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Pre-pregnancy stress reactivity and pregnancy outcome.

ABSTRACT: Stress has been proposed as a cause of preterm birth (PTB) and small-for-gestational age (SGA), but stress does not have the same effects on all women. It may be that a woman's reaction to stress relates to her pregnancy health, and previous studies indicate that higher reactivity is associated with reduced birthweight and gestational age. The objective of this study was to examine the relationship between pre-pregnancy cardiovascular reactivity to stress and pregnancy outcome. The sample included 917 women in the Coronary Artery Risk Development in Young Adults Study who had cardiovascular reactivity measured in 1987-88 and at least one subsequent singleton livebirth within an 18-year period. Cardiovascular reactivity was measured using a video game, star tracing and cold pressor test. Gestational age and birthweight were based on the women's self-report, with PTB defined as birth <37 weeks' gestation and SGA as weight <10th percentile for gestational age. Linear and Poisson regression and generalised estimating equations were used to model the relationship between reactivity to stress and birth outcomes with control for confounders. Few associations were seen between reactivity and pregnancy outcomes. Higher pre-pregnancy diastolic blood pressure (adjusted relative risk 1.14; 95% confidence interval [CI] 0.98, 1.34) and mean arterial pressure reactivity (1.15; 0.98, 1.36) were associated with risk of PTB at first pregnancy, while SGA was associated with lower systolic blood pressure reactivity (0.76; 0.60, 0.95). No associations were seen with other measures of reactivity. Contrary to hypothesis, the association between heart rate reactivity and PTB in first pregnancy was stronger in whites (adjusted relative risk 1.39; 1.03, 1.88) than in blacks (1.00; 0.83, 1.20; P for interaction = 0.08). Similar results were found for mean arterial pressure. No strong associations were found between higher pre-pregnancy stress reactivity and SGA or PTB, and stress reactivity did not have a stronger association with birth outcomes in blacks than whites.

SUBMITTER: Harville EW

PROVIDER: S-EPMC3506123 | biostudies-literature | 2010 Nov

REPOSITORIES: biostudies-literature

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Pre-pregnancy stress reactivity and pregnancy outcome.

Harville Emily W EW Gunderson Erica P EP Matthews Karen A KA Lewis Cora E CE Carnethon Mercedes M

Paediatric and perinatal epidemiology 20100812 6

Stress has been proposed as a cause of preterm birth (PTB) and small-for-gestational age (SGA), but stress does not have the same effects on all women. It may be that a woman's reaction to stress relates to her pregnancy health, and previous studies indicate that higher reactivity is associated with reduced birthweight and gestational age. The objective of this study was to examine the relationship between pre-pregnancy cardiovascular reactivity to stress and pregnancy outcome. The sample includ ...[more]

PMID: 20955234

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Project description:BackgroundStudies have reported an increased risk of adverse pregnancy outcome associated with pre-pregnancy body mass index (BMI). However, the data on such associations in urban areas of southern Chinese women is limited, which drive us to clarify the associations of pre-pregnancy BMI and the risks of adverse pregnancy outcomes (preterm birth (PTB) and low birth weight (LBW)) and maternal health outcomes (gestational hypertension and cesarean delivery).MethodsWe performed a hospital-based case-control study including 3,864 Southern Chinese women who gave first birth to a live singleton infant from January 2015 to December 2015. PTB was stratified into three subgroups according to gestational age (extremely PTB, very PTB and moderate PTB). Besides, we combined birth weight and gestational age to dichotomise as being small for gestational age (SGA, less than the tenth percentile of weight for gestation) and non-small for gestational age (NSGA, large than the tenth percentile of weight for gestation), gestational week was also classified into categories of term, 34-36 week and below 34 week.. We then divided newborns into six groups: (1) term and NSGA; (2) 34-36 week gestation and NSGA; (3) below 34 week gestation and NSGA; (4) term and SAG; (5) 34-36 week gestation and SAG; (6) below 34 week gestation and SAG. Adjusted logistic regression models was used to estimate the odds ratios of adverse outcomes.ResultsUnderweight women were more likely to give LBW (AOR = 1.44, 95% CI [1.11-1.89]), the similar result was seen in term and SAG as compared with term and NSAG (AOR = 1.78, 95% CI [1.45-2.17]), whereas underweight was significantly associated with a lower risk of gestational hypertension (AOR = 0.45, 95% CI [0.25-0.82) and caesarean delivery (AOR = 0.74, 95% CI [0.62-0.90]). The risk of extremely PTB is relatively higher among overweight and obese mothers in a subgroup analysis of PTB (AOR = 8.12, 95% CI [1.11-59.44]; AOR = 15.06, 95% CI [1.32-172.13], respectively). Both maternal overweight and obesity were associated with a greater risk of gestational hypertension (AOR = 1.71, 95% CI [1.06-2.77]; AOR = 5.54, 95% CI [3.02-10.17], respectively) and caesarean delivery (AOR = 1.91, 95% CI [1.53-2.38]; AOR = 1.85, 95% CI [1.21-2.82], respectively).ConclusionsOur study suggested that maternal overweight and obesity were associated with a significantly higher risk of gestational hypertension, caesarean delivery and extremely PTB. Underweight was correlated with an increased risk of LBW and conferred a protective effect regarding the risk for gestational hypertension and caesarean delivery for the first-time mothers among Southern Chinese.

Project description:Corticosterone plays a central role in maintaining homeostasis, promoting energy acquisition, and regulating the stress response in birds. Exposure to elevated levels of corticosterone during development can profoundly alter offspring behaviour and physiology, but the effects of elevated maternal corticosterone on offspring development remain poorly understood.We tested two competing hypotheses concerning the effect of maternally derived corticosterone on growth and development of free-living house wrens: (i) elevated maternal corticosterone causes damaging effects on nestling phenotype and fitness (collateral damage hypothesis) and (ii) increased maternal corticosterone enhances offspring fitness by preparing nestlings for the environment experienced by their mother (environmental/maternal-matching hypothesis).We used a non-invasive means to increase maternal corticosterone by providing females with corticosterone-injected mealworms prior to and during egg production in the absence of any overt pre-natal maternal stress. To disentangle pre- and post-natal effects of this elevation in maternal corticosterone, we cross-fostered young in two experiments: (i) nestlings of control and experimental females were reared by unmanipulated, natural females in a uniform maternal environment; (ii) a split-brood design that enabled us to assess the interaction between the mother's corticosterone treatment and that of the nestlings.There were significant pre-natal effects of increased maternal corticosterone on nestling growth and survival. Offspring of females experiencing experimentally increased corticosterone were heavier and larger than offspring of control females. There also was a significant interaction between maternal corticosterone treatment and the corticosterone treatment to which young were exposed within the egg in their effect on nestling survival while in the nest; experimental young exhibited greater survival than control young, but only when reared by control mothers. There was also a significant effect of maternal corticosterone treatment on nestling stress reactivity and, in both experiments, on the eventual recruitment of offspring as breeding adults in the local population.These patterns are broadly consistent with the environmental/maternal-matching hypothesis, and highlight the importance of disentangling pre- and post-natal effects of manipulations of maternal hormone levels on offspring phenotype.

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Pre-pregnancy stress reactivity and pregnancy outcome.

Publications

Pre-pregnancy stress reactivity and pregnancy outcome.

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