title: Ambulatory assessments of psychological and peripheral stress-markers predict birth outcomes in teen pregnancy.
abstract: OBJECTIVE
  Pregnant adolescents have high rates of poor birth outcomes, but the causes are unclear. We present a prospective, longitudinal study of pregnant adolescents assessing associations between maternal psychobiological stress indices and offspring gestational age at birth and birthweight.
  
  
  METHODS
  Healthy nulliparous pregnant adolescents were recruited (n=205) and followed during pregnancy. Ambulatory assessments over 24h of perceived psychological stress (collected every 30 min) and salivary cortisol (6 samples) and a summary questionnaire, the Perceived Stress Scale, were collected at three time points (13-16, 24-27, and 34-37 gestational weeks). Corticotropin-releasing hormone, C-reactive protein, and interleukin 6 were assayed from blood taken at the latter 2 sessions. A final sample of 119 participants was selected for analyses.
  
  
  RESULTS
  The ambulatory assessment of perceived psychological stress was positively correlated with the Perceived Stress Scale (r=.20, p=.03) but neither was associated with any of the biological assays (all ps>.20). Based on backward selection regression models that included all stress variables and relevant covariates, the ambulatory assessments of perceived psychological stress and cortisol - though not the Perceived Stress Scale - were negatively associated with gestational age at birth (F(4, 107)=3.38, p=.01) while cortisol was negatively related to birthweight (F(5, 107)=14.83, p<.0001).
  
  
  CONCLUSIONS
  Targeted interventions to reduce psychological and biological indicators of heightened stress during pregnancy may have positive public health benefits for the offspring given the associations of shortened gestation and lower birthweight with risk for poor mental and physical health outcomes.
authors.affiliation: Department of Psychiatry, Columbia University Medical Center, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Spicer
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Werner
authors.forename: Yihong
authors.initials: Y
authors.lastname: Zhao
authors.forename: Chien Wen
authors.initials: CW
authors.lastname: Choi
authors.forename: Sara
authors.initials: S
authors.lastname: Lopez-Pintado
authors.forename: Tianshu
authors.initials: T
authors.lastname: Feng
authors.forename: Margaret
authors.initials: M
authors.lastname: Altemus
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gyamfi
authors.forename: Catherine
authors.initials: C
authors.lastname: Monk
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D015415:Biomarkers / Q000097:blood / Q000378:metabolism*; D001724:Birth Weight; D002097:C-Reactive Protein / Q000378:metabolism; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism / Q000523:psychology; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence / Q000097:blood* / Q000523:psychology*; D011446:Prospective Studies; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000378:metabolism* / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone
keywords: Adolescence; Birthweight; Cortisol; Gestational age at birth; Pregnancy; Stress