Beyond Prenatal Stress: Prenatal Obesity and Inflammation and Child Health

• In Event: 1-021 - Maternal Obesity and Nutrition during Pregnancy: Effects on Offspring Neurobehavioral Development

Integrative Statement

Introduction: An emerging research paradigm for studying child psychological and physical health is the developmental origins hypothesis, which proposes that in utero exposures may set or program biological (e.g., stress, metabolic) systems in the fetus, with long-term implications for health. Maternal stress or anxiety is one of the most studied exposures for child behavioral and mental health, but recent research suggests that it may be confounded with other common prenatal exposures, which may also have significant impact on child physical and mental health. Prenatal obesity and inflammation are two such prenatal exposures that have an established link with neurodevelopment in the developmental origins literature using animal models; their associations with child health are now a topic of wide-spread interest.

Methods: Data for the current proposal derive from several prospective longitudinal studies with extensive prenatal assessment of maternal health, biological samples, and obstetric and child outcomes. The first study, which followed 120 high psychosocial risk but medically normal risk women for approximately 2 years, collected detailed data on maternal health, nutrition, and immunity throughout the perinatal period. The second study, which followed 210 women, collected extensive data on psychological symptoms, physical health, and stress physiology in pregnancy; children were assessed through 17 months of age. The third study is following a sample of 290 women and has collected extensive data on nutrition, stress, and immune health in pregnant mothers; data on child outcomes are so far available through 6 months (this is an ongoing study; data through 12 months will be available by March 2019). All studies include extensive data on perinatal (e.g., smoking) and obstetric (e.g., low birth weight) risks, which are adjusted for in analyses.

Results: We present a summary of the results across studies to illustrate an expanded model of prenatal maternal health, prenatal exposures and child health and development. One set of data analyses underscore the confounded nature of inflammation, early and current life stress, health behaviors and nutrition, especially obesity, in maternal prenatal health. For example, interleukin(IL)-6 in pregnancy, a marker of inflammation, was associated with maternal BMI (r’s = .45** and .37** in mid- and late pregnancy, respectively), age at first pregnancy (r = -.20*), sleep quality (r = -.22*), and socio-demographic risk, indexed by educational status (r = -.21*). In addition, maternal obesity was significantly associated with prenatal maternal stress physiology, indexed by diurnal cortisol (r -.20*). Preliminary findings from the third ongoing study indicate that maternal obesity and inflammation in pregnancy are associated with early markers of child cognitive development, based on the Bayley scales.

Conclusions: The findings both support and expand the developmental origins hypothesis in suggesting that the prenatal predictors of child physical and mental health outcomes are substantially confounded, and that maternal life-course history and nutrition and health behaviors in pregnancy may have collective influence on child neurodevelopment.

Authors

• Thomas O'Connor, University of Rochester
  Presenting Author

• Ana Vallejo Sefair, University of Rochester Medical Center
  Non-Presenting Author