Pathways by Which Stress May Affect Pregnancy Outcomes, Maternal Health and Fetal Development

Pathways by Which Stress May Affect Pregnancy Outcomes, Maternal Health and Fetal Development

In a recent review article in the journal Neuroscience & Biobehavioral Reviews, Lisa Christian discusses some biological mechanisms linking stress with maternal health, pregnancy outcomes and fetal development, focusing on peripheral immune markers, and stress reactivity and inflammatory processes during pregnancy

Preterm delivery affects 12–13% of birth in the US, versus 5–9% in other developed countries. Evidence accumulated over the last 2-3 decades indicates that psychological stress is associated with an increased  risk  of  preterm  birth  after  controlling  for  related  traditional  risk factors.

Stress experienced during pregnancy has also been linked to other pregnancy complications such as miscarriage, preeclampsia, low birth weight or major congenital malformations, and stress increases the risk of the child to develop diseases in the subsequent periods of life.

In the Neuroscience & Biobehavioral Reviews article, Lisa Christian from the Ohio State University Medical Center, Columbus, OH has outlined recent data linking stress with maternal and fetal health. Although previous research has focused almost exclusively on neuroendocrine mechanisms, several recent studies indicate that inflammatory processes may contribute to the association of psychosocial stress with preterm birth.

For example, high levels of proinflammatory cytokines in maternal serum and amniotic fluid including IL-6, IL-8, and TNF-alpha, have been causally implicated in risk of preterm delivery. As discussed by the author further research is needed to delineate effects of stress on adaptation of inflammatory processes across pregnancy at the level of circulating cytokines levels; inflammatory responses to in vivo and in vitro immune triggers and inflammatory responses in the context of psychosocial stressors.

Thus, stress-immune interactions research in the context of pregnancy has great potential for elucidating mechanisms underlying risk of adverse perinatal health outcomes, and this approach may provide a basis for individualized health care services.

SOURCE: Neurosci Biobehav Rev 2012, 36:350. Epub 2011 Jul 19.

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