Sociodemographic factors affecting perceived stress during pregnancy and the association with immune-mediator concentrations

Caroline McLeod; Myla D. Ebeling; John E. Baatz; Judy R. Shary; Jennifer R. Mulligan; Carol L. Wagner

doi:10.1515/jpm-2021-0227

Article

Sociodemographic factors affecting perceived stress during pregnancy and the association with immune-mediator concentrations

Caroline McLeod , Myla D. Ebeling , John E. Baatz , Judy R. Shary , Jennifer R. Mulligan and Carol L. Wagner

Published/Copyright: November 10, 2021

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From the journal Journal of Perinatal Medicine Volume 50 Issue 2

Abstract

Objectives

Determine which sociodemographic factors are most associated with increased maternal perceived stress during pregnancy. Evaluate the association between maternal stress and plasma immune-mediator concentrations (IMCs).

Methods

As part of a prospective, randomized clinical trial, 247 participants completed a Perceived Stress Scale survey (PSS-10) during each trimester of pregnancy. Blood samples were collected from participants and were analyzed for 25-hydroxyvitamin D (25(OH)D) concentration and for several IMCs: interferon-gamma, interleukins (IL-) IL-2, IL-4, IL-5, IL-10, vascular endothelial growth factor, c-reactive protein, and tumor necrosis factor alpha (TNF-α) (R&D Elisa). The potential associations between PSS-10 scores, sociodemographic factors, and IMCs were assessed.

Results

In bivariate analysis, participants who were not married and/or had high risk pregnancies were more likely to have increased PSS-10 scores (p<0.05). Increased PSS-10 scores were associated with higher serum concentrations of IL-2 and TNF-α, and decreased concentrations of IL-10 and 25(OH)D. In linear regression analysis, single marital status, high-risk pregnancy, IL-2, and TNF-α were independent predictors of PSS-10 scores.

Conclusions

This study identifies specific sociodemographic factors that are associated with increased perceived stress during pregnancy. This study also provides evidence that increased perceived stress is associated with physiological changes as measured by changes in circulating IL-2, TNF-α, IL-10, and 25(OH)D concentrations.

Keywords: cytokines; demographics; immune modulators; maternal stress; pregnancy; pregnancy stress; social factors

Corresponding author: Caroline McLeod, BS, College of Medicine, 171 Ashley Ave, MSC 403, Charleston, SC 29425, USA, Phone: +704 984 2621, E-mail: mcleocar@musc.edu

Funding source: W. K. Kellogg Foundation

Award Identifier / Grant number: P3020828

Funding source: South Carolina Clinical & Translational Research Institute (SCTR), MUSC's Clinical and Translational Science Awards Hub

Award Identifier / Grant number: NIH/NCRR UL1TR001450

Acknowledgments

We would like to thank the women who graciously participated in this study, without whom we could not have learned what we did.

Research funding: This original trial from which this analysis was derived was supported, in part, by the W. K. Kellogg Foundation award P3020828 and the South Carolina Clinical & Translational Research Institute (SCTR), MUSC’s Clinical and Translational Science Awards Hub funded by NIH/NCRR Grant Number 1UL1TR001450. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the Kellogg Foundation, NIH, or NCRR.
Author contributions: Using their own language, all authors whose names appear on the submission: (1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The Institutional Review Board at the Medical University of South Carolina (MUSC) approved this study protocol (PRO#0020570). This study was performed in accordance with the Declaration of Helsinki.

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Received: 2021-05-06

Accepted: 2021-10-07

Published Online: 2021-11-10

Published in Print: 2022-02-23

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Articles in the same Issue

https://doi.org/10.1515/jpm-2021-0227

Keywords for this article

cytokines; demographics; immune modulators; maternal stress; pregnancy; pregnancy stress; social factors