Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy

Coussons-Read, Mary; Okun, Michele L.; Nettles, Christopher D.

doi:10.1016/j.bbi.2006.08.006

Cited by 378 publications

(290 citation statements)

References 35 publications

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“…14,74-77 Moreover, insomnia, depression, 83,84 and stress 85 are all independently associated with immune dysregulation. Several studies in the literature confirm that exaggerated inflammation, specifically chronic low-grade inflammation, is one biological pathway linked to adverse pregnancy outcomes.…”

Section: Discussionmentioning

confidence: 99%

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Okun

Buysse

Hall

2015

Journal of Clinical Sleep Medicine

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Study Objectives: Although a substantial number of pregnant women report symptoms of insomnia, few studies have used a validated instrument to determine the prevalence in early gestation. Identifi cation of insomnia in pregnancy is vital given the strong connection between insomnia and the incidence of depression, cardiovascular disease, or immune dysregulation. The goal of this paper is to provide additional psychometric evaluation and validation of the Insomnia Symptom Questionnaire (ISQ) and to establish prevalence rates of insomnia among a cohort of pregnant women during early gestation. Methods: The ISQ was evaluated in 143 pregnant women at 12 weeks gestation. The internal consistency and criterion validity of the dichotomized ISQ were compared to traditional measures of sleep from sleep diaries, actigraphy, and the Pittsburgh Sleep Quality Index using indices of sensitivity, specifi city, positive and negative predictive value (PPV, NPV), and likelihood ratio (LR) tests. Results: The ISQ identifi ed 12.6% of the sample as meeting a case defi nition of insomnia, consistent with established diagnostic criteria. Good reliability was established with Cronbach α = 0.86. The ISQ had high specifi city (most > 85%), but sensitivity, PPV, NPV, and LRs varied according to which sleep measure was used as the validating criterion. Conclusions: Insomnia is a health problem for many pregnant women at all stages in pregnancy. These data support the validity and reliability of the ISQ to identify insomnia in pregnant women. The ISQ is a short and cost-effective tool that can be quickly employed in large observational studies or in clinical practice where perinatal women are seen. 1 Among the many sleep complaints associated with pregnancy, diffi culty initiating or maintaining sleep or unrefreshing sleep, are the most frequently reported issues .1,2 Collectively these sleep symptoms comprise only one aspect of clinical insomnia. According to diagnostic criteria for insomnia, one must have: (1) a diffi culty initiating or maintaining sleep, and/or unrefreshing sleep despite adequate opportunity for sleep; (2) the duration of the sleep complaint is at least 1 mo; and (3) complaints of significant impairment in social, occupational, or daily functioning. 3,4 Insomnia is associated with activation of the stress system resulting in autonomic hyperarousa l. 5,6 It is also linked to various morbidities including depressi on.7-12 Emerging evidence implicates autonomic hyperarousal as a pathway through which the risk of depression is augmen ted. 13 This association is particularly relevant for pregnant women because there is evidence that depression is associated with an increased risk for preterm birth ( PTB), 14 and prenatal depression negatively impairs maternal-child bonding and neurocognitive develo pment.14-17 Having a simple diagnostic tool to identify clinical insomnia in pregnant women could be a fi rst step in reducing the incidence of depression, autonomic hyperarousal, as well as adverse pregnancy outcomes, such as PT...

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Section: Discussionmentioning

confidence: 99%

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Okun

Buysse

Hall

2015

Journal of Clinical Sleep Medicine

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“…In addition, maternal stress during gestation can have detrimental effects on growth (Fowden et al, 2006), neuroendocrine (Weinstock, 1997) and immune (Merlot et al, 2008) functions in the offspring after birth. The deleterious effects of stress on pregnancy and foetal development seem to be related to maternal immune changes (Arck, 2001;Joachim et al, 2003;Coussons-Read et al, 2007) and to maternal neuroendocrine activity, especially to glucocorticoid secretions (Barbazanges et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

Behavioural, endocrine and immune responses to repeated social stress in pregnant gilts

