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Eckermann HA, Lugones M, Abdala D, Roge H, de Weerth C. Maternal early life and prenatal stress in relation to birth outcomes in Argentinian mothers. Dev Psychobiol 2024; 66:e22502. [PMID: 38807271 DOI: 10.1002/dev.22502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/15/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024]
Abstract
Environmental influences before and during pregnancy significantly impact offspring development. This study investigates open research questions regarding the associations between maternal early life stress (ELS), prenatal psychosocial stress, prenatal hair cortisol (HC), and birth outcomes in Argentinian women. Data on ELS, prenatal life events, HC (two samples representing first and second half of pregnancy), and birth outcomes were collected from middle-class Argentinian women (N = 69) upon delivery. Linear mixed models indicated that HC increased from the first half to the second half of pregnancy with considerable variability in the starting values and slopes between individuals. Mothers who experienced more ELS, were taller, or more educated, tended to show lower increases in HC. Older age was positively related to HC increases. Our data did not suggest an interaction between ELS and prenatal life events in relation to HC. We found that the change in HC was most likely negatively associated with birth weight. Our data are most compatible with either a weak or the absence of an association between ELS or prenatal life events and absolute values of HC. Mothers with stronger increases in hair cortisol tended to have newborns with slightly lower birth weight. Hence, ELS and birthweight may either have been related to changes in cortisol exposure during pregnancy or to factors that influence accumulation or retention of cortisol in hair.
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Affiliation(s)
- Henrik Andreas Eckermann
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Micaela Lugones
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Daniel Abdala
- Department of Neonatology, Hospital Español de Mendoza, Mendoza, Argentina
| | - Horacio Roge
- Department of Neonatology, Hospital Español de Mendoza, Mendoza, Argentina
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
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Meredith Weiss S, Aydin E, Lloyd-Fox S, Johnson MH. Trajectories of brain and behaviour development in the womb, at birth and through infancy. Nat Hum Behav 2024:10.1038/s41562-024-01896-7. [PMID: 38886534 DOI: 10.1038/s41562-024-01896-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 04/04/2024] [Indexed: 06/20/2024]
Abstract
Birth is often seen as the starting point for studying effects of the environment on human development, with much research focused on the capacities of young infants. However, recent imaging advances have revealed that the complex behaviours of the fetus and the uterine environment exert influence. Birth is now viewed as a punctuate event along a developmental pathway of increasing autonomy of the child from their mother. Here we highlight (1) increasing physiological autonomy and perceptual sensitivity in the fetus, (2) physiological and neurochemical processes associated with birth that influence future behaviour, (3) the recalibration of motor and sensory systems in the newborn to adapt to the world outside the womb and (4) the effect of the prenatal environment on later infant behaviours and brain function. Taken together, these lines of evidence move us beyond nature-nurture issues to a developmental human lifespan view beginning within the womb.
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Affiliation(s)
- Staci Meredith Weiss
- University of Cambridge, Department of Psychology, Cambridge, UK.
- University of Roehampton, School of Psychology, London, UK.
| | - Ezra Aydin
- University of Cambridge, Department of Psychology, Cambridge, UK
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Sarah Lloyd-Fox
- University of Cambridge, Department of Psychology, Cambridge, UK
| | - Mark H Johnson
- University of Cambridge, Department of Psychology, Cambridge, UK
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
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Davis EP, Demers CH, Deer L, Gallop RJ, Hoffman MC, Grote N, Hankin BL. Impact of prenatal maternal depression on gestational length: post hoc analysis of a randomized clinical trial. EClinicalMedicine 2024; 72:102601. [PMID: 38680516 PMCID: PMC11053273 DOI: 10.1016/j.eclinm.2024.102601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
Background Shortened gestation is a leading cause of childhood morbidity and mortality with lifelong consequences for health. There is a need for public health initiatives on increasing gestational age at birth. Prenatal maternal depression is a pervasive health problem robustly linked via correlational and epidemiological studies to shortened gestational length. This proof-of-concept study tests the impact of reducing prenatal maternal depression on gestational length with analysis of a randomized clinical trial (RCT). Methods Participants included 226 pregnant individuals enrolled into an RCT and assigned to receive either interpersonal psychotherapy (IPT) or enhanced usual care (EUC). Recruitment began in July 2017 and participants were enrolled August 10, 2017 to September, 8 2021. Depression diagnosis (Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; DSM 5) and symptoms (Edinburgh Postnatal Depression Scale and Symptom Checklist) were evaluated at baseline and longitudinally throughout gestation to characterize depression trajectories. Gestational dating was collected based on current guidelines via medical records. The primary outcome was gestational age at birth measured dichotomously (≥39 gestational weeks) and the secondary outcome was gestational age at birth measured continuously. Posthoc analyses were performed to test the effect of reducing prenatal maternal depression on gestational length. This trial is registered with ClinicalTrials.gov (NCT03011801). Findings Steeper decreases in depression trajectories across gestation predicted later gestational age at birth, specifically an increase in the number of full-term babies born ≥39 gestational weeks (EPDS linear slopes: OR = 1.54, 95% CI 1.10-2.16; and SCL-20 linear slopes: OR = 1.67, 95% CI 1.16-2.42). Causal mediation analyses supported the hypothesis that participants assigned to IPT experienced greater reductions in depression symptom trajectories, which in turn, contributed to longer gestation. Supporting mediation, the natural indirect effect (NIE) showed that reduced depression trajectories resulting from intervention were associated with birth ≥39 gestational weeks (EPDS, OR = 1.65, 95% CI 1.02-2.66; SCL-20, OR = 1.85, 95% CI 1.16-2.97). Interpretation We used a RCT design and found that reducing maternal depression across pregnancy was associated with lengthened gestation. Funding This research was supported by the NIH (R01 HL155744, R01 MH109662, R21 MH124026, P50 MH096889).
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Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, USA
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Catherine H. Demers
- Department of Psychology, University of Denver, Denver, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - LillyBelle Deer
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Robert J. Gallop
- Department of Mathematics, West Chester University, West Chester, PA, USA
| | - M. Camille Hoffman
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Nancy Grote
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Vasconcelos I, von Hafe M, Adão R, Leite-Moreira A, Brás-Silva C. Corticotropin-releasing hormone and obesity: From fetal life to adulthood. Obes Rev 2024:e13763. [PMID: 38699883 DOI: 10.1111/obr.13763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/02/2024] [Accepted: 03/19/2024] [Indexed: 05/05/2024]
Abstract
Obesity is among the most common chronic disorders, worldwide. It is a complex disease that reflects the interactions between environmental influences, multiple genetic allelic variants, and behavioral factors. Recent developments have also shown that biological conditions in utero play an important role in the programming of energy homeostasis systems and might have an impact on obesity and metabolic disease risk. The corticotropin-releasing hormone (CRH) family of neuropeptides, as a central element of energy homeostasis, has been evaluated for its role in the pathophysiology of obesity. This review aims to summarize the relevance and effects of the CRH family of peptides in the pathophysiology of obesity spanning from fetal life to adulthood.
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Affiliation(s)
- Inês Vasconcelos
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Madalena von Hafe
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Adão
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Enfermedades Respiratorias (Ciberes), Madrid, Spain
| | - Adelino Leite-Moreira
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carmen Brás-Silva
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
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Zamani-Hank Y, Brincks A, Talge NM, Slaughter-Acey J, Margerison C. The Association Between Adverse Childhood Experiences and Preterm Delivery: A Latent Class Approach. J Womens Health (Larchmt) 2024; 33:522-531. [PMID: 38457646 DOI: 10.1089/jwh.2023.0196] [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] [Indexed: 03/10/2024] Open
Abstract
Background: Racial and socioeconomic status (SES) disparities in preterm delivery (PTD) have existed in the United States for decades. Disproportionate maternal exposures to adverse childhood experiences (ACEs) may increase the risk for adverse birth outcomes. Moreover, racial and SES disparities exist in the prevalence of ACEs, underscoring the need for research that examines whether ACEs contribute to racial and SES disparities in PTD. Methods: We examined the relationship between ACEs and PTD in a longitudinal sample of N = 3,884 women from the National Longitudinal Study of Adolescent to Adult Health (1994-2018). We applied latent class analysis to (1) identify subgroups of women characterized by patterns of ACE occurrence; (2) estimate the association between latent class membership (LCM) and PTD, and (3) examine whether race and SES influence LCM or the association between LCM and PTD. Results: Two latent classes were identified, with women in the high ACEs class characterized by a higher probability of emotional abuse, physical abuse, sexual abuse, and foster care placement compared with the low ACEs class, but neither class was associated with PTD. Race and SES did not predict LCM. Conclusions: Our findings suggest that ACEs may not impact PTD risk in previously hypothesized ways. Future research should assess the impact of ACEs on the probability of having live birth pregnancies as well as the role of potential protective factors in mitigating the impact of ACEs on PTD.
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Affiliation(s)
- Yasamean Zamani-Hank
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Ahnalee Brincks
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Nicole M Talge
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jaime Slaughter-Acey
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Claire Margerison
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
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Bailey NA, Davis EP, Sandman CA, Glynn LM. DHEA: a neglected biological signal that may affect fetal and child development. J Child Psychol Psychiatry 2024. [PMID: 38426566 DOI: 10.1111/jcpp.13952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND The stress-sensitive maternal hypothalamic-pituitary-adrenal (HPA) axis through the end-product cortisol, represents a primary pathway through which maternal experience shapes fetal development with long-term consequences for child neurodevelopment. However, there is another HPA axis end-product that has been widely ignored in the study of human pregnancy. The synthesis and release of dehydroepiandosterone (DHEA) is similar to cortisol, so it is a plausible, but neglected, biological signal that may influence fetal neurodevelopment. DHEA also may interact with cortisol to determine developmental outcomes. Surprisingly, there is virtually nothing known about human fetal exposure to prenatal maternal DHEA and offspring neurodevelopment. The current study examined, for the first time, the joint impact of fetal exposure to prenatal maternal DHEA and cortisol on infant emotional reactivity. METHODS Participants were 124 mother-infant dyads. DHEA and cortisol were measured from maternal hair at 15 weeks (early gestation) and 35 weeks (late gestation). Observational assessments of positive and negative emotional reactivity were obtained in the laboratory when the infants were 6 months old. Pearson correlations were used to examine the associations between prenatal maternal cortisol, prenatal maternal DHEA, and infant positive and negative emotional reactivity. Moderation analyses were conducted to investigate whether DHEA might modify the association between cortisol and emotional reactivity. RESULTS Higher levels of both early and late gestation maternal DHEA were linked to greater infant positive emotional reactivity. Elevated late gestation maternal cortisol was associated with greater negative emotional reactivity. Finally, the association between fetal cortisol exposure and infant emotional reactivity was only observed when DHEA was low. CONCLUSIONS These new observations indicate that DHEA is a potential maternal biological signal involved in prenatal programming. It appears to act both independently and jointly with cortisol to determine a child's emotional reactivity. Its role as a primary end-product of the HPA axis, coupled with the newly documented associations with prenatal development shown here, strongly calls for the inclusion of DHEA in future investigations of fetal programming.
