Pregnancy-specific Stress Research Articles

The Structural Model of Spirituality and Psychological Well-Being for Pregnancy-Specific Stress.

Women experience different types of stress in their lifetime. The present study was conducted to examine the structural model of spirituality and psychological well-being for pregnancy-specific stress. The present descriptive correlational study was conducted on 450 pregnant Iranian women (150 women from each trimester) in Dehdasht city in 2015. Data were collected using the personal-social questionnaire, the pregnancy-specific stress questionnaire, the spirituality questionnaire and the psychological well-being questionnaire and were then analyzed in SPSS-16 and Lisrel-8.8 for carrying out a path analysis. The fit indices of the model indicate the good fit and high compatibility of the model and rational relationships between the variables (GFI=0.94, NFI=0.85, CFI=0.94 and RMSEA=0.048). Of the variables that affected pregnancy-specific stress through both paths, spirituality had a positive effect (B=0.11) and the personal-social variable a negative effect (B=-0.37). Psychological well-being affected pregnancy-specific stress negatively and directly and through one path only (B=-0.59). The results obtained through the model confirm the effect of spirituality and psychological well-being in reducing pregnancy-specific stress. Given that handling stress has a major role in the quality of daily life in pregnant women, stress management skills are recommended to be promoted among pregnant women so as to mitigate stress and its negative consequences.

The Effect of Group Counseling Based on Cognitive-Behavioral Approach on Pregnancy-Specific Stress and Anxiety

Background: Females encounter various stresses during life. Different courses of female’s life, namely menstruation, pregnancy, and childbirth, cause particular physical and mental changes that make them more vulnerable. Objectives: The purpose of this study was to investigate the effect of group counseling based on cognitive-behavioral approach on pregnancy-specific stress and anxiety Methods: This randomized trial recruited 62 qualified pregnant females during year 2016. The participants were selected through convenience sampling and divided to 2 groups, the intervention and the control group, based on randomized blocks of 4. The control group received routine prenatal care and an instructional package for dealing with stresses during pregnancy. The intervention group received counseling for 6 sessions of 90 minutes besides routine prenatal care. Both groups were evaluated at baseline and at the end of the study using pregnancy-specific stress and anxiety questionnaire. The collected data were analyzed using the SPSS16 software. Results: Based on the results of this study, the 2 groups did not significantly differ in terms of age, educational level, occupation, ethnicity, and housing. The score of stress during pregnancy was not significantly different at baseline either. However, mean score of stress after the intervention was significantly lower in the intervention group than the control group (P = 0.001). Conclusions: Cognitive-behavioral counseling can be used as an optional method for reducing the pregnancy-specific stress and anxiety, and improving the pregnant female’s mental health.

Obesity and the association with maternal mental health symptoms

Objective: To evaluate the association between maternal obesity and mood disorders including depression, anxiety, stress, and pregnancy-specific stress during pregnancy.Study design: This was a planned secondary analysis of a prospective cohort study investigating factors associated with preterm delivery. The cohort included women who initiated prenatal care before 20 weeks with a singleton pregnancy. Maternal mental health was assessed using four standard psychosocial behavioral measures to screen for depression, pregnancy-specific stress, anxiety, and stress. Screen positive scores for each tool were established based on previously published “high” scores.Results: Of the 1010 women included in the cohort, 355 (35.1%) were obese. There was no significant difference in the number of obese women with stress (64.2% versus 68.4%, p = 0.18), pregnancy-specific stress (26.2% versus 22.1%, p = 0.15), or anxiety (38.6% versus 41.2%, p = 0.42); however, a greater number of obese women did report symptoms consistent with major depression when compared to women with BMIs <30 (30.4% versus 21.2%, p < 0.01).Conclusion: Obese women had higher rates of depression in early pregnancy compared to nonobese women. As many of the health behavior interventions for obese women during pregnancy have proven ineffective, incorporating depression screening and treatment into prenatal care may improve perinatal outcomes.

