Lecture 9: Peri and post-natal stress Flashcards
Examples of pre-natal stress?
depressive symptoms, anxiety, work stress, unemployment, relationship issues, death of the spouse or another family member, lack of social support, nutritional deficiencies, infections and illnesses, and natural disasters
What is pre-natal stress?
Stress that is happening to the mother during pregnancy
What is fetal programming?
Influences during a sensitive developmental period that affect the development of specific tissues that produce effects which persist throughout life like cytokines, cortisol can affect the baby
How can cortisol be activated?
The enzyme 11 beta can be influenced by physiological changes, 11beta-HSD1 enzyme can catalyze the interconversion of inactive cortisone to active cortisol
What are epigenetics?
The influence of early life experience on activating certain genes, which means that events from the first trimester will have larger consequences than from the second and third trimester
Barker hypothesis (DoHaD hypothesis
growth retardation, low birth weight, and premature birth have a causal relationship to the origins of hypertension, coronary heart disease, and non-insulin-dependent diabetes, in middle age.
Hunger winter hypothesis
Those who were starved in the hunger winter were followed in a long-term study. Starvation during the first trimester gave the most impact later in life, resulting in more diabetes, adverse lipids, obesity, stress sensitivity, CHD and cancer
What was the method of the ABCD study?
Involved prenatal screening so taking blood from pregnant women around 10-12 weeks in, this is then linked to postnatal data through the municipality about their pregnancy outcome. Questionnaires are given during the pregnancy and after the pregnancy
What is seen as an important limitation of the study?
Cortisol, but the levels are seen to change throughout the day, so should have been measured but cortisol was only measured at the time of data collection?
What did results find from this study?
Even after adjusted for depressive symptoms, the effect sizes do not change-> depressive symptoms do not influence the relationship btw maternal cortisol and term birthweight. On the population level the risk of low birthweight increased with cortisol but mixed results on the individual level
What did another study about working conditions and birthweight find?
Adjusted for a lot of factors especially smoking as those with bad working conditions were more likely to smoke. Results found that a combination of 32 working hours and high job strain significantly decreased the birthweight of their child, creating a negative impact as large as smoking (can decrease birthweight by 150g)
Whare are the consequences of decreased levels of folic acid?
Can increase the risk of diabetes-associated congenital disabilities and autism, risk of childhood leukemia
What was an important factor for preventive interventions?
Knowing the language-> knowing Dutch increased folic acid intake, as those from other ethnicities do not know the language and less likely to go to hospitals for screening as there is less info on the healthcare system
What was found about blood pressure and experiencing stress?
Cumulative stress increased systolic blood pressure and diastolic blood pressure by 1.5mmHg. A relationship between cortisol and fat mass index in women, but no large effects were found at 5-6. No association found between the autonomic nervous system activation and the accumulation of stress, no mediation of fetal growth retardation or shorter gestational age
What was the aim of the ABCD study?
To contribute to knowledge on early life factors related to optimal child development and health
Increase awareness of socioeconomic and ethnic inequalities in health at birth and later in life
To contribute to prevention programs to decrease inequalities in health
