scholarly journals Maternal prenatal stress during the first trimester and infant birthweight in Soweto, South Africa

2021 ◽  
Author(s):  
Andrew Wooyoung Kim ◽  
Rihlat Said Mohamed ◽  
Christopher W. Kuzawa ◽  
Shane A. Norris
Keyword(s):  
South Africa ◽  
Birth Outcomes ◽  
Prenatal Stress ◽  
Maternal Stress ◽  
First Trimester ◽  
Growth Restriction ◽  
Early Gestation ◽  
Maternal Prenatal Stress ◽  
Infant Birth ◽  
The Impact

ABSTRACTBackgroundApproximately 14.2% of newborns are estimated to be born low birth weight (LBW) in South Africa. Past work has implicated maternal prenatal stress as a potent predictor of poor birth outcomes, including preterm birth, intrauterine growth restriction, and LBW. However, less is presently known about the impacts of prenatal stress during early gestation in low- and middle-income contexts, where public health burdens due to LBW are much higher.ObjectiveWe assess the effects of psychosocial stress during the first trimester on birthweight in a large sample of women (n = 657) in Soweto, South Africa, a peri-urban township located in the Greater Johannesburg area.MethodsData come from the Soweto First 1000 Days Cohort, a study of maternal and fetal predictors of infant birth outcomes. Multiple regression models were used to examine the impact of prenatal stress on infant birthweight.ResultsThe prevalence of LBW was 16.6%. Adjusting for maternal age, gestational age, fetal gender, body mass index, and parity, maternal prenatal stress during the first trimester was a borderline predictor of lower birthweight in this sample (β = 12.7, p = 0.071, 95% CI [-26.4, 1.10]). Women who reported greater levels of stress appeared to have non-significantly longer gestations, and the negative impact of maternal stress on birthweight only appeared after adjusting for this pattern.ConclusionsThese results suggest that fetal growth restriction associated with first trimester maternal stress may contribute to lower birthweights in this sample. Our findings report modest relationships between maternal stress specific to early gestation as likely important to birth outcomes in this urban South African sample.

Reduced birth weight caused by sextuple drug resistant Plasmodium falciparum infection in early 2nd trimester

2021 ◽  
Author(s):  
Helle Hansson ◽  
Daniel T R Minja ◽  
Sofie L Moeller ◽  
John P A Lusingu ◽  
Ib C Bygbjerg ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Birth Weight ◽  
Birth Outcomes ◽  
Birth Outcome ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
First Trimester ◽  
Close Monitoring ◽  
The Impact ◽  
Mutant Haplotype

Abstract Mutations in the Plasmodium falciparum genes Pfdhfr and Pfdhps, particularly the sextuple mutant haplotype threatens the antimalarial effectiveness of sulfadoxine-pyrimethamine as intermittent preventive treatment during pregnancy (IPTp). To explore the impact of sextuple mutant haplotype infections on outcome measures after provision of IPTp-SP, we monitored birth outcomes in women followed from prior to conception or from the first trimester until delivery. Women infected with sextuple haplotypes in early 2 nd trimester specifically, delivered newborns with a lower birth weight (-267g, 95% CI -454; -59, p=0·01) compared to women who did not have malaria during pregnancy and women infected with less SP resistant haplotypes (-461g, 95% CI -877; -44, p=0·03). Thus, sextuple haplotype infections seems to impact the effectiveness of SP for IPTp and directly impact birth outcome by lowering birth weight. Close monitoring and targeted malaria control during early pregnancy is therefore crucial to improve birth outcomes.

scholarly journals Birth outcomes following antiretroviral exposure during pregnancy: Initial results from a pregnancy exposure registry in South Africa

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ushma C. Mehta ◽  
Cari Van Schalkwyk ◽  
Prineetha Naidoo ◽  
Arthi Ramkissoon ◽  
Otty Mhlongo ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Congenital Malformations ◽  
First Trimester ◽  
First Year ◽  
Increased Risk ◽  
Bivariable Analysis ◽  
Major Congenital Malformations ◽  
Clinical Records ◽  
Surface Examination ◽  
The Impact