Psychometric properties of the Prenatal Health Behavior Scale in mid- and late pregnancy

Introduction: Psychometrically sound self-report measures are important tools to advance research on health behaviors in pregnancy. The Prenatal Health Behavior Scale (PHBS) has been used in prior studies to quantify health behaviors and examine their associations with relevant variables, but its psychometric properties have not been carefully investigated.Methods: In a sample of low-risk women, we examined the factor structure, reliability, and validity of the PHBS at mid- (N = 138) and late (N = 102) pregnancy.Results: In confirmatory factor analysis, items on the PHBS loaded onto a single reliable factor, but separating health-promoting and health-impairing behavior into two factors had better model fit. The scales defined by these two factors had good internal consistency in mid- and late pregnancy, were only moderately correlated, and were predicted by somewhat different sets of sociodemographic and psychological variables. Pregnancy-specific stress was a robust predictor of health-promoting and health-impairing behavior across time.Discussion: Results bolster confidence in the reliability and validity of the PHBS and its appropriateness as a self-report tool for investigation of health behaviors among pregnant women. This study is one of the first investigations to examine patterns and predictors of health behavior practices at two time periods of pregnancy.

Multiple Factors in the Second Trimester of Pregnancy on Preterm Labor Symptoms and Preterm Birth

The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB. Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p<.001), shorter cervix (<25mm) (OR=5.63, CI=1.29~24.54, p<.05), BMI >25 (kg/m²) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05). The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.

Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience

ObjectiveTo examine the relationship between prenatal maternal stress, resilience, and sleep quality, and to determine whether resilience plays a mediating role in the relationship between prenatal maternal stress and sleep quality among pregnant women. MethodsTwo hundred and thirty-one pregnant women in their second trimester participated in the study. They completed questionnaires, including: the Pittsburgh Sleep Quality Index (PSQI), the Pregnancy Stress Rating Scale (PSRS), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). A structural equation model was used to analyze the relationships among prenatal maternal stress, resilience, and sleep quality, with resilience as a mediator. ResultsPrenatal maternal stress was negatively associated with sleep quality in pregnant women (p < 0.01), whereas resilience was positively associated with sleep quality (p < 0.01). Furthermore, resilience mediated the relationship between prenatal maternal stress and sleep quality, and the mediation effect ratio was 22.0% (p < 0.01). ConclusionsThe risk factor for disturbed sleep was pregnancy-specific stress; however, the protective factor for sleep quality was resilience. This finding could provide scientific evidence for the development of intervention strategies with which to improve sleep quality in pregnant women.

Prenatal stress and hemodynamics in pregnancy: a systematic review.

Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on hemodynamics during pregnancy remains unclear. This systematic review was conducted in order to assess the quality of the evidence available to date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. The PubMed/Medline, EMBASE, PsycINFO, Maternity and Infant Care, Trip, Cochrane Library, and CINAHL databases were searched using the search terms pregnancy; stress; fetus; blood; Doppler; ultrasound. Studies were eligible for inclusion if prenatal stress was assessed with standardized measures, hemodynamics was measured with Doppler ultrasound, and methods were adequately described. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-accepted quality appraisal guidelines. Of 2532 studies reviewed, 12 met the criteria for inclusion. Six reported that prenatal stress significantly affects maternal or fetal hemodynamics; six found no significant association between maternal stress and circulation. Significant relationships between prenatal stress and uterine artery resistance (RI) and pulsatility (PI) indices, umbilical artery RI, PI, and systolic/diastolic ratio, fetal middle cerebral artery PI, cerebroplacental ratio, and umbilical vein volume blood flow were found. To date, there is limited evidence that prenatal stress is associated with changes in circulation. More carefully designed studies with larger sample sizes, repeated assessments across gestation, tighter control for confounding factors, and measures of pregnancy-specific stress will clarify this relationship.

Effect of pregnancy-specific stress on spontaneous preterm birth among Chinese people

Background: The current evidence implicates that psychosocial stress, especially pregnancy-specific stress, is associated with the risk of spontaneous preterm birth.The aim of the present study was to determine the effect of pregnancy-specific stress on spontaneous preterm birth among Chinese people. Materials and Methods: A total of 2,189 pregnant women were enrolled and followed up until parturition from February 2011 to January 2012. Maternal pregnancy-specific stress was assessed using the revised Pregnancy Stress Rating Scale (PSRS) at third trimester in pregnancy. Socio-demographic and psychological data were collected through interviews, medical, and obstetrical examination records. Results: High levels of maternal pregnancy-specific stress during the third trimester increased risk of spontaneous preterm birth compared with the low and medium levels (adjusted risk ratios, 2.92; 95% confidence interval, 1.12 - 7.58). The first stressor from the revised PSRS includes a risk factor for the safety of infants. Conclusions: High level of pregnancyspecific stress in third trimester might predict spontaneous preterm birth.