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Affiliation(s)
- Natasha A Bailey
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, USA
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Curt A Sandman
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Laura M Glynn
- Department of Psychology, Chapman University, Orange, CA, USA
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Castro-Quintas Á, Eixarch E, Martin-Gonzalez NS, Daura-Corral M, Marques-Feixa L, Palma-Gudiel H, Rocavert-Barranco M, Miguel-Valero A, Monteserín-García JL, de la Fuente-Tomás L, Crispi F, Arias B, García-Portilla MP, Fañanás L. Diurnal cortisol throughout pregnancy and its association with maternal depressive symptoms and birth outcomes. Psychoneuroendocrinology 2024; 161:106930. [PMID: 38142606 DOI: 10.1016/j.psyneuen.2023.106930] [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: 04/14/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Depression during pregnancy is a common complication that can negatively affect fetal health and birth outcomes. Cortisol is believed to be a key mediator of this association. Although pregnancy entails a natural increase in cortisol levels, preclinical depression could alter its circadian rhythm, producing excessively high overall diurnal cortisol levels that might be harmful for the fetus and future offspring development. OBJECTIVES Using a prospective longitudinal design, we aimed to study (i) trimestral cortisol circadian rhythm and its overall levels throughout pregnancy in healthy women, (ii) the extent to which maternal depressive symptoms influence both cortisol rhythmicity and overall levels, and (iii) the possible adverse consequences of elevated maternal cortisol on the offspring's weight and gestational age at birth. STUDY DESIGN 112 healthy pregnant women from the general Spanish population were recruited before their first pregnancy. To assess cortisol circadian rhythm, participants provided four saliva samples at each trimester of pregnancy (at awakening, 30 min after awakening, before lunch and before going to bed). Overall cortisol levels were calculated with AUCg approximation. Depressive symptoms were evaluated in each trimester and defined according to EPDS cut-off values (1st trimester, EPDS ≥ 11; 2nd and 3rd trimesters, EPDS ≥ 10). At birth, the risk for low weight, prematurity and weight birth percentile was retrieved for 100 infants. Mixed models and simple effects were employed to study changes of maternal cortisol circadian rhythm and overall levels throughout pregnancy and the possible influence of maternal depressive symptoms. Finally, logistic regressions were performed to assess the associations between maternal overall cortisol levels in each trimester of pregnancy and birth anthropometrics. RESULTS Although overall diurnal cortisol levels increase throughout pregnancy, cortisol circadian rhythm is preserved in all trimesters [1st (F(3110)= 92.565, p < .001), 2nd (F(3,85)= 46.828, p < .001) and 3rd (F(3,90)= 65.555, p < .001)]. However, women with depressive symptoms showed a flattened cortisol circadian pattern only during the second trimester, characterized by a blunted awakening peak and reduced evening decline (F(3,85)= 4.136, p = .009), but not during the first (F(3,11)= 1.676, p = .176) or the third (F(3,90)= 1.089, p = .358) trimesters. Additionally, they did not show a cortisol increase from second to third trimester (p = .636). Finally, higher maternal cortisol levels in second and third trimesters seemed to be associated with increased risk of prematurity (adjusted OR -0.371, 95% CI 0.490-0.972, p = .034) and low birth weight percentile (adjusted OR -0.612, 95% CI 0.348-0.846, p = .007) respectively. CONCLUSION Maternal cortisol levels increased throughout pregnancy, although cortisol circadian rhythm was preserved in all trimesters of pregnancy. However, prenatal depressive symptoms were associated with flattened maternal cortisol circadian rhythm in mid-pregnancy. Therefore, it seems that women with depressive symptoms tended to increase less gradually their cortisol levels from mid to late pregnancy. Finally, higher maternal cortisol levels in mid and late-pregnancy seem to be associated with poorer birth anthropometrics Early detection of depressive symptoms in general population could help to prevent putative obstetrical and birth adverse outcomes.
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Affiliation(s)
- Águeda Castro-Quintas
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Elisenda Eixarch
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Network Centre for Biomedical Research on Rare Diseases (CIBER of Rare Diseases, CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Nerea San Martin-Gonzalez
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Maria Daura-Corral
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Laia Marques-Feixa
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Helena Palma-Gudiel
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain; College of Public Health and Health Professions, Department of Epidemiology, University of Florida, United States
| | | | - Alba Miguel-Valero
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Jose Luis Monteserín-García
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Lorena de la Fuente-Tomás
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo, Asturias, Spain
| | - Fátima Crispi
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Network Centre for Biomedical Research on Rare Diseases (CIBER of Rare Diseases, CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Barbara Arias
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - María Paz García-Portilla
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo, Asturias, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain.
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Izawa S, Kawasaki M, Sugaya N, Nomura S. Time-course changes in fingernail cortisol levels during pregnancy and postpartum. Sci Rep 2024; 14:1145. [PMID: 38212622 PMCID: PMC10784579 DOI: 10.1038/s41598-024-51650-2] [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: 07/25/2023] [Accepted: 01/08/2024] [Indexed: 01/13/2024] Open
Abstract
The cortisol level in fingernails can reflect the cumulative hormones produced in the body several months prior. However, previous studies have only demonstrated the cross-sectional associations of fingernail cortisol with salivary or hair cortisol, and not longitudinal changes in fingernail cortisol in situations where cortisol levels in the body could be expected to change. Therefore, this study focused on pregnancy as a model for changes in cortisol levels over a prolonged period of time, and investigating the time courses of fingernail cortisol during pregnancy and the postpartum period. We collected nail samples from 30 healthy women during pregnancy and 12 months postpartum to measure the cortisol levels in the nail. Results showed that cortisol levels in fingernail clippings increased from 1 month before childbirth to 4 months postpartum, with the levels peaking at 2 months postpartum. Additionally, we found higher cortisol levels in fingernail clippings in primiparas than in those of multiparas. The time course of fingernail cortisol levels could replicate the longitudinal changes in cortisol in the body, and differences between multiparas and primiparas seemed to be biologically plausible, which could support the concept of fingernail cortisol as a retrospective index of hormone production.
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Affiliation(s)
- Shuhei Izawa
- Occupational Stress and Health Management Research Group, National Institute of Occupational Safety and Health, Kawasaki, Japan.
| | - Mikiko Kawasaki
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
- Japanese Red Cross Kyushu International College of Nursing, Munakata, Japan
| | - Nagisa Sugaya
- Occupational Stress and Health Management Research Group, National Institute of Occupational Safety and Health, Kawasaki, Japan
| | - Shusaku Nomura
- Faculty of Engineering, Nagaoka University of Technology, Nagaoka, Japan.
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Howland MA. Recalibration of the stress response system over adult development: Is there a perinatal recalibration period? Dev Psychopathol 2023; 35:2315-2337. [PMID: 37641984 PMCID: PMC10901284 DOI: 10.1017/s0954579423000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
During early life-sensitive periods (i.e., fetal, infancy), the developing stress response system adaptively calibrates to match environmental conditions, whether harsh or supportive. Recent evidence suggests that puberty is another window when the stress system is open to recalibration if environmental conditions have shifted significantly. Whether additional periods of recalibration exist in adulthood remains to be established. The present paper draws parallels between childhood (re)calibration periods and the perinatal period to hypothesize that this phase may be an additional window of stress recalibration in adult life. Specifically, the perinatal period (defined here to include pregnancy, lactation, and early parenthood) is also a developmental switch point characterized by heightened neural plasticity and marked changes in stress system function. After discussing these similarities, lines of empirical evidence needed to substantiate the perinatal stress recalibration hypothesis are proposed, and existing research support is reviewed. Complexities and challenges related to delineating the boundaries of perinatal stress recalibration and empirically testing this hypothesis are discussed, as well as possibilities for future multidisciplinary research. In the theme of this special issue, perinatal stress recalibration may be a mechanism of multilevel, multisystem risk, and resilience, both intra-individually and intergenerationally, with implications for optimizing interventions.
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Affiliation(s)
- Mariann A Howland
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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10
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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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11
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Liu M, Ji M, Cheng J, Li Y, Tian Y, Zhao H, Wang Y, Zhu S, Zhang L, Xu X, Feng GS, Liang X, Bao H, Tang Y, Kong S, Lu J, Wang H, Lu Z, Deng W. Deciphering a critical role of uterine epithelial SHP2 in parturition initiation at single cell resolution. Nat Commun 2023; 14:7356. [PMID: 37963860 PMCID: PMC10646072 DOI: 10.1038/s41467-023-43102-8] [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: 03/02/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023] Open
Abstract
The timely onset of female parturition is a critical determinant for pregnancy success. The highly heterogenous maternal decidua has been increasingly recognized as a vital factor in setting the timing of labor. Despite the cell type specific roles in parturition, the role of the uterine epithelium in the decidua remains poorly understood. This study uncovers the critical role of epithelial SHP2 in parturition initiation via COX1 and COX2 derived PGF2α leveraging epithelial specific Shp2 knockout mice, whose disruption contributes to delayed parturition initiation, dystocia and fetal deaths. Additionally, we also show that there are distinct types of epithelium in the decidua approaching parturition at single cell resolution accompanied with profound epithelium reformation via proliferation. Meanwhile, the epithelium maintains the microenvironment by communicating with stromal cells and macrophages. The epithelial microenvironment is maintained by a close interaction among epithelial, stromal and macrophage cells of uterine stromal cells. In brief, this study provides a previously unappreciated role of the epithelium in parturition preparation and sheds lights on the prevention of preterm birth.
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Affiliation(s)
- Meng Liu
- State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Mengjun Ji
- State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen, Fujian, China
| | - Jianghong Cheng
- State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen, Fujian, China
| | - Yingzhe Li
- State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen, Fujian, China
| | - Yingpu Tian
- State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen, Fujian, China
| | - Hui Zhao
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yang Wang
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Sijing Zhu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Leilei Zhang
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Xinmei Xu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Gen-Sheng Feng
- Department of Pathology, Division of Biological Sciences, University of California San Diego, La Jolla, CA, USA
| | - Xiaohuan Liang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, China
| | - Haili Bao
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yedong Tang
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Shuangbo Kong
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jinhua Lu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Haibin Wang
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China.
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Zhongxian Lu
- State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen, Fujian, China.
| | - Wenbo Deng
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China.
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China.
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12
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Zhao H, Wang Y, Xu H, Liu M, Xu X, Zhu S, Liu Z, Cai H, Wang Y, Lu J, Yang X, Kong S, Bao H, Wang H, Deng W. Stromal cells-specific retinoic acid determines parturition timing at single-cell and spatial-temporal resolution. iScience 2023; 26:107796. [PMID: 37720083 PMCID: PMC10502414 DOI: 10.1016/j.isci.2023.107796] [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: 03/13/2023] [Revised: 05/23/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023] Open
Abstract
The underlying mechanisms governing parturition remain largely elusive due to limited knowledge of parturition preparation and initiation. Accumulated evidences indicate that maternal decidua plays a critical role in parturition initiation. To comprehensively decrypt the cell heterogeneity in decidua approaching parturition, we investigate the roles of various cell types in mouse decidua process and reveal previously unappreciated insights in parturition initiation utilizing single-cell RNA sequencing (scRNA-seq). We enumerate the cell types in decidua and identity five different stromal cells populations and one decidualized stromal cells. Furthermore, our study unravels that stromal cells prepare for parturition by regulating local retinol acid (RA) synthesis. RA supplement decreases expression of extracellular matrix-related genes in vitro and accelerates the timing of parturition in vivo. Collectively, the discovery of contribution of stromal cells in parturition expands current knowledge about parturition and opens up avenues for the intervention of preterm birth (PTB).
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Affiliation(s)
- Hui Zhao
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yang Wang
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Hui Xu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Meng Liu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Xinmei Xu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Sijing Zhu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Zhao Liu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Han Cai
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yinan Wang
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jinhua Lu
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Xiaoqing Yang
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Nantong University, Xisi Road, Nantong, Jiangsu, China
| | - Shuangbo Kong
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Haili Bao
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Haibin Wang
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Wenbo Deng
- Fujian Provincial Key Laboratory of Reproductive Health Research, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Medicine, Xiamen University, Xiamen, Fujian, China
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13
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Ruan T, Yue Y, Lu W, Zhou R, Xiong T, Jiang Y, Ying J, Tang J, Shi J, Wang H, Xiao G, Li J, Qu Y, Mu D. Association between low ambient temperature during pregnancy and adverse birth outcomes: A systematic review and meta-analysis. Chin Med J (Engl) 2023; 136:2307-2315. [PMID: 36805588 PMCID: PMC10538931 DOI: 10.1097/cm9.0000000000002361] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Extreme temperature events, including extreme cold, are becoming more frequent worldwide, which might be harmful to pregnant women and cause adverse birth outcomes. We aimed to investigate the association between exposure to low ambient temperature in pregnant women and adverse birth outcomes, such as preterm birth, low birth weight, and stillbirth, and to summarize the evidence herein. METHODS Relevant studies were searched in PubMed, Cochrane, and Embase electronic databases until November 2021. Studies involving low ambient temperature, preterm birth, birth weight, and stillbirth were included. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses were followed to conduct this study risk of bias and methods for data synthesis. RESULTS A total of 34 studies were included. First, pregnant women exposed to low ambient temperature had an increased risk of preterm birth (risk ratio [RR] 1.08; 95% confidence interval [CI] 1.04-1.13). Subgroup analyses revealed that exposure during late pregnancy was more likely to induce preterm birth. In addition, only pregnant women exposed to <1st percentile of the mean temperature suffered increased risk of preterm birth. Moreover, pregnant women living in medium or hot areas were more prone to have preterm births than those in cold areas when exposed to low ambient temperatures. Asians and Blacks were more susceptible to low ambient temperatures than Caucasians. Second, pregnant women exposed to low ambient temperature had an increased risk of low birth weight (RR 1.07; 95% CI 1.03-1.12). Third, pregnant women had an increased risk of stillbirth while exposed to low ambient temperature during the entire pregnancy (RR 4.63; 95% CI 3.99-5.38). CONCLUSIONS Exposure to low ambient temperature during pregnancy increases the risk of adverse birth outcomes. Pregnant women should avoid exposure to extremely low ambient temperature (<1st percentile of the mean temperature), especially in their late pregnancy. This study could provide clues for preventing adverse outcomes from meteorological factors. REGISTRATION No. CRD42021259776 at PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ).
