Mothers’ childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways

Abstract

Research suggests the health consequences of economic hardship can be transmitted across generations. Some of these disparities are thought to be passed to offspring during gestation. But this hypothesis has not been tested in contemporary American samples, and the mechanisms of transmission have not been characterized. Accordingly, this study had two goals: first, to determine if women exposed to economic hardship during childhood showed higher rates of adverse birth outcomes; and second, to evaluate the contribution of inflammation, psychosocial, lifestyle, and obstetric characteristics to this phenomenon. This prospective study enrolled 744 women with singleton pregnancies (59.1% White; 16.3% Black; 18.7% Latina; 5.9% Other). Childhood economic hardship was measured by self-report. Birth outcomes included length of gestation and incidence of preterm birth; birth weight percentile and small for gestational age; length of hospital stay and admission to Special Care Nursery. Analyses revealed that mothers’ childhood economic hardship was independently associated with multiple adverse birth outcomes, even following adjustment for demographics, maternal education, and obstetrical confounders. Women raised in economically disadvantaged conditions had shorter gestation length and higher preterm delivery rates. Their babies had lower birth weights, were more likely to be small for gestational age, stayed in the hospital longer, and had more Special Care Nursery admissions. Mediation analyses suggested these associations arose through multiple pathways, and highlighted roles for inflammation, education, adiposity, and obstetric complications. Collectively, these findings suggest that childhood economic hardship predisposes women to adverse birth outcomes, and highlights likely behavioral and biological mechanisms.

Pathways linking childhood abuse history and current socioeconomic status to inflammation during pregnancy

“…Consistent with the larger literature (Miller et al, 2017; Mitchell et al, 2018; Walsh et al, 2016), the current study provides further evidence that adversities experienced during childhood and adulthood are associated with elevated inflammatory markers during pregnancy. Specifically, bivariate correlations revealed that a history of childhood abuse was positively associated with both CRP and IL-6 in a sample of pregnant women, while current SES was negatively associated with both CRP and IL-6.…”

“…One risk factor that has been linked to excessive inflammation during pregnancy is exposure to chronic adversity. Women who have experienced significant adversities during childhood (e.g., abuse) and adulthood (e.g., poverty or low socioeconomic conditions) are at risk for excessive inflammation, which has implications for pregnancy (Miller et al, 2017; Mitchell et al, 2018; Walsh et al, 2016). A history of childhood exposure to abuse and low socioeconomic status (SES) have been independently associated with a chronic inflammatory state characterized by elevations in inflammatory markers across the lifespan (Azad et al, 2012; Baumeister et al, 2016; Danese et al, 2007; Pollitt et al, 2008), in addition to adverse pregnancy outcomes characterized by excessive inflammation (Bushnik et al, 2017; Gavin et al, 2012; Silva et al, 2008; Smith et al, 2016).…”

Using graph learning to understand adverse pregnancy outcomes and stress pathways

“…In all, there were 744 women at visit A and 639 at visit B; ultimately, 686 post-delivery medical records, such as pregnancy outcomes, were available. Additional details about the original data collection can be found in prior publications [14]. Ethics approval for the original data collection was provided by the Institutional Review Board of Northwestern University in Evanston IL, project number STU00039484.…”

Puberty and the Evolution of Developmental Science

“…The contexts informing individual development also may be distal: transgenerational sex‐specific effects of parental as well as grandparental circumstances on descendants’ maturation, health, and survivorship increasingly have been documented (Pembrey et al., ). Maternal hardship in early life increases likelihood of poor outcomes of pregnancy including low birth weight (G. E. Miller et al., ), which is known to be associated with offspring age at menarche and long‐term health outcomes (Adair, ). In addition, evidence has been accumulating for age‐specific (pre vs. late puberty) effects of paternal nutrition on offspring health across one or two generations (Isganaitis, Suehiro, & Cardona, ; Rando, ).…”