Epidemiology, Robert Wood Johnson Health and Society Scholar, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Ian M Breunig
- Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Bruce G Link
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
| | - Jeffrey G Snodgrass
- Department of Anthropology, Colorado State University, Fort Collins, Colorado, USA
| | - Stephan Weiler
- Department of Economics, Colorado State University, Fort Collins, Colorado, USA
| | - Howard W Mielke
- Department of Pharmacology, Tulane University, School of Medicine, New Orleans, Louisiana, USA
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Marceau K, Ruttle PL, Shirtcliff EA, Essex MJ, Susman EJ. Developmental and contextual considerations for adrenal and gonadal hormone functioning during adolescence: Implications for adolescent mental health. Dev Psychobiol 2014; 57:742-68. [PMID: 24729154 DOI: 10.1002/dev.21214] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 03/03/2014] [Indexed: 12/13/2022]
Abstract
Substantial research has implicated the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes independently in adolescent mental health problems, though this literature remains largely inconclusive. Given the cross-talk between the HPA and HPG axes and their increased activation in adolescence, a dual-axis approach that examines both axes simultaneously is proposed to predict the emergence and persistence of adolescent mental health problems. After briefly orienting readers to HPA and HPG axis functioning, we review the literature examining associations between hormone levels and changes with behavior during adolescence. Then, we provide a review of the literature supporting examination of both axes simultaneously and present the limited research that has taken a dual-axis approach. We propose future directions including consideration of between-person and within-person approaches to address questions of correlated changes in HPA and HPG hormones. Potential moderators are considered to increase understanding of the nuanced hormone-behavior associations during key developmental transitions.
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Affiliation(s)
- Kristine Marceau
- The Pennsylvania State University, University Park, PA. .,Brown University, Center for Alcohol and Addiction Studies, Providence, RI. .,Department of Psychiatry, Rhode Island Hospital, Providence, RI.
| | - Paula L Ruttle
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Elizabeth A Shirtcliff
- Iowa State University, Department of Human Development and Family Studies, New Orleans, LA
| | - Marilyn J Essex
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin, Madison, WI
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Larsen AD, Hannerz H, Thulstrup AM, Bonde JP, Obel C, Hougaard KS. Psychosocial job strain and risk of congenital malformations in offspring--a Danish National cohort study. BJOG 2014; 121:830-8; discussion 839. [PMID: 24593253 DOI: 10.1111/1471-0528.12612] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate if maternal exposure to psychosocial job strain at work (high demands and low control) measured by questionnaire early in pregnancy (median week 15) is associated with malformations in the offspring. DESIGN Population-based cohort study. SETTING The Danish National Birth Cohort. POPULATION A cohort of 60,386 singleton children with full information on mother's occupational status, exposure to psychosocial job strain and all covariates during pregnancy. METHODS Logistic regression analysis was used to calculate the odds of congenital malformations as a function of job strain with adjustment for maternal age, body mass index, parity, smoking, alcohol use, manual versus nonmanual work, maternal serious disease and gestational age at interview. MAIN OUTCOME MEASURES Circulatory malformation, musculoskeletal malformation or any malformation. RESULTS Logistic regression analyses, both crude and adjusted, indicated no associations between working under high strain and giving birth to a child with circulatory malformation (adjusted odds ratio [OR] 1.04, 95% confidence interval [95% CI] 0.75-1.44), musculoskeletal malformation (aOR 0.88, 95% CI 0.71-1.10) or any malformation (aOR 0.99, 95% CI 0.85-1.15). Supplementary analyses including restriction to first-borns and a stratified analysis with respect to manual and nonmanual work did not change the results. CONCLUSIONS Association between exposure to high job strain during pregnancy and elevated risk of circulatory, muscle and any malformations is not supported by this study.
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Affiliation(s)
- A D Larsen
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
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Prenatal stress and risk of behavioral morbidity from age 2 to 14 years: the influence of the number, type, and timing of stressful life events. Dev Psychopathol 2014; 23:507-20. [PMID: 23786692 DOI: 10.1017/s0954579411000241] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The maternal experience of stressful events during pregnancy has been associated with a number of adverse consequences for behavioral development in offspring, but the measurement and interpretation of prenatal stress varies among reported studies. The Raine Study recruited 2900 pregnancies and recorded life stress events experienced by 18 and 34 weeks' gestation along with numerous sociodemographic data. The mother's exposure to life stress events was further documented when the children were followed-up in conjunction with behavioral assessments at ages 2, 5, 8, 10, and 14 years using the Child Behavior Checklist. The maternal experience of multiple stressful events during pregnancy was associated with subsequent behavioral problems for offspring. Independent (e.g., death of a relative, job loss) and dependent stress events (e.g., financial problems, marital problems) were both significantly associated with a greater incidence of mental health morbidity between age 2 and 14 years. Exposure to stressful events in the first 18 weeks of pregnancy showed similar associations with subsequent total and externalizing morbidity to events reported at 34 weeks of gestation. These results were independent of postnatal stress exposure. Improved support for women with chronic stress exposure during pregnancy may improve the mental health of their offspring in later life.
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