Effects of stress and depression on inflammatory immune parameters in pregnancy

Abstract

There is a substantial body of literature that links psychological stress to adverse pregnancy outcomes, particularly preterm birth. Comparatively few studies have examined potential biologic mechanisms that explain these associations. Attention to inflammatory processes is warranted. This article describes emerging studies that demonstrate that, as in nonpregnant humans and animals, psychological stress and distress (ie, depressive symptoms) predict dysregulation of inflammatory processes in human pregnancy. This includes elevations in circulating inflammatory cytokines, exaggerated inflammatory responses to invivo biologic challenges, and more robust inflammatory responses to psychological challenges. Continued research in this area isneeded to determine the implications of such stress-induced immune dysregulation forbirth outcomes and for maternal health and fetal development.