Physiological reactivity to psychological stress in human pregnancy: Current knowledge and future directions

Christian, Lisa M.

doi:10.1016/j.pneurobio.2012.07.003

Cited by 82 publications

(75 citation statements)

References 158 publications

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“…Overall these data suggest that stress responses are attenuated during healthy pregnancy. for review see 25, 26 Similar attenuation of responsivity has been reported in animal models. 27–29 These adaptations may be critical from protecting the mother and fetus from excessive exposure to physiological activation.…”

Section: Stress and Inflammatory Processes Among Pregnant Womensupporting

confidence: 59%

Effects of stress and depression on inflammatory immune parameters in pregnancy

Christian

2014

American Journal of Obstetrics and Gynecology

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There is a substantial body of literature linking psychological stress to adverse pregnancy outcomes, particularly preterm birth. Comparatively few studies have examined potential biological mechanisms explaining these associations. Attention to inflammatory processes is warranted. The current paper describes emerging studies demonstrating that, as in nonpregnant humans and animals, psychological stress and distress (i.e., depressive symptoms) predict dysregulation of inflammatory processes in human pregnancy. This includes elevations in circulating inflammatory cytokines, exaggerated inflammatory responses to in vivo biological challenges, and more robust inflammatory responses to psychological challenges. Continued research in this area is needed to determine the implications of such stress-induced immune dysregulation for birth outcomes as well as maternal health and fetal development.

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Section: Stress and Inflammatory Processes Among Pregnant Womensupporting

confidence: 59%

Effects of stress and depression on inflammatory immune parameters in pregnancy

Christian

2014

American Journal of Obstetrics and Gynecology

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“…Pregnancy creates substantial hormonal and physiological changes, is often followed by stressful social and transitions and is a vulnerable time for onset of mental disorders (1). Although post partum depression has been extensively evaluated, less is known about occurrence and biological determinants of suicide risk (SR) and major depression episode (MDE) in early pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Omega-6 fatty acids and greater likelihood of suicide risk and major depression in early pregnancy

Vaz

Kac

Nardi³

et al. 2014

Journal of Affective Disorders

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Objective To estimate the prevalence of suicide risk (SR) and major depressive episode (MDE) in early pregnancy, and the relationship of fatty acids serum status to these outcomes. Method Cross-sectional analyses of 234 pregnant women enrolled in a prospective cohort study in Rio de Janeiro/Brazil were performed. SR and MDE were defined according to MINI International Neuropsychiatric Interview. Fatty acids compositions were determined in serum samples obtained between the 6th and 13th gestational week. Statistical analyses included univariate and multiple logistic regressions. Fatty acids data were expressed both as percent of total fatty acids and converted to Z scores then entered as continuous variable into regression models. Results The prevalence of SR was 19.6% and MDE was 17.0%. Higher likelihood of SR was observed among women with higher arachidonic acid [AA (20:4n-6): OR=1.45, 95% CI 1.02-2.07] and adrenic acid [AdA (22:4 n-6): OR=1.43, 95% CI 1.01-2.04], and for MDE: AA [OR=1.47, 95% CI 1.03-2.10], and AdA [OR=1.59, 95% CI 1.09-2.32], per standard deviation of fatty acid, in adjusted logistic regressions. Conclusion Higher serum status of AA and AdA, two omega-6 fatty acids, were associated with greater likelihood of SR and MDE among pregnant Brazilian women independently of confounding variables.

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“…Some methods that have been used to measure the different facets of stress include psychologic measures, often measured with a questionnaire, and physiologic markers, measured by saliva or blood. These biologic samples can be difficult to obtain, are costly to analyze, and are equivocally linked to stress (16-20). Overall, questionnaires are a more cost-efficient way to measure stress; however, although questionnaires are developed and validated to measure specific aspects of stress in certain populations, it can be difficult to determine the actual construct being measured or the construct validity.…”

Section: Introductionmentioning

confidence: 99%

Measurement of Perceived Stress Among Pregnant Women: A Comparison of Two Different Instruments

Solivan

Xiong

Harville

et al. 2015

Matern Child Health J

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Objective Assess the amount of agreement between the classification of stress from the Perceived Stress Scale (PSS) and the Assessment of Stress portion of the Prenatal Psychosocial Profile (PPP) among pregnant women. Methods A secondary data analysis on a cross-sectional study of 301 pregnant women from the New Orleans and Baton Rouge areas who were exposed to Hurricane Katrina was conducted. Women with complete data (219) were analyzed. Women scoring in the third tertile of each instrument were compared. The kappa statistic was used to assess agreement between instruments. Additional comparisons were made with three instruments that measure other important psychosocial constructs that could be related to stress: the Edinburgh Depression Scale (EDS) and the Assessments of Support (partner and other support) and Self-Esteem from the PPP. Results No significant difference was found between the two tests. The PSS and the PPP were both statistically significantly correlated to each other (ρ=0.71, p<.01). Thirty-five women were classified discordantly resulting in a Kappa Coefficient of 0.61 (95% CI 0.50-0.72, p<.01). No significant differences were found between these two instruments in correlation with the EDS (PPP, r=0.76; PSS, r=0.72; p<.01 for each), partner support (PPP, r=−0.47; PSS r=−0.46; p<.01 for each), other support (PPP, r=−0.31; PSS r=−0.32; p<.01 for each) and self-esteem (PPP, r=−0.41; PSS, r=−0.52; p<.01 for each), respectively. Conclusions Given the similarities between the PSS and PPP, researchers are encouraged to choose and administer one instrument to participants, or to use the instruments in combination as an external reliability check.

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Physiological reactivity to psychological stress in human pregnancy: Current knowledge and future directions

Cited by 82 publications

References 158 publications

Effects of stress and depression on inflammatory immune parameters in pregnancy

Effects of stress and depression on inflammatory immune parameters in pregnancy

Omega-6 fatty acids and greater likelihood of suicide risk and major depression in early pregnancy

Measurement of Perceived Stress Among Pregnant Women: A Comparison of Two Different Instruments

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