Association between preconception maternal stress and offspring birth weight: findings from an Australian longitudinal data linkage study

Computational Approaches for Connecting Maternal Stress to Preterm Birth

Multiple studies have hinted at a complex connection between maternal stress and preterm birth (PTB). This article describes the potential of computational methods to provide new insights into this relationship. For this, we outline existing approaches for stress assessments and various data modalities available for profiling stress responses, and review studies that sought either to establish a connection between stress and PTB or to predict PTB based on stress-related factors. Finally, we summarize the challenges of computational methods, highlighting potential future research directions within this field.

Patterns of Labour Interventions and Associated Maternal Biopsychosocial Factors in Australia: a Path Analysis

In Australia, nearly half of births involve labour interventions. Prior research in this area has relied on cross-sectional and administrative health data and has not considered biopsychosocial factors. The current study examined direct and indirect associations between biopsychosocial factors and labour interventions using 19 years of population-based prospective data. The study included singleton babies among primiparous women of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. Data from 5459 women who started labour were analysed using path analysis. 42.2% of babies were born without intervention (episiotomy, instrumental, or caesarean delivery): Thirty-seven percent reported vaginal birth with episiotomy and instrumental birth interventions, 18% reported an unplanned caesarean section without episiotomy and/or instrumental interventions, and 3% reported unplanned caesarean section after episiotomy and/or instrumental interventions. Vaginal births with episiotomy and/or instrumental interventions were more likely among women with chronic hypertension (RRR(95%-CI):1.50(1.12-2.01)), a perceived length of labour of more than 36 h (RRR(95%-CI):1.86(1.45-2.39)), private health insurance (RRR(95%-CI):1.61(1.41-1.85)) and induced labour (RRR(95%-CI):1.69(1.46-1.94)). Risk factors of unplanned caesarean section without episiotomy and/or instrumental birth intervention included being overweight (RRR(95%-CI):1.30(1.07-1.58)) or obese prepregnancy (RRR(95%-CI):1.63(1.28-2.08)), aged ≥ 35 years (RRR(95%-CI):1.87(1.46-2.41)), having short stature (< 154 cm) (RRR(95%-CI):1.68(1.16-2.42)), a perceived length of labour of more than 36 h (RRR(95%-CI):3.26(2.50-4.24)), private health insurance (RRR(95%-CI):1.38(1.17-1.64)), and induced labour (RRR(95%-CI):2.56(2.16-3.05)). Prevention and management of hypertension, diabetes, and obesity during preconception and/or antenatal care are keys for reducing labour interventions and strengthening the evidence-base around delivery of best practice obstetric care.

Preconception stress exposure from childhood to adolescence and birth outcomes: The impact of stress type, severity and consistency

The negative effects of prenatal stress on offspring health are well established, but there remains little understanding of the influence of stress prior to conception despite known effects on biological systems that are important for a healthy pregnancy. Furthermore, operational definitions of stress vary considerably, and exposure is often characterized via summed, ordinal scales of events. We hypothesized that type, severity, and consistency of preconception stress would be associated with birthweight and gestational age (GA) at birth. Data were drawn from a subsample of participants in the 21-year longitudinal Pittsburgh Girls Study (PGS, N = 2,450) that has followed women annually since childhood. Prior work in the PGS derived three domains of stress exposure between ages 7-17 years related to subsistence (e.g., resource strain, overcrowding), safety (e.g., community violence, inter-adult aggression), and caregiving (e.g., separation, maternal depression). We tested the effects of dimensions of preconception stress on birthweight and GA among offspring of 490 PGS participants who delivered at age 18 or older (n = 490; 76% Black, 20% White, 4% Multiracial). Our hypotheses were partially supported with results varying by stress type and severity and by infant sex. Severity of preconception exposure to subsistence stress was prospectively associated with lower offspring birthweight (B = -146.94, SE = 69.07, 95% CI = -282.66, -11.22). The association between severity of caregiving stress in childhood and adolescence and GA at birth was moderated by infant sex (B = 0.85, SE = .41, 95% CI = 0.04, 1.66), suggesting greater vulnerability to this type of stress for male compared to female infants. Exposure to safety stressors did not predict birth outcomes. Infants of Black compared with White mothers had lower birthweight in all models regardless of preconception stress type, severity or consistency. However, we observed no moderating effects of race on preconception stress-birth outcome associations. Demonstrating specificity of associations between preconception stress exposure and prenatal health has the potential to inform preventive interventions targeting profiles of exposure to optimize birth outcomes.

Canada's Colonial Genocide of Indigenous Peoples: A Review of the Psychosocial and Neurobiological Processes Linking Trauma and Intergenerational Outcomes

The policies and actions that were enacted to colonize Indigenous Peoples in Canada have been described as constituting cultural genocide. When one considers the long-term consequences from the perspective of the social and environmental determinants of health framework, the impacts of such policies on the physical and mental health of Indigenous Peoples go well beyond cultural loss. This paper addresses the impacts of key historical and current Canadian federal policies in relation to the health and well-being of Indigenous Peoples. Far from constituting a mere lesson in history, the connections between colonialist policies and actions on present-day outcomes are evaluated in terms of transgenerational and intergenerational transmission processes, including psychosocial, developmental, environmental, and neurobiological mechanisms and trauma responses. In addition, while colonialist policies have created adverse living conditions for Indigenous Peoples, resilience and the perseverance of many aspects of culture may be maintained through intergenerational processes.