Maternal chronic stress correlates with serum levels of cortisol,
glucose and C-peptide in the fetus, and maternal non chronic stress with
fetal growth
Introduction: During pregnancy, maternal stressors cause changes in both
maternal and fetal HPA axes. We therefore investigated the impact of
maternal non chronic and chronic stress on fetal glucose metabolism and
growth, and serum levels of cortisol in the fetus.
Materials and methods: Normal weight pregnant women (n = 192; mean +/-
SD 27.9 +/- 4.2 years old, and; 26.9 +/- 2.4 kg/m(2)) were assessed
during the 2nd and 3rd trimester with anthropometry, fetal ultrasound,
blood samples for serum CRH, cortisol and IL6, and STAI trait and state
stress questionnaires. We measured serum cortisol, insulin and
c-peptide, and plasma glucose from cord blood. Neonates underwent
anthropometry at the 3rd post-delivery day.
Results: In both 2nd and 3rd trimesters, women with STAI trait scores >=
40 had significantly greater levels of fasting serum CRH and cortisol
than those with STAI trait scores < 40.
2nd trimester: STAI trait scores correlated positively with cord blood
glucose and c-peptide. Maternal serum CRH correlated negatively with U/S
fetal biparietal head diameter, while serum cortisol correlated
positively with abdominal circumference. Maternal serum IL6, CRH and
cortisol all correlated positively with birth waist circumference.
3rd trimester: Women with STAI state scores >= 40 had fetuses with
larger U/S abdominal and smaller head circumferences compared to those
of women with STAI scores< 40. Women with STAI trait scores >= 40 had
greater levels of cord blood cortisol, glucose, and c-peptide compared
to women with STAI scores< 40. STAI state scores >= 40 correlated
positively with maternal CRH and U/S fetal abdominal circumference, and
negatively with fetal head circumference and biparietal diameter. STAI
trait scores correlated positively with cord blood c-peptide, glucose,
insulin and cortisol. Maternal serum levels of CRH correlated positively
with U/S fetal abdominal circumference and cord blood cortisol, and
negatively with fetal head circumference and biparietal head diameter.
Maternal serum levels of both CRH and cortisol correlated positively
with cord blood c-peptide, glucose, and insulin. STAI trait was the best
positive predictor of cord blood cortisol, glucose and c-peptide, whilst
STAI state was the best positive and negative predictor, respectively of
fetal abdominal circumference and fetal head circumference or biparietal
diameter.
Conclusions: Increased maternal chronic stress (reflected by the STAI
trait score) associates with increased fetal cortisol, glucose,
c-peptide secretion and thus, insulin resistance. Maternal non chronic
stress (STAI state) in the 3rd trimester associates with changes in
fetal growth pattern, including increased and decreased measurements of
fetal abdominal and head growth respectively