title: Prolonged periods without food intake during pregnancy increase risk for elevated maternal corticotropin-releasing hormone concentrations.
abstract: OBJECTIVE
  Fasting during pregnancy stimulates preterm delivery in animals and increases women's risk for preterm delivery. Fasting stimulates hypothalamic corticotropin-releasing hormone production in animals. Elevated maternal corticotropin-releasing hormone concentrations are associated with preterm birth. We hypothesized that prolonged periods without food during pregnancy increase maternal corticotropin-releasing hormone concentrations, which lead to preterm delivery.
  
  
  METHODS
  In the Behavior in Pregnancy Study, we examined prolonged periods without eating during pregnancy and corticotropin-releasing hormone concentrations and gestational age at delivery with multivariate logistic regression analysis (n = 237).
  
  
  RESULTS
  Prolonged periods without food lasting 13 hours or longer were associated with elevated maternal corticotropin-releasing hormone concentrations compared with prolonged periods without food lasting less than 13 hours at two time points during pregnancy, controlling for pregravid body mass index, energy intake, income, race, smoking, and maternal age (18-20 weeks: adjusted odds ratio, 2.5; 95% CI, 0.9-7.1; 28-30 weeks: adjusted odds ratio, 1.7; 95% CI, 0.7-4.2). There was an inverse, linear relationship between maternal corticotropin-releasing hormone concentrations and gestational age at delivery.
  
  
  CONCLUSIONS
  Prolonged periods without food intake during pregnancy are associated with elevated maternal corticotropin-releasing hormone concentrations and with preterm delivery.
authors.affiliation: Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, NC, USA. tracy.herrmann@hsc.utah.edu
authors.forename: T S
authors.initials: TS
authors.lastname: Herrmann
authors.forename: A M
authors.initials: AM
authors.lastname: Siega-Riz
authors.forename: C J
authors.initials: CJ
authors.lastname: Hobel
authors.forename: C
authors.initials: C
authors.lastname: Aurora
authors.forename: C
authors.initials: C
authors.lastname: Dunkel-Schetter
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D003346:Corticotropin-Releasing Hormone / Q000097:blood*; D002149:Energy Intake; D015444:Exercise; D005215:Fasting / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007182:Income; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000209:etiology*; D010298:Parity; D011247:Pregnancy; D044469:Racial Groups; D012307:Risk Factors; D013312:Stress, Physiological; D013997:Time Factors
chemical_list: D003346:Corticotropin-Releasing Hormone