Stress during pregnancy: maternal endocrine–immune imbalances and fetal health

The Effect of Childbirth Self-Efficacy on Perinatal Outcomes

“…There is also evidence that a woman’s psychosocial status can affect perinatal outcomes. For example, increased stress during pregnancy is associated with higher rates of premature birth (Arck, 2010), grief during pregnancy is associated with stillbirth (Laszlo, 2013) and women with fear of childbirth more frequently have unplanned cesarean births (Sydsjo, Sydsjo, Gunnervik, Bladh, & Josefsson, 2012). However, there are inconsistencies in knowledge regarding enhancing a woman’s psychosocial status with the goal of improving perinatal outcomes (Gagnon & Sandall, 2007; Goldenberg, 2011; Kogan, 1998; Novick, 2004; Ruiz-Mirazo, Lopez-Yarto, & McDonald, 2012).…”

The occurrence of preterm delivery is linked to pregnancy-specific distress and elevated inflammatory markers across gestation

“…Studies have shown that both stress and pregnancy-specific distress are related to poor pregnancy outcomes (i.e. Arck 2010;Maina et al 2008;Zhu et al 2010), and a primary finding is that prenatal stress can increase prematurity and the incidence of infants born at low birth weight (LBW) for their gestational age (Nkansah-Amankra et al 2010;Orr et al 1992;Wadhwa et al 1993). Despite improvements in the practice and accessibility of prenatal care, the rate of preterm birth (< 37 weeks gestation) remains relatively high in the US (12-13%), and infants born even moderately prematurely can be affected by a variety of ongoing behavioral, developmental, and health challenges (Batton et al 2011;Dong and Yu 2011;Goldenberg et al 2008) Notably, shortened gestational age at birth, even within the “at term” range (37-40 weeks) has been associated with suboptimal brain development and altered cognitive development (Davis et al 2011;Yang et al 2010).…”

“…Normal pregnancy requires a balance of aspects of the immune, endocrine, and nervous systems that delicately shifts through the course of pregnancy to support maternal and fetal well-being, and it is likely that perturbation of this balance increases the risk of poor pregnancy outcomes (Arck 2010;Arck 2001). Support for this notion comes from observations that women who experience activation of the immune system via viral or bacterial infection during pregnancy are prone to pregnancy complications including preterm delivery and exhibit elevated levels of proinflammatory cytokines even after the infection has been resolved (Gibbs et al 1992;Gomez et al 1995;Gotsch et al 2008;McGregor et al 2000;Wadhwa et al 2001).…”

The Prenatal Distress Questionnaire: an investigation of factor structure in a high risk population

“…This approach has demonstrated that both general stress measures and pregnancy-specific stress measures have been found to predict preterm birth (Arck, 2010;Coussons-Read et al, 2012;Dunkel Schetter & Glynn, 2010) and other adverse pregnancy outcomes including poorer neonatal neurobehavioural outcomes (Talge, Neal, & Glover, 2007) and social developmental outcomes (Wadhwa, 2005). Furthermore, Lobel et al (2008) suggest that pregnancy-specific stress may be a more potent type of stress than general stress and such measures may be more reliable predictors of preterm birth (Dunkel Schetter & Glynn, 2010).…”