Abstract
Antenatal maternal stress is thought to negatively affect fetal development, birth outcomes, and infant’s development. Glucocorticoids
are suggested to be a common link between prenatal stressors and infant’s health. However, data on these mechanisms are rare
and sometimes conflicting. The objective of this study was to examine the effects of maternal distress during pregnancy on
fetal development and birth weight in humans prospectively. This study focuses on cortisol as one mediating the mechanism
of the association between maternal distress and birth outcomes. Pregnancy-related and general distress was measured in 81
women with uncomplicated, singleton pregnancies. The rise of salivary cortisol on awakening (CAR) was assessed in weeks 13–18
and 35–37 postmenstrual age of pregnancy. Mothers completed a structured interview, the perceived stress scale, a widely used
psychological instrument that provided a global measure of perceived stress, as well as the Prenatal Distress Questionnaire,
a self-report questionnaire designed to assess worries and anxiety in pregnancy. Pre-, peri-, and postnatal medical risk factors
as well as birth characteristics were extracted from medical records routinely kept by the attending obstetricians. Hierarchical
multiple regressions indicate that maternal cortisol levels explained 19.8% of the variance in birth weight and 9% of the
variance in body length at birth, even after controlling for gestational age, parity, pre-pregnancy BMI, smoking, and infant’s
sex. Newborns of mothers with higher cortisol levels in pregnancy had lower birth weights and were shorter at birth. An ANCOVA
for repeated measures indicated that, after controlling for covariates, pregnancy-related as well as general distress in pregnancy
did not influence cortisol levels after awakening (area under the curve). No significant associations between perceived stress
and anthrometric measures at birth were found. In conclusion, maternal cortisol levels in pregnancy influence intrauterine
growth and may be a better predictor for birth outcome than perceived stress.
are suggested to be a common link between prenatal stressors and infant’s health. However, data on these mechanisms are rare
and sometimes conflicting. The objective of this study was to examine the effects of maternal distress during pregnancy on
fetal development and birth weight in humans prospectively. This study focuses on cortisol as one mediating the mechanism
of the association between maternal distress and birth outcomes. Pregnancy-related and general distress was measured in 81
women with uncomplicated, singleton pregnancies. The rise of salivary cortisol on awakening (CAR) was assessed in weeks 13–18
and 35–37 postmenstrual age of pregnancy. Mothers completed a structured interview, the perceived stress scale, a widely used
psychological instrument that provided a global measure of perceived stress, as well as the Prenatal Distress Questionnaire,
a self-report questionnaire designed to assess worries and anxiety in pregnancy. Pre-, peri-, and postnatal medical risk factors
as well as birth characteristics were extracted from medical records routinely kept by the attending obstetricians. Hierarchical
multiple regressions indicate that maternal cortisol levels explained 19.8% of the variance in birth weight and 9% of the
variance in body length at birth, even after controlling for gestational age, parity, pre-pregnancy BMI, smoking, and infant’s
sex. Newborns of mothers with higher cortisol levels in pregnancy had lower birth weights and were shorter at birth. An ANCOVA
for repeated measures indicated that, after controlling for covariates, pregnancy-related as well as general distress in pregnancy
did not influence cortisol levels after awakening (area under the curve). No significant associations between perceived stress
and anthrometric measures at birth were found. In conclusion, maternal cortisol levels in pregnancy influence intrauterine
growth and may be a better predictor for birth outcome than perceived stress.
- Content Type Journal Article
- DOI 10.1007/s00737-010-0183-1
- Authors
- Margarete I. Bolten, Institute for Psychology, Department of Clinical Child and Adolescent Psychology, University of Basel, Missionsstrasse 64a, 4055 Basel, Switzerland
- Harald Wurmser, Child Care Centre, Ludwig-Maximilians-University Munich, Heiglhofstraße 63, 81377 Munich, Germany
- Angelika Buske-Kirschbaum, Institute of Psychology, Department of Biological Psychology Technical, University of Dresden, Zellescher Weg 17, 01062 Dresden, Germany
- Mechthild Papoušek, Child Care Centre, Ludwig-Maximilians-University Munich, Heiglhofstraße 63, 81377 Munich, Germany
- Karl-Martin Pirke, Institute for Psychology, Department of Psychobiology, University of Trier, Johanniterufer 15, 54290 Trier, Germany
- Dirk Hellhammer, Institute for Psychology, Department of Psychobiology, University of Trier, Johanniterufer 15, 54290 Trier, Germany
- Journal Archives of Women’s Mental Health
- Online ISSN 1435-1102
- Print ISSN 1434-1816