title: Immune system function, stress, exercise and nutrition profile can affect pregnancy outcome: Lessons from a Mediterranean cohort.
abstract: Pregnancy is associated with major physiological and future psychosocial changes, and maternal adaptation to these changes is crucial for normal foetal development. Psychological stress in pregnancy predicts an earlier birth and lower birth weight. Pregnancy-specific stress contributes directly to preterm delivery. The importance of nutrition and exercise during pregnancy with regard to pregnancy outcome has long been acknowledged. This importance has only been further emphasized by the recent changes in food quality and availability, lifestyle changes and a new understanding of foetal programming's effects on adult outcomes. We hypothesised that for a successful pregnancy certain events at a nutritional, immune, psycho-emotional and genetic level should be tightly linked. Therefore, in this study we followed an 'integrative' approach to investigate how maternal stress, nutrition, pregnancy planning and exercise influence pregnancy outcome. A key finding of our study is that there was a significant reduction in the intake of alcohol, caffeine-containing and sugary drinks during pregnancy. However, passive smoking in the household remained unchanged. In terms of immune profile, a significant inverse correlation was noted between difficulty to 'fight' an infection and number of colds (r=-0.289, P=0.003) as well as the number of infections (r=-0.446, P<0.0001) during pregnancy. The vast majority of the pregnant women acquired a more sedentary lifestyle in the third trimester. In planned, but not in unplanned, pregnancies stress predicted infant weight, independent of age and body mass index (BMI). Notably, in mothers with negative attitudes towards the pregnancy, those with an unplanned pregnancy gave birth to infants with significantly higher weights than those with planned pregnancies. Collectively these data suggest that there is a higher order of complexity, possibly involving gene-environment interactions that work together to ensure a positive outcome for the mother as well as the foetus.
authors: Centre for Cell and Chromosome Biology, Division of Biosciences, Brunel University, Uxbridge,  UK ;
authors: D
authors: D
authors: Mparmpakas
authors: A
authors: A
authors: Goumenou
authors: E
authors: E
authors: Zachariades
authors: G
authors: G
authors: Pados
authors: Y
authors: Y
authors: Gidron
authors: E
authors: E
authors: Karteris
keywords: birth weight; maternal stress; smoking
references: Am J Clin Nutr. 2004 Aug;80(2):348-56
references: 15277155
references: Food Addit Contam. 2003 Jan;20(1):1-30
references: 12519715
references: Food Funct. 2012 Jan;3(1):30-3
references: 22130653
references: Respir Res. 2011 Jan 10;12:5
references: 21219618
references: Aust Fam Physician. 2011 Jun;40(6):403-7
references: 21655488
references: Epidemiology. 2001 Jan;12(1):38-42
references: 11138817
references: Midwifery. 2009 Aug;25(4):344-56
references: 17935843
references: N Engl J Med. 2000 May 18;342(20):1500-7
references: 10816189
references: Allergy. 2008 Oct;63(10):1310-6
references: 18782109
references: Health Psychol. 2008 Sep;27(5):604-15
references: 18823187
references: Womens Health (Lond). 2008 Nov;4(6):639-56
references: 19072465
references: BMJ Open. 2011 May 12;1(1):e000083
references: 22021755
references: Occup Environ Med. 2004 Dec;61(12):1021-6
references: 15550609
references: Acta Obstet Gynecol Scand. 2007;86(2):161-6
references: 17364278
references: Br J Health Psychol. 2005 May;10(Pt 2):255-68
references: 15969853
references: Br J Nutr. 2009 Sep;102(5):744-9
references: 19243664
references: Hum Reprod Update. 2011 Sep-Oct;17(5):589-604
references: 21747128
references: Am J Obstet Gynecol. 2008 Jan;198(1):7-22
references: 18166297
references: Public Health Nutr. 2009 Feb;12(2):148-55
references: 18503726
references: Am J Clin Nutr. 2010 Sep;92(3):626-33
references: 20592133
references: Lancet. 2010 Apr 24;375(9724):1482-90
references: 20223514
references: Mil Med. 2005 Jan;170(1):38-43
references: 15724852
references: Prim Care. 2009 Mar;36(1):151-65, ix
references: 19231607
references: BJOG. 2009 Feb;116(3):408-15
references: 19187373
references: Sports Med. 2010 Jun 1;40(6):493-507
references: 20524714
references: Arch Gynecol Obstet. 2009 Nov;280(5):695-8
references: 19238414
references: Int J Behav Nutr Phys Act. 2010 Feb 03;7:13
references: 20181084
references: Am J Epidemiol. 1978 Sep;108(3):161-75
references: 707484