Childhood maltreatment and inflammation among pregnant women with gestational diabetes mellitus: A pilot study

Bublitz, Margaret H.; Monte, Suzanne de la; Martin, Susan; Larson, Lucia; Bourjeily, Ghada

doi:10.1177/1753495x17701320

Cited by 15 publications

(12 citation statements)

References 35 publications

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“…1 Findings are also in line with results from our previous cross-sectional study in which pregnant women with histories of childhood adversity displayed elevated proinflammatory cytokine levels. 5 Rates of childhood sexual abuse in this study (20%) were aligned with national averages, 32,33 and consistent with past evidence that childhood sexual abuse is uniquely dysregulating to stress-related biology in pregnancy. Specifically, studies have found that women with histories of childhood sexual abuse, with or without childhood physical abuse, displayed greater inflammation, 5 greater salivary cortisol 34 and greater hair cortisol 35 in pregnancy, particularly in the third trimester.…”

Section: Discussionsupporting

confidence: 88%

“…According to the biological embedding model of early adversity, 1 experiences of childhood adversity program immune cells to have an exaggerated inflammatory response to stimuli and a decreased sensitivity to feedback from glucocorticoids, resulting in nonresolving inflammation and a "pro-inflammatory phenotype." Nonpregnant victims of childhood adversity display elevations in inflammatory cytokines (IL-6, IL-1b, TNF-a), [2][3][4] and there is some evidence, including work by our group, 5 that elevations in inflammation among victims of childhood adversity persist into pregnancy. [6][7][8] Prenatal depression is also highly prevalent among women who experienced childhood adversity 9 and is associated with elevated inflammation; higher depressive symptoms in pregnancy have been associated with higher C-reactive protein (CRP), 10 IL-6, 11 and IL-1b 12 in past research.…”

Section: Introductionmentioning

confidence: 87%

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Childhood adversity, prenatal depression, and maternal inflammation across pregnancy

et al. 2021

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Background To examine whether change in neutrophil–lymphocyte ratio, a marker of systemic inflammation, differs by childhood adversity and prenatal depression. Methods Prenatal complete blood count data were used to calculate neutrophil–lymphocyte ratio in first and third trimesters. The Adverse Childhood Experiences scale measured childhood adversity, and the Patient Health Questionnaire-9 measured depression. This is a secondary analysis of a study of predictors of risk for sleep-disordered breathing. Results Participants were 98 pregnant women, mean age 30 years ( SD = 5), mean body mass index of 35 kg/m2 ( SD = 7), 61% identified as white, and 28% identified as Hispanic. Women who reported childhood sexual abuse history displayed greater increase in neutrophil–lymphocyte ratio over pregnancy relative to women without childhood sexual abuse. Change in neutrophil–lymphocyte ratio across pregnancy did not differ by prenatal depression. Conclusion Experiences of sexual abuse in childhood may impact markers of systemic inflammation in pregnancy.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 87%

Childhood adversity, prenatal depression, and maternal inflammation across pregnancy

et al. 2021

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“…Childhood physical abuse, emotional abuse and emotional neglect were associated with elevated serum CRP across pregnancy (111). Women with gestational diabetes who had a history of childhood maltreatment had elevated IL-15 in pregnancy (112).…”

Section: Maternal Adverse Childhood Experiencesmentioning

confidence: 97%

Inflammation: A Proposed Intermediary Between Maternal Stress and Offspring Neuropsychiatric Risk

Hantsoo

Kornfield

Anguera

et al. 2019

Biological Psychiatry

165

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During pregnancy, programming of the fetal central nervous system (CNS) establishes vulnerabilities for emergence of neuropsychiatric phenotypes later in life. Psychosocial influences during pregnancy, such as stressful life events or chronic stress, correlate with offspring neuropsychiatric disorders and with inflammation, respectively. Stress promotes inflammation, but the role of inflammation as a mediator between maternal psychosocial stress and offspring neuropsychiatric outcomes has not been extensively studied in humans. This review summarizes clinical evidence linking specific types of stress to maternal inflammatory load during pregnancy. We propose that inflammation is a mediator in the relationship between psychosocial stress and offspring neuropsychiatric outcomes, potentially influenced by poor maternal glucocorticoidimmune coordination. We present relevant experimental animal research supporting this hypothesis. We conclude that clinical and preclinical research support the premise that stressinduced maternal immune activation (MIA) contributes in part to prenatal programming of risk. Programming of risk is likely due to a combination of vulnerabilities, including multiple or repeated inflammatory events, timing of such events, poor maternal regulation of inflammation, genetic vulnerability, and lifestyle contributors.

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“…7 Previously published data from this cohort show a significantly lower prevalence of SDB. 8 The differences in prevalence estimates of SDB in women with gestational diabetes mellitus (GDM) may be related to differences in racial and ethnic distribution, the technology used to diagnose SDB (in-laboratory polysomnography vs. in-home sleep monitors), and the definition of the condition.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, mechanisms underlying the association between OSA and metabolic outcomes such as GDM may be quite different in pregnancy than in the general population and are currently understudied. We have recently explored the potential role of the hypothalamic-pituitary-adrenal axis activation in this association and demonstrated that the cortisol awakening response was lower among pregnant women with OSA compared to those without, 8 after adjusting for depression and stress. We hypothesized that women with OSA may have elevated levels of circulating pro-inflammatory cytokines.…”

Section: Introductionmentioning

confidence: 99%

The role of inflammation in the association between gestational diabetes and obstructive sleep apnea: A pilot study

et al. 2018

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Background Obstructive sleep apnea is associated with pregnancy complications including gestational diabetes. Mechanisms underlying the association between obstructive sleep apnea and gestational diabetes remain to be elucidated. Methods Twenty-three participants with gestational diabetes underwent home sleep apnea testing. Obstructive sleep apnea was defined as an apnea hypopnea index > 5. Fasting morning blood samples were measured using multianalyte profiling (xMAP) multiplexed bead array immunoassay for Interleukin 6, tumor necrosis factor-alpha, and Interleukin 8. Results Age, body mass index, and gestational age at enrollment were 31 + 4.4 years, 35.7 + 7.4 kg/m2, and 28 ± 4 weeks, respectively. Participants were 52% Caucasian and 16% had obstructive sleep apnea. We observed positive correlations between apnea hypopnea index and Interleukin 6 (r = 0.62, p = 0.005), Interleukin 8 (r = 0.56, p = .56), and tumor necrosis factor-alpha (r = .58, p = .009). Women with obstructive sleep apnea had higher levels of Interleukin 6 (F = 5.01, p = .037) and Interleukin 8 (F = 6.33, p = .021) vs. women without obstructive sleep apnea. Conclusion These preliminary results indicate that in women with gestational diabetes, apnea hypopnea index is associated with an elevated inflammatory profile.

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Childhood maltreatment and inflammation among pregnant women with gestational diabetes mellitus: A pilot study

Abstract: This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.

Cited by 15 publications

References 35 publications

Childhood adversity, prenatal depression, and maternal inflammation across pregnancy

Childhood adversity, prenatal depression, and maternal inflammation across pregnancy

Inflammation: A Proposed Intermediary Between Maternal Stress and Offspring Neuropsychiatric Risk

The role of inflammation in the association between gestational diabetes and obstructive sleep apnea: A pilot study

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