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Affiliation(s)
- Tiechao Ruan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yan Yue
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wenting Lu
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ruixi Zhou
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Tao Xiong
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yin Jiang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Junjie Ying
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jun Tang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jing Shi
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hua Wang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Guoguang Xiao
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jinhui Li
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yi Qu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
| | - Dezhi Mu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China
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14
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Herzberg MP, Triplett R, McCarthy R, Kaplan S, Alexopoulos D, Meyer D, Arora J, Miller JP, Smyser TA, Herzog ED, England SK, Zhao P, Barch DM, Rogers CE, Warner BB, Smyser CD, Luby J. The Association Between Maternal Cortisol and Infant Amygdala Volume Is Moderated by Socioeconomic Status. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:837-846. [PMID: 37881545 PMCID: PMC10593881 DOI: 10.1016/j.bpsgos.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/25/2023] [Accepted: 03/11/2023] [Indexed: 10/27/2023] Open
Abstract
Background It has been well established that socioeconomic status is associated with mental and physical health as well as brain development, with emerging data suggesting that these relationships begin in utero. However, less is known about how prenatal socioeconomic environments interact with the gestational environment to affect neonatal brain volume. Methods Maternal cortisol output measured at each trimester of pregnancy and neonatal brain structure were assessed in 241 mother-infant dyads. We examined associations between the trajectory of maternal cortisol output across pregnancy and volumes of cortisol receptor-rich regions of the brain, including the amygdala, hippocampus, medial prefrontal cortex, and caudate. Given the known effects of poverty on infant brain structure, socioeconomic disadvantage was included as a moderating variable. Results Neonatal amygdala volume was predicted by an interaction between maternal cortisol output across pregnancy and socioeconomic disadvantage (standardized β = -0.31, p < .001), controlling for postmenstrual age at scan, infant sex, and total gray matter volume. Notably, amygdala volumes were positively associated with maternal cortisol for infants with maternal disadvantage scores 1 standard deviation below the mean (i.e., less disadvantage) (simple slope = 123.36, p < .01), while the association was negative in infants with maternal disadvantage 1 standard deviation above the mean (i.e., more disadvantage) (simple slope = -82.70, p = .02). Individuals with disadvantage scores at the mean showed no association, and there were no significant interactions in the other brain regions examined. Conclusions These data suggest that fetal development of the amygdala is differentially affected by maternal cortisol production at varying levels of socioeconomic advantage.
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Affiliation(s)
- Max P. Herzberg
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Regina Triplett
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
| | - Ronald McCarthy
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
| | - Sydney Kaplan
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
| | | | - Dominique Meyer
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
| | - Jyoti Arora
- Department of Biostatistics, Washington University in St. Louis, St. Louis, Missouri
| | - J. Philip Miller
- Department of Biostatistics, Washington University in St. Louis, St. Louis, Missouri
| | - Tara A. Smyser
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Erik D. Herzog
- Department of Biology, Washington University in St. Louis, St. Louis, Missouri
| | - Sarah K. England
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
| | - Deanna M. Barch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
- Department of Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Cynthia E. Rogers
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
- Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri
| | - Barbara B. Warner
- Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri
| | - Christopher D. Smyser
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
- Department of Radiology, Washington University in St. Louis, St. Louis, Missouri
- Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri
| | - Joan Luby
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
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15
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Yeramilli V, Cheddadi R, Benjamin H, Martin C. The Impact of Stress, Microbial Dysbiosis, and Inflammation on Necrotizing Enterocolitis. Microorganisms 2023; 11:2206. [PMID: 37764050 PMCID: PMC10534571 DOI: 10.3390/microorganisms11092206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Necrotizing enterocolitis (NEC) is the leading cause of intestinal morbidity and mortality in neonates. A large body of work exists; however, the pathogenesis of NEC remains poorly understood. Numerous predictors have been implicated in the development of NEC, with relatively less emphasis on maternal factors. Utilizing human tissue plays a crucial role in enhancing our comprehension of the underlying mechanisms accountable for this devastating disease. In this review, we will discuss how maternal stress affects the pathogenesis of NEC and how changes in the intestinal microbiome can influence the development of NEC. We will also discuss the results of transcriptomics-based studies and analyze the gene expression changes in NEC tissues and other molecular targets associated with the pathogenesis of NEC.
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Affiliation(s)
| | | | | | - Colin Martin
- Division of Pediatric, Department of Surgery, University of Alabama at Birmingham, 1600 7th Ave. S., Lowder Building Suite 300, Birmingham, AL 35233, USA
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16
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Fox MM, Knorr DA, Kwon D, Wiley KS, Parrish MH. How prenatal cortisol levels relate to grandmother-mother relationships among a cohort of Latina women. Am J Hum Biol 2023; 35:e23883. [PMID: 36862026 PMCID: PMC10474942 DOI: 10.1002/ajhb.23883] [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: 09/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
INTRODUCTION As part of the human reproductive strategy, mothers receive childcare assistance from others. For kin, allomothers are adaptively incentivized to provide assistance due to inclusive fitness benefits. Previous studies across a broad range of populations identify grandmothers as particularly consistent allomothers. Minimal attention has been paid to the possibility that allomothers may begin investing in offspring quality during the prenatal stage of life. Here, we innovate within the area of grandmother allocare research by examining the prenatal stage of life and biopsychosocial mechanisms by which prenatal grandmother effects may be enacted. METHODS Data derive from the Mothers' Cultural Experiences study, a cohort of 107 pregnant Latina women in Southern California. At <16 weeks' gestation, we administered questionnaires, collected morning urine samples, and measured cortisol by enzyme-linked immunosorbent assay, correcting for specific gravity. We measured the soon-to-be maternal and paternal grandmothers' relationship quality, social support, frequency of seeing each other, communicating, and geographic proximity to pregnant mothers, that is, their daughters and daughters-in-law. These measures were self-reported by the pregnant mothers. We assessed how grandmother constructs related to the pregnant women's depression, stress, anxiety, and cortisol levels. RESULTS We observed benefits conferred by maternal grandmothers for mothers' prenatal mental health and lower cortisol levels. Paternal grandmothers also conferred mental health benefits to pregnant daughters-in-law, but higher cortisol levels. CONCLUSION Our results suggest that grandmothers, especially maternal grandmothers, are able to improve their inclusive fitness by caring for pregnant daughters, and allomother support may positively impact prenatal health. This work extends the traditional cooperative breeding model by identifying a prenatal grandmother effect, and, by examining a maternal biomarker.
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Affiliation(s)
- Molly M. Fox
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Delaney A. Knorr
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Dayoon Kwon
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Kyle S. Wiley
- Department of Anthropology, University of California, Los Angeles, Los Angeles, CA, 90095 USA
| | - Michael H. Parrish
- Department of Psychology, University of California, Los Angeles, CA 90095 USA
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17
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Deer LK, Su C, Thwaites NA, Davis EP, Doom JR. A framework for testing pathways from prenatal stress-responsive hormones to cardiovascular disease risk. Front Endocrinol (Lausanne) 2023; 14:1111474. [PMID: 37223037 PMCID: PMC10200937 DOI: 10.3389/fendo.2023.1111474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/10/2023] [Indexed: 05/25/2023] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of death globally, with the prevalence projected to keep rising. Risk factors for adult CVD emerge at least as early as the prenatal period. Alterations in stress-responsive hormones in the prenatal period are hypothesized to contribute to CVD in adulthood, but little is known about relations between prenatal stress-responsive hormones and early precursors of CVD, such as cardiometabolic risk and health behaviors. The current review presents a theoretical model of the relation between prenatal stress-responsive hormones and adult CVD through cardiometabolic risk markers (e.g., rapid catch-up growth, high BMI/adiposity, high blood pressure, and altered blood glucose, lipids, and metabolic hormones) and health behaviors (e.g., substance use, poor sleep, poor diet and eating behaviors, and low physical activity levels). Emerging evidence in human and non-human animal literatures suggest that altered stress-responsive hormones during gestation predict higher cardiometabolic risk and poorer health behaviors in offspring. This review additionally highlights limitations of the current literature (e.g., lack of racial/ethnic diversity, lack of examination of sex differences), and discusses future directions for this promising area of research.
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Affiliation(s)
- LillyBelle K. Deer
- Department of Psychology, University of Denver, Denver, CO, United States
| | - Chen Su
- Department of Psychology, University of Denver, Denver, CO, United States
| | | | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, United States
- Department of Psychiatry & Human Behavior, University of California, Irvine, Irvine, CA, United States
| | - Jenalee R. Doom
- Department of Psychology, University of Denver, Denver, CO, United States
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18
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Mlili NE, Ahabrach H, Cauli O. Hair Cortisol Concentration as a Biomarker of Symptoms of Depression in the Perinatal Period. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:71-83. [PMID: 35297354 DOI: 10.2174/1871527321666220316122605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
Pregnancy is a sensitive period when women experience major hormonal and psychological changes. A high prevalence of the symptoms of depression and manifested major depression rates have been reported during this period, leading to negative outcomes both for mothers and the offspring. Despite its prevalence, the aetiology of depression is not yet fully understood. Nonetheless, alterations in cortisol levels have been proposed as a reliable biomarker to identify pregnant women at risk of perinatal depression. Hair cortisol has recently been extensively used in bio-psychological studies as a suitable non-invasive biomarker for several neuropsychiatric disorders. Various studies have published evidence regarding the relationship between cortisol fluctuations during the perinatal period, measured both in hair and in other substrates, and the onset of perinatal symptoms of depression. This current review provides an overview of cortisol level changes measured in women's hair during pregnancy or the postpartum period and its association with perinatal symptoms of depression. Further studies, including repetitive measurement of both hair cortisol and depression throughout the prenatal period, must be performed to clarify the relationship between cortisol levels and perinatal symptoms of depression.
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Affiliation(s)
- Nisrin El Mlili
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Hanan Ahabrach
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia 46010, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, Valencia 46010, Spain
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19
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Zhang L, Zhu S, Wu Y, Chen D, Liang Z. Association between maternal second-trimester stress and adverse pregnancy outcomes according to pre-pregnancy body mass index and gestational weight gain. Front Psychiatry 2023; 14:1129014. [PMID: 37032953 PMCID: PMC10076625 DOI: 10.3389/fpsyt.2023.1129014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Objective To investigate the impact of maternal second-trimester stress on pregnancy outcomes according to pre-pregnancy body mass index (BMI) and gestational weight gain (GWG). Methods We did a prospective study in Women's Hospital, School of Medicine, Zhejiang University and included 960 pregnant women in our final analysis. Obstetric characteristics and the incidence of adverse pregnancy outcomes were examined in stressed and non-stressed women. The associations between maternal prenatal stress with adverse pregnancy outcomes were analyzed by logistic regression. Results The incidence of premature rupture of membranes (PROM) was significantly higher in stressed pregnant women than non-stressed pregnant women (p = 0.035), whereas no significant difference in the incidence rates of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), primary cesarean delivery, preterm birth, macrosomia, low birth weight, fetal stress, admission into neonatal intensive care unit (NICU) or neonatal jaundice was found between two groups. Maternal second-trimester stress was an independent risk factor for the development of PROM (aOR = 1.468, 95% CI 1.037-2.079). Moreover, maternal second-trimester stress was significantly associated with PROM in pregnant women with normal pre-pregnancy BMI (aOR = 1.587, 95% CI 1.068-2.357) while no association was observed in either underweight or overweight and obese pregnant women. Meanwhile, no difference was found in the odds of PROM with maternal second-trimester stress in all GWG subgroups. Conclusion Maternal second-trimester stress is associated with a higher risk of PROM and it is significant in pregnant women with normal pre-pregnancy BMI. Therefore, interventions to reduce stress during second-trimester of pregnancy might be essential for lowering the prevalence of PROM in pregnant women with normal pre-pregnancy BMI.
