The association of maternal prenatal psychosocial stress with vascular function in the child at age 10–11 years: findings from the Avon longitudinal study of parents and children

Aimée E Van Dijk,Debbie A Lawlor,Reinoud Jbj Gemke,John Deanfield,Tanja Gm Vrijkotte,Karien Stronks,Karen Dawe

doi:10.1177/2047487313486039

Abstract

ObjectiveTo investigate whether (1) maternal psychosocial stress (depression/anxiety) during pregnancy is associated with offspring vascular function and (2) whether any association differs depending on the gestational timing of exposure to stress. We also investigated whether any association is likely to be due to intrauterine mechanisms by (3) comparing with the association of paternal stress with offspring vascular function and (4) examining whether any prenatal association is explained by maternal postnatal stress.Methods and resultsAssociations were examined in a UK birth cohort, with offspring outcomes (systolic and diastolic blood pressure, SBP and DBP, endothelial function assessed by brachial artery flow-mediated dilatation (FMD); arterial stiffness assessed by carotid to radial pulse wave velocity (PWV), brachial artery distensibility (DC), and brachial artery diameter (BD) assessed at age 10–11 years (n = 4318). Maternal depressive symptoms and anxiety were assessed at 18 and 32 weeks gestation and 8 months postnatally. Paternal symptoms were assessed at week 19. With the exception of DBP and BD, there were no associations of maternal depressive symptoms with any of the vascular outcomes. Maternal depressive and anxiety symptoms were associated with lower offspring DBP and wider BD, though the latter attenuated to the null with adjustment for confounding factors. Paternal symptoms were not associated with offspring outcomes. Maternal postnatal depressive symptoms were associated with lower offspring SBP.ConclusionsWe found no evidence to support the hypothesis that maternal stress during pregnancy adversely affects offspring vascular function at age 10–12 years via intrauterine mechanisms.

Highlights

Maternal stress or the administration of glucocorticoids (‘stress hormones’) have been linked to altered fetal growth and might have permanent effects on the tissue structure and function of the offspring.[1]
The aim of this study was to examine whether (1) maternal psychosocial stress during pregnancy is associated with offspring vascular function (assessed by systolic blood pressure (SBP), diastolic blood pressure (DBP), endothelial function assessed by brachial artery flow-mediated dilatation (FMD), arterial stiffness assessed by carotid to radial pulse wave velocity (PWV), brachial distensibility coefficient (DC), and brachial artery diameter) and (2) whether any association differs depending on the gestational timing of exposure to stress
Maternal Age at delivery White ethnicity Pre-pregnancy body mass index Obesity Social class I II III III IV V Primiparous Smoking Non-smoking Stopped before pregnancy or in first trimester Smoked during pregnancy Alcohol None 1 glass/week >1 glass/day Pregnancy-related hypertension

Summary

Introduction

Maternal stress or the administration of glucocorticoids (‘stress hormones’) have been linked to altered fetal growth and might have permanent effects on the tissue structure and function of the offspring.[1]. Few pregnant women will be treated with glucocorticoids, but the results of these studies have been used to suggest that common mental complaints (depression and anxiety) associated with stress, if experienced by the mother during pregnancy might increase her offspring’s risk of cardiovascular disease. If this is true it would have important public health implications, but to our knowledge few studies have examined this

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Conclusion