Couret

Otten

Puppe

et al. 2009

Animal

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Pregnant sows are exposed to various stressors in intensive pig husbandry that may have negative consequences on their health, reproductive performances and welfare. Social stress is one of these challenges, because gestating sows have to be housed in groups according to EU guidelines (2001/88/CE). The purpose of this study was to determine the consequences of repeated social stress in pregnant female pigs on their behavioural, endocrine and immunological responses and on pregnancy outcome. Pregnant gilts were submitted to a repeated social stress procedure induced by housing unfamiliar gilts in pairs changed twice a week between days 77 and 105 of gestation (S group, n 5 18). Control gilts were housed in stable pairs during the same period (C group, n 5 18). Agonistic behaviour was observed during the first 3 h after each grouping. Skin lesions were numbered 2 h after each grouping. Salivary cortisol was measured before and repeatedly during the 4 weeks of grouping. Gilts were immunized against keyhole limpet haemocyanin (KLH) on days 81 and 95 of gestation. Immunoglobulins G against KLH, proliferative responses to concanavalin A, lipopolysaccharide, pokeweed mitogen and KLH and peripheral blood leukocyte numbers were evaluated 1 week before the first grouping and 3 days after the last one. Agonistic interactions and skin lesions were observed in S gilts at each grouping, although there was a decline between the first and the last grouping ( P , 0.05). The repeated social stress induced a sustained endocrine response as shown by elevated salivary cortisol levels from 1 to 48 h after grouping in S gilts compared to C gilts. The cellular as well as the humoral immunity and the leukocyte numbers were not influenced by social stress. Gestation length tended to be shorter in S gilts ( P 5 0.09), but litter size, piglet weight or mortality at birth were not affected. Variability of the response of S gilts to groupings was partly explained by their average success value determined according to the outcome (defeat or win) of all the groupings. In conclusion, our study demonstrates that the application of repeated social stress to pregnant gilts during the last third of their gestation repeatedly activates their hypothalamo-pituitary-adrenal axis but does not impair their immune function and pregnancy outcome.

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“…Epidemiological data suggest pregnancy increases influenza mortality (Memoli et al, 2012;Rasmussen et al, 2008), exacerbates asthma (Kircher et al, 2002), and leads to lung injury (Sheng et al, 2012) and deleterious effects of stress (Coussons-Read et al, 2007). This risk extends to commonplace environmental exposures like inert respirable particulates without soluble components considered non-toxic.…”

Section: Introductionmentioning

confidence: 99%

Estrogen-mediated impairment of macrophageal uptake of environmental TiO₂particles to explain inflammatory effect of TiO₂on airways during pregnancy

Zhang

Mikhaylova

Kobzik³

et al. 2014

Journal of Immunotoxicology

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Innate defenses against environmental particulate exposures can become deficient when physiological background of the organism is unbalanced. Even those exposures considered innocuous may then become harmful. For example, one of the important inherent risks of pregnancy is increased inflammatory responsiveness in the airways, which extends to exposures considered otherwise innocuous: it has been observed that normally ''inert'' particulates become inflammatory in pregnancy. They lead to enhanced airway inflammation associated with increased asthma risk in the offspring in the BALB/c model. It was hypothesized that pregnancy hormones alter macrophageal uptake and clearance of particles. This study shows that the phagocytic activity of alveolar macrophages (AM) and RAW264.7 cells against titanium dioxide (TiO 2 ) was inhibited in pregnancy by $10% and in vitro by estradiol by $20%; progesterone potentiated this effect. Hence, enhanced inflammation in pregnancy as an outcome of exposure to the ''inert'' TiO 2 may be due to an effect of pregnancy hormones which decrease the ability of the airways to clear the particles. AM (at 10 6 cells/recipient) isogenically transplanted from pregnant mothers into airways of recipients were able to confer the phenotype of inflammatory response to TiO 2 (PMN counts of 1.62 [± 0.19] Â 10 5 /ml versus 0.61 [± 0.13] Â 10 5 /ml in control). Because this small amount of transferred AM could not replace the AM population in the recipients' lungs, it is postulated that the effect is mediated by inhibitory signaling factors that AM produce and release; hence, a list of probable molecules was identified via genome-wide microarray.

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Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy

Cited by 378 publications

References 35 publications

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Behavioural, endocrine and immune responses to repeated social stress in pregnant gilts

Estrogen-mediated impairment of macrophageal uptake of environmental TiO₂particles to explain inflammatory effect of TiO₂on airways during pregnancy

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Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy

Cited by 378 publications

References 35 publications

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Behavioural, endocrine and immune responses to repeated social stress in pregnant gilts

Estrogen-mediated impairment of macrophageal uptake of environmental TiO2particles to explain inflammatory effect of TiO2on airways during pregnancy

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Estrogen-mediated impairment of macrophageal uptake of environmental TiO₂particles to explain inflammatory effect of TiO₂on airways during pregnancy