title: Maternal psychological distress, prenatal cortisol, and fetal weight.
abstract: OBJECTIVE
  The objective of this study was to examine the effects of maternal psychological distress on estimated fetal weight during midgestation and explore the maternal hypothalamic-pituitary axis and sympathoadrenal dysregulation as potential risk factors for these effects.
  
  
  METHODS
  Fetal ultrasound biometry measurements and maternal sociodemographic characteristics, emotional distress symptoms, and first morning urine samples were collected during a clinical ultrasound examination for a cross-sectional sample of 98 women who were between 16 and 29 weeks pregnant. Fetal weight was estimated from ultrasound biometry measurements; maternal emotional distress was assessed using the daily hassles (stress), Center for Epidemiologic Studies-Depression (depression), and State-Trait Anxiety Inventory (anxiety) scales; and urine samples were assayed for cortisol and norepinephrine levels.
  
  
  RESULTS
  Correlation analyses revealed that both maternal psychological (daily hassles, depression, and anxiety) and biochemical (cortisol and norepinephrine) variables were negatively related to fetal biometry measurements and estimated fetal weight. A structural equation model further revealed that when the independent variance of maternal sociodemographic, psychological distress, and biochemistry measures were accounted for, prenatal cortisol was the only significant predictor of fetal weight.
  
  
  CONCLUSIONS
  Women exhibiting psychological distress during pregnancy exhibit elevated cortisol levels during midgestation that are in turn related to lower fetal weight.
authors.affiliation: Touch Research Institutes, Department of Pediatrics, University of Miami School of Medicine, P.O. Box 016820, Miami, FL 33101, USA. mdiego@med.miami.edu
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Diego
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Jones
authors.forename: Tiffany
authors.initials: T
authors.lastname: Field
authors.forename: Maria
authors.initials: M
authors.lastname: Hernandez-Reif
authors.forename: Saul
authors.initials: S
authors.lastname: Schanberg
authors.forename: Cynthia
authors.initials: C
authors.lastname: Kuhn
authors.forename: Adolfo
authors.initials: A
authors.lastname: Gonzalez-Garcia
mesh_terms: D000328:Adult; D000886:Anthropometry; D001007:Anxiety / Q000453:epidemiology / Q000652:urine; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000652:urine; D004644:Emotions; D005260:Female; D047109:Fetal Development; D005333:Fetus / Q000502:physiology*; D005431:Florida; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D009638:Norepinephrine / Q000652:urine*; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000523:psychology / Q000652:urine; D011262:Pregnancy Trimester, Second; D011581:Psychological Tests; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology* / Q000652:urine; D011795:Surveys and Questionnaires; D016216:Ultrasonography, Prenatal
chemical_list: D006854:Hydrocortisone; D009638:Norepinephrine