Does Antenatal Maternal Psychological Distress Affect Placental Circulation in the Third Trimester?

Helbig, A.; Kaasen, Anne; Malt, Ulrik Fredrik; Haugen, Guttorm

doi:10.1371/journal.pone.0057071

Cited by 28 publications

(38 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Seven of the studies assessed healthy, medically low-risk pregnant women (Helbig et al, 2013;Kent et al, 2002;Mendelson et al, 2011;Roos et al, 2015;Sjostrom et al, 1997;Teixeira et al, 1999;Vythilingum et al, 2010), two assessed medically high-risk pregnant women (Caliskan et al, 2009;Helbig et al, 2011), and Harville et al (2008) included both high-and low-risk participants. Two studies specifically assessed pregnant women with existing psychiatric diagnoses (Maina et al, 2008;Monk et al, 2012).…”

Section: Included Studiesmentioning

confidence: 99%

“…One study (Caliskan et al, 2009) failed to provide exclusion criteria, and two studies failed to describe the study sample for key characteristics (Kent et al, 2002;Teixeira et al, 1999). Six studies (Caliskan et al, 2009;Helbig et al, 2011;Helbig et al, 2013;Kent et al, 2002;Teixeira et al, 1999;Vythilingum et al, 2010) were cross-sectional, with participants assessed at varying gestational ages, which can make it more difficult to assess acute versus chronic stress as well as changes in blood flow over time. All but one (Harville et al, 2008) study had small sample sizes, which can make it difficult to detect minor effects and does not allow conclusions about clinical significance.…”

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

“…Five studies explicitly excluded participants on the basis of a pre-existing psychiatric diagnosis (Helbig et al, 2011;Helbig et al, 2013;Maina et al, 2008;Mendelson et al, 2011;Monk et al, 2012), and seven did not (Caliskan et al, 2009;Harville et al, 2008;Kent et al, 2002;Roos et al, 2015;Sjostrom et al, 1997;Teixeira et al, 1999;Vythilingum et al, 2010).…”

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

“…Although three studies (Helbig et al, 2013;Maina et al, 2008;Sjostrom et al, 1997) listed reasons why participants were lost to follow-up, none adequately described or compared key characteristics in participants who completed the study and those who did not.…”

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

“…Standardized outcome measures decrease measurement bias and make comparability across studies less problematic but increase the risk of subjective response bias, and the choice of stress measures varied considerably. Only three studies (Helbig et al, 2011;Helbig et al, 2013;Mendelson et al, 2011) addressed pregnancyspecific stress. Four studies (Harville et al, 2008;Maina et al, 2008;Monk et al, 2012;Sjostrom et al, 1997) included a clinical interview to assess maternal psychological state, while eight (Caliskan et al, 2009;Helbig et al, 2011;Helbig et al, 2013;Kent et al, 2002;Mendelson et al, 2011;Roos et al, 2015;Teixeira et al, 1999;Vythilingum et al, 2010) relied on self-report measures.…”

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

See 4 more Smart Citations

Prenatal stress and hemodynamics in pregnancy: a systematic review

Levine¹,

Alderdice²,

Grunau

et al. 2016

Arch Womens Ment Health

View full text Add to dashboard Cite

Purpose: Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on hemodynamics during pregnancy remains unclear. This systematic review was conducted in order to assess the quality of the evidence available to date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. Methods:The PubMed/Medline, EMBASE, PsycINFO, Maternity and Infant Care, Trip, Cochrane Library, and CINAHL databases were searched using the search terms pregnancy; stress; fetus; blood; Doppler; ultrasound. Studies were eligible for inclusion if prenatal stress was assessed with standardized measures, hemodynamics was measured with Doppler ultrasound, and methods were adequately described. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using wellaccepted quality-appraisal guidelines.Results: Of 2,532 studies reviewed, 12 met the criteria for inclusion. Six reported that prenatal stress significantly affects maternal or fetal hemodynamics; six found no significant association between maternal stress and circulation. Significant relationships between prenatal stress and uterine artery RI and PI, umbilical artery RI, PI, and S/D ratio, fetal MCA PI, cerebroplacental ratio, and umbilical vein volume blood flow were found. Conclusions:To date, there is limited evidence that prenatal stress is associated with changes in circulation. More carefully designed studies with larger sample sizes, repeated assessments across gestation, tighter control for confounding factors, and measures of pregnancy-specific stress will clarify this relationship.

show abstract

Section: Included Studiesmentioning

confidence: 99%

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

Section: Quality Assessment Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Prenatal stress and hemodynamics in pregnancy: a systematic review

Levine¹,

Alderdice²,

Grunau

et al. 2016

Arch Womens Ment Health

View full text Add to dashboard Cite

show abstract

Stress and preterm birth: biological and vascular mechanisms affecting the feto‐placental circulation and the length of gestation

Najafzadeh

2016

Sonography

View full text Add to dashboard Cite

Preterm birth is the leading cause of perinatal morbidity and mortality. Women experiencing high levels of stress in pregnancy are at an increased risk of preterm delivery. This review examines the biological pathways of the maternal stress response, in particular, the functioning of the maternal hypothalamic-pituitary-adrenal axis, and investigates the role of the placenta in altering this response mechanism. Furthermore, the impact of the products of hypothalamic-pituitary-adrenal axis on the blood flow resistance of the feto-placental arteries is explained. Prior Doppler studies of maternal stress were reviewed. The study of correlations between maternal stress and resistive indices of feto-placental arteries was common themes in these studies. Their conclusions, however, were inconsistently explained by their methodological differences and limited control for potential confounders. The biological mechanisms of stress control provide the impression that it is plausible that antenatal stress could affect the placental function and influence preterm delivery, but to date, this has not been conclusively established. If the investigation is further expanded to include measures of fetal biometry, additional blood vessels and an assessment over a longer period in gestation, subtle changes in the feto-placental blood supply may be revealed, and a link to preterm birth is feasible.

show abstract

Mechanisms Linking In Utero Stress to Altered Offspring Behaviour

Mina

Reynolds

2014

Behavioral Neurobiology of Stress-Related Disorders

View full text Add to dashboard Cite

Development in utero is recognised as a determinant of health in later life, a concept known as early life 'programming'. Several studies in humans have now shown a link between in utero stressors of maternal stress, anxiety and depression and adverse behavioural outcomes for the offspring including poorer cognitive function and behavioural and emotional problems. These behaviours are observed from the very early neonatal period and appear to persist through to adulthood. Underlying mechanisms are not known but overexposure of the developing foetus to glucocorticoids has been proposed. Dysregulation of the maternal and offspring hypothalamic-pituitary-adrenal (HPA) axis has been proposed as a mechanism linking in utero stress with offspring behavioural outcomes. Studies suggest that altered circulating levels of maternal cortisol during pregnancy and/or changes in placental gene expression or methylation, which result in increased glucocorticoid transfer to the developing foetus, are linked to changes in offspring behaviour and in activity of the offspring HPA axis. Further understanding of the underlying pathways and identification of any gestation of vulnerability are needed to help design interventions to reduce in utero stress and improve behavioural outcomes in the offspring.

show abstract

Does Antenatal Maternal Psychological Distress Affect Placental Circulation in the Third Trimester?

Cited by 28 publications

References 39 publications

Prenatal stress and hemodynamics in pregnancy: a systematic review

Prenatal stress and hemodynamics in pregnancy: a systematic review

Stress and preterm birth: biological and vascular mechanisms affecting the feto‐placental circulation and the length of gestation

Mechanisms Linking In Utero Stress to Altered Offspring Behaviour

Contact Info

Product

Resources

About