The relationship between self-report and biomarkers of stress in low-income reproductive-age women

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 12/2010; 203(6):577.e1-8. DOI: 10.1016/j.ajog.2010.08.002
Source: PubMed


The purpose of this study was to determine whether there is an association between self-reported and biologic measures of stress in low-income, reproductive-age women.
Between 1999 and 2005, randomly selected reproductive-age women from the 1998 welfare rolls in Chicago, IL, were interviewed yearly to assess psychosocial, socioeconomic, and health characteristics. The association of 2 stress-sensitive biomarkers (Epstein-Barr virus antibody titer (EBV) and C-reactive protein level) with self-reported stress was assessed.
Of the 206 women who were interviewed, 205 women (99%) agreed to provide a blood sample. There was no difference in mean EBV or C-reactive protein levels based on age, race, parity, employment, marital status, or education. Women who reported a higher degree of perceived stress or reported experiences of discrimination had significantly higher levels of EBV (P < .05).
Measures of self-reported psychosocial stress are associated with elevated levels EBV antibody in a low-income population of reproductive-age women.

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Available from: Lisa Sharp, Aug 18, 2014
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    • "Numerous studies have demonstrated that psychological stress can encourage reactivation of latent viruses, including EBV (e.g., Glaser, Kiecolt-Glaser, Speicher, & Holliday, 1985). In pregnant women, greater EBV reactivation has been observed in association with maternal depression, perceived stress, and perceived racial discrimination (Borders et al., 2010; Haeri et al., 2011). We examined 56 women (38 African American and 18 Caucasian) at each trimester of pregnancy and postpartum . "
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    • "Informed by previous research (Borders et al., 2010; McClure et al., 2010; McDade, 2005), we included a number of potential confounders of the associations between SES and abuse with EBV, including sex, age (continuous, years), race/ethnicity (White; Black; Asian; Hispanic; Native American, multi-racial, and other), and smoker present in the household during adolescence (yes, no, missing). "
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    • "In a study of adults ages 25–90, greater viral reactivation was evidenced among Blacks compared to non-Hispanic Whites (Stowe et al., 2010). In addition, a study of women of childbearing age demonstrated that perceived racial discrimination was associated with greater EBV reactivation (Borders et al., 2010). Thus, though limited, available evidence suggests that race and racial discrimination affect EBV reactivation. "
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    ABSTRACT: Adverse pregnancy outcomes, including preterm birth, are markedly higher among African-Americans versus Whites. Stress-induced immune dysregulation may contribute to these effects. Epstein-Barr virus (EBV) reactivation provides a robust model for examining cellular immune competence. This study examined associations of EBV virus capsid antigen immunoglobulin G (VCA IgG) with gestational stage, race, and racial discrimination in women during pregnancy and postpartum. Fifty-six women (38 African-American, 18 White) were included. African-Americans and Whites did not differ in age, education, income, parity, or body mass index (ps⩾.51). During the 1st, 2nd, and 3rd trimester and ∼5weeks postpartum, women completed measures of racial discrimination, perceived stress, anxiety, depressive symptoms and health behaviors. EBV VCA IgG antibody titers were measured via ELISA in serum collected at each visit. In the overall sample, EBV VCA IgG antibody titers were lower in the 3rd versus 1st trimester (p=.002). At every timepoint (1st, 2nd, 3rd trimester and postpartum), African-American women exhibited higher serum EBV VCA IgG antibody titers than Whites (ps<.001). This effect was most pronounced among African-Americans reporting greater racial discrimination [p=.03 (1st), .04 (2nd), .12 (3rd), .06 (postpartum)]. Associations of race and racial discrimination with EBV VCA IgG antibody titers were not accounted for by other measures of stress or health behaviors. Compared to Whites, African-American women showed higher EBV VCA IgG antibody titers, indicative of impaired cellular immune competence, across pregnancy and postpartum. This effect was particularly pronounced among African-American women reporting greater racial discrimination, supporting a role for chronic stress in this association. In women overall, EBV antibody titers declined during late as compared to early pregnancy. This may be due to pregnancy-related changes in cell-mediated immune function, humoral immune function, and/or antibody transfer to the fetus in late gestation. As a possible marker of stress-induced immune dysregulation during pregnancy, the role of EBV reactivation in racial disparities in perinatal health warrants further attention.
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