Feb. 23, 2015
Chronic inflammation, rheumatoid arthritis, autoimmune diseases, and a number of other conditions, can factor in pre-term labor and pre-term delivery.
The first Cafe Scientifique this semester, hosted in Clyde’s Feb. 11, featured Mary Coussons-Read, provost and professor of psychology at UCCS lecturing on “The Psychoneuroimmunology of Pregnancy: Implications for Birth and Human Development.”
Cousson-Read’s research group studied several pregnant women in the Denver area, a group of women with unstable housing situations and food sources, and women who were middle-class or above. These women would experience different stressors during pregnancy due to their socioeconomic statuses.
They studied the effects of stress, distress and major life changes as well as anxiety and depression on pregnancy over a period of 16 years.
“Pregnancy is a balancing act so, not surprisingly, a bunch of stuff changes for women when they are pregnant, besides, you know, having an allograph growing in your belly,” Cousson-Read explained. “A lot of physiological changes occur during gestation.”
Sickness and fever cause the body to have an inflammatory response naturally, but “when women are pregnant, they are less likely to mount an inflammatory response.”
“The body is trying to not reject the fetus as a foreign body. But stress can change this balance to predispose women to a bad outcome,” Cousson-Read explained.
The risk factors Cousson’s lab studied were pre-term labor, pre-term birth and shortened gestational age at birth because of the high rate of mortality and morbidity in infants pre-term and even as early as 37 weeks of gestation.
“They’re still not quite as well developed as when you go all the way to 40 weeks, as it turns out. The longer you stay in the womb, the better off you are.”
11 percent of babies were born pre-term as of 2007, which Cousson-Read indicated is high for a developed country.
Cousson-Read and her research group analyzed cytokines, inflammatory mediators produced by cells of the immune system, specifically, proinflammatories such as interluken 1, interluken 6, and tumor necrosis factor alpha, and anti-inflammatories like interluken 10 using ELIZA assays.
All of these are biological responses to stress, but chronic inflammation can eventually cause tissue damage and loss of tissue function, said Cousson-Read.
Physicians measure C-reactive proteins, which are a downstream indicator that can measure these biological responses.
Women with low levels of anti-inflammatory cytokines, influenced by stress, have a higher likelihood of spontaneous miscarriage. Stressed mothers were more likely to have low birth weight babies and more pregnancy complications such as preeclampsia, hypertension during pregnancy.
“From a developmental standpoint, this is a really big field, there’s a whole field looking at this now,” she said. “Children of stressed pregnancies may have more illnesses as well as behavioral and developmental delays. There’s literature suggesting that children of stressed pregnancies are more likely to have ADD.”
While Cousson-Read recognizes that much of the work is correlational, she argues these studies are not insignificant, “suggesting that stress during pregnancy has long-lasting effects, coming back to that idea of epigenetics.”
Previous studies demonstrated that alterations in nervous system activity, specifically catecholamines and certain neurotransmitters and neuropeptides, endocrine system activity, specifically CRH cortisol and other hormones, and immune system activity, especially anti-inflammatory activity, must be in balance during a healthy pregnancy.
“We were one of the first groups to try to figure out how stress affects pregnancy and what the biological mechanisms for that might be,” Cousson-Read said. “This has been pretty exciting to see this develop.”
Cousson-Read’s group studied the population of lower socioeconomic status women through Planned Parenthood of the Rocky Mountains in Denver. Some were homeless, incarcerated and were experiencing food insecurity.
“This was probably the most high risk group of women we could have possibly found,” she said. “We studied psychological stress, social support, and then we measured in their serum levels of interluken 6, and tumor necrosis factor alpha and interluken 10 during three different places in pregnancy.”
As expected, the study showed a correlation between elevated stress and proinflammatory cytokines. Lack of social support corresponded to low levels of anti-inflammatories.
The second study was a group of extremely high socioeconomic women recruited from the CU-Anschutz medical campus, with excellent prenatal care and planned pregnancies.
Their stress factors were different, such as job loss, a new job, or buying a house, getting married or divorced, but could still be detected in the serum at similar levels.
A follow-up study looked at birth outcomes as well as anti-inflammatory and pro-inflammatory detection, and analyzed the effects of overall stress versus stress directly related to the pregnancy.