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20
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Clark J, Bulka CM, Martin CL, Roell K, Santos HP, O’Shea TM, Smeester L, Fry R, Dhingra R. Placental epigenetic gestational aging in relation to maternal sociodemographic factors and smoking among infants born extremely preterm: a descriptive study. Epigenetics 2022; 17:2389-2403. [PMID: 36134874 PMCID: PMC9665142 DOI: 10.1080/15592294.2022.2125717] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 11/03/2022] Open
Abstract
Social determinants of health (SDoH) are defined as the conditions in which people are born, grow, live, work, and age. The distribution of these conditions is influenced by underlying structural factors and may be linked to adverse pregnancy outcomes through epigenetic modifications of gestational tissues. A promising modification is epigenetic gestational age (eGA), which captures 'biological' age at birth. Measuring eGA in placenta, an organ critical for foetal development, may provide information about how SDoH 'get under the skin' during pregnancy to influence birth outcomes and ethnic/racial disparities. We examined relationships of placental eGA with sociodemographic factors, smoking, and two key clinical outcomes: Apgar scores and NICU length of stay. Using the Robust Placental Clock, we estimated eGA for placental samples from the Extremely Low Gestational Age Newborns cohort (N = 408). Regression modelling revealed smoking during pregnancy was associated with placental eGA acceleration (i.e., eGA higher than chronologic gestational age). This association differed by maternal race: among infants born to mothers racialized as Black, we observed greater eGA acceleration (+0.89 week, 95% CI: 0.38, 1.40) as compared to those racialized as white (+0.27 week, 95% CI: -0.06, 0.59). Placental eGA acceleration was also correlated with shorter NICU lengths of stay, but only among infants born to mothers racialized as Black (-0.08 d/week-eGA, 95% CI: -0.12, -0.05). Together, these observed associations suggest that interpretations of epigenetic gestational aging may be tissue-specific.
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Affiliation(s)
- Jeliyah Clark
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Catherine M. Bulka
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Chantel L. Martin
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Kyle Roell
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
| | - Hudson P. Santos
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
- Biobehavioral Lab, School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - T. Michael O’Shea
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lisa Smeester
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca Fry
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
- Curriculum in Toxicology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Radhika Dhingra
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
- Institute for Environmental Health Solutions, University of North Carolina, Chapel Hill, NC, USA
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21
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MAYNE GB, DeWITT PE, RINGHAM B, WARRENER AG, CHRISTIANS U, DABELEA D, HURT KJ. A Nested Case-Control Study of Allopregnanolone and Preterm Birth in the Healthy Start Cohort. J Endocr Soc 2022; 7:bvac179. [PMID: 36632210 PMCID: PMC9825133 DOI: 10.1210/jendso/bvac179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Indexed: 11/26/2022] Open
Abstract
Context Chronic stress is a risk factor for preterm birth; however, objective measures of stress in pregnancy are limited. Maternal stress biomarkers may fill this gap. Steroid hormones and neurosteroids such as allopregnanolone (ALLO) play important roles in stress physiology and pregnancy maintenance and therefore may be promising for preterm birth prediction. Objective We evaluated maternal serum ALLO, progesterone, cortisol, cortisone, pregnanolone, and epipregnanolone twice in gestation to evaluate associations with preterm birth. Methods We performed a nested case-control study using biobanked fasting serum samples from the Healthy Start prebirth cohort. We included healthy women with a singleton pregnancy and matched preterm cases with term controls (1:1; N = 27 per group). We used a new HPLC-tandem mass spectrometry assay to quantify ALLO and five related steroids. We used ANOVA, Fisher exact, χ2, t test, and linear and logistic regression as statistical tests. Results Maternal serum ALLO did not associate with preterm birth nor differ between groups. Mean cortisol levels were significantly higher in the preterm group early in pregnancy (13w0d-18w0d; P < 0.05) and higher early pregnancy cortisol associated with increased odds of preterm birth (at 13w0d; odds ratio, 1.007; 95% CI, 1.0002-1.014). Progesterone, cortisone, pregnanolone, and epipregnanolone did not associate with preterm birth. Conclusion The findings from our pilot study suggest potential utility of cortisol as a maternal serum biomarker for preterm birth risk assessment in early pregnancy. Further evaluation using larger cohorts and additional gestational timepoints for ALLO and the other analytes may be informative.
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Affiliation(s)
- Gabriella B MAYNE
- Department of Anthropology, University of Colorado, Denver, CO 80204, USA
| | - Peter E DeWITT
- Department of Pediatrics Informatics and Data Science, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Brandy RINGHAM
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Anna G WARRENER
- Department of Anthropology, University of Colorado, Denver, CO 80204, USA
| | - Uwe CHRISTIANS
- iC42 Clinical Research & Development, Department of Anesthesiology, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Dana DABELEA
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - K Joseph HURT
- Correspondence: K. Joseph Hurt, MD, PhD, 12700 East 19th Ave, Aurora, CO 80045, USA.
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22
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Espejo-Beristain G, Ahuja-Aguirre C, Carrasco-García AA, Hernandez-Cruz B, Paredes-Ramos P. Environmental enrichment for primiparous and multiparous pregnant sows and its effect on cortisol and behavior at farrowing and production parameters at weaning. Livest Sci 2022. [DOI: 10.1016/j.livsci.2022.105103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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23
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Nowak AL, Anderson CM, Ford JL, Mackos A, Ohm J, Saadat N, Tan A, Zhao Y, Misra DP, Giurgescu C. DNA Methylation Patterns of Glucocorticoid Pathway Genes in Preterm Birth Among Black Women. Biol Res Nurs 2022; 24:493-502. [PMID: 35512640 PMCID: PMC9630727 DOI: 10.1177/10998004221099253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Preterm birth (PTB; <37 weeks gestation) rates have increased for 5 of the last 6 consecutive years in the United States. These rates are particularly alarming for U.S. non-Hispanic Black women who give birth prematurely at 1.5 times the rate of non-Hispanic White women. Previous research suggests that psychological stress is associated with PTB in Black women. However, the biological pathways by which stress alters birth timing are not clear. We examined DNA methylation (DNAm) in peripheral blood leukocytes in 6 glucocorticoid, stress-related genes in 44 (22 PTB; 22 term birth) pregnant Black women. Four cytosine-phosphate-guanine (CpG) sites were identified as differentially methylated (p < 0.05) between women with PTB and women with term births. The ability to identify stress-related biological markers that are associated with PTB among Black women would provide a critical step toward decreasing the PTB disparity among these women. Future studies should include larger sample sizes and gene expression analyses of the stress-related biological pathways to PTB.
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Affiliation(s)
| | | | - Jodi L. Ford
- College of Nursing, The Ohio State
University, Columbus, OH, USA
| | - Amy Mackos
- College of Nursing, The Ohio State
University, Columbus, OH, USA
| | - Joyce Ohm
- Department of Genetics and
Genomics, Roswell Park Comprehensive Cancer
Center, Buffalo, NY, USA
| | - Nadia Saadat
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Alai Tan
- College of Nursing, The Ohio State
University, Columbus, OH, USA
| | - Yihong Zhao
- School of Nursing, Columbia University, New York, NY, USA
| | - Dawn P. Misra
- Department of Epidemiology and
Biostatistics, Michigan State
University, East Lansing, MI, USA
| | - Carmen Giurgescu
- College of Nursing, University of Central
Florida, Orlando, FL, USA
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24
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Murphy HR, Gu Y, Wu Q, Brunner J, Panisch LS, Best M, Arnold MS, Duberstein ZT, Putzig J, Carnahan J, Groth SW, Barrett ES, Qiu X, O'Connor TG. Prenatal diurnal cortisol: Normative patterns and associations with affective symptoms and stress. Psychoneuroendocrinology 2022; 143:105856. [PMID: 35797838 DOI: 10.1016/j.psyneuen.2022.105856] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Abstract
The hypothalamic-pituitary-adrenal (HPA) axis in pregnancy has attracted considerable research attention, in part, because it may be a mechanism by which diverse prenatal exposures alter perinatal and child health outcomes. Symptoms of affective disturbance and stress are among the most-studied prenatal factors associated with HPA axis alterations, but there remains uncertainty about the nature of the association because of the limitations to, and variability in, data collection and analytic approaches. The current study capitalized on a prospective, longitudinal pregnancy cohort that examined salivary diurnal cortisol, collected at 5 time points across the day, at each trimester in a diverse sample of women. Detailed data on affective symptoms and major life events were collected at each trimester, as were data on health behaviors, medication, and socio-demographics. Results indicated modest stability of individual differences in diurnal cortisol across pregnancy, which was evident for diurnal slope (ICC = .20) and measures of total output (area under the curve, ICC = .25); substantial gestation-related increases in total cortisol output across pregnancy was also observed (p < .001). Adjusting for health behaviors, medication, and socio-demographic covariates, elevated levels of depressive symptoms and major life events were significantly (p < .05) associated with a higher morning awakening value and flatter diurnal slope, which was evident across all trimesters. In addition to the normative gestation-related changes in cortisol production, our results demonstrate selective but robust associations between psychological symptoms, stressors, and the HPA axis across gestation, and suggest both methodological and mechanistic strategies for future study.
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Affiliation(s)
- Hannah R Murphy
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Yu Gu
- Biostatistics and Computational Biology, University of Rochester, 265 Crittenden Blvd., Box 630, Rochester, NY 14642, USA
| | - Qiuyi Wu
- Biostatistics and Computational Biology, University of Rochester, 265 Crittenden Blvd., Box 630, Rochester, NY 14642, USA
| | - Jessica Brunner
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Lisa S Panisch
- Wayne State University School of Social Work, 5447 Woodward Ave., Detroit, MI 48202, USA
| | - Meghan Best
- Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Molly S Arnold
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, NY 14627, USA
| | - Zoe T Duberstein
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, NY 14627, USA
| | - Jenelle Putzig
- Pediatrics Infectious Diseases, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Jennifer Carnahan
- Pediatrics Infectious Diseases, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Susan W Groth
- School of Nursing, University of Rochester, 255 Crittenden Blvd., Rochester, NY, USA
| | - Emily S Barrett
- Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd., Piscataway, NJ 08854, USA
| | - Xing Qiu
- Biostatistics and Computational Biology, University of Rochester, 265 Crittenden Blvd., Box 630, Rochester, NY 14642, USA
| | - Thomas G O'Connor
- Wynne Center for Family Research, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Obstetrics and Gynecology, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642, USA; Psychology, University of Rochester, Meliora Hall, P.O. Box 270266, Rochester, NY 14627, USA; Neuroscience, University of Rochester, 601 Elmwood Avenue, Box 603, KMRB G.9602, Rochester, NY 14642, USA; Psychiatry, University of Rochester, 300 Crittenden Blvd., Rochester, NY 14642, USA.
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Tyborowska A, Gruber K, Beijers R, Kühn S, Roelofs K, de Weerth C. No evidence for association between late pregnancy maternal cortisol and gray matter volume in a healthy community sample of young adolescents. Front Neurosci 2022; 16:893847. [PMID: 36117621 PMCID: PMC9470950 DOI: 10.3389/fnins.2022.893847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/05/2022] [Indexed: 11/21/2022] Open
Abstract
A compelling amount of animal and human research has shown that perceived maternal stress during pregnancy can affect the neurodevelopment of the offspring. Prenatal maternal cortisol is frequently proposed as the biological key mechanism underlying this link; however, literature that investigates the effects of prenatal cortisol on subsequent neurodevelopment in humans is scarce. By using longitudinal data from a relatively large community sample of mother-child dyads (N = 73), this pre-registered study prospectively examined the role of maternal prenatal cortisol concentrations on subsequent individual differences in gray matter volume (GMV) and hippocampal subfield volumes at the onset of puberty of the offspring (12 years of age). Two markers of cortisol, that is, evening cortisol and circadian decline over the day, were used as indicators of maternal physiological stress during the last trimester of pregnancy. The results indicate that prenatal maternal cortisol levels were not associated with GMV or hippocampal subfield volumes of the children. These findings suggest that late pregnancy maternal cortisol may not be related to the structural development of the offspring's brain, at least not in healthy community samples and at the onset of puberty. When examining the influence of prenatal stress on offspring neurodevelopment, future investigations should delineate gestational timing effects of the cortisol exposure, cortisol assessment method, and impact of additional biomarkers, as these were not investigated in this study.
