Effects of prenatal psychosocial stress on pregnancy outcomes and physical and neurobehavioral development in infancy with gender-difference

• Main Authors: Hui Li, Ning Jia, Qian Su, Zhongliang Zhu, Xiang Liu, Monesh Kumar Sungkur, Samjida Majeed Padari, Yanyan Zhang, Li Yang, Guokui Tang
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2012-09-01
• Series: European Journal of Psychotraumatology
• Subjects: prenatal psychosocial stress; infant; birth weight; head circumference; NBNA

Statement of the problem : Previous animal experiments suggest that prenatal stress affects pregnancy outcomes and impairs cognitive functions of offspring. Our goal was to investigate how prenatal exposure to stressful life events influence pregnancy outcome and infant's physical and neurobehavioral development. Methods : A clinical trial was performed. One thousand eight hundred and fifty-six pregnant women were willingly assessed using the Life Events Scale for Pregnant Women (LESPW) before delivery. Those whose score were more than or equal to 375 on LESPW were assigned to higher levels of psychological stress during pregnancy. One hundred and forty-two cases were selected from 1856 pregnant women controlling for variables such as gestational age, maternal age, obstetric complications, socioeconomic status, and trait anxiety. The prenatal stress (PNS) group and the control (CON) group were composed of 71 full-term infants each (1:1 pair matched). Infants’ birth weight (BW) and head circumference (HC) from both groups were assessed at birth and the neonatal neurobehavioral development was evaluated at 72 hours using the neonatal behavioral neurological assessment (NBNA). Results : Three hundred and twenty-seven cases from 1856 scored more than 375 on LESPW, incidence of stress was 17.62%. The proportion of undesirable pregnancy outcomes from 327 cases were 147 cases (44.95%), with threatened abortion 38 (11.62%), premature delivery 31 (9.48%), pregnancy complications 73 (22.32%), stillbirth 5 (1.53%), and low birth weight infants 120 (36.7%). The pregnancy outcomes of the non-stressed 1529 cases were undesirable in 579 cases (37.87%), with threatened abortion 123 (8.04%), premature delivery without cause 208 (13.6%), pregnancy complications 240 (15.70%), stillbirth 8 (0.52%), and low birth weight infants 159 (10.4%). BW, HC and the score of NBNA of full-term infants in the PNS were lower than those of the CON (P < 0.05). The score of NBNA of boys was significantly lower with no change in BW and HC in the PNS, and BW and HC of the girls were lower compared to boys in the PNS (P<0.05). There were no significant differences in BW, HC, and NBNA between the boys and girls in the CON. Conclusion : Pregnant women with stress were at increased risk of adverse pregnancy outcome, low birth weight infants in high levels of maternal psychosocial stress were significantly higher than that of premature birth. This shows us that PNS can induce fetal intrauterine growth retardation, and influence newborn's physical and neurobehavioral development, especially in newborn girls.