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Santaularia NJ, Hunt SL, Bonilla Z. Exploring the Links Between Immigration and Birth Outcomes Among Latine Birthing Persons in the USA. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01999-x. [PMID: 38713369 DOI: 10.1007/s40615-024-01999-x] [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: 10/10/2023] [Revised: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Birth outcomes are worse for birthing people and infants in the USA than other high-income economies and worse still for underprivileged communities. Historically, the Latine community has experienced positive birth outcomes, despite low socioeconomic status and other socio-political disadvantages, leading to what has been termed as the Hispanic birth paradox. However, this perinatal advantage and protective effect appears to have been shattered by unfavorable policies, structural conditions, societal attitudes, and traumatic events impacting Latine immigrants, leading to negative effects on the health and well-being of birthing Latines-regardless of citizenship status and increasing rates of preterm birth and low birth weight infants. METHODS AND RESULTS We conducted a comprehensive literature review and identified two pathways through which birth outcomes among Latine birthing persons may be compromised regardless of citizenship status: (1) a biological pathway as toxic levels of fear and anxiety created by racialized stressors accumulate in the bodies of Latines and (2) a social pathway as Latines disconnect from formal and informal sources of support including family, friends, health care, public health programs, and social services during the course of the pregnancy. CONCLUSION Future research needs to examine the impact of immigration climate and policies on health and racial equity in birth outcomes among Latines regardless of citizenship status. Attaining health and racial equity necessitates increased awareness among health providers, public health practitioners, and policy makers of the impact of larger socio-political pressures on the health of Latine birthing persons.
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Affiliation(s)
- N Jeanie Santaularia
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Shanda Lee Hunt
- University Libraries, University of Minnesota, Minneapolis, MN, USA
| | - Zobeida Bonilla
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Salomon R, Weiss S. Relationships Among Number of Stressors, Perceived Stress, and Salivary Cortisol Levels During the Third Trimester of Pregnancy. J Obstet Gynecol Neonatal Nurs 2024; 53:160-171. [PMID: 38048897 PMCID: PMC10939920 DOI: 10.1016/j.jogn.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVE To examine relationships among the number of stressors, perceived stress, and salivary cortisol levels during the third trimester of pregnancy. DESIGN Secondary analysis of cross-sectional data. SETTING Participants' homes. PARTICIPANTS Women during the third trimester of pregnancy (N = 73). METHODS Participants provided saliva samples at four time points over 2 days for cortisol assay and completed questionnaires to assess stressors and perceived stress. We computed multiple linear regression models to examine the relationships among the number of stressors and perceived stress to cortisol awakening response, diurnal slope, and overall cortisol secretion. We also computed a multiple linear regression model to examine the relationship between perceived stress and the number of stressors. RESULTS Greater perceived stress was associated with reduced overall cortisol secretion across the day (β = -0.41, p = .01). The number of stressors was associated with perceived stress (β = 0.48, p = .002) but not salivary cortisol measures. CONCLUSION Elevated perceived stress and the related cortisol alterations that we identified could represent salient targets for enhancing hypothalamic-pituitary-adrenal axis function during the third trimester. Perceived stress may shape the relationship between exposure to stressors and cortisol response during pregnancy. Future research is warranted to confirm study results and to understand the implications for parturition and fetal development.