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Affiliation(s)
- Anna Tyborowska
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Katharina Gruber
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Roseriet Beijers
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Simone Kühn
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - Karin Roelofs
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
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26
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Ramos IF, Ross KM, Rinne GR, Somers JA, Mancuso RA, Hobel CJ, Coussons-Read M, Dunkel Schetter C. Pregnancy anxiety, placental corticotropin-releasing hormone and length of gestation. Biol Psychol 2022; 172:108376. [PMID: 35667479 PMCID: PMC10022399 DOI: 10.1016/j.biopsycho.2022.108376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE High pregnancy anxiety is a consistent predictor of earlier labor and delivery. Placental corticotropin-releasing hormone (pCRH) predicts earlier delivery consistently and it has been identified as a biological mediator of the association between pregnancy anxiety and gestational length. However, studies have not examined whether changes in pregnancy anxiety are associated with earlier birth as mediated by changes in pCRH during pregnancy. Accordingly, this study tests whether linear changes in pregnancy anxiety are associated with length of gestation indirectly through nonlinear increases in pCRH over pregnancy. METHODS A sample of pregnant women (n=233) completed prenatal assessments in early pregnancy, second trimester, and third trimester that included a 4-item assessment of pregnancy anxiety and collection of blood samples assayed for pCRH using radioimmunoassay. Length of gestation was abstracted from medical records after birth. RESULTS Increases in pregnancy anxiety from early pregnancy to third trimester predicted shorted length of gestation, as did nonlinear increases in pCRH over pregnancy. However, there was no evidence of an indirect effect of changes in pregnancy anxiety on length of gestation via changes in pCRH. CONCLUSIONS These results indicate that linear changes in pregnancy anxiety and nonlinear changes in pCRH during pregnancy are independent risk factors for shortened gestational length. This study adds to a small but growing body of work on biopsychological processes in pregnancy and length of gestation. Modeling changes in psychological and biological processes during pregnancy could provide more insight into understanding risk for adverse pregnancy outcomes.
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27
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Curtis DS, Smith KR, Chae DH, Washburn T, Lee H, Kim J, Kramer MR. Highly public anti-Black violence and preterm birth odds for Black and White mothers. SSM Popul Health 2022; 18:101112. [PMID: 35535210 PMCID: PMC9077530 DOI: 10.1016/j.ssmph.2022.101112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/22/2022] [Accepted: 04/27/2022] [Indexed: 12/02/2022] Open
Abstract
Highly public anti-Black violence may increase preterm birth in the general population of pregnant women via stress-mediated paths, particularly Black women exposed in early gestation. To examine spillover from racial violence in the US, we included a total of 49 high publicity incidents of the following types: police lethal force toward Black persons, legal decisions not to indict/convict officers involved, and hate crime murders of Black victims. National search interest in these incidents was measured via Google Trends to proxy for public awareness of racial violence. Timing of racial violence was coded in relation to a three-month preconception period and subsequent pregnancy trimesters, with the primary hypothesis being that first trimester exposure is associated with higher preterm birth odds. The national sample included 1.6 million singleton live births to US-born Black mothers and 6.6 million births to US-born White mothers from 2014 to 2017. Using a preregistered analysis plan, findings show that Black mothers had 5% higher preterm birth odds when exposed to any high publicity racial incidents relative to none in their first trimester, and 2-3% higher preterm birth odds with each log10 increase in national interest. However, post hoc sensitivity tests that included month fixed effects attenuated these associations to null. For White mothers, associations were smaller but of a similar pattern, and were attenuated when including month fixed effects. Highly public anti-Black violence may act as a national stressor, yet whether racial violence is associated with reproductive outcomes in the population is unknown and merits further research.
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Affiliation(s)
- David S. Curtis
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, 84112, USA
| | - Ken R. Smith
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, 84112, USA
| | - David H. Chae
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, 70112, USA
| | - Tessa Washburn
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, 84112, USA
| | - Hedwig Lee
- Department of Sociology, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Jaewhan Kim
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, 84112, USA
| | - Michael R. Kramer
- Department of Epidemiology, Emory University, Atlanta, GA, 30322, USA
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Associations between maternal awakening salivary cortisol levels in mid-pregnancy and adverse birth outcomes. Arch Gynecol Obstet 2022; 306:1989-1999. [PMID: 35320387 DOI: 10.1007/s00404-022-06513-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/06/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Elevated levels of maternal cortisol have been hypothesized as the intermediate process between symptoms of depression and psychosocial stress during pregnancy and adverse birth outcomes. Therefore, we examined associations between cortisol levels in the second trimester of pregnancy and risks of three common birth outcomes in a nested case-control study. METHODS This study was embedded in the PRIDE Study (n = 3,019), from which we selected all cases with preterm birth (n = 64), low birth weight (n = 49), and small-for-gestational age (SGA; n = 65), and 260 randomly selected controls, among the participants who provided a single awakening saliva sample in approximately gestational week 19 in 2012-2016. Multivariable linear and logistic regression was performed to assess the associations between continuous and categorized cortisol levels and the selected outcomes. RESULTS We did not observe any associations between maternal cortisol levels and preterm birth and low birth weight. However, high cortisol levels (≥ 90th percentile) seemed to be associated with SGA (adjusted odds ratio 2.1, 95% confidence interval 0.9-4.8), in particular among girls (adjusted odds ratio 3.7, 95% confidence interval 1.1-11.9, based on eight exposed cases) in an exploratory analysis. CONCLUSION The results of this study showed no suggestions of associations between maternal awakening cortisol levels in mid-pregnancy and adverse birth outcomes, except for an increased risk of SGA.
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Understanding and Reducing Persistent Racial Disparities in Preterm Birth: a Model of Stress-Induced Developmental Plasticity. Reprod Sci 2022; 29:2051-2059. [PMID: 35298790 DOI: 10.1007/s43032-022-00903-4] [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: 11/27/2021] [Accepted: 02/27/2022] [Indexed: 10/18/2022]
Abstract
Preterm birth is a leading cause of neonatal mortality and is characterized by substantial racial disparities in the US. Despite efforts to reduce preterm birth, rates have risen and racial disparities persist. Maternal stress is a risk factor for preterm birth; however, often, it is treated as a secondary variable rather than a primary target for intervention. Stress is known to affect several biological processes leading to downstream sequelae. Here, we present a model of stress-induced developmental plasticity where maternal stress is a key environmental cue impacting the length of gestation and therefore a primary target for intervention. Black women experience disproportionate and unique maternal stressors related to perceived racism and discrimination. It is therefore not surprising that Black women have disproportionate rates of preterm birth. The downstream effects of racism on preterm birth pathophysiology may reflect an appropriate response to stressors through the highly conserved maternal-fetal-placental neuroendocrine stress axis. This environmentally sensitive system mediates both maternal stress and the timing of birth and is a mechanism by which developmental plasticity occurs. Fortunately, stress does not appear to be an all-or-none variable. Evidence suggests that developmental plasticity is dynamic, functioning on a continuum. Therefore, simple, stress-reducing interventions that support pregnant women may tangibly reduce rates of preterm birth and improve birth outcomes for all women, particularly Black women.
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Khodadadi N, Dastoorpoor M, Khanjani N, Ghasemi A. Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes in Ahvaz, Iran. Reprod Health 2022; 19:33. [PMID: 35109854 PMCID: PMC8811963 DOI: 10.1186/s12978-022-01344-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/03/2022] [Indexed: 12/19/2022] Open
Abstract
Background Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes. The aim of this study was to investigate the relation between Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. Methods Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to research the effect of UTCI on adverse pregnancy outcomes. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. Results The results showed that the low values of UTCI index (11.6 °C, in lags 0–6, 0–13) caused significant increase in the risk of preterm labor. However, hot thermal stress (high UTCI) significantly increased the risk of stillbirth in lag 0–13. We did not observe any significant relation between UTCI and other pregnancy outcomes in this study. Conclusions It seems like both hot and cold weathers can be associated with adverse pregnancy outcomes. Scientists have found that climate change has adverse effects on human health. Because pregnant women are one of the most vulnerable groups, these negative impacts may affect their fetuses, which make up the next generation. In this study, we examined the effect of temperature on some pregnancy outcomes, including low birth weight, preterm labor, spontaneous abortion, preeclampsia and gestational hypertension in Ahvaz city, which is one of the hottest cities in the world. One way to assess temperature impact on humans is by using temperature indicators. In this study we used the Universal Thermal Climate Index (UTCI) for this purpose. The data at different time intervals were collected and evaluated with specific models. Our results showed that low values of UTCI, which is equivalent to cold weather, significantly increase the risk of preterm labor. But, high levels of UTCI, which means hot weather, significantly increase the risk of stillbirth. In conclusion; both hot and cold weather can be associated with adverse pregnancy outcomes in Ahvaz city. Therefore, pregnant women should protect themselves from exposure to hot and cold weather.
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Affiliation(s)
- Narges Khodadadi
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Afsaneh Ghasemi
- Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Fasa, Iran.
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Barrett ES, Corsetti M, Day D, Thurston SW, Loftus CT, Karr CJ, Kannan K, LeWinn KZ, Smith AK, Smith R, Tylavsky FA, Bush NR, Sathyanarayana S. Prenatal phthalate exposure in relation to placental corticotropin releasing hormone (pCRH) in the CANDLE cohort. ENVIRONMENT INTERNATIONAL 2022; 160:107078. [PMID: 35007898 PMCID: PMC8821329 DOI: 10.1016/j.envint.2022.107078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/20/2021] [Accepted: 01/02/2022] [Indexed: 06/05/2023]
Abstract
CONTEXT Phthalates may disrupt maternal-fetal-placental endocrine pathways, affecting pregnancy outcomes and child development. Placental corticotropin releasing hormone (pCRH) is critical for healthy pregnancy and child development, but understudied as a target of endocrine disruption. OBJECTIVE To examine phthalate metabolite concentrations (as mixtures and individually) in relation to pCRH. DESIGN Secondary data analysis from a prospective cohort study. SETTING Prenatal clinics in Tennessee, USA. PATIENTS 1018 pregnant women (61.4% non-Hispanic Black, 32% non-Hispanic White, 6.6% other) participated in the CANDLE study and provided data. Inclusion criteria included: low-medical-risk singleton pregnancy, age 16-40, and gestational weeks 16-29. INTERVENTION None. MAIN OUTCOME MEASURES Plasma pCRH at two visits (mean gestational ages 23.0 and 31.8 weeks) and change in pCRH between visits (ΔpCRH). RESULTS In weighted quantile sums (WQS) regression models, phthalate mixtures were associated with higher pCRH at Visit 1 (β = 0.07, 95 %CI: 0.02, 0.11) but lower pCRH at Visit 2 (β = -0.08, 95 %CI: -0.14, -0.02). In stratified analyses, among women with gestational diabetes (n = 59), phthalate mixtures were associated with lower pCRH at Visit 1 (β = -0.17, 95 %CI: -0.35, 0.0006) and Visit 2 (β = -0.35, 95 %CI: -0.50, -0.19), as well as greater ΔpCRH (β = 0.16, 95 %CI: 0.07, 0.25). Among women with gestational hypertension (n = 102), phthalate mixtures were associated with higher pCRH at Visit 1 (β = 0.20, 95 %CI: 0.03, 0.36) and Visit 2 (β = 0.42; 95 %CI: 0.19, 0.64) and lower ΔpCRH (β = -0.17, 95 %CI: -0.29, -0.06). Significant interactions between individual phthalate metabolites and pregnancy complications were observed. CONCLUSIONS Phthalates may impact placental CRH secretion, with differing effects across pregnancy. Differences in results between women with and without gestational diabetes and gestational hypertension suggest a need for further research examining whether women with pregnancy complications may be more vulnerable to endocrine-disrupting effects of phthalates.