Relationship of coping ways and anxiety with Pregnancy Specific-stress.

Objectives:To explore whether coping strategies and general anxiety are associated with pregnancy-specific stress (PSS) and how much of variance of PSS is explained with these variables.Methods:A cross sectional study was conducted at two teaching hospitals between November 2013 and December 2015. Total 190 pregnant women (60 women at 6-13-weeks of gestation, 60 at 13-26 weeks, and 70 at 27-40 weeks of gestation) completed the study. The participants completed three questionnaires including; Pregnancy experience scale (PES-41), Ways of Coping Questionnaire (WCQ), and State-Trait anxiety inventory (SATI). Pearson coefficients and analysis of regression was done to assess the correlations between variables.Results:Pregnant women who experienced higher mean level of pregnancy specific-stress had significantly higher mean level of occult anxiety, overt anxiety, and total anxiety than women who did not experience PSS. Although there was a positive and significant relationship between intensity of hassles and uplifts and ways of coping, the correlation between PSS and ways of coping was not significant. The results of analysis regression showed that general anxiety during pregnancy predicted 25% of the variance of PSS (F=4.480, β=0.159). Also, ways of coping predicted 38% of the variance in pregnancy Hassles (F=7.033, β=0.194).Conclusion:The ways of coping predicted the variance of pregnancy hassles, but does not evaluate pregnancy specific-stress. To think about PSS in terms of general anxiety may help to clarify past findings and to guide future research and interventions.

Perceived stress and anxiety among Ghanaian pregnant women

The aim of the study was to assess the prevalence of stress and anxiety, as well as the association that exists between stress/anxiety and sociodemographic characteristics, among pregnant women at the Tamale West Hospital in Ghana. This study was conducted among 154 pregnant women vis-iting the Tamale West hospital for antenatal care, from March to May, 2015. All participants were evaluated using a Self-designed semi-structured questionnaire for socio-demographic information, the Center for Epidemiological Studies Depression Scale (CES-D) for stress assessment and State Trait Anxiety Inventory (STAI) for assessment of anxiety. The response rate was 96.3%, with an age range of 17-42. Whereas 43.5% of the studied population were illiterate, 24.0% had attained basic education, 21.4% had attained secondary education while only 11.0% had attained tertiary educa-tion. Most of the studied participants were unemployed (57.8%), with a mean ± s.d. income level of Ghc 103.4±207.9. Almost all of them were married (96.8%) with mean ± s.d. marriage duration of 6.2±4.8 years, mean ± s.d. number of birth of 1.7±1.4 as well as mean ± s.d. gestation week of 21.3±10.9 weeks. Almost all the pregnant women had no complication in the current pregnancy (99.4%) as well as in their previous pregnancy (96.1%). The mean ± s.d. of anxiety score as well as stress score from the studied population were 15.3±3.2 and 13.2±4.9 respectively. The prevalence of anxiety was 9.7% whiles that for stress among these studied participants was 28.6%. Higher propor-tion (26.6%) of educated women had anxiety disorders with a lower (21.9±10.8) mean gestation peri-od being associated with anxiety disorders. Age was higher (28.1±5.8; p=0.0155) in women with pregnancy specific stress than in normal women (25.0±7.9). A higher proportion of women who were married (99.1%; 0.0097) were normal as compared to those who had pregnancy stress (90.9%). Mean number of births was seen to be higher among normal women (4.3±5.9; 0.0054) than those with stress (1.8±1.4). This study reiterates the rising levels of pregnancy specific stress and anxiety, with social and medical factors such as literacy levels, gestational period, age, marital status and parity playing major roles in the determination of pregnancy related stress and anxiety levels. Keywords : Mood disorder, ante-natal, gestational week, risk factors, Ghana

Social support and maternal stress during pregnancy: a PATH model

Background: Lack of appropriate social support and resultant increased maternal stress during pregnancy contributes to negative pregnancy outcomes for both mothers and the future offspring. Objective: The primary aim of this study was to investigate the relationship between social support and maternal stress during pregnancy. Methods: This descriptive-correlative study was conducted on 210 pregnant women who met inclusion criteria and attended Shahryar Social Security Hospital from August to December 2012. Participants were recruited through a purposive convenient sampling. Questionnaires about socio-economic status, the Vaux Social Support Record and pregnancy-specific stress were completed by participants. SPSS-19 and Lisrel 8.8 were used for data and path analysis. Results: There was a significant relationship between perceived social support and maternal stress ( p < .05); however, support from family members and partners had the most affect. An emergent path model fitted (CF1 = 1, RMSEA = 0.00) and, accordingly, direct social support ( t -value = 7.3) influenced maternal stress during pregnancy. But socio-economic status did not show significant impact. Conclusions: Since social support is a measurable and multi-dimensional factor, health managers and policy makers ought to assess, recognize and apply specific support resources for pregnant women. Our data also support the idea that empowering family members and partners to support pregnant women by involving them in prenatal care programs is important to reduce maternal stress rate.

