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.
Highlights
The aims of this study were threefold: 1) To conceptually replicate the previously reported association between childhood traumatic events (CTE) and placental Corticotrophin-Releasing Hormone (pCRH) levels and rate of rise (Moog et al, 2016) by examining whether such association could be detected in a larger sample, specif ically a sociodemographically diverse sample of 1303 pregnant Black and White women, adjusting for some of the same obstetric, clinical, and health related factors known to be associated with pCRH levels, as well as additional potential confounders not included in their model; 2) To leverage our diverse sample to test whether associations between CTE and pCRH
Racially and sociodemographically diverse sample of women, the present study examined the association of maternal CTE with the level and rate of rise of pCRH during pregnancy, whether such association varied by race, and whether the consideration of traumatic events in adulthood, interpersonal violence, or neighborhood risk dur ing pregnancy, would provide additional predictive value
The present study found an association between experiencing trau matic events in childhood, physical or sexual abuse or do mestic violence, and higher levels and rise of pCRH across pregnancy in a large, sociodemographically and racially diverse sample of women, after adjusting for multiple obstetric, clinical, and health related factors associated with pCRH levels
Summary
A large empirical literature suggests that maternal exposure to psychosocial stress during pregnancy increases the risk of multiple adverse birth-related outcomes as well as maternal psychiatric and child developmental outcomes, including spontaneous abortions, preterm birth, low birth weight, postpartum depression, infant growth retarda tion, postnatal health, augmented stress reactivity, and, in older chil dren, reduced cognitive abilities and behavioral- and socioemotional problems (Bergman et al, 2007; Buffa et al, 2018; Class et al, 2011; Davis et al, 2011; Entringer et al, 2009; Hobel et al, 2008; Loomans et al, 2012; Madigan et al, 2018; Qobadi et al, 2016; M. Robinson et al, 2008). A large empirical literature suggests that maternal exposure to psychosocial stress during pregnancy increases the risk of multiple adverse birth-related outcomes as well as maternal psychiatric and child developmental outcomes, including spontaneous abortions, preterm birth, low birth weight, postpartum depression, infant growth retarda tion, postnatal health, augmented stress reactivity, and, in older chil dren, reduced cognitive abilities and behavioral- and socioemotional problems A more comprehensive understanding of envi ronmental factors contributing to pCRH level and rate of rise, especially potentially modifiable risk factors, is needed
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