Allostatic load, a measure of chronic physiological stress, is associated with pregnancy outcomes, but not fertility, among women with unexplained infertility

Barrett, Emily S.; Vitek, Wendy; Mbowe, Omar; Thurston, Sally W.; Legro, Richard S.; Alvero, Ruben; Baker, Valerie L.; Bates, G. Wright; Casson, Peter R.; Coutifaris, Christos; Eisenberg, Esther; Hansen, Karl R.; Krawetz, Stephen A.; Robinson, Randal D.; Rosen, Mitchell P.; Usadi, Rebecca; Zhang, Heping; Santoro, Nanette; Diamond, Michael P.

doi:10.1093/humrep/dey261

Cited by 34 publications

(27 citation statements)

References 38 publications

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“…Other indicators with VIP scores greater than 1 included depression, PDA-rated negative affect, anxiety, and PTSD symptoms. Across all 3 social support subscales with potential scores ranging from 0 to 40, PSYG had the lowest (17,18), PHSG next (22)(23)(24)(25)(26), and HG highest (26-29) (SI Appendix, Table S1 and Social Support and Outcomes. As social support indices were the strongest differentiators of the stress groups, we investigated if maternal stress group effects on our key perinatal outcomes would remain when controlling for the composite social support score.…”

Section: Resultsmentioning

confidence: 99%

“…Allostatic load (AL) incorporates multiple subclinical physiological/ physical parameters (e.g., diastolic and systolic blood pressure [BP], heart rate, body mass index [BMI], immune markers, and cortisol with consideration of relevant lifestyle factors [diet, exercise, and social support]) into a single index to measure the cumulative impact of "wear and tear" on the body of repeated activation, and associated dysregulation, of physiological systems stemming from chronically stressful situations (23,24). Higher AL during pregnancy is associated with increased odds of both PTB (25,26) and delivering a lowbirth-weight infant (25,27). Individual AL factors, including elevated maternal ambulatory BP and cortisol, have been associated with fetal neurodevelopment including lower resting FHR, increased FHR reactivity, and reduced FHR-movement coupling (28,29).…”

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confidence: 99%

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Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes

Walsh

McCormack

Webster

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

169

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Maternal prenatal stress influences offspring neurodevelopment and birth outcomes including the ratio of males to females born; however, there is limited understanding of what types of stress matter, and for whom. Using a data-driven approach with 27 variables from questionnaires, ambulatory diaries, and physical assessments collected early in the singleton pregnancies of 187 women, 3 latent profiles of maternal prenatal stress emerged that were differentially associated with sex at birth, birth outcomes, and fetal neurodevelopment. Most women (66.8%) were in the healthy group (HG); 17.1% were in the psychologically stressed group (PSYG), evidencing clinically meaningful elevations in perceived stress, depression, and anxiety; and 16% were in the physically stressed group (PHSG) with relatively higher ambulatory blood pressure and increased caloric intake. The population normative male:female secondary sex ratio (105:100) was lower in the PSYG (2:3) and PHSG (4:9), and higher in the HG (23:18), consistent with research showing diminished male births in maternal stress contexts. PHSG versus HG infants were born 1.5 wk earlier (P < 0.05) with 22% compared to 5% born preterm. PHSG versus HG fetuses had decreased fetal heart rate–movement coupling (P < 0.05), which may indicate slower central nervous system development, and PSYG versus PHSG fetuses had more birth complications, consistent with previous findings among offspring of women with psychiatric illness. Social support most strongly differentiated the HG, PSYG, and PHSG groups, and higher social support was associated with increased odds of male versus female births. Stress phenotypes in pregnant women are associated with male vulnerability and poor fetal outcomes.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes

Walsh

McCormack

Webster

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

169

View full text Add to dashboard Cite

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“…We also know that female age has a prominent negative impact on fertility and the solutions are not simple, however, an alternative like validated dynamic models could predict both natural and ART-mediated in short time (15). Another study showed that allostatic load that is specific in chronic situation like infertility was not associated with fertility outcomes like conception, spontaneous abortion, and live birth (16). However, a cohort study on 4,999 couples showed that the prediction ranges could help in counselling couples for at least two years after their fertility work-up (17).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous pregnancies and determinant factors in infertility: A cross-sectional study