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Affiliation(s)
- Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ 08854, USA.
| | - Matthew Corsetti
- Department of Biostatistics and Computational Biology, University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Drew Day
- Seattle Children's Research Institute, University of Washington, Seattle, WA 98101, USA
| | - Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA; Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; Department of Pediatrics, University of Washington, Seattle, WA 98104, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Roger Smith
- Hunter Medical Research Institute, University of Newcastle, Newcastle 2300, Australia
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Sheela Sathyanarayana
- Seattle Children's Research Institute, University of Washington, Seattle, WA 98101, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA; Department of Pediatrics, University of Washington, Seattle, WA 98104, USA
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Yu T, Zhou L, Xu J, Kan H, Chen R, Chen S, Hua H, Liu Z, Yan C. Effects of prenatal exposures to air sulfur dioxide/nitrogen dioxide on toddler neurodevelopment and effect modification by ambient temperature. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 230:113118. [PMID: 34979314 DOI: 10.1016/j.ecoenv.2021.113118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Emerging evidence suggests that prenatal exposure to ambient SO2 or NO2 induces fetal brain-damage. However, effects of prenatal exposure to SO2 or NO2 on toddler neurodevelopment and the effect-modification by ambient temperature remain unclear. Therefore, a prospective birth-cohort study was conducted from 2010 to 2012 in Shanghai, and 225 mother-child pairs were followed-up from mid-to-late pregnancy until 24-36 months postpartum. During the whole pregnancy, daily SO2/NO2 and temperature levels were obtained for each woman. Gesell-Development-Schedule was used to assess toddler neurodevelopment in the domains of gross-motor, fine-motor, adaptive-behavior, language and social-behavior. Distributed-lag-nonlinear-models simultaneously accounting for exposure-response and lag-response associations were applied to assess the impacts of prenatal SO2/NO2 exposure on neurodevelopment. Each 10-μg/m3 increase in weekly average SO2 concentrations had adverse associations with gross-motor in gestational-weeks 1-6, with adaptive-behavior in weeks 26-30, and with language in weeks 30-36 (developmental-quotient changes: - 1.17% to - 0.12%, P-values < 0.05). Each 10-μg/m3 increase in weekly average NO2 concentrations had adverse associations with gross-motor in gestational-weeks 33-36, with fine-motor in weeks 26-36 and with social-behavior in weeks 31-36 (developmental-quotient changes: - 0.91% to - 0.20%, P-values < 0.05). The cumulative effects for the whole pregnancy showed that each 10-μg/m3 increase in SO2 induced significant deficits in gross-motor and adaptive-behavior (developmental-quotient changes: - 4.71% and - 4.06%, respectively, P < 0.05). We found prenatal cumulative SO2 exposure induced more deficits in low temperature in language and adaptive-behavior than in high/moderate temperature. Thus, prenatal ambient SO2/NO2 exposure in specific time-windows (1st and 3rd trimesters for SO2; 3rd trimester for NO2) could impair toddler neurodevelopment and low temperature may aggravate the SO2-induced neurotoxicity.
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Affiliation(s)
- Ting Yu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Leilei Zhou
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092 China
| | - Jian Xu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Haidong Kan
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032 China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200032 China
| | - Renjie Chen
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032 China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai 200032 China
| | - Shuwen Chen
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Hui Hua
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zhiwei Liu
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Chonghuai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092 China
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Caparros-Gonzalez RA, Lynn F, Alderdice F, Peralta-Ramirez MI. Cortisol levels versus self-report stress measures during pregnancy as predictors of adverse infant outcomes: a systematic review. Stress 2022; 25:189-212. [PMID: 35435113 DOI: 10.1080/10253890.2022.2059348] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Systematically review existing evidence to (1) identify the association between self-report stress and cortisol levels measured during pregnancy; and, (2) assess their association with adverse infant outcomes to determine which is the better predictor. A systematic review was conducted in accordance with PRISMA guidelines. Search terms focused on pregnancy, psychological stress and cortisol. Nine electronic databases were searched, in addition to reference lists of relevant papers. Eligibility criteria consisted of studies that included measurement of self-reported psychological stress, cortisol and assessed their associations with any infant-related outcome. Further limits included studies published in English or Spanish with human female participants. A meta-regression was not feasible due to differences in study samples, measurement tools employed, types of cortisol assessed and outcomes reported. A narrative synthesis was provided. 28 studies were eligible for inclusion. Convergent validity between self-report measures and cortisol was reported by three studies (range r = 0.12-0.41). Higher levels of self-report stress were significantly associated with intrauterine growth restriction (fetal biparietal diameter, low fetal head circumference, abdominal circumference), low gestational age at birth, low anthropometric measures (birth length, head circumference, length of the neonate), poor infant neurodevelopment (cognitive development) and potentially pathogenic gut microbiota (Clostridiaceae Clostridium, Haemophilus) in six studies. Higher cortisol levels were significantly associated with intrauterine growth restriction (fetal biparietal diameter, low fetal head circumference, abdominal circumference), low gestational age at birth, low infant birth weight, poor infant neurodevelopment (attention scores on the Network Neurobehavioral Scale) and low levels of potentially protective gut microbiota (Lactobacillus, Slackia and Actinobaculum) in 13 studies. Of the studies that assessed which type of measure was a better predictor of infant outcomes (n = 6), there was agreement that cortisol levels were statistically better at predicting adverse outcomes than self-reported stress. Self-report stress measures appear to be modest predictors of adverse infant outcomes in comparison to cortisol. A number of methodological limitations need to be addressed in future studies to help understand the relationship between cortisol and self-reported stress and how they are related to adverse infant outcomes.
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Affiliation(s)
- Rafael A Caparros-Gonzalez
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Fiona Lynn
- Medical Biology Center, School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Barrett ES, Workman T, Hazlehurst MF, Kauderer S, Loftus C, Kannan K, Robinson M, Smith AK, Smith R, Zhao Q, LeWinn KZ, Sathyanarayana S, Bush NR. Prenatal polycyclic aromatic hydrocarbon (PAH) exposure in relation to placental corticotropin releasing hormone (pCRH) in the CANDLE pregnancy cohort. Front Endocrinol (Lausanne) 2022; 13:1011689. [PMID: 36440232 PMCID: PMC9691680 DOI: 10.3389/fendo.2022.1011689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2022] Open
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous endocrine-disrupting combustion by-products that have been linked to preterm birth. One possible mechanism is through disruption of placental corticotropin releasing hormone (pCRH), a key hormone implicated in parturition. As an extension of recent research identifying pCRH as a potential target of endocrine disruption, we examined maternal PAH exposure in relation to pCRH in a large, diverse sample. Participants, drawn from the CANDLE cohort, part of the ECHO-PATHWAYS Consortium, completed study visits at 16-29 weeks (V1) and 22-39 weeks (V2) gestation (n=812). Seven urinary mono-hydroxylated PAH metabolites (OH-PAHs) were measured at V1 and serum pCRH at V1 and V2. Associations between individual log-transformed OH-PAHs (as well as two summed PAH measures) and log(pCRH) concentrations across visits were estimated using mixed effects models. Minimally-adjusted models included gestational age and urinary specific gravity, while fully-adjusted models also included sociodemographic characteristics. We additionally evaluated effect modification by pregnancy complications, fetal sex, and maternal childhood trauma history. We observed associations between 2-OH-Phenanthrene (2-OH-PHEN) and rate of pCRH change that persisted in fully adjusted models (β=0.0009, 0.00006, 0.0017), however, positive associations with other metabolites (most notably 3-OH-Phenanthrene and 1-Hydroxypyrene) were attenuated after adjustment for sociodemographic characteristics. Associations tended to be stronger at V1 compared to V2 and we observed no evidence of effect modification by pregnancy complications, fetal sex, or maternal childhood trauma history. In conclusion, we observed modest evidence of association between OH-PAHs, most notably 2-OH-PHEN, and pCRH in this sample. Additional research using serial measures of PAH exposure is warranted, as is investigation of alternative mechanisms that may link PAHs and timing of birth, such as inflammatory, epigenetic, or oxidative stress pathways.
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Affiliation(s)
- Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers University, Rutgers School of Public Health, Piscataway, NJ, United States
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, United States
- *Correspondence: Emily S. Barrett,
| | - Tomomi Workman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Marnie F. Hazlehurst
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Sophie Kauderer
- Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, United States
| | - Christine Loftus
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, United States
| | - Morgan Robinson
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, United States
| | - Alicia K. Smith
- Department of Gynecology and Obstetrics, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Roger Smith
- Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
- Seattle Children’s Research Institute, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, United States
- Department of Pediatrics, Division of Developmental Medicine, University of California San Francisco, San Francisco, CA, United States
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Hill M, Pařízek A, Šimják P, Koucký M, Anderlová K, Krejčí H, Vejražková D, Ondřejíková L, Černý A, Kancheva R. Steroids, steroid associated substances and gestational diabetes mellitus. Physiol Res 2021. [DOI: 10.33549//physiolres.934794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
As gestational diabetes mellitus (GDM) is both a frequent and serious complication, steroid levels in pregnancy are extremely elevated and their role in pregnancy is crucial, this review focuses on the role of steroids and related substances in the GDM pathophysiology. Low SHBG levels are associated with insulin resistance and hyperinsulinemia, while also predicting a predisposition to GDM. Other relevant agents are placental hormones such as kisspeptin and CRH, playing also an important role beyond pregnancy, but which are synthesized here in smaller amounts in the hypothalamus. These hormones affect both the course of pregnancy as well as the synthesis of pregnancy steroids and may also be involved in the GDM pathophysiology. Steroids, whose biosynthesis is mainly provided by the fetal adrenal glands, placenta, maternal adrenal glands, and both maternal and fetal livers, are also synthesized in limited amounts directly in the pancreas and may influence the development of GDM. These substances involve the sulfated Δ5 steroids primarily acting via modulating different ion channels and influencing the development of GDM in different directions, mostly diabetogenic progesterone and predominantly anti-diabetic estradiol acting both in genomic and non-genomic way, androgens associated with IR and hyperinsulinemia, neuroactive steroids affecting the pituitary functioning, and cortisol whose production is stimulated by CRH but which suppresses its pro-inflammatory effects. Due to the complex actions of steroids, studies assessing their predominant effect and studies assessing their predictive values for estimating predisposition to GDM are needed.
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Affiliation(s)
- M Hill
- Institute of Endocrinology, Prague, Czech Republic.
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Berthelon M, Kruger D, Sanchez R. Maternal stress during pregnancy and early childhood development. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101047. [PMID: 34340016 DOI: 10.1016/j.ehb.2021.101047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
We estimate the impact of prenatal stress on early childhood development outcomes known as "middle years" or intermediate outcomes, which has not been studied previously. Using a unique measure of actual maternal stress induced by a large earthquake, we find that relative to children that were not exposed, in utero maternal stress reduces children's cognitive skills and socio-emotional problems by age 3, and that the effects are heterogeneous. The negative impacts on cognitive skills occur during the first trimester of pregnancy and are found among both low and high-income children, and boys and girls. The harmful effects on socio-emotional behaviors occur when stress is experienced in the last trimester of pregnancy.
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Affiliation(s)
- Matias Berthelon
- Universidad Adolfo Ibáñez, IZA and COES, Av. Padre Hurtado 750, Viña del Mar, Chile.
| | - Diana Kruger
- Universidad Adolfo Ibáñez, IZA, COES, and PEP, Av. Padre Hurtado 750, Viña del Mar, Chile.
| | - Rafael Sanchez
- Universidad Diego Portales, CEP and IZA, Monseñor Sótero Sanz 162, Providencia, Chile.