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Del Pozzo J, Kouba I, Alvarez A, O'Sullivan-Bakshi T, Krishnamoorthy K, Blitz MJ. Environmental Justice Index and adverse pregnancy outcomes. AJOG GLOBAL REPORTS 2024; 4:100330. [PMID: 38586614 PMCID: PMC10994970 DOI: 10.1016/j.xagr.2024.100330] [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] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The Environmental Justice Index is a tool released by the Centers for Disease Control and Prevention that quantifies and ranks the environmental burden and social vulnerability of each census tract. Racial and ethnic disparities in adverse pregnancy outcomes are well established. The relative contributions of individual (person-level) and environmental (neighborhood-level) risk factors to disease prevalence remain poorly understood. OBJECTIVE This study aimed to determine whether the Environmental Justice Index is associated with adverse pregnancy outcomes after adjustment for individual clinical and sociodemographic risk factors. STUDY DESIGN This was a retrospective cross-sectional study of all patients who delivered a singleton newborn at ≥23 weeks of gestation between January 2019 and February 2022 at 7 hospitals within a large academic health system in New York. Patients were excluded if their home address was not available, if the address could not be geocoded to a census tract, or if the census tract did not have corresponding Environmental Justice Index data. Patients were also excluded if they had preexisting diabetes or hypertension. For patients who had multiple pregnancies during the study period, only the first pregnancy was included for analysis. Clinical and demographic data were obtained from the electronic medical record. Environmental Justice Index score, the primary independent variable, ranges from 0 to 1. Higher Environmental Justice Index scores indicate communities with increased cumulative environmental burden and increased social vulnerability. The primary outcome was adverse pregnancy outcome, defined as the presence of ≥1 of any of the following conditions: hypertensive disorders of pregnancy, gestational diabetes, preterm birth, fetal growth restriction, low birthweight, small for gestational age newborn, placental abruption, and stillbirth. Multivariable logistic regression was performed to investigate the relationship between Environmental Justice Index score and adverse pregnancy outcome, adjusting for potential confounding variables, including body mass index group, race and ethnicity group, advanced maternal age, nulliparity, public health insurance, and English as the preferred language. RESULTS A total of 65,273 pregnancies were included for analysis. Overall, adverse pregnancy outcomes occurred in 37.6% of pregnancies (n=24,545); hypertensive disorders of pregnancy (13.4%) and gestational diabetes (12.2%) were the most common adverse pregnancy outcome conditions. On unadjusted analysis, the strongest associations between Environmental Justice Index score and individual adverse pregnancy outcome conditions were observed for stillbirth (odds ratio, 1.079; 95% confidence interval, 1.025-1.135) and hypertensive disorders of pregnancy (odds ratio, 1.052; 95% confidence interval, 1.042-1.061). On multivariable logistic regression, every 0.1 increase in Environmental Justice Index score was associated with 1.4% higher odds of adverse pregnancy outcome (adjusted odds ratio, 1.014; 95% confidence interval, 1.007-1.021). The strongest associations with adverse pregnancy outcomes were observed with well-established clinical and social risk factors, including class 3 obesity (adjusted odds ratio, 1.710; 95% confidence interval, 1.580-1.849; reference: body mass index <25 kg/m2) and certain race and ethnicity groups (reference: non-Hispanic White), particularly Asian and Pacific Islander (adjusted odds ratio, 1.817; 95% confidence interval, 1.729-1.910), and non-Hispanic Black (adjusted odds ratio, 1.668; 95% confidence interval, 1.581-1.760) people. CONCLUSION Environmental Justice Index score is positively associated with adverse pregnancy outcomes, and most strongly associated with stillbirth and hypertensive disorders of pregnancy. Geospatial analysis with Environmental Justice Index may help to improve our understanding of health inequities by identifying neighborhood characteristics that increase the risk of pregnancy complications.
