Association of high cortisol levels in pregnancy and altered fetal growth. Results from the MAASTHI, a prospective cohort study, Bengaluru

Shriyan, Prafulla; Sudhir, Paulomi M.; Schayck, Onno C. P. van; Babu, Giridhara R

doi:10.1016/j.lansea.2023.100196

Cited by 5 publications

(2 citation statements)

References 32 publications

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“…66 Strengthening the hypothesis that hypercortisolemia contributes to fetal growth restriction seen in mothers experiencing chronic stress or melancholia, an Indian study of 230 pregnant women showed that plasma cortisol levels over 17.66 μg/L at 24 weeks of gestation double the risk of fetal growth restriction, compared with lower levels. 71 Emotional eating seems to have an important effect on fetal growth, as demonstrated in a study of adolescents fed a high-carbohydrate diet from gestational days 130 to 134, whose placentas were poorly vascularized, leading to a 20 to 28% reduction in fetal weight. 72 Of note, when adult female rats fed a high-fructose diet were randomized to progesterone or placebo, plasma PAI-1 levels were significantly increased in controls, but not in progesteronetreated animals.…”

Section: Normotensive Fetal Growth Restrictionmentioning

confidence: 99%

The Impact of Emotional Responses on Female Reproduction: Fibrinolysis in the Spotlight

Hoirisch-Clapauch

2024

Semin Thromb Hemost

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Fibrinolytic enzymes modify various substrates required for tissue remodeling, playing a crucial role in mechanisms underlying resilience, reward processing, ovulation, embryo implantation, and placentation. Individuals with low resilience and reduced reward responsiveness, when exposed to chronic stress, are at increased risk of experiencing a range of negative emotions. Chronic anxiety and melancholia are examples of negative emotions associated with hypercortisolism, while fear and atypical depression are characterized by systemic inflammation. Both cortisol and inflammatory cytokines stimulate the production of plasminogen activator inhibitor-1 (PAI-1), a potent fibrinolysis inhibitor. Chronic anxiety, fear, and depression are among the many hypofibrinolytic conditions increasing the risk of oligo-anovulation, miscarriage, fetal growth restriction, and preeclampsia. Although significant, the impact of negative emotions on implantation is not as obvious as on ovulation or placentation. Other hypofibrinolytic conditions that may affect female reproduction through mechanisms dependent or independent of PAI-1 include metabolic disturbances (e.g., due to consumption of highly palatable foods, often used to alleviate negative affect), inflammation, hyperhomocysteinemia, hypothyroidism, hypercortisolism, antiphospholipid antibodies, and the 4G allele of the PAI-1 gene. Benzodiazepines and antidepressants should be used with caution in the first trimester as this combination may cause malformations. Also, selective serotonin reuptake inhibitors have fibrinolytic properties that increase the risk of bleeding after surgical procedures. Psychological interventions, especially group therapy, are effective in the prevention of reproductive disorders. Controlled trials are needed to test the hypothesis that female reproductive health depends on psychological well-being, a balanced diet and physical activity, suppression of inflammation and autoantibodies, and homocysteine and hormonal homeostasis.

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Section: Normotensive Fetal Growth Restrictionmentioning

confidence: 99%

The Impact of Emotional Responses on Female Reproduction: Fibrinolysis in the Spotlight

Hoirisch-Clapauch

2024

Semin Thromb Hemost

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“…не знайдено впливу кортизолу на вагу новонароджених [5], а Prafulla Shriyan та співавт. підтверджують гіпотезу, що високий рівень кортизолу в матері може негативно впливати на вагу при на-родженні, вагу/довжину новонароджених і симптоми післяпологової депресії в матерів [46]. Щоб ввести ясність у зростаючу кількість літератури, Stephana J. Cherak та співавт.…”

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Mental health of pregnant women: modern realities

Poladich,

Govsieiev

2024

UJHW

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This review provides data on the impact of the war in Ukraine and the COVID-19 pandemic on the mental health of Ukrainian women during pregnancy, childbirth, and the postpartum period. It is noted that even in peacetime, the perinatal period is quite vulnerable. The aim of the study is to analyze the impact of post-traumatic stress disorder (PTSD) on the course of pregnancy, childbirth and the postpartum period. According to statistics, one in five women may have a perinatal mental disorder. In today's realities, mental health is given considerable attention. Mental health disorders, such as depression, anxiety and PTSD, manifested by negative thoughts, loss of interest and/or pleasure, fatigue and/or increased anxiety, are the most common diagnoses. It is clear that pregnancy and the postpartum period, although they can be joyful, are also times of stress and difficulty for mothers as they face physiological and psychosocial changes. Particular attention is paid to the connection of maternal depression and anxiety with an increase in inflammatory biomarkers in the mother during pregnancy, which is associated with an increased risk of neurodevelopment in children. Despite the contradictory results of the hypothesis about fetal programming, it is important to recognize that caring for the mother and the child are interconnected. Pregnant mothers who have PTSD are at increased risk of premature termination of pregnancy and premature birth, the development of preeclampsia, gestational diabetes, and other obstetric and perinatal losses. A review of the literature confirms the relevance of studying the impact of PTSD on the perinatal period, since timely diagnosis and treatment of mental disorders is a key element of preserving the health of pregnant women and ensuring the stable development of the nation. The authors declare no conflict of interest.

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Placental Nanoparticle-mediated IGF1 Gene Therapy Corrects Fetal Growth Restriction in a Guinea Pig Model

Davenport,

Wilson,

Williams

et al. 2024

Preprint

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Fetal growth restriction (FGR) caused by placental insufficiency is a major contributor to neonatal morbidity and mortality. There is currently no in utero treatment for placental insufficiency or FGR. The placenta serves as the organ for the developing fetus and offers an excellent opportunity for therapeutic interventions. Here we show efficacy of repeated treatments of trophoblast-specific human insulin-like 1 growth factor (IGF1) gene therapy delivered in a non-viral, polymer nanoparticle to the placenta for the treatment of FGR. Using the guinea pig maternal nutrient restriction model of FGR, nanoparticle-mediated IGF1 treatment was delivered to the placenta via ultrasound guidance across the second half of pregnancy, after establishment of FGR. This treatment resulted in correction of fetal weight in MNR animals compared to control, improved fetal physiology and no negative maternal side-effects. Overall, we show for the first time a therapy capable of improving the entire pregnancy environment: maternal, placental, and fetal. This combined with our previous studies using this therapy at both mid pregnancy and in numerous cell and animal models demonstrate the plausibility of this therapy for future human translation to improve health outcomes of neonates and decrease numerous morbidities associated with the developmental origins of disease.

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Association of high cortisol levels in pregnancy and altered fetal growth. Results from the MAASTHI, a prospective cohort study, Bengaluru

Cited by 5 publications

References 32 publications

The Impact of Emotional Responses on Female Reproduction: Fibrinolysis in the Spotlight

The Impact of Emotional Responses on Female Reproduction: Fibrinolysis in the Spotlight

Mental health of pregnant women: modern realities

Placental Nanoparticle-mediated IGF1 Gene Therapy Corrects Fetal Growth Restriction in a Guinea Pig Model

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