Prenatal maternal stress and birth outcomes in rural Ghana: sex-specific associations

被引：29

作者：

Ae-Ngibise, Kenneth Ayuurebobi ^{[1
,2
]}

Wylie, Blair J. ^{[3
]}

Boamah-Kaali, Ellen ^{[1
]}

Jack, Darby W. ^{[4
]}

Oppong, Felix Boakye ^{[1
]}

Chillrud, Steven N. ^{[5
]}

Gyaase, Stephaney ^{[1
]}

Kaali, Seyram ^{[1
]}

Agyei, Oscar ^{[1
]}

Kinney, Patrick L. ^{[6
]}

Mujtaba, Mohammed ^{[1
]}

Wright, Rosalind J. ^{[7
,8
]}

Asante, Kwaku Poku ^{[1
]}

Lee, Alison G. ^{[9
]}

机构：

[1] Kintampo Hlth Res Ctr, Ghana Hlth Serv, Kintampo, Brong Ahafo Reg, Ghana

[2] Univ Newcastle, Sch Med & Publ Hlth, Callaghan, NSW, Australia

[3] Beth Israel Deaconess Med Ctr, Dept Obstet & Gynecol, Div Maternal Fetal Med, Boston, MA 02215 USA

[4] Columbia Univ, Mailman Sch Publ Hlth, Dept Environm Hlth Sci, New York, NY 10032 USA

[5] Columbia Univ, Lamont Doherty Earth Observ, Palisades, NY USA

[6] Boston Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA USA

[7] Icahn Sch Med Mt Sinai, Dept Environm Med & Publ Hlth, New York, NY 10029 USA

[8] Icahn Sch Med Mt Sinai, Kravis Childrens Hosp, Dept Pediat, New York, NY 10029 USA

[9] Icahn Sch Med Mt Sinai, Div Pulm Crit Care & Sleep Med, 1468 Madison Ave, New York, NY 10029 USA

来源：

BMC PREGNANCY AND CHILDBIRTH | 2019年 / 19卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Negative life events; Prenatal maternal stress; Birth anthropometrics; Birth outcomes; Sex-specific effects; GLUCOCORTICOID EXPOSURE; GESTATIONAL-AGE; FETAL SEX; EXPRESSION; WEIGHT; PREGNANCY; PRETERM; DEXAMETHASONE; VALIDATION; MORTALITY;

D O I：

10.1186/s12884-019-2535-9

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

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: 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: In all children, high prenatal maternal stress was associated with reduced birth length (beta = - 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 (beta = - 0.16, p = 0.02; beta = - 0.18, p = 0.04 respectively; p-value for trend = 0.04) and head circumference (beta = - 0.66, p = 0.05; beta = - 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: 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.

引用

页数：8

共 43 条

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