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Affiliation(s)
- Jaclyn Del Pozzo
- Northwell Health, New Hyde Park (Drs Del Pozzo and Kouba, Mr Alvarez, and Dr Blitz), NY
- Department of Obstetrics and Gynecology, South Shore University Hospital (Drs Del Pozzo, Kouba, and Blitz), Bay Shore, NY
- Zucker School of Medicine (Drs Del Pozzo, Kouba, and Blitz), Hempstead, NY
| | - Insaf Kouba
- Northwell Health, New Hyde Park (Drs Del Pozzo and Kouba, Mr Alvarez, and Dr Blitz), NY
- Department of Obstetrics and Gynecology, South Shore University Hospital (Drs Del Pozzo, Kouba, and Blitz), Bay Shore, NY
- Zucker School of Medicine (Drs Del Pozzo, Kouba, and Blitz), Hempstead, NY
| | - Alejandro Alvarez
- Northwell Health, New Hyde Park (Drs Del Pozzo and Kouba, Mr Alvarez, and Dr Blitz), NY
- Department of Biostatistics, Office of Academic Affairs, Northwell Health (Mr Alvarez), New Hyde Park, NY
| | - Tadhg O'Sullivan-Bakshi
- Feinstein Institutes for Medical Research, Northwell Health (Mr. O'Sullivan-Bakshi and Ms. Krishnamoorthy), Manhasset, NY
| | - Kaveri Krishnamoorthy
- Feinstein Institutes for Medical Research, Northwell Health (Mr. O'Sullivan-Bakshi and Ms. Krishnamoorthy), Manhasset, NY
| | - Matthew J. Blitz
- Northwell Health, New Hyde Park (Drs Del Pozzo and Kouba, Mr Alvarez, and Dr Blitz), NY
- Department of Obstetrics and Gynecology, South Shore University Hospital (Drs Del Pozzo, Kouba, and Blitz), Bay Shore, NY
- Zucker School of Medicine (Drs Del Pozzo, Kouba, and Blitz), Hempstead, NY
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health (Dr Blitz), Manhasset, NY
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Li J, Gao X, Wang S, Yao D, Shao S, Wu H, Xu M, Yi Q, Xie L, Zhu Z, Song D, Li H. The role of m6A methylation in prenatal maternal psychological distress and birth outcome. J Affect Disord 2023; 338:52-59. [PMID: 37269885 DOI: 10.1016/j.jad.2023.05.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Prenatal maternal psychological distress (PMPD) is a known risk factor for adverse birth outcomes. N6-methyladenosine RNA (m6A) methylation is crucial in moderating RNA biology. This study aimed to evaluate the relationships between PMPD, birth outcomes, and placental m6A methylation. METHODS This was a prospective cohort study. PMPD exposure was assessed by questionnaires about prenatal stress, depression, and anxiety. Placental m6A methylation was measured using a colorimetric assay. The relationships between PMPD, m6A methylation, gestational age (GA), and birth weight (BW) were analyzed using structural equation models (SEMs). Maternal weight gain during pregnancy and infant sex were included as covariables. RESULTS The study included 209 mother-infant dyads. In an adjusted SEM, PMPD was associated with BW (B = -26.034; 95 % CI: -47.123, -4.868) and GA (B = -0.603; 95 % CI: -1.102, -0.154). M6A methylation was associated with PMPD (B = 0.055; 95 % CI: 0.040,0.073) and BW (B = -305.799; 95 % CI: -520.164, -86.460) but not GA. The effect of PMPD on BW was partially mediated by m6A methylation (B = -16.817; 95 % CI: -31.348, -4.638) and GA (B = -12.280; 95 % CI: -23.612, -3.079). Maternal weight gain was associated with BW (B = 5.113; 95 % CI: 0.229,10.438). LIMITATIONS The study sample size was small, and the specific mechanism of m6A methylation on birth outcomes needs to be further explored. CONCLUSIONS In this study, PMPD exposure negatively affected BW and GA. Placental m6A methylation was associated with PMPD and BW and partially mediated the effect of PMPD on BW. Our findings highlight the importance of perinatal psychological evaluation and intervention.
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Affiliation(s)
- Jing Li
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Xueyun Gao
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Shan Wang
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Dan Yao
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Shuya Shao
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Haoyue Wu
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Meina Xu
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Qiqi Yi
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China
| | - Longshan Xie
- Department of Functional Neuroscience, The First People's Hospital of Foshan, North 81 Lingnan Avenue, Foshan 528000, Guangdong, China
| | - Zhongliang Zhu
- Key Laboratory of Resource Biology and Biotechnology in Western China, Maternal and Infant Health Research Institute and Medical College, Northwestern University, 229 Taibai North Road, Xi'an 710069, Shaanxi, China
| | - Dongli Song
- Division of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, 751 South Bascom Avenue, San Jose, CA 95128, USA; Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, 725 Welch Rd 2 West, Palo Alto, CA 94304, USA.
| | - Hui Li
- Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi, China; Department of Neonatology, Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an 710002, Shaanxi, China.
