Abstract
ObjectivePrenatal maternal stress could have permanent effects on the offspring’s tissue structure and function, which may predispose to cardiovascular diseases. We investigated whether maternal psychosocial stress is a prenatal factor affecting the blood pressure (BP) of offspring.Study DesignIn the Amsterdam Born Children and their Development (ABCD) study, around gestational week 16, depressive symptoms, state-anxiety, pregnancy-related anxiety, parenting daily hassles and job strain were recorded by questionnaire. A cumulative stress score was also calculated (based on 80th percentiles). Systolic and diastolic BP and mean arterial pressure (MAP) were measured in the offspring at age 5–7 years. Inclusion criteria were: no use of antihypertensive medication during pregnancy; singleton birth; no reported cardiovascular problems in the child (N = 2968 included).ResultsAfter adjustment for confounders, the single stress scales were not associated with systolic and diastolic BP, MAP and hypertension (p>0.05). The presence of 3–4 psychosocial stressors prenatally (4%) was associated with 1.5 mmHg higher systolic and diastolic BP (p = 0.046; p = 0.04) and 1.5 mmHg higher MAP in the offspring (p = 0.02) compared to no stressors (46%). The presence of 3–4 stressors did not significantly increase the risk for hypertension (OR 1.8; 95% CI 0.93.4). Associations did not differ between sexes. Bonferroni correction for multiple testing rendered all associations non-significant.ConclusionsThe presence of multiple psychosocial stressors during pregnancy was associated with higher systolic and diastolic BP and MAP in the child at age 5–7. Further investigation of maternal prenatal stress may be valuable for later life cardiovascular health.
Highlights
According to the ‘fetal programming hypothesis’, prenatal exposure to suboptimal intra-uterine conditions could predispose the individual to chronic disease at adult age [1]
After adjustment for confounders, the single stress scales were not associated with systolic and diastolic blood pressure (BP), mean arterial pressure (MAP) and hypertension (p.0.05)
The presence of multiple psychosocial stressors during pregnancy was associated with higher systolic and diastolic BP and MAP in the child at age 5–7
Summary
According to the ‘fetal programming hypothesis’, prenatal exposure to suboptimal intra-uterine conditions could predispose the individual to chronic disease at adult age [1] Such conditions can be maternal stress or the administration of stress hormone (glucocorticoid), which alters fetal growth and has permanent effects on the tissue structure and function of the offspring [2]. One involves inflammation markers: maternal psychosocial factors can contribute to increased inflammation during pregnancy [19], which influences the development of adult cardiovascular disease, this mechanism has not been extensively investigated [20] Another potential pathway requires the influence of psychosocial stress on the maternal hypothalamic-pituitary-adrenal (HPA) axis: This leads to hypersecretion of the glucocorticoid cortisol, which may influence the development of the fetal HPA axis [6,7,16] and immune function [21] as it partly crosses the placenta. Hyperactivity of the offspring’s HPA axis is in turn associated with risk factors for cardiovascular diseases such as increased blood pressure (BP), insulin resistance, glucose intolerance and hyperlipidemia [25]
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