Psychosocial Stress During First Pregnancy Predicts Infant Health Outcomes in the First Postnatal Year

Abstract

Objective To evaluate the impact of psychosocial stress during pregnancy on infant health outcomes in the first postnatal year. Methods A sample of 3000 women completed a stress inventory (the Psychosocial Hassles Scale) during their third trimester before first childbirth. Infant health outcomes were measured via maternal report at 1, 6 and 12 months postpartum. Poisson regression was used to model the effect of maternal stress during pregnancy on infant health outcomes in the first year, controlling for age, race/ethnicity, education, insurance coverage, marital status, and cigarette smoking during pregnancy. Results Women who were younger, minority, unmarried, publicly insured and without a college degree were more likely to report high levels of prenatal stress. High prenatal stress was a significant predictor of maternal reporting of gastrointestinal illness (p<0.0001), respiratory illness (p=0.025), and total illness in the first year (p< 0.0001). High prenatal stress was also a significant predictor of urgent care visits (p< 0.0001) and emergency department visits (p= 0.001). It was not a significant predictor of hospitalizations (p= 0.36). Conclusions Maternal prenatal stress is associated with increased maternal reporting of infant illness, as well as increased frequency of both urgent care visits and emergency department visits.

Maternal childhood and lifetime traumatic life events and infant bronchiolitis

“…In a large study of first-birth pregnancies among predominantly white, rural women, stress during pregnancy was associated with increased maternal report of infant illness in the first year, including respiratory infection. 12 A similar finding was reported in smaller study of well-educated European mothers and their children. 13 Lee and colleagues determined that high levels of anxiety during pregnancy were associated with increased risk of bronchiolitis and lower, but not upper, respiratory tract infections.…”

“…anxiety in pregnancy) are associated with respiratory infection in the first postnatal year. In a large study of first‐birth pregnancies among predominantly white, rural women, stress during pregnancy was associated with increased maternal report of infant illness in the first year, including respiratory infection . A similar finding was reported in smaller study of well‐educated European mothers and their children .…”

“…7,8 An aberrant maternal stress response during pregnancy has been shown to adversely influence fetal development, including fetal immune functioning which can be linked to respiratory outcomes after birth. 9,10 Maternal stress during pregnancy has been associated with decreased time to first infection in infancy, 11 increased risk for bronchiolitis and respiratory illness in infancy, [12][13][14] and wheezing and asthma later in childhood. 15 Recent evidence suggests that this association between maternal stress and child respiratory health is relevant not only to stressors that occur during an index pregnancy, but also stressors that may have occurred prior to pregnancy that may yield prolonged exposure to stress correlates (e.g.…”

Maternal psychological distress during pregnancy and childhood health outcomes: a narrative review

“…Other studies examined maternal psychological distress during pregnancy as bereavement or adverse life events, self-reported perceived stress, psychological job strain or community violence with respiratory outcomes and showed an association of these exposures with an increased risk of child wheezing, asthma or lower lung function. 73,76,[78][79][80][87][88][89][90][91][92][93][94][95][96][97][98][99][100][101][102][103] Maternal psychological distress during pregnancy may also influence the risk of allergy and eczema in children. 93 Birth cohort studies observed no associations of maternal psychological distress during pregnancy with childhood allergic sensitization (measured with skin prick tests) or physician-diagnosed food allergy.…”

Ontogeny of emotional and behavioral problems in a low-income, Mexican American sample.

“…As such, evidence that Mexican Americans also experience disproportionately more health disparities, including elevated rates of poverty, decreased access to health care, and heightened rates of postpartum and thus likely prenatal stress, is particularly concerning (Gress-Smith, Luecken, Lemery-Chalfant, & Howe, 2012; Murphey et al, 2014). Although poverty and ethnic minority status are known to exacerbate risk for both prenatal stress as well as children’s negative adjustment outcomes (e.g., Degnan, Almas, & Fox, 2010; Pitzer et al, 2009; Phelan, DiBenedetto, Paul, Zhu, & Kjerulff, 2015), relatively little is known about whether or how prenatal stress and children’s adjustment may be related among Mexican Americans.…”