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Shriyan P, Sudhir P, van Schayck OC, Babu GR. Association of high cortisol levels in pregnancy and altered fetal growth. Results from the MAASTHI, a prospective cohort study, Bengaluru. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 14:100196. [PMID: 37461746 PMCID: PMC7614758 DOI: 10.1016/j.lansea.2023.100196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/09/2023] [Accepted: 03/28/2023] [Indexed: 07/20/2023]
Abstract
Background The role of maternal stress levels on mothers' mental health and fetal growth has been previously studied. However, the evidence linking cortisol exposure during pregnancy to growth outcomes in infants is sparsely available from lower and middle-income countries. We aim to investigate the association of serum cortisol levels in pregnancy with infant birth outcomes and postpartum depressive symptoms in a public health facility in India. Methods The current study is a part of the maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI) prospective cohort. We assessed the relationship between maternal exposure to serum cortisol and adverse neonatal outcomes and postpartum depressive symptoms. Serum cortisol levels in stored blood samples were measured in 230 pregnant women as a biomarker for stress during pregnancy. Pregnant women between 18 and 45 years of age were recruited for the study, presenting at ≥14 weeks of gestation and providing voluntary written informed consent. The Edinburgh Postnatal Depression Scale assessed postpartum depressive symptoms, and detailed infant anthropometric measurements were carried out at birth. Findings We found that higher levels (>17.66 μg/L) are significantly associated with low birth weight (OR = 2.28; 95% CI 1.21-4.32) and lower weight for length (OR = 2.16; 95% CI 1.07-4.35). The odds of developing postpartum depressive symptoms in pregnant women with higher mean cortisol cut-off levels is 2.3-fold [OR: 2.33, 95% CI (1.17, 4.64)] compared than women with lower cortisol levels. No significant association was found between serum cortisol and infants' birth weight for gestational age, head circumference, the sum of skinfold thickness, and crown-rump length. Interpretation Our results support the hypothesis that higher maternal cortisol levels may adversely impact birth weight, weight for length in newborns, and postpartum depressive symptoms in mothers. Funding This study was supported by the India Alliance Senior Fellowship [Grant No. IA/CPHS/20/1/505278] awarded to Giridhara R. Babu.
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Affiliation(s)
- Prafulla Shriyan
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka, 560023, India
| | - Paulomi Sudhir
- Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Onno C.P. van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Giridhara R. Babu
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka, 560023, India
- Clinical and Public Health Research Fellowship, The Wellcome Trust/DBT India Alliance, New Delhi, 110025, India
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Tien Nguyen S, Bui Minh T, Trung Dinh H, Dinh Le T, Phi Thi Nguyen N, Tran TTH, Hien Vu T, Luong Cong T, Ho Thi Nguyen L, Tuan Pham P, Viet Tran T, Xuan Nguyen K. Relationship Between Maternal Serum Cortisol and Maternal Insulin Resistance and Fetal Ultrasound Characteristics in Gestational Diabetes Mellitus. Diabetes Metab Syndr Obes 2023; 16:365-372. [PMID: 36788989 PMCID: PMC9922503 DOI: 10.2147/dmso.s400995] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/27/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Cortisol is proven to play a crucial role in hyperglycemia and fetal development in gestational diabetes mellitus (GDM). This research aims to investigate the relationship between maternal serum cortisol and insulin resistance indices and fetal ultrasound characteristics in women with GDM. METHODS A cross-sectional and descriptive study on 144 GDM in Vietnam from January 2015 to December 2020. Serum cortisol was measured using electrochemiluminescence immunoassay at 8 a.m. on the examination day in the vicinity of the 24th gestational week. Fetal ultrasound was performed by an experienced person who was blind to the study. RESULTS The mean cortisol level in the GDM group was 627.04 nmol/L. Serum cortisol levels positively correlated with abdominal circumference (AC), fasting plasma glucose (FPG), insulin, triglycerides, HOMA2-IR, and Mathew indices (with r of 0.18, 0.22, 0.18, 0.17, 0.18, and 0.22, respectively). Serum cortisol levels negatively correlated with QUICKI and McAuley indices (with r of -0.19 and -0.21), respectively. In a univariate linear regression, maternal serum cortisol positively correlated with fetal AC, head circumference (HC), and biparietal diameter (BPD) (with r of 0.21; 0.23; and 0.25, respectively). In a multivariate linear regression analysis, cortisol positively correlated with fetal AC, HC, and BPD after adjusting to maternal McAuley index. CONCLUSION Serum cortisol levels in GDM correlated with fasting blood glucose, triglycerides, and insulin resistance. Besides, serum cortisol levels in GDM positively correlated with fetal development.