Social support for pregnant women

Abstract This paper is a review of the literature concerning the importance of social support during pregnancy. Being pregnant is a special event in every woman’s life, since it is associated with physical and mental changes. In addition to being a physiological event, pregnancy creates a burden for the body and induces stress. Pregnant women tend to suffer from fear of the unknown, especially regarding: baby, themselves, course of delivery, the need for a new role – of a mother, economic, professional, emotional situations and relationship with partner. The diagnosis of high-risk pregnancy and the need for hospitalization increase the incidence of negative emotions and experiences such as: permanent anxiety about the child’s life, anger, sadness, doubts about the diagnosis, fear of pregnancy complications, frustration and dissatisfaction with the implementation of the functions of maternal concerns during the stay in the hospital. Anxiety and fear that appear during pregnancy affect the attitude of women in pregnancy and after childbirth. Various authors frequently use the term “pregnancy-specific stress”. There is a relationship between concerns, stress in the mother during pregnancy and lifestyle, duration of pregnancy, and the possible complications during intrauterine and neonatal life. Social support significantly influences the quality of coping with stress in pregnant women. If a pregnant woman receives strong social support from her network, the negative emotions and concerns would be reduced. Receiving support also boosts the chances of successful pregnancy completion. The people from the immediate social network of a pregnant woman, like their partner, spouse, family, friends, midwife, doctor, are the most vital source of support.

Development of the cortisol circadian rhythm in the light of stress early in life

The secretion of the stress hormone cortisol follows a diurnal circadian rhythm. There are indications that this rhythm is affected by stress early in life. This paper addresses the development of the cortisol circadian rhythm between 1 and 6 years of age, and the role of maternal stress and anxiety early in the child’s life on this (developing) rhythm. Participants were 193 healthy mother-child dyads from a community sample. Self-reported maternal stress and anxiety and physiological stress (saliva cortisol), were assessed prenatally (gestational week 37). Postnatally, self-reported maternal stress and anxiety were measured at 3, 6, 12, 30, and 72 months. Saliva cortisol samples from the children were collected on two days (four times each day) at 12, 30, and 72 months of age. The total amount of cortisol during the day and the cortisol decline over the day were determined to indicate children’s cortisol circadian rhythm. Multilevel analyses showed that the total amount of cortisol decreased between 1 and 6 years. Furthermore, more maternal pregnancy-specific stress was related to higher total amounts of cortisol in the child. Higher levels of early postnatal maternal anxiety were associated with flatter cortisol declines in children. Higher levels of early postnatal maternal daily hassles were associated with steeper child cortisol declines over the day. These results indicated developmental change in children’s cortisol secretion from 1 to 6 years and associations between maternal stress and anxiety early in children’s lives and children’s cortisol circadian rhythm in early childhood.

The effects of music listening on psychosocial stress and maternal–fetal attachment during pregnancy

ObjectiveWhile music listening has been studied as an intervention to help reduce anxiety in pregnant women, few studies have explored the effect of music listening on pregnancy-specific stress relief. This study examines the effects of music listening on psychosocial stress and maternal–fetal attachment during pregnancy. DesignA randomized controlled trial was implemented. A valid sample of 296 pregnant women in their second or third trimester was randomly distributed into an experimental group (n=145) and a control group (n=151). InterventionsThe experimental group received routine prenatal care and music listening. The control group received routine prenatal care only. Main outcome measuresData were collected using a demographic form, Pregnancy Stress Rating Scale (PSRS), Perceived Stress Scale (PSS), and Maternal–Fetal Attachment Scale (MFAS). ResultsThe post-test results identified a significantly lower level of psychosocial stress in the experimental group than in the control group, particularly in terms of the stresses related to baby care and changing family relationships and to maternal role identification. However, no statistically significant differences in terms of perceived stress and maternal–fetal attachment were found between the post-test results of the two groups. ConclusionThis study provides evidence in support of using of music in interventions designed to relieve psychosocial stress in prenatal women.IRB approval number: ER98223