Background: In 2013, a pregnancy exposure registry and birth defects surveillance (PER/BDS) system was initiated in eThekwini District, KwaZulu-Natal (KZN), to assess the impact of antiretroviral treatment (ART) on birth outcomes.Objectives: At the end of the first year, we assessed the risk of major congenital malformations (CM) and other adverse birth outcomes (ABOs) detected at birth, in children born to women exposed to ART during pregnancy.Method: Data were collected from women who delivered at Prince Mshiyeni Memorial Hospital, Durban, from 07 October 2013 to 06 October 2014, using medicine exposure histories and birth outcomes from maternal interviews, clinical records and neonatal surface examination. Singleton births exposed to only one ART regimen were included in bivariable analysis for CM risk and multivariate risk analysis for ABO risk.Results: Data were collected from 10 417 women with 10 517 birth outcomes (4013 [38.5%] HIV-infected). Congenital malformations rates in births exposed to Efavirenz during the first trimester (T1) (RR 0.87 [95% CI 0.12–6.4; p = 0.895]) were similar to births not exposed to ART during T1. However, T1 exposure to Nevirapine was associated with the increased risk of CM (RR 9.28 [95% CI 2.3–37.9; p = 0.002]) when compared to the same group. Other ABOs were more frequent in the combination of HIV/ART-exposed births compared to HIV-unexposed births (29.9% vs. 26.0%, adjusted RR 1.23 [1.14–1.31; p 0.001]).Conclusion: No association between T1 use of EFV-based ART regimens and CM was observed. Associations between T1 NVP-based ART regimen and CM need further investigation. HIV- and ART-exposed infants had more ABOs compared to HIV-unexposed infants.

scholarly journals Maternal syphilis treatment and pregnancy outcomes: a retrospective study in Jiangxi Province, China

2020 ◽  
Author(s):  
Zhihua Wan ◽  
Huan Zhang ◽  
Haigang Xu ◽  
Yang Hu ◽  
Cai Tan ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Jiangxi Province ◽  
Adequate Treatment ◽  
Syphilis Treatment ◽  
Maternal Syphilis ◽  
The Impact

Abstract BackgroundStudies investigating the associations of maternal syphilis treatment with birth outcomes mainly concentrated in economically developed areas. Limited data are available in economically underdeveloped areas, such as Jiangxi Province. The study aims to investigate the impact of maternal treatment on birth outcomes in Jiangxi Province, China.MethodsData were obtained from the China’s Information System of Prevention of Mother-to-Child Transmission in Jiangxi Province. All syphilis infected pregnant women who delivered ≥28 gestational weeks and were registered in this system between 1 January 2013 and 31 December 2019 were enrolled. Pregnancy outcomes were evaluated by group-specific analyses according to their treatment status, adequacy and initiation time.Results4210 syphilis infected pregnant women were included in the analyses. Infants born to untreated mothers (n = 1364) were at significantly higher risk for stillbirth (adjusted odds ratio (aOR) = 1.74, 95% CI, 1.01-3.00, P = 0.045), preterm birth (aOR = 1.27, 95% CI, 1.02-1.59, P = 0.034) and low birth weight (LBW) (aOR = 1.44; 95% CI, 1.11-1.86, P = 0.006) than those born to treated mothers (n = 2846) after adjustment for confounding factors. A significantly higher risk of stillbirth (aOR = 3.68; 95% CI, 1.62-8.34, P = 0.002), preterm birth (aOR = 2.26; 95% CI, 1.71-3.00, P < 0.001), LBW (aOR = 2.23; 95% CI, 1.59-3.14, P < 0.001) and congenital syphilis (CS) (aOR = 3.63; 95% CI, 1.80-7.31, P < 0.001) was found in infants exposed to mothers treated inadequately (n = 1299) than those treated adequately (n = 1547). No pregnant women who initiated the treatment in the first trimester (n = 682) delivered a neonatal CS case. Compared with mothers who initiated treatment in the first trimester (n = 682), those initiated in the third trimester (n = 1234) suffered an increased risk of stillbirth (aOR = 4.48; 95% CI, 1.31-15.30, P = 0.017), preterm birth (aOR = 2.34; 95% CI, 1.61-3.40, P < 0.001) and LBW (aOR = 3.25; 95% CI, 1.97-5.37, P < 0.001). ConclusionsMaternal treatment, especially early and adequate treatment, plays a crucial role in mitigating adverse pregnancy outcomes among syphilis infected women.

scholarly journals Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes

2019 ◽  
Vol 116 (48) ◽  
pp. 23996-24005 ◽  
Author(s):  
Kate Walsh ◽  
Clare A. McCormack ◽  
Rachel Webster ◽  
Anita Pinto ◽  
Seonjoo Lee ◽  
...  
Keyword(s):  
Social Support ◽  
Birth Outcomes ◽  
Prenatal Stress ◽  
System Development ◽  
Caloric Intake ◽  
Nervous System Development ◽  
Stressed Group ◽  
Data Driven Approach ◽  
Stress Influences ◽  
Maternal Prenatal Stress