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Affiliation(s)
- Son Tien Nguyen
- Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Tien Bui Minh
- Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Hoa Trung Dinh
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
- National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Tuan Dinh Le
- Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Nga Phi Thi Nguyen
- Department of Rheumatology and Endocrinology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Thi Thanh Hoa Tran
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Trinh Hien Vu
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Thuc Luong Cong
- Cardiovascular Center, Military Hospital 103, Vietnam Medical Military University, Ha Noi, Vietnam
| | - Lan Ho Thi Nguyen
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Phuong Tuan Pham
- Department of Requested Treatment, National Hospital of Endocrinology, Ha Noi, Vietnam
- National Hospital of Endocrinology, Ha Noi, Vietnam
| | - Tien Viet Tran
- Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, 10000, Vietnam
| | - Kien Xuan Nguyen
- Department of Military Medical Command and Organization, Vietnam Medical Military University, Ha Noi, Vietnam
- Correspondence: Kien Xuan Nguyen, Department of Military Medical Command and Organization, Vietnam Military Medical University, 160 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi city, Vietnam, Email
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Kolomboy F, Fatmawati A, Hadriani H, Lisnawati L, Elisanti AD. What Did the Neonatal Integrative Developmental Care Model and Routine Developmental Care Affect on Stress of Premature Babies? Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Neonatal integrative developmental care model (NIDCM) is a holistic model of premature baby care referring to seven basic neuroprotective developmental cares (DCs) by involving the family.
AIM: This study aimed to assess the effect of the application of NIDCM on the stress response of premature babies.
METHODS: The research design used was quasi-experimental with a non-equivalent control group pre- and post-test. The study was conducted in the neonatal care room of Dr. Wahidin Sudirohusodo Makassar Hospital from January 2020 to April 2021. The sample was 76 subjects consisting of 38 premature babies (19 controls and 19 interventions) and 38 mothers (19 controls and 19 interventions). The collected samples were taken to the Medical Research Laboratory of Universitas Hasanuddin (HUMRC) for testing. Furthermore, baby stress was assessed from salivary cortisol levels by enzyme linked immunosorbent assay. In addition, the effect of initial cortisol, final cortisol, and birth weight on changes in salivary cortisol in premature babies was determined using the Chi-square test.
RESULTS: Neither NIDCM intervention nor routine DC has been shown to descriptive statistically decrease the stress response of premature babies in the neonatal care room, some of which are even increased. However, specifically in premature babies with a birth weight of <1800 g, NIDCM showed a better effect in lowering cortisol after treatment than regular DC.
CONCLUSIONS: The application of NIDCM intervention reduces the stressor felt by the babies in the neonatal care room, besides the condition of babies with a birth weight of fewer than 1800 g needs special attention with the NIDCM intervention.