Saadati

Nikbakht

Sattari

et al. 2020

IJRM

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Background: The phenomenon of infertility may be derived from different factors - either in males or females or both genders, including few unexplained factors. It is generally managed by medical and surgical treatments. Objective: To find a relation of occurrence of spontaneous pregnancy (SP) with effective factors in infertility. Materials and Methods: This cross-sectional study was conducted at two referral infertility centers (university and privacy center) in the southwest of Iran from March 2015 and March 2016 on 655 infertile couples, who were divided in two groups of with (n = 31) and without (n = 624) SP. The variables included female and male age, male smoking, male job, the place of living, the causes of infertility, the type and duration of infertility, and the subgroups of infertility causes. Results: Infertility may be caused due to both male- and female- related factors (47.5%). While female-related infertility was found in 31.5%, male-related infertility in 14.5%, and infertility due to unexplained factors in 6.6% of our patients. The rate of SP was 4.7%, which had a significant relation with the duration of infertility (p = 0.01), with women’s age (p = 0.048), unexplained infertility (p = 0.001), and husband’s job (p = 0.004). Conclusion: The occurrence of SP in infertile couples was related to age of the female partner, the duration of unexplained infertility, and the male partner’s job. Key words: Male infertility, Female infertility, Spontaneous pregnancy, Epidemiology, Etiology.

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“… 10 15 35 The markers included are plasma leptin and IL-6 for the inflammatory domain, plasma cortisol for the neuroendocrine domain, and plasma LDL, HDL, FFA, triglycerides, fasting glucose, SBP and DBP for the cardiometabolic domain. 9 For HDL, the lowest quartile received the score of ‘1’, while the other quartiles received the score of ‘0’. For SBP and DBP, the clinical cut-off values were used: SBP greater than or equal to 120 mm Hg and DBP greater than or equal to 80 mm Hg were given the score of ‘1’.…”

Section: Methodsmentioning

confidence: 99%

“…The AL index is a composite score of subclinical physiological parameters that define AL, and this index has been associated with pregnancy outcomes such as preterm birth, 7 8 pre-eclampsia, 9 and small for gestational age (SGA). 10 However, it is unclear whether AL during pregnancy contributes to the development and progression of GDM and whether the AL index predicts adverse birth outcomes in GDM.…”

Section: Introductionmentioning

confidence: 99%

Gestational diabetes status and dietary intake modify maternal and cord blood allostatic load markers

Jack-Roberts

Maples

Kalkan

et al. 2020

BMJ Open Diab Res Care

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IntroductionAllostatic load (AL) defines cardiometabolic, inflammatory, and neuroendocrine changes in the body in response to internal and external stressors. It is largely unknown whether gestational diabetes mellitus (GDM) alters maternal and fetal AL, which in turn affects GDM outcomes. Whether dietary intakes and quality can modify AL and thus influence GDM progression is also unknown.Research design and methodsIn this study, we recruited 35 GDM and 30 non-GDM women in gestational week 25–33. Fasting blood samples were collected at enrollment, and cord venous blood samples were collected at delivery for the measurement of a series of AL biomarkers to calculate the composite AL index. Three-day dietary recalls were conducted at enrollment.ResultsResults suggest that GDM women had 60% higher composite AL index scores (p value=0.01). Maternal AL index was associated with shorter duration of gestation (β=−0.33, p value=0.047) and higher fetal AL index (β=0.47, p value=0.006) after adjusting for GDM status. Dietary intake of monounsaturated fatty acids was negatively associated with maternal AL index (β=−0.20, p value=0.006). GDM women had lower total caloric intake and dietary glycemic load, yet their linolenic acid, vitamin C and E intakes were also decreased (all p value<0.05). These dietary differences were not related to birth outcomes measured.ConclusionsIn this study, GDM status and dietary intakes modify AL in this population. AL may serve as an indicator of GDM control. Future research on dietary interventions that can improve maternal AL markers during GDM is warranted.

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Allostatic load, a measure of chronic physiological stress, is associated with pregnancy outcomes, but not fertility, among women with unexplained infertility

Abstract: Clinical Trials.gov number: NCT01044862.

Cited by 34 publications

References 38 publications

Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes

Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes

Spontaneous pregnancies and determinant factors in infertility: A cross-sectional study

Gestational diabetes status and dietary intake modify maternal and cord blood allostatic load markers

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