Maternal Psychosocial Adversity During Pregnancy Is Associated With Length of Gestation and Offspring Size at Birth: Evidence From a Population-Based Cohort Study

Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
Psychosomatic Medicine (Impact Factor: 3.47). 05/2010; 72(4):419-26. DOI: 10.1097/PSY.0b013e3181d2f0b0
Source: PubMed


To study in a large-scale cohort with prospective data the associations of psychosocial adversities during pregnancy with length of gestation and offspring size at birth.
We defined a priori two types of psychosocial adversity during pregnancy: life stress (perceived burdens in major areas of life) and emotional symptoms (e.g. anxiety). Measures of offspring size at birth, including body weight, body length, abdominal and head circumference, were obtained from a national medical birth registry. We included in the analyses gestational age and offspring size at birth controlled for length of gestation; the latter was calculated by gestational-age-specific z scores (ZS) reported in 10(-3). We conducted multiple regression analyses adjusted for potential confounders to estimate the association between exposures and birth outcomes (n = 78017 pregnancies).
Life stress (per score increase by 1; range, 0-18) was associated with shorter length of gestation (days; B, -0.14; 95% confidence interval (CI), -0.19, -0.10), increased offspring body weight (ZS; B, 9.14; 95% CI, 4.99, 13.28), body length (ZS; B, 6.58; 95% CI, 2.39, 10.77), abdominal circumference (ZS; B, 9.96; 95% CI, 5.77, 14.16), and head circumference (ZS; B, 6.13; 95% CI, 1.95, 10.30). Emotional symptoms were associated with shorter length of gestation (days; B, -0.04; 95% CI, -0.07, -0.004) and decreased body length (ZS; B, -4.44; 95% CI, -7.57, -1.32) only.
Life stress and emotional symptoms both predicted a shorter length of gestation, while only life stress predicted an increased offspring size at birth controlled for length of gestation; yet, the associations were rather small. The fetoplacental-maternal unit may regulate fetal growth according to the type of psychosocial adversity and even increase fetal growth in response to maternal stress in major areas of life. This potentially reflects a basic principle of intrauterine human development in response to stress.

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    • "The stage of change questions for physical activity and nutrition behaviour are adapted from Te Wai O Rona: Diabetes Prevention Strategy [19], itself adapted from Prochaska [70]. Mental Health (stress, depression, anxiety) has been shown to affect birth weight and gestational age [71]. Therefore we chose to measure mental health with the widely-used WHO well being index [72] and pregnancy specific worries with the Cambridge worry scale [73]. "
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    • "Prenatal exposure to severe physical or mental stress may affect the development and life-long health of the offspring. Effects include reduced birthweight, shorter length of gestation, increased risk of metabolic, cardiac and psychiatric disease, and shortened lifespan (Barbosa, 2000; Reynolds et al., 2007; Seckl and Holmes, 2007; Xiong et al., 2008; Tamashiro and Moran, 2010; Tegethoff et al., 2010). The effect of severe maternal stress likely depends on the timing of exposure, as it may alter time-specific developmental processes (Glynn et al., 2001; Malaspina et al., 2008; Class et al., 2011; Torche, 2011). "
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    • "We obtained information on maternal stress from a telephone interview taken around 30 weeks of gestation. We studied two a priori–defined types of stress— emotional stress and life stress—as used in previous studies (Sondergaard et al. 2003; Tegethoff et al. 2010a, 2010b). The separation of these two types of maternal stress is theoretically based on the well-described stressor specificity of biological responses, which may differentially affect the fetus (Pacak and Palkovits 2001; Richardson et al. 2006). "
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