Maternal prenatal stress influences offspring neurodevelopment and birth outcomes including the ratio of males to females born; however, there is limited understanding of what types of stress matter, and for whom. Using a data-driven approach with 27 variables from questionnaires, ambulatory diaries, and physical assessments collected early in the singleton pregnancies of 187 women, 3 latent profiles of maternal prenatal stress emerged that were differentially associated with sex at birth, birth outcomes, and fetal neurodevelopment. Most women (66.8%) were in the healthy group (HG); 17.1% were in the psychologically stressed group (PSYG), evidencing clinically meaningful elevations in perceived stress, depression, and anxiety; and 16% were in the physically stressed group (PHSG) with relatively higher ambulatory blood pressure and increased caloric intake. The population normative male:female secondary sex ratio (105:100) was lower in the PSYG (2:3) and PHSG (4:9), and higher in the HG (23:18), consistent with research showing diminished male births in maternal stress contexts. PHSG versus HG infants were born 1.5 wk earlier (P < 0.05) with 22% compared to 5% born preterm. PHSG versus HG fetuses had decreased fetal heart rate–movement coupling (P < 0.05), which may indicate slower central nervous system development, and PSYG versus PHSG fetuses had more birth complications, consistent with previous findings among offspring of women with psychiatric illness. Social support most strongly differentiated the HG, PSYG, and PHSG groups, and higher social support was associated with increased odds of male versus female births. Stress phenotypes in pregnant women are associated with male vulnerability and poor fetal outcomes.

Maternal prenatal stress and infant birth weight and gestational age: A meta-analysis of prospective studies

2015 ◽  
Vol 36 ◽  
pp. 179-199 ◽  
Author(s):  
Eve-Line Bussières ◽  
George M. Tarabulsy ◽  
Jessica Pearson ◽  
Réjean Tessier ◽  
Jean-Claude Forest ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Prospective Studies ◽  
Prenatal Stress ◽  
Meta Analysis ◽  
Maternal Prenatal Stress ◽  
Infant Birth

scholarly journals Prenatal Maternal Stress and Physical Abuse among Homeless Women and Infant Health Outcomes in the United States

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Ray M. Merrill ◽  
Rickelle Richards ◽  
Arielle Sloan
Keyword(s):  
Birth Weight ◽  
Maternal Health ◽  
Stressful Life Events ◽  
Maternal Stress ◽  
The United States ◽  
Negative Influence ◽  
Homeless Women ◽  
Pregnancy Risk ◽  
Infant Birth ◽  
The Impact

Background. This study examines whether the relationship between maternal stress or abuse situations and infant birth weight differs between homeless and non-homeless women. Methods. Analyses are based on data from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2002–2007. Results. Homeless women were significantly more likely to experience stressful life events, abusive situations, and poor maternal health than non-homeless women during pregnancy. Birth weight among infants of homeless women was, on average, 17.4 grams lighter than for infants of non-homeless women, after adjusting for maternal age, race, ethnicity, region, education, and marital status. The impact of maternal health, stress, and abuse variables on pregnancy and infant birth weight significantly interacted with homeless status. For example, vaginal bleeding, nausea, kidney/bladder infection, and failure to receive early prenatal care had significantly larger negative impacts on birth weight among homeless women than non-homeless women. Infant birth weight was consistently lower among homeless women, more so when maternal stress and abuse were involved, across all classifications of their prepregnancy weight. Conclusion. Stress and abusive situations among pregnant women have a negative influence on pregnancy-related conditions and infant birth weight. However, this negative influence is even more pronounced among homeless women.

scholarly journals Interactive relations between maternal prenatal stress, fetal brain connectivity, and gestational age at delivery

2021 ◽  
Author(s):  
Moriah E. Thomason ◽  
Jasmine L. Hect ◽  
Rebecca Waller ◽  
Paul Curtin
Keyword(s):  
Social Support ◽  
Maternal Health ◽  
Health Behaviors ◽  
Human Brain ◽  
Birth Outcomes ◽  
Prenatal Stress ◽  
Brain Connectivity ◽  
Fetal Brain ◽  
Gestational Age At Delivery ◽  
Maternal Prenatal Stress

AbstractStudies reporting significant associations between maternal prenatal stress and child outcomes are frequently confounded by correlates of prenatal stress that influence the postnatal rearing environment. The major objective of this study is to identify whether maternal prenatal stress is associated with variation in human brain functional connectivity prior to birth. We utilized fetal fMRI in 118 fetuses [48 female; mean age 32.9 weeks (SD = 3.87)] to evaluate this association and further addressed whether fetal neural differences were related to maternal health behaviors, social support, or birth outcomes. Community detection was used to empirically define networks and enrichment was used to isolate differential within- or between-network connectivity effects. Significance for χ2 enrichment was determined by randomly permuting the subject pairing of fetal brain connectivity and maternal stress values 10,000 times. Mixtures modelling was used to test whether fetal neural differences were related to maternal health behaviors, social support, or birth outcomes. Increased maternal prenatal negative affect/stress was associated with alterations in fetal frontoparietal, striatal, and temporoparietal connectivity (β = 0.82, p < 0.001). Follow-up analysis demonstrated that these associations were stronger in women with better health behaviors, more positive interpersonal support, and lower overall stress (β = 0.16, p = 0.02). Additionally, magnitude of stress-related differences in neural connectivity was marginally correlated with younger gestational age at delivery (β = −0.18, p = 0.05). This is the first evidence that negative affect/stress during pregnancy is reflected in functional network differences in the human brain in utero, and also provides information about how positive interpersonal and health behaviors could mitigate prenatal brain programming.