Psychosocial correlates of health-promoting and health-impairing behaviors in pregnancy

Behaviors during pregnancy including eating, exercise, cigarette smoking, and other substance use affect the health of a pregnant woman and her fetus. However, little is known about what influences pregnant women to engage in these health behaviors. Based upon relevant theory, we hypothesized that because health-promoting behaviors require continuous efforts that may depend upon a reliable, stable set of resources, intrapersonal traits, namely self-esteem and optimism, would be associated with the practice of health-promoting behaviors during pregnancy. In addition, we hypothesized that variables reactive to the more immediate context, pregnancy-specific stress and perceived control over pregnancy, would be associated with the practice of health-impairing behaviors. We distinguished health-promoting and health-impairing behaviors in a diverse sample of 165 pregnant women and investigated whether such behaviors are associated with distinct psychosocial factors. Results supported study hypotheses and provide evidence that even after controlling for maternal age, income, body mass index, and gestation, a stable, self-relevant disposition, self-esteem, is associated with the practice of health-promoting behaviors in pregnancy whereas pregnancy-specific stress, a situationally-evoked factor, is associated with the practice of health-impairing prenatal behaviors. Perceived control over pregnancy, which may reflect stable disposition and situational perceptions, was associated with health-promoting and health-impairing behaviors.

Pregnancy-specific stress, preterm birth, and gestational age among high-risk young women.

There is evidence that pregnancy-specific stress is associated with preterm birth. The purpose of this study is to examine the association between change in pregnancy-specific stress over the course of pregnancy and birth outcomes (i.e., preterm birth and gestational age) in an understudied but vulnerable group using a theoretically derived model. Multivariate linear and logistic regression techniques were used to examine the association between pregnancy-specific stress (measured in second and third trimester) and length of gestation (i.e., preterm birth and gestational age) among a sample of 920 Black and/or Latina adolescent and young women. Second trimester pregnancy-specific stress was not associated with preterm birth or gestational age. Third trimester pregnancy-specific stress was associated with preterm birth but not with gestational age. Change in pregnancy-specific stress between second and third trimester was significantly associated with increased likelihood of preterm delivery and shortened gestational age, even after controlling for important biological, behavioral, psychological, interpersonal, and sociocultural risk factors. Findings emphasize the importance of measuring pregnancy-specific stress across pregnancy, as the longitudinal change from second to third trimester was significantly associated with length of gestation measured both as a dichotomous variable (preterm birth) and a continuous variable (gestational age). Furthermore, this is the first study to observe the association of pregnancy-specific stress with length of gestation in this understudied population-unique in age, race, and ethnicity.

Differential expression of placental glucocorticoid receptors and growth arrest-specific transcript 5 in term and preterm pregnancies: evidence for involvement of maternal stress.

Pregnancy-specific stress predicts birth outcomes. We hypothesized that there is a maternal stress-GR interaction that can influence fetal birth weight. This study examined the relationship between mothers' stress and attitude towards their pregnancies, placental glucocorticoid receptors (GRs) and growth arrest-specific transcript 5 (GAS5) expression, and the status of GR polymorphism, with their infants' birth weights. GAS5 and GRα were the predominant transcripts in both term and preterm placentas, with GAS5 being primarily localized in the syncytiotrophoblasts. In an attempt to mimic moderate and high stress environment in vitro, BeWo and JEG-3 cytotrophoblast cell lines were treated with 10 nM–1000 nM cortisol. Only expression of GAS5 was significantly upregulated by cortisol in all treatments compared with basal levels, but none of the GRs changed expression significantly. In an attempt to assess a stress versus gene interaction, we studied four GR polymorphisms. In the homozygous group for Tth111I polymorphism, mothers with negative attitudes towards the pregnancy gave birth to infants with significantly lower birth weights compared to women with positive/neutral attitudes. None of the GR splice variants were associated with maternal stress. However, placental GAS5 levels were inversely correlated with maternal stress. This study points towards a potential gene-environment interaction that could be of predictive value for fetal weight.

Preferences for a third-trimester ultrasound scan in a low-risk obstetric population: a discrete choice experiment.