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Olsson Mägi CA, Wik Despriee Å, Småstuen MC, Almqvist C, Bahram F, Bakkeheim E, Bjerg A, Glavin K, Granum B, Haugen G, Hedlin G, Jonassen CM, Lødrup Carlsen KC, Rehbinder EM, Rolfsjord LB, Staff AC, Skjerven HO, Vettukattil R, Nordlund B, Söderhäll C. Maternal Stress, Early Life Factors and Infant Salivary Cortisol Levels. CHILDREN 2022; 9:children9050623. [PMID: 35626800 PMCID: PMC9139396 DOI: 10.3390/children9050623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/09/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
Abstract
Background: Salivary cortisol (SC), a commonly used biomarker for stress, may be disrupted by negative events in pregnancy, at birth and in infancy. We aimed to explore if maternal perceived stress (PSS) in or after pregnancy and SC levels in pregnancy were associated with SC in early infancy, and, secondly, to identify early life factors associated with infants’ SC levels (iSC). Methods: At 3 months of age, SC was analyzed in 1057 infants participating in a Nordic prospective mother-child birth cohort study. Maternal PSS was available from questionnaires at 18- and 34-week gestational age (GA) and 3-month post-partum, and SC was analyzed at 18-week GA. Early life factors included sociodemographic and infant feeding from questionnaires, and birth data from medical charts. Associations to iSC were analyzed by Spearman correlation and multinomial logistic regression analyses. Results: In this exploratory study neither PSS at any time point nor maternal SC (mSC) were associated with iSC. Higher birth weight was associated with higher levels of iSC, while inverse associations were observed in infants to a mother not living with a partner and mixed bottle/breastfeeding. Conclusions: Maternal stress was not associated with iSC levels, while birth weight, single motherhood and infant feeding may influence iSC levels.
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Affiliation(s)
- Caroline-Aleksi Olsson Mägi
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
- Correspondence:
| | - Åshild Wik Despriee
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Faculty of Health, VID Specialized University, NO-0424 Oslo, Norway; (M.C.S.); (K.G.)
| | | | - Catarina Almqvist
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Fuad Bahram
- Research Centre, Stockholm South General Hospital, SE-118 83 Stockholm, Sweden;
| | - Egil Bakkeheim
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Anders Bjerg
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Martina Children’s Hospital, SE-114 86 Stockholm, Sweden
| | - Kari Glavin
- Faculty of Health, VID Specialized University, NO-0424 Oslo, Norway; (M.C.S.); (K.G.)
| | - Berit Granum
- Department of Chemical Toxicology, Norwegian Institute of Public Health, NO-0213 Oslo, Norway;
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Obstetrics and Gynaecology, Oslo University Hospital, NO-0424 Oslo, Norway
| | - Gunilla Hedlin
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
| | - Christine Monceyron Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, NO-1430 Ås, Norway;
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, NO-1714 Kalnes, Norway
| | - Karin C. Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Eva Maria Rehbinder
- Department of Dermatology and Vaenerology, Oslo University Hospital, NO-0424 Oslo, Norway;
| | - Leif-Bjarte Rolfsjord
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
- Department of Paediatric and Adolescent Medicine Elverum, Innlandet Hospital Trust, NO-2381 Brumunddal, Norway
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Obstetrics and Gynaecology, Oslo University Hospital, NO-0424 Oslo, Norway
| | - Håvard Ove Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Björn Nordlund
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
| | - Cilla Söderhäll
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
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9
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Naya CH, Toledo-Corral CM, Chavez T, Lerner D, Lurvey N, Eckel SP, Peterson AK, Grubbs BH, Dunton GF, Breton CV, Bastain TM. Third trimester cortisol is positively associated with gestational weight gain in pregnant women with class one obesity. Int J Obes (Lond) 2022; 46:366-373. [PMID: 34718334 PMCID: PMC9012147 DOI: 10.1038/s41366-021-01009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/27/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVE Prevalence of pre-pregnancy obesity and excessive gestational weight gain (GWG) are higher among women of color with low SES. Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis and its end-product, cortisol, during pregnancy is hypothesized to be associated with excessive GWG. However, past studies have produced inconsistent findings and often did not include health disparities populations. This study examined the association between pre-pregnancy body mass index (BMI), third trimester diurnal cortisol, and GWG in low-income, predominantly Hispanic women. SUBJECTS/METHODS The MADRES study is an ongoing prospective cohort study of primarily Hispanic, low-income pregnant women and their children in Los Angeles, California. Data from 176 participants were included in this study. Total cortisol secretion (area under the curve, AUC) was quantified using four salivary cortisol samples (awakening, 30 min after awakening, afternoon, and bedtime) that were collected at home on one day during the third trimester of pregnancy. Moderation of the association between total cortisol and GWG by pre-pregnancy BMI was tested using multiple linear regression with a multiplicative interaction term. RESULTS There was no association between total cortisol secretion and GWG overall (p = 0.82), but the association between total cortisol and GWG was stronger for women with class 1 pre-pregnancy obesity compared to women with normal pre-pregnancy BMI (interaction term p = 0.04). CONCLUSIONS Results suggest that obesity status before pregnancy may be exacerbating the physiological impact of cortisol on GWG.
