Acculturation, Maternal Cortisol, and Birth Outcomes in Women of Mexican Descent

Abstract

Objective This study investigated the effects of acculturation on cortisol, a biological correlate of maternal psychological distress, and perinatal infant outcomes, specifically gestational age at birth and birth weight. Methods Fifty-five pregnant women of Mexican descent were recruited from a community hospital and collected saliva samples at home over 3 days during pregnancy at 15–18 (early), 26–2 (mid), and 32+ (late) weeks gestation and once in the postpartum period (4–12 weeks). These values were used to determine the diurnal cortisol slope at each phase of pregnancy. Mothers also completed an acculturation survey and gave permission for a medical chart review to obtain neonate information. Results Multiple regression analyses determined that greater acculturation levels significantly predicted earlier infant gestational age at birth (R2=0.09, p=0.03). T-tests revealed that mothers of low birth weight infants weight (<2500g) had significantly higher acculturation scores than mothers of infants with birth weight >2500g (t=−2.95, p=0.005). A blunted maternal cortisol slope during pregnancy was also correlated with low birth weight (r=−0.29, p=0.05), but not gestational age (r=−0.08, p=0.59). In addition, more acculturated women had a flatter diurnal cortisol slope late in pregnancy (R2=0.21, p=0.01). Finally diurnal maternal cortisol rhythms were identified as a potential mediator between increased acculturation and birth weight. Conclusions This study associated increased acculturation with perinatal outcomes in the US Mexican population. This relationship may be mediated by prenatal maternal diurnal cortisol, which can program the health of the fetus leading to several adverse perinatal outcomes.

Effect of Maternal Psycological Stress (Krodha-Shokadi Mansika Bhava) on Fetal Development

“…[1] Stress appraisal, personal history and outlook, lifestyle, coping style and environmental threats (real or imagined) are only some of the contributors to the experience of stress.…”

“I am the worst pregnant woman ever”: A mixed-method study of the nature of psychological distress during pregnancy

“…One study concluded that the combination of elevated distress and certain inflammatory processes was significantly predictive of PTB. Pregnancy-specific distress and elevated inflammatory markers were predictive of shortened gestational length and PTB (Coussons-Read et al, 2012). The independent effect of stress was identified in one study (Hedegaard, Henriksen, Sabroe, & Secher, 1993), while the rest reported a combination of elevated distress levels alongside inflammatory bio-markers, history of obstetric adversities, years of schooling, and smoking.…”

“…Specifically, the association of ethnicity to PTB was mediated through lower levels of personal resources, language barriers, economic difficulties, separation from friends and family, racial and neighbourhood discrimination for migrants (Coussons-Read et al, 2012;Rini et al, 1999;Ruiz et al, 2012), which all present an important area for future investigations. This finding is in line with the literature that explores Black race as one of the most predictive factors for PTB (Giurgescu, McFarlin, Lomax, Craddock, & Albrecht, 2011;Graham, Frank, Zyzanski, Kitson, & Reeb, 1992;Kiely et al, 2011).…”

“…Levels of stress, measured during the 2 nd and 3 rd trimesters were identified as best predictors of prematurity (Coussons-Read et al, 2012;Hedegaard et al, 1993;Rondó et al, 2003). In the study by Hedegaard and colleagues (1993), it was stress experienced during week 30, and not earlier (at 16 weeks), that was evidenced to contribute to an increased PTB risk.…”

“…The activation of the hypothalamic-pituitary-adrenal (HPA) axis, or increases in the production of corticotropinreleasing hormone (CRH) in the mother as a result of her experiencing stressors during pregnancy is one potential theory (Smith & Nicholson, 2007;Smith et al, 2009;Wadhwa, , 2005Wadhwa, Porto, Garite, Chicz-DeMet, & Sandman, 1998). Additionally, infections of the reproductive and urinary tracts, sexually transmitted diseases, systemic infections have all been linked to birth outcomes through various immune-mediating processes, compromised by the experiences of stress during pregnancy (Coussons-Read et al, 2012;D'Anna-Hernandez et al, 2012). Lastly, it has been suggested that the behavioural pathways to adverse birth outcomes may consist of unhealthy lifestyle factors during pregnancy, such as smoking, substance use, and poor nutrition (Bakker et al, 2011;Barros, Mitsuhiro, Chalem, Laranjeira, & Guinsburg, 2011;Bonassi et al, 1994;Kramer & McDonald, 2009).…”