Influence of Maternal Childhood Adversity on the Psycho-Neuroendocrine-Inflammatory Profile During Pregnancy
Repository Posting Date2015-08-03T20:18:47Z
Author DetailsKaren J. Kotz, PhDc, RN, MSN, APN, NNP-BC, email: KarenJKotz@gmail.com; Herbert L. Mathews, PhD, email: HMathew@luc.edu; Linda Witek Janusek, PhD, RN, FAAN, email: LJanuse@luc.edu
Lead Author Sigma AffliationAlpha Beta
Level of EvidenceOutcomes Research
Research ApproachQuantitative Research
KeywordsAdversity; Pregnancy; Depression; Anxiety; Social Support; neonatal outcomes; Cytokines; Cortisol; Pregnancy Outcomes--Psychosocial Factors
CINAHL HeadingsPregnancy Outcomes--Psychosocial Factors
Exposure to excessive stress either before or during pregnancy can disrupt neuroendocrine-immune processes required for successful pregnancy outcomes. Thus, the purpose of this study was to investigate the relationship among maternal childhood adversity, psychological, and neuroendocrine-immune processes during pregnancy; and to explore the impact of maternal stress on neonatal outcomes (birthweight and gestational age). In addition, the modifying effect of maternal social support was examined. Ninety-five healthy, low-risk pregnant women were enrolled and evaluated during their second and third trimesters of pregnancy. Women completed psychometric instruments and provided blood samples for measurement of the proinflammatory cytokine, IL-6; and a hair sample for measurement of hair cortisol (as an index of chronic stress over the previous three month period). Infant birthweight and gestational age were obtained from medical records. Key findings demonstrated maternal childhood adversity was associated with greater perceived stress, depressive risk, anxiety, and mood disorder, at mid- and late-pregnancy; while maternal childhood adversity was associated with lower social support at mid- and late-pregnancy. In addition, maternal exposure to greater childhood adversity was correlated with higher circulating levels of proinflammatory cytokine, IL-6, at late-pregnancy. Moreover, higher IL-6 levels were linked to earlier gestational age and lower birthweight. Findings also revealed that women who experienced greater maternal childhood adversity in combination with lower social support during their pregnancy delivered infants with lower birthweight and earlier gestational age. Increased levels of maternal hair cortisol during the third trimester were associated with higher levels of perceived stress during the second trimester, and women who expressed less positive feelings about their pregnancy had higher levels of hair cortisol at mid-pregnancy. These findings add to the growing body of evidence demonstrating that exposure to adversity early in life has long-lasting effects that influence stress levels and depressive mood during pregnancy, and this may disrupt inflammatory and neuroendocrine regulation deeded for optimal maternal-infant health outcomes. The findings can contribute to improved approaches to identify and stratify risk for adverse maternal-infant health outcomes, as well as guide the development of early intervention programs and health policy for women who are pregnant or who plan to become pregnant. Such contribution is significant in that the well-being of mothers and infants determine the health of the next generation.
Funder(s)Sigma Theta Tau International
Description2013 Sigma Theta Tau International, Doris Bloch Research Award Recipient
Date of Publication2015-08-03
Citation of Original PublicationKotz, K. J., Mathews, H. L., & Janusek, L. W. (2015). Influence of maternal childhood adversity on the psycho-neuroendocrine-inflammatory profile during pregnancy. Virginia Henderson Global Nursing e-Repository. Retrieved from http://www.nursinglibrary.org/vhl/handle/10755/563644
Notes2013 Doris Bloch Research Grant Recipient
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.