Establish maternal preferences for a third-trimester ultrasound scan in a healthy, low-risk pregnant population. Cross-sectional study incorporating a discrete choice experiment. A large, urban maternity hospital in Northern Ireland. One hundred and forty-six women in their second trimester of pregnancy. A discrete choice experiment was designed to elicit preferences for four attributes of a third-trimester ultrasound scan: health-care professional conducting the scan, detection rate for abnormal foetal growth, provision of non-medical information, cost. Additional data collected included age, marital status, socio-economic status, obstetric history, pregnancy-specific stress levels, perceived health and whether pregnancy was planned. Analysis was undertaken using a mixed logit model with interaction effects. Women's preferences for, and trade-offs between, the attributes of a hypothetical scan and indirect willingness-to-pay estimates. Women had significant positive preference for higher rate of detection, lower cost and provision of non-medical information, with no significant value placed on scan operator. Interaction effects revealed subgroups that valued the scan most: women experiencing their first pregnancy, women reporting higher levels of stress, an adverse obstetric history and older women. Women were able to trade on aspects of care and place relative importance on clinical, non-clinical outcomes and processes of service delivery, thus highlighting the potential of using health utilities in the development of services from a clinical, economic and social perspective. Specifically, maternal preferences exhibited provide valuable information for designing a randomized trial of effectiveness and insight for clinical and policy decision makers to inform woman-centred care.

Maternal psychosocial stress during pregnancy is associated with newborn leukocyte telomere length

In adults, one of the major determinants of leukocyte telomere length (LTL), a predictor of age-related diseases and mortality, is cumulative psychosocial stress exposure. More recently we reported that exposure to maternal psychosocial stress during intrauterine life is associated with LTL in young adulthood. The objective of the present study was to determine how early in life this effect of stress on LTL is apparent by quantifying the association of maternal psychosocial stress during pregnancy with newborn telomere length. In a prospective study of N = 27 mother-newborn dyads maternal pregnancy-specific stress was assessed in early gestation and cord blood peripheral blood mononuclear cells were subsequently collected and analyzed for LTL measurement. After accounting for the effects of potential determinants of newborn LTL (gestational age at birth, weight, sex, and exposure to antepartum obstetric complications), there was a significant, independent, linear effect of pregnancy-specific stress on newborn LTL that accounted for 25% of the variance in adjusted LTL (β = -0.099; P = .04). Our finding provides the first preliminary evidence in human beings that maternal psychological stress during pregnancy may exert a "programming" effect on the developing telomere biology system that is already apparent at birth, as reflected by the setting of newborn LTL.

Glucocorticoids in hair as biomarkers of traumatization in healthy individuals and PTSD patients

Rationale/statement of the problemSubstantial evidence suggests conditions in intrauterine life may play a critical role in subsequent health and disease susceptibility related outcomes (i.e., the concept of fetal or developmental programming of health and disease). The elucidation of biological mechanisms underlying these effects is an area of active investigation. We suggest that telomere biology may represent a novel mechanism underlying the effects of a disparate set of suboptimal intrauterine exposures on various health and disease risk phenotypes. From an evolutionary-developmental perspective, energy substrate availability (i.e., nutrition) and challenges that have the potential to impact the structural or functional integrity and survival of the organism (i.e., stress) likely represent the most important environmental considerations underlying natural selection and developmental plasticity. Maternal stress and nutrition in pregnancy therefore represent attractive candidate processes in the context of fetal programming of telomere biology. Our previous work has established an important role for prenatal stress and stress-related processes in adult telomere biologyMethodsIn two longitudinal birth cohorts, stress- and nutrition-related processes were assessed during pregnancy and telomere length (TL) was subsequently measured in newborns (cord blood) and infants (buccal cells).Results(1) Among the nutrition-related factors, maternal lower folate levels (an essential methyl donor) and higher triglyceride concentrations in early pregnancy were significantly and independently associated with shorter newborn TL. (2) Among psychosocial stress-related measures, higher maternal pregnancy-specific stress was associated with shorter newborn TL. (3) Maternal estrogen (E3) levels during early pregnancy were associated with longer infant TL.ConclusionTaken together, our findings provide the first evidence in humans that maternal nutrition and stress-related processes during pregnancy may exert a programming effect on the newborn and infant telomere biology system. In utero telomere biology represents a potential molecular mechanism whereby different exposures in this critical developmental period before birth could impact subsequent health and disease susceptibility related outcomes over the life span, including aging and longevity