Loss of a close family member the year before or during pregnancy and the risk of placental abruption: a cohort study from Denmark and Sweden

2013 ◽  
Vol 44 (9) ◽  
pp. 1855-1866 ◽  
Author(s):  
K. D. László ◽  
C. V. Ananth ◽  
A. K. Wikström ◽  
T. Svensson ◽  
J. Li ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Placental Abruption ◽  
Maternal Stress ◽  
First Trimester ◽  
Growth Restriction ◽  
Chronic Hypertension ◽  
Increased Risk ◽  
First Trimester Of Pregnancy ◽  
Close Family

BackgroundMaternal stress during pregnancy is associated with a modestly increased risk of fetal growth restriction and pre-eclampsia. Since placental abruption shares similar pathophysiological mechanisms and risk factors with fetal growth restriction and pre-eclampsia, we hypothesized that maternal stress may be implicated in abruption risk. We investigated the association between maternal bereavement during pregnancy and placental abruption.MethodWe studied singleton births in Denmark (1978–2008) and Sweden (1973–2006) (n = 5 103 272). In nationwide registries, we obtained data on death of women's close family members (older children, siblings, parents, and partners), abruption and potential confounders.ResultsA total of 30 312 (6/1000) pregnancies in the cohort were diagnosed with placental abruption. Among normotensive women, death of a child the year before or during pregnancy was associated with a 54% increased odds of abruption [95% confidence interval (CI) 1.30–1.82]; the increased odds were restricted to women who lost a child the year before or during the first trimester in pregnancy. In the group with chronic hypertension, death of a child the year before or in the first trimester of pregnancy was associated with eight-fold increased odds of abruption (odds ratio 8.17, 95% CI 3.17–21.10). Death of other relatives was not associated with abruption risk.ConclusionsLoss of a child the year before or in the first trimester of pregnancy was associated with an increased risk of abruption, especially among women with chronic hypertension. Studies are needed to investigate the effect of less severe, but more frequent, sources of stress on placental abruption risk.

scholarly journals The impact of first trimester phthalate and phenol exposure on IGF2/H19 genomic imprinting and birth outcomes

2014 ◽  
Vol 133 ◽  
pp. 396-406 ◽  
Author(s):  
Jessica LaRocca ◽  
Alexandra M. Binder ◽  
Thomas F. McElrath ◽  
Karin B. Michels
Keyword(s):  
Birth Outcomes ◽  
Genomic Imprinting ◽  
First Trimester ◽  
The Impact

scholarly journals Does Chemotherapy for Gynecological Malignancies during Pregnancy Cause Fetal Growth Restriction?

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Nabil Abdalla ◽  
Magdalena Bizoń ◽  
Robert Piórkowski ◽  
Paweł Stanirowski ◽  
Krzysztof Cendrowski ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Ethical Issues ◽  
First Trimester ◽  
Chemotherapeutic Agents ◽  
Growth Restriction ◽  
Main Concern ◽  
Dose Frequency ◽  
Treatment Protocols ◽  
The Impact

Cancer and pregnancy rarely coincide. Gynecological cancers are among the most common malignancies to occur during pregnancy, and chemotherapy with or without surgery is the primary treatment option. The main concern of administering chemotherapy during pregnancy is congenital malformation, although it can be avoided by delaying treatment until after organogenesis. The dose, frequency, choice of chemotherapeutic agents, time of treatment commencement, and method of administration can be adjusted to obtain the best maternal treatment outcomes while simultaneously minimizing fetal toxicity. Use of chemotherapy after the first trimester, while seemingly safe, can cause fetal growth restriction. However, the exact effect of chemotherapy on such fetal growth restriction has not been fully established; information is scarce owing to the rarity of malignancy occurring during pregnancy, the lack of uniform treatment protocols, different terminologies for defining certain fetal growth abnormalities, the influence of mothers’ preferred options, and ethical issues. Herein, we present up-to-date findings from the literature regarding the impact of chemotherapy on fetal growth.

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