Prenatal maternal stress and birth outcomes in rural Ghana: sex-specific associations.
Adult
Birth Weight
Female
Fetal Development
Fetal Growth Retardation
/ epidemiology
Ghana
/ epidemiology
Humans
Infant, Low Birth Weight
Infant, Newborn
Male
Pregnancy
Pregnancy Complications
/ diagnosis
Pregnancy Outcome
/ epidemiology
Prospective Studies
Risk Factors
Sex Factors
Stress, Psychological
/ complications
Birth anthropometrics
Birth outcomes
Negative life events
Prenatal maternal stress
Sex-specific effects
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
29 Oct 2019
29 Oct 2019
Historique:
received:
27
02
2019
accepted:
24
09
2019
entrez:
31
10
2019
pubmed:
31
10
2019
medline:
26
3
2020
Statut:
epublish
Résumé
In developed countries, prenatal maternal stress has been associated with poor fetal growth, however this has not been evaluated in rural sub-Saharan Africa. We evaluated the effect of prenatal maternal stress on fetal growth and birth outcomes in rural Ghana. Leveraging a prospective, rural Ghanaian birth cohort, we ascertained prenatal maternal negative life events, categorized scores as 0-2 (low stress; referent), 3-5 (moderate), and > 5 (high) among 353 pregnant women in the Kintampo North Municipality and Kintampo South District located within the middle belt of Ghana. We employed linear regression to determine associations between prenatal maternal stress and infant birth weight, head circumference, and length. We additionally examined associations between prenatal maternal stress and adverse birth outcome, including low birth weight, small for gestational age, or stillbirth. Effect modification by infant sex was examined. In all children, high prenatal maternal stress was associated with reduced birth length (β = - 0.91, p = 0.04; p-value for trend = 0.04). Among girls, moderate and high prenatal maternal stress was associated with reduced birth weight (β = - 0.16, p = 0.02; β = - 0.18, p = 0.04 respectively; p-value for trend = 0.04) and head circumference (β = - 0.66, p = 0.05; β = - 1.02, p = 0.01 respectively; p-value for trend = 0.01). In girls, high prenatal stress increased odds of any adverse birth outcome (OR 2.41, 95% CI 1.01-5.75; p for interaction = 0.04). Sex-specific analyses did not demonstrate significant effects in boys. All infants, but especially girls, were vulnerable to effects of prenatal maternal stress on birth outcomes. Understanding risk factors for impaired fetal growth may help develop preventative public health strategies. NCT01335490 (prospective registration). Date of Registration: April 14, 2011. Status of Registration: Completed.
Sections du résumé
BACKGROUND
BACKGROUND
In developed countries, prenatal maternal stress has been associated with poor fetal growth, however this has not been evaluated in rural sub-Saharan Africa. We evaluated the effect of prenatal maternal stress on fetal growth and birth outcomes in rural Ghana.
METHODS
METHODS
Leveraging a prospective, rural Ghanaian birth cohort, we ascertained prenatal maternal negative life events, categorized scores as 0-2 (low stress; referent), 3-5 (moderate), and > 5 (high) among 353 pregnant women in the Kintampo North Municipality and Kintampo South District located within the middle belt of Ghana. We employed linear regression to determine associations between prenatal maternal stress and infant birth weight, head circumference, and length. We additionally examined associations between prenatal maternal stress and adverse birth outcome, including low birth weight, small for gestational age, or stillbirth. Effect modification by infant sex was examined.
RESULTS
RESULTS
In all children, high prenatal maternal stress was associated with reduced birth length (β = - 0.91, p = 0.04; p-value for trend = 0.04). Among girls, moderate and high prenatal maternal stress was associated with reduced birth weight (β = - 0.16, p = 0.02; β = - 0.18, p = 0.04 respectively; p-value for trend = 0.04) and head circumference (β = - 0.66, p = 0.05; β = - 1.02, p = 0.01 respectively; p-value for trend = 0.01). In girls, high prenatal stress increased odds of any adverse birth outcome (OR 2.41, 95% CI 1.01-5.75; p for interaction = 0.04). Sex-specific analyses did not demonstrate significant effects in boys.
CONCLUSIONS
CONCLUSIONS
All infants, but especially girls, were vulnerable to effects of prenatal maternal stress on birth outcomes. Understanding risk factors for impaired fetal growth may help develop preventative public health strategies.
TRIAL REGISTRATION
BACKGROUND
NCT01335490 (prospective registration). Date of Registration: April 14, 2011. Status of Registration: Completed.
Identifiants
pubmed: 31664941
doi: 10.1186/s12884-019-2535-9
pii: 10.1186/s12884-019-2535-9
pmc: PMC6819589
doi:
Banques de données
ClinicalTrials.gov
['NCT01335490']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
391Subventions
Organisme : Thrasher Research Fund
ID : Early Career Award
Organisme : FIC NIH HHS
ID : R21 TW010957
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL1353
Pays : United States
Organisme : NIEHS NIH HHS
ID : R01 ES019547
Pays : United States
Organisme : CHEST Foundation
ID : Foundation Grant
Organisme : NIEHS NIH HHS
ID : P30 ES009089
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL135349
Pays : United States
Organisme : NIEHS NIH HHS
ID : K23 ES021471
Pays : United States
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