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Allen MC, Moog NK, Buss C, Yen E, Gustafsson HC, Sullivan EL, Graham AM. Co-occurrence of preconception maternal childhood adversity and opioid use during pregnancy: Implications for offspring brain development. Neurotoxicol Teratol 2021; 88:107033. [PMID: 34601061 PMCID: PMC8578395 DOI: 10.1016/j.ntt.2021.107033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 12/11/2022]
Abstract
Understanding of the effects of in utero opioid exposure on neurodevelopment is a priority given the recent dramatic increase in opioid use among pregnant individuals. However, opioid abuse does not occur in isolation-pregnant individuals abusing opioids often have a significant history of adverse experiences in childhood, among other co-occurring factors. Understanding the specific pathways in which these frequently co-occurring factors may interact and cumulatively influence offspring brain development in utero represents a priority for future research in this area. We highlight maternal history of childhood adversity (CA) as one such co-occurring factor that is more prevalent among individuals using opioids during pregnancy and which is increasingly shown to affect offspring neurodevelopment through mechanisms beginning in utero. Despite the high incidence of CA history in pregnant individuals using opioids, we understand very little about the effects of comorbid prenatal opioid exposure and maternal CA history on fetal brain development. Here, we first provide an overview of current knowledge regarding effects of opioid exposure and maternal CA on offspring neurodevelopment that may occur during gestation. We then outline potential mechanistic pathways through which these factors might have interactive and cumulative influences on offspring neurodevelopment as a foundation for future research in this area.
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Affiliation(s)
- Madeleine C Allen
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States
| | - Nora K Moog
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Luisenstrasse 57, 10117 Berlin, Germany
| | - Claudia Buss
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Luisenstrasse 57, 10117 Berlin, Germany; Development, Health and Disease Research Program, University of California, Irvine, 837 Health Sciences Drive, Irvine, California 92697, United States
| | - Elizabeth Yen
- Department of Pediatrics, Tufts Medical Center, Boston, MA 02111, United States
| | - Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States; Division of Neuroscience, Oregon National Primate Research Center, 505 NW 185(th) Ave., Beaverton, OR 97006, United States; Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States
| | - Alice M Graham
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States.
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Haq SU, Bhat UA, Kumar A. Prenatal stress effects on offspring brain and behavior: Mediators, alterations and dysregulated epigenetic mechanisms. J Biosci 2021. [DOI: 10.1007/s12038-021-00153-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Ortega VA, Mercer EM, Giesbrecht GF, Arrieta MC. Evolutionary Significance of the Neuroendocrine Stress Axis on Vertebrate Immunity and the Influence of the Microbiome on Early-Life Stress Regulation and Health Outcomes. Front Microbiol 2021; 12:634539. [PMID: 33897639 PMCID: PMC8058197 DOI: 10.3389/fmicb.2021.634539] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Stress is broadly defined as the non-specific biological response to changes in homeostatic demands and is mediated by the evolutionarily conserved neuroendocrine networks of the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system. Activation of these networks results in transient release of glucocorticoids (cortisol) and catecholamines (epinephrine) into circulation, as well as activation of sympathetic fibers innervating end organs. These interventions thus regulate numerous physiological processes, including energy metabolism, cardiovascular physiology, and immunity, thereby adapting to cope with the perceived stressors. The developmental trajectory of the stress-axis is influenced by a number of factors, including the gut microbiome, which is the community of microbes that colonizes the gastrointestinal tract immediately following birth. The gut microbiome communicates with the brain through the production of metabolites and microbially derived signals, which are essential to human stress response network development. Ecological perturbations to the gut microbiome during early life may result in the alteration of signals implicated in developmental programming during this critical window, predisposing individuals to numerous diseases later in life. The vulnerability of stress response networks to maladaptive development has been exemplified through animal models determining a causal role for gut microbial ecosystems in HPA axis activity, stress reactivity, and brain development. In this review, we explore the evolutionary significance of the stress-axis system for health maintenance and review recent findings that connect early-life microbiome disturbances to alterations in the development of stress response networks.
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Affiliation(s)
- Van A Ortega
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada
| | - Emily M Mercer
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Owerko Centre, The Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Marie-Claire Arrieta
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
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Irwin JL, Meyering AL, Peterson G, Glynn LM, Sandman CA, Hicks LM, Davis EP. Maternal prenatal cortisol programs the infant hypothalamic-pituitary-adrenal axis. Psychoneuroendocrinology 2021; 125:105106. [PMID: 33340919 PMCID: PMC9743740 DOI: 10.1016/j.psyneuen.2020.105106] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/15/2022]
Abstract
One of the key proposed agents of fetal programming is exposure to maternal glucocorticoids. Experimental animal studies provide evidence that prenatal exposure to elevated maternal glucocorticoids has consequences for hypothalamic-pituitary-adrenal (HPA) axis functioning in the offspring. There are very few direct tests of maternal glucocorticoids, such as cortisol, during human pregnancy and associations with infant cortisol reactivity. The current study examined the link between maternal prenatal cortisol trajectories and infant cortisol reactivity to the pain of inoculation in a sample of 152 mother-infant (47.4% girls) pairs. The results from the current study provide insight into fetal programming of the infant HPA axis, demonstrating that elevated prenatal maternal cortisol is associated with a larger infant cortisol response to challenge at both 6 and 12 months of age.
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Affiliation(s)
- Jessica L Irwin
- Department of Psychology, University of La Verne, La Verne, CA 91750, United States; Department of Psychology, Chapman University, Orange, CA 92866, United States.
| | - Amy L Meyering
- Department of Psychology, University of Denver, Denver, CO 80208, United States
| | - Gage Peterson
- Department of Psychology, Chapman University, Orange, CA 92866, United States
| | - Laura M Glynn
- Department of Psychology, Chapman University, Orange, CA 92866, United States; Department of Psychiatry and Human Behavior, University of California, Irvine, CA 92697, United States
| | - Curt A Sandman
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA 92697, United States
| | - Laurel M Hicks
- Renée Crown Wellness Institute, University of Colorado, Boulder, CO 80302, United States
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO 80208, United States; Department of Psychiatry and Human Behavior, University of California, Irvine, CA 92697, United States
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Shenassa ED, Widemann LG, Hunt CD. Antepartum Depression and Preterm Birth: Pathophysiology, Epidemiology, and Disparities due to structural racism. Curr Psychiatry Rep 2021; 23:14. [PMID: 33630175 DOI: 10.1007/s11920-021-01223-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Informed by the evidence of links between physiology of stress and parturition, we review recent epidemiologic evidence (2015-2020) of antenatal depression as a risk factor for preterm birth (PTB). We also explain racial/ethnic disparities in depression and preterm birth as a consequence of structural racism. RECENT FINDINGS Epidemiologic evidence is consistent in linking antepartum depression with an elevated risk of PTB. Antidepressant usage has been linked with an elevated risk of PTB. However, recent evidence suggests that severity of depression is the underlying driver of the elevated risk attributed to antidepressant usage. The number of depressive symptoms, as a proxy for severity of maternal stress, may be a more informative predictor of PTB than criterion based predictors. Across various study designs, measurement modalities, and populations, antenatal depression predicts an elevated risk of delivering preterm. The physiology of stress provides a plausible explanation for this observation. Excessive stress-induced elevations in maternal and then fetal HPA hormones can alter maternal and fetal homeostasis and hasten the timing of parturition. Antenatal depression and exposure to structural racism are two stressors that can trigger the maternal stress response. Chronically elevated levels of stress hormones among women of color in the USA provide a likely physiologic explanation for Black-White disparities in the risk of PTB. Focusing on the number of depressive symptoms as the more informative predictor of PTB raises several questions. We consider these questions as well as directions for future research in the context of recent advances in the field.
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Affiliation(s)
- Edmond D Shenassa
- Maternal & Child Health Program, Department of Family Science; and Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA. .,Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA. .,Department of Epidemiology & Biostatistics, School of Medicine, University of Maryland, Baltimore, MD, USA.
| | - Lea G Widemann
- Maternal & Child Health Program, Department of Family Science; and Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Cole D Hunt
- Maternal & Child Health Program, Department of Family Science; and Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
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Yu Y, Liang HF, Chen J, Li ZB, Han YS, Chen JX, Li JC. Postpartum Depression: Current Status and Possible Identification Using Biomarkers. Front Psychiatry 2021; 12:620371. [PMID: 34211407 PMCID: PMC8240635 DOI: 10.3389/fpsyt.2021.620371] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/19/2021] [Indexed: 12/25/2022] Open
Abstract
Postpartum depression (PPD) is a serious health issue that can affect about 15% of the female population within after giving birth. It often conveys significant negative consequences to the offsprings. The symptoms and risk factors are somewhat similar to those found in non-postpartum depression. The main difference resides in the fact that PPD is triggered by postpartum specific factors, including especially biological changes in the hormone levels. Patients are usually diagnosed using a questionnaire onsite or in a clinic. Treatment of PPD often involves psychotherapy and antidepressant medications. In recent years, there have been more researches on the identification of biological markers for PPD. In this review, we will focus on the current research status of PPD, with an emphasis on the recent progress made on the identification of PPD biomarkers.
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Affiliation(s)
- Yi Yu
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Center for Analyses and Measurements, College of Chemical Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Hong-Feng Liang
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China
| | - Jing Chen
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Zhi-Bin Li
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Yu-Shuai Han
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Jia-Xi Chen
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Ji-Cheng Li
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
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Davis EP, Narayan AJ. Pregnancy as a period of risk, adaptation, and resilience for mothers and infants. Dev Psychopathol 2020; 32:1625-1639. [PMID: 33427164 PMCID: PMC7863987 DOI: 10.1017/s0954579420001121] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The pregnancy period represents a unique window of opportunity to identify risks to both the fetus and mother and to deter the intergenerational transmission of adversity and mental health problems. Although the maternal-fetal dyad is especially vulnerable to the effects of stress during pregnancy, less is known about how the dyad is also receptive to salutary, resilience-promoting influences. The present review adopts life span and intergenerational perspectives to review four key areas of research. The first part describes how pregnancy is a sensitive period for both the mother and fetus. In the second part, the focus is on antecedents of maternal prenatal risks pertaining to prenatal stress response systems and mental health. The third part then turns to elucidating how these alterations in prenatal stress physiology and mental health problems may affect infant and child outcomes. The fourth part underscores how pregnancy is also a time of heightened fetal receptivity to maternal and environmental signals, with profound implications for adaptation. This section also reviews empirical evidence of promotive and protective factors that buffer the mother and fetus from developmental and adaptational problems and covers a sample of rigorous evidence-based prenatal interventions that prevent maladaptation in the maternal-fetal dyad before babies are born. Finally, recommendations elaborate on how to further strengthen understanding of pregnancy as a period of multilevel risk and resilience, enhance comprehensive prenatal screening, and expand on prenatal interventions to promote maternal-fetal adaptation before birth.
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Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
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Steine IM, LeWinn KZ, Lisha N, Tylavsky F, Smith R, Bowman M, Sathyanarayana S, Karr CJ, Smith AK, Kobor M, Bush NR. Maternal exposure to childhood traumatic events, but not multi-domain psychosocial stressors, predict placental corticotrophin releasing hormone across pregnancy. Soc Sci Med 2020; 266:113461. [PMID: 33126094 PMCID: PMC9380779 DOI: 10.1016/j.socscimed.2020.113461] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/19/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022]
Abstract
Maternal psychosocial stress increases the risk of adverse birth and postnatal outcomes for the mother and child, but the role of maternal exposure to childhood traumatic events (CTE) and multi-domain psychosocial stressors for the level and rise of placental Corticotrophin-Releasing Hormone (pCRH) across pregnancy has been understudied. In a sociodemographically and racially diverse sample of 1303 women (64% Black, 36% White/others) with low-medical risk pregnancies at enrollment from Shelby County, Tennessee, USA, blood samples were drawn twice, corresponding roughly to second and third trimester, and extracted prior to conducting radioimmune assays for pCRH. Mothers reported CTE (physical abuse, sexual abuse, or family violence, in childhood), adulthood traumatic events, and interpersonal violence during pregnancy. Neighborhood crime/deprivation was derived using geospatially-linked objective databases. General linear and mixed models tested associations between stress exposure variables and pCRH levels and rate of rise, adjusting for obstetric/clinical/health related factors. Maternal CTE did not predict pCRH levels at time 1, but positively predicted levels at time 2, and the rate of rise in pCRH across pregnancy. Race did not moderate this association. No additional maternal stress exposures across adulthood or during pregnancy predicted pCRH outcomes. Findings indicate that childhood violence or abuse exposure can become biologically embedded in a manner predicting later prenatal physiology relevant for maternal and offspring health, and that such embedding may be specific to childhood, but not adulthood, stress. Findings also highlight the placental-fetal unit as a mechanistic pathway through which intergenerational transmission of the adverse effects of childhood adversities may occur.