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Affiliation(s)
- Christine H Naya
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University Northridge, Northridge, CA, USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alicia K Peterson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan H Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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10
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Sundararajan A, Vora K, Saiyed S, Natesan S. Comparative profiling of prenatal cortisol and DHEA-S among pregnant women with poor birth outcome and pregnant women with normal birth outcome. Clin Endocrinol (Oxf) 2021; 95:863-872. [PMID: 34370329 DOI: 10.1111/cen.14569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/12/2021] [Accepted: 07/19/2021] [Indexed: 12/26/2022]
Abstract
CONTEXT Cortisol and dehydroepiandrosterone-sulfate (DHEA-S) are indispensable hormones for normal pregnancy. It is unclear if these hormones, specifically DHEA-S can offer value for predicting poor birth outcome. OBJECTIVE To compare prenatal cortisol and DHEA-S levels among pregnant women with normal or poor birth outcome. METHODS Plasma and saliva were collected prospectively from women in second-third trimester of pregnancy. Women with normal birth outcome (NBO) (n = 501) included live birth, no pregnancy complications and ≥2.5 kg infant birth weight. Women with poor birth outcome included adverse birth outcome (ABO) (n = 50) or low birth weight outcome (LBW) (n = 147). Enzyme-linked immunosorbent assay was performed to measure hormone concentrations in plasma and saliva. RESULTS Circulatory-DHEA-S levels in pregnant women with ABO were higher than women with NBO (p = .043). Among ABO, only stillbirth cases demonstrated significant increase in circulatory-DHEA-S levels (p = .006). Circulatory and salivary cortisol/DHEA-S ratio was lower among women with stillbirth (p = .004) and ABO outcome (p = .043) respectively compared with women with NBO. Consistently, increased odds of ABO were observed in pregnant women with highest circulatory-DHEA-S levels (odds ratio quartile score 1 vs. 4, 2.79, p = .027) and lowest salivary cortisol/DHEA-S ratio (score 4 vs. 2, 2.83, p = .025). Increased odds of stillbirth outcome were observed in pregnant women with highest circulatory-DHEA-S levels (odds ratio quartile score 1 vs. 4, 8.47, p = .046) and lowest circulatory cortisol/DHEA-S ratio (score 4 vs. 1, 4.803, p = .048). Associations remained significant after adjusting for confounders. Women with LBW did not demonstrate significant changes in cortisol or DHEA-S levels. CONCLUSION Prenatal measurement of DHEA-S or cortisol/DHEA-S ratio may offer significant value for predicting adverse birth, specifically stillbirth outcome.
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Affiliation(s)
| | - Kranti Vora
- Indian Institute of Public Health Gandhinagar, Lekawada, Gandhinagar, India
- University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Shahin Saiyed
- Indian Institute of Public Health Gandhinagar, Lekawada, Gandhinagar, India
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