Effect of Maternal Stress on Fetal Heart Rate Assessed by Vibroacoustic Stimulation

Abstract

This study was designed to determine whether maternal stress levels, state and trait anxiety levels, and stress hormones affect fetal heart rate (FHR) patterns after vibroacoustic stimulation (VAS) at 30 weeks of gestation. A total of 24 healthy pregnant women with a single fetus pregnancy were enrolled. Corticotropin releasing hormone (CRH) and adrenocorticotropic hormone in maternal plasma and cortisol, and chromogranin A in saliva were measured. The FHR patterns after VAS were divided into three types: type I, a long period of acceleration or one acceleration lasting > 1 min or at least two accelerations lasting > 15 s; type II, a biphasic response with acceleration followed by deceleration; and type III, no response or prolonged deceleration. In the high trait anxiety group, CRH levels were significantly higher than in the low trait anxiety group, and FHR patterns after VAS showed mostly a type II response pattern. These findings suggest that stress in pregnant women with high trait anxiety may influence FHR patterns after VAS.

Elevated maternal cortisol leads to relative maternal hyperglycemia and increased stillbirth in ovine pregnancy

“…Although pregnancy loss in humans with elevated cortisol or diabetes may be multifactorial, changes in cardiac size and/or function in the fetus have been suggested as one factor contributing to late-term fetal loss in these pregnancies (34,35,41). Although it is enticing to hypothesize that the dramatic increase in stillbirths found in the present study is related to the changes in the fetal heart previously observed at 130 days of gestation in this model (8,31) and that have been found with glucocorticoid administration (12,20,32,37,43), there is no clear association with heart weight in this group of fetuses. However, in gestational diabetes there may be fetal diastolic dysfunction independent of hypertrophy (2).…”

“…In diabetic pregnancies, fetal lactic acidosis and hypoxia have both been reported near term, and bradycardic episodes, ST segment depression, and fetal acidemia have been observed during labor in fetuses of both gestational and pregestational diabetic mothers (31,37,38), as well as heart failure with abnormal ECG during labor (19). An increased incidence of fetal bradycardic responses to fetal stress occurs in women demonstrating high anxiety during pregnancy (20). It is not known whether acidemia and bradycardia occur during labor in fetuses with Cushing's disease; however, in ovine fetuses, exposure to glucocorticoids appears to increase the bradycardia and acidemia during a hypoxic episode (9,11).…”

Sex moderates associations between prenatal glucocorticoid exposure and human fetal neurological development

“…For example, unstimulated FM is related to maternal psychological states such as anxiety, depression, anger and pregnancy‐specific stress (Conde, Figueiredo, Tendais, Teixeira, Costa, Pacheco, Rodrigues & Nogueira, 2010; DiPietro, Costigan & Gurewitch, 2003; DiPietro, Hilton, Hawkins, Costigan & Pressman, 2002b; DiPietro et al ., 2010; Field, Diego, Hernandez‐Reif, Salman, Schanberg, Kuhn, Yando & Bendell, 2002). Few studies have examined associations between maternal anxiety and depression and fetal heart rate response to stimulation (Allister, Lester, Carr & Liu, 2001; Makino, Matsuda, Yoneyama, Hirasawa, Takagi, Ohta & Konishi, 2009; Monk, Fifer, Myers, Bagiella, Duong, Chen, Leotti & Altincatal, 2010), and only a single study has examined and shown that maternal psychological state (depression symptoms) is associated with FM responses to VAS stimulation (Dieter, Emory, Johnson & Raynor, 2008). Further, both exogenous and endogenous glucocorticoids (GCs) are associated with unstimulated fetal motor activity (DiPietro, Kivlighan, Costigan & Laudenslager, 2009; Field, Diego, Hernandez‐Reif, Gil & Vera, 2005; Mulder, Koenen, Blom & Visser, 2004).…”

Exploratory analysis of textual data from the Mother and Child Handbook using a text mining method (II): Monthly changes in the words recorded by mothers

“…Although measurement of stress during pregnancy is not easy, the STAI has been found to be a suitable tool for objectively measuring stress levels during pregnancy, because it clearly differentiates between the temporary condition of ‘state anxiety’ and the more general, long‐standing condition of ‘trait anxiety’ and has been adequately validated and checked for consistency . We previously demonstrated that the level of corticotropin releasing hormone, one of the markers of stress hormones, was significantly higher in individuals with high trait anxiety and concluded that STAI trait anxiety may be useful for evaluating chronic maternal stress …”