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Affiliation(s)
- Iris M Steine
- Visiting Scholar, UC Berkeley, Department of Psychology, 2121 Berkeley Way, Berkeley, CA, 94704, USA; Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
| | - Kaja Z LeWinn
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, USA
| | - Nadra Lisha
- Department of General Internal Medicine, University of California San Francisco, USA
| | - Frances Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Roger Smith
- Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Maria Bowman
- Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Sheela Sathyanarayana
- University of Washington Department of Pediatrics, Seattle, USA; Seattle Children's Research Institute, Seattle, USA; University of Washington Department of Environmental and Occupational Health Sciences, Seattle, USA
| | - Catherine J Karr
- University of Washington Department of Environmental and Occupational Health Sciences, Seattle, USA; University of Washington Departments of Pediatrics, Seattle, USA
| | - Alicia K Smith
- Department of Gynecology and Obstetrics, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA
| | - Michael Kobor
- Department of Medical Genetics, University of British Columbia, Canada
| | - Nicole R Bush
- Departments of Psychiatry and Pediatrics, University of California San Francisco, USA
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Ruiz RJ, Newman M, Suchting R, Pasillas RM, Records K, Stowe RP, Moore TA. Pregnant Mexican American Biopsychosocial/Cultural risks for adverse infant outcomes. Nurs Open 2020; 8:709-720. [PMID: 33570300 PMCID: PMC7877225 DOI: 10.1002/nop2.676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/09/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022] Open
Abstract
Aims To test a model of psychosocial/cultural/biological risk factors for poor birth outcomes in Latina pregnant women. Design An observational study measuring acculturation, progesterone, cortisol, cotinine, age, marital status, income, stress, depressive symptoms and coping. We tested a structural equation model to predict risk. Methods We obtained a convenience sample (N = 515) of low medical risk pregnant Mexican American Hispanic women at 22–24 weeks of gestation. Bilingual research nurses collected data from blood, urine and questionnaires. Self‐report measures were the Beck Depression Inventory‐II, the Perceived Stress Scale, the Acculturation Rating Scale for Mexican Americans‐II and the Brief Cope. We measured progesterone and cortisol in plasma and cotinine levels in urine by enzyme‐linked immunoassays. Results A PLS‐SEM model revealed that Mexican American Hispanic pregnant women who were younger, single, lower income, more acculturated and who had greater negative coping, stress and depression were most at risk for having earlier and smaller babies.
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Affiliation(s)
| | - Matt Newman
- Serenity Research & Consulting, LLC, Austin, TX, USA
| | - Robert Suchting
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Kathie Records
- School of Nursing, The University of Northern Colorado, Greeley, CO, USA
| | | | - Tiffany A Moore
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
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Tesfa D, Aleminew W, Tadege M, Digssie A, Abebe B, Abebaw S, Kefale B. Level of Happiness and Its Associated Factors Among Pregnant Women in South Gondar Zone Hospitals, North Central Ethiopia. Int J Womens Health 2020; 12:983-991. [PMID: 33177889 PMCID: PMC7652223 DOI: 10.2147/ijwh.s275709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022] Open
Abstract
Background Happiness is the most indicator of good quality of life particularly for pregnant women. Reduced happiness of pregnant women can result in reduced maternal health services utilization and can result in adverse newborn and maternal outcomes. Assessing the level of happiness and its factors are important for pregnant women and the next generation. Hence, the current research paper aimed to assess the level of happiness and its associated factors among pregnant women who attended antenatal care follow-up in South Gondar Zone Hospitals. Methods Institution-based cross-sectional study was carried out from September 2018 to February 2019 among 1606 expectant pregnant women in the last 6 months. The Oxford Happiness Questionnaire (OHQ) was used as a measure of the degree of happiness and used four as average person score. Besides, bivariate, multivariable logistic analyses were deployed to identify associations. Results A total of 1606 pregnant women were participating in this study. The prevalence of low level of pregnancy happiness in this study was 24% (95% CI: 20.7 −26.6). Mothers who exposed to unintended pregnancy (AOR; 1.94, CI 95% 1.86–4.52), reported intimate partner violence (AOR; 2.42, 95% CI 1.67–3.54) and being in the third trimester (AOR; 1.89 95% CI 1.19–3.01) were the most predictor variables with the low level of happiness. Conclusion Approximately one-fourth of the pregnant women had a low level of pregnancy happiness. Mothers who were exposed to unintended pregnancy encountered intimate partner violence, who were in the third trimester were the most significant variables associated with a low level of happiness. Governmental and non-governmental organizations work on women’s reproduction rights and the zonal health department with local health offices should educate on the prevention of intimate partner violence and unintended pregnancy and its consequences and also empower women to cope with changes and challenges of pregnancy and childbirth.
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Affiliation(s)
- Desalegn Tesfa
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Melaku Tadege
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alemayehu Digssie
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bedilu Abebe
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sofonyas Abebaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Belayneh Kefale
- Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Premji SS, Shaikh K, Lalani S, Yim IS, Moore S, Ali NA, Aijaz S, Letourneau N. COVID-19 and Women's Health: A Low- and Middle-Income Country Perspective. Front Glob Womens Health 2020; 1:572158. [PMID: 34816156 PMCID: PMC8593932 DOI: 10.3389/fgwh.2020.572158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/17/2020] [Indexed: 11/25/2022] Open
Abstract
Corona Virus Disease (COVID-19), a contagious disease, is a global pandemic affecting the lives and health of individuals across borders, genders and races. Much of what is known about the effects of natural disasters and disease outbreaks on women's health in particular, is based on studies conducted in high-income countries. The evolving evidence suggests that COVID-19 has a profound negative impact on the perinatal mental health of women. It is also clear that global pandemics such as COVID-19 disproportionately affect the less affluent, including individuals living in low- and middle-income countries. The purpose of this review is to summarize and critically discuss extant knowledge on COVID-19 as it relates to the perinatal health of women in low and middle-income countries, using Pakistan as a case example. We specifically highlight the effects on perinatal mental health, preterm birth, and timing of the COVID-19 exposure. Our review suggests that it is essential to consider the effects of COVID-19 within this cultural context and that findings from high-income countries do not necessarily translate to the situation in low and middle-income countries.
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Affiliation(s)
- Shahirose Sadrudin Premji
- Faculty of Health, School of Nursing, York University, Toronto, ON, Canada
- *Correspondence: Shahirose Sadrudin Premji
| | - Kiran Shaikh
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Sharifa Lalani
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Ilona S. Yim
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Sarah Moore
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Naureen Akber Ali
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Saher Aijaz
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
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Kluczniok D, Bertsch K, Hindi Attar C, Neukel C, Fuchs A, Jaite C, Dittrich K, Bödeker K, Heinz A, Winter S, Brunner R, Herpertz SC, Bermpohl F. Early life maltreatment and depression: Mediating effect of maternal hair cortisol concentration on child abuse potential. Psychoneuroendocrinology 2020; 120:104791. [PMID: 32683140 DOI: 10.1016/j.psyneuen.2020.104791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Maternal early life maltreatment (ELM) and history of depression can bear a risk for adverse development in the child. One neurobiological pathway for the transmission of both maternal ELM and remitted depression (MDD) might be altered maternal cortisol levels. In the present study, we examine (1) main and interacting effects of maternal ELM and remitted MDD on hair cortisol concentration (HCC) in mothers, whether (2) maternal HCC explains the association between maternal ELM or remitted MDD and maternal child abuse potential, and (3) whether maternal child abuse potential as well as maternal HCC are associated with maternal report of child well-being. METHODS The current study involved 127 mother-child dyads. Maternal history of ELM and psychopathology were assessed via the Mini International Neuropsychiatric Interview (M.I.N.I.) and Childhood Experience and Care (CECA) interview. The Child Abuse Potential Inventory (CAPI) was used to assess maternal child abuse and neglect potential. We applied the Kidscreen-27 parent report to study child well-being. To assess HCC, hair strands were taken from the mothers. To test the research questions, a two-factorial analysis of covariance, mediation analysis using ordinary least squares regressions with bootstrapping, and Pearson correlations were calculated. RESULTS Mothers with ELM had significantly increased HCC. There was no effect of remitted MDD on HCC, nor an interaction effect of both factors. HCC was a significant mediator of the association between maternal ELM and maternal child abuse potential. Maternal child abuse potential as well as HCC were significantly associated with reduced child well-being. DISCUSSION Our data suggest that adverse experiences in childhood are associated with altered HPA-axis functioning reflected in increased levels of HCC. HPA-axis activity is not altered in mothers with remitted MDD. From a clinical point of view, one might speculate that the partially mediating effect of maternal HCC could indicate a starting point in the prevention of the intergenerational cycle of abuse.
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Affiliation(s)
- Dorothea Kluczniok
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany.
| | - Katja Bertsch
- Department of Psychology, Ludwig Maximilian University Munich, Germany; Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Catherine Hindi Attar
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Corinne Neukel
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Anna Fuchs
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Germany
| | - Katja Dittrich
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Germany
| | - Katja Bödeker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Sibylle Winter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Germany
| | - Romuald Brunner
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Sabine C Herpertz
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany
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49
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Prenatal stress and epigenetics. Neurosci Biobehav Rev 2020; 117:198-210. [DOI: 10.1016/j.neubiorev.2017.05.016] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 12/22/2022]
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Kanner J, Williams AD, Nobles C, Ha S, Ouidir M, Sherman S, Mendola P. Ambient temperature and stillbirth: Risks associated with chronic extreme temperature and acute temperature change. ENVIRONMENTAL RESEARCH 2020; 189:109958. [PMID: 32980027 DOI: 10.1016/j.envres.2020.109958] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ambient temperature events are increasing in frequency and intensity. Our prior work in a U.S. nationwide study suggests a strong association between both chronic and acute temperature extremes and stillbirth risk. OBJECTIVE We attempted to replicate our prior study by assessing stillbirth risk associated with average whole-pregnancy temperatures and acute ambient temperature changes in a low-risk U.S. METHODS Singleton deliveries in the NICHD Consecutive Pregnancies Study (Utah, 2002-2010; n = 112,005) were identified using electronic medical records. Ambient temperature was derived from the Weather Research and Forecasting model. Binary logistic regression determined the adjusted odds ratio (aOR) and 95% confidence interval (95% CI) for stillbirth associated with whole-pregnancy exposure to extreme cold (<10th percentile) and hot (>90th percentile) versus moderate (10th-90th percentiles) average temperature, adjusting for maternal demographics, season of conception, hypertensive disorders of pregnancy, and gestational diabetes. In a case-crossover analysis, we estimated the stillbirth aOR and 95% CI for each 1° Celsius increase during the week prior to delivery using conditional logistic regression. In both models, we adjusted for relative humidity, ozone, and fine particulates. RESULTS We observed 500 stillbirth cases among 498 mothers. Compared to moderate temperatures, whole-pregnancy exposure to extreme cold (aOR: 4.42, 95% CI:3.43, 5.69) and hot (aOR: 5.06, 95% CI: 3.34, 7.68) temperatures were associated with stillbirth risk. Case-crossover models observed a 7% increased odds (95% CI: 1.04, 1.10) associated with each 1° Celsius increase during the week prior to delivery. DISCUSSION Both chronic and acute ambient temperature were associated with odds of stillbirth in this low-risk population, similar to our prior nationwide findings. Future increases in temperature extremes are likely and the observed risk in a low-risk population suggests this association merits attention.
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Affiliation(s)
- Jenna Kanner
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, USA
| | - Andrew D Williams
- Master of Public Health Program, Department of Population Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, USA
| | - Carrie Nobles
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, USA
| | - Sandie Ha
- School of Social Sciences, Humanities, and Arts, University of California, Merced, 5200 N. Lake Rd., Merced, CA, 95343, USA
| | - Marion Ouidir
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, USA
| | - Seth Sherman
- The Emmes Company, 401 N Washington St #700, Rockville, MD, 20850, USA
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, USA.
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