Childhood adversity impact on gut microbiota and inflammatory response to stress during pregnancy
Open accessAbstract
Background Adverse childhood experiences (ACEs), such as abuse or chronic stress, program an exaggerated adult inflammatory response to stress. Emerging rodent research suggests that the gut microbiome may be a key mediator in the association between early life stress and dysregulated glucocorticoid-immune response. However, ACE impact on inflammatory response to stress, or on the gut microbiome, have not been studied in human pregnancy, when inflammation increases risk of poor outcomes. The aim of this study was to assess the relationships among ACE, the gut microbiome, and cytokine response to stress in pregnant women.Methods Physically and psychiatrically healthy adult pregnant women completed the Adverse Childhood Experiences Questionnaire (ACE-Q) and gave a single stool sample between 20 and 26 weeks gestation. Stool DNA was isolated and 16S sequencing was performed. Three 24-hour food recalls were administered to assess dietary nutrient intake. A subset of women completed the Trier Social Stress Test (TSST) at 22-34 weeks gestation; plasma interleukin-6 (IL-6), interleukin-1β (IL-1β), high sensitivity C-reactive protein (hsCRP), tumor necrosis factor α (TNF-α), and cortisol were measured at four timepoints pre and post stressor, and area under the curve (AUC) was calculated.Results Forty-eight women completed the ACE-Q and provided stool; 19 women completed the TSST. Women reporting 2 or more ACEs (high ACE) had greater differential abundance of gut Prevotella than low ACE participants (q = 5.7 × 10^-13). Abundance of several gut taxa were significantly associated with cortisol, IL-6, TNF-α and CRP AUCs regardless of ACE status. IL-6 response to stress was buffered among high ACE women with high intake of docosahexaenoic acid (DHA) (p = 0.03) and eicosapentaenoic acid (EPA) (p = 0.05).Discussion Our findings suggest that multiple childhood adversities are associated with changes in gut microbiota composition during pregnancy, and such changes may contribute to altered inflammatory and glucocorticoid response to stress. While preliminary, this is the first study to demonstrate an association between gut microbiota and acute glucocorticoid-immune response to stress in a clinical sample. Finally, exploratory analyses suggested that high ACE women with high dietary intake of ω-3 polyunsaturated fatty acids (PUFAs) had a dampened inflammatory response to acute stress, suggesting potentially protective effects of ω-3s in this high-risk population. Given the adverse effects of inflammation on pregnancy and the developing fetus, mechanisms by which childhood adversity influence the gut-brain axis and potential protective factors such as diet should be further explored.
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Maternal stress during pregnancy is associated with a distinct fecal microbiota profile.
“In addition, maternal stress during pregnancy display a distinct fecal microbiota profile (Hantsoo et al., 2019;Hechler et al., 2019), that has generational consequences.”
From The Microbiota-Gut-Brain Axis (2019) · cites this paper as Hantsoo et al., 2019
The Results (Gut Microbiome) report higher fecal Prevotella abundance in pregnant women with multiple adverse childhood experiences, supporting an association between earlier stress and a microbiota difference measured during pregnancy. But the exposure was childhood adversity, not maternal stress during pregnancy, and the study found no overall differences in microbiota diversity or community composition between groups. (LLM, conf=0.87)
Experimental — accuracy not yet measuredOther factors, such as epimutations, fetal reprogramming, and gut microbiome transfer, may induce intergenerational phenotypic changes.
“Importantly, in addition to epigenetic modifications, other factors, such as epimutations (an mutation occur at the epigenetic level), fetal reprogramming (266), and even gut microbiome transfer (267) may induce intergenerational phenotypic changes.”
From Epigenetic Modifications in Stress Response Genes Associated With Childhood Trauma (2019) · cites this paper as [267]
The Conclusions report that childhood adversity was associated with differences in pregnant women’s gut microbiota, but do not address microbiome transfer or intergenerational phenotypic changes. Searches for maternal-to-offspring microbial transmission, microbiota transfer, and intergenerational effects found no passage establishing the point attributed to citation 267. (LLM, conf=0.74)
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Biomarkers of inflammation and placental dysfunction are associated with subsequent preterm birth
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Self-citationPreadolescent Adversity Programs a Disrupted Maternal Stress Reactivity in Humans and Mice
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Self-citationAttachment security moderates the link between adverse childhood experiences and cellular aging
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Flagged first, then by citations
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- Authors
- Hantsoo, L., Jašarević, E., Criniti, S., McGeehan, B., Tanes, C., Sammel, M. D., Elovitz, M. A., Compher, C., Wu, G., & Epperson, C. N.
- Affiliations
- University of Pennsylvania (US)
- University of Maryland, Baltimore (US)
- Children's Hospital of Philadelphia (US)
- Corresponding author
- Hantsoo, Liisa
- ORCID
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 75
- Pages
- 240-250
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC6349044
- OpenAlex
- W2898944101
- Cited by
- 156
- References
- 102
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 23 · 2023: 24 · 2022: 21 · 2021: 26 · 2020: 22 · 2019: 12
- FWCI
- 5.33
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Pennsylvania Health System
- National Institute of Mental Health (P50MH099910, K23MH107831)
- National Institute of Nursing Research (R01NR014784)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD085848)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- adverse childhood experiences, gut microbiota, pregnancy, cytokines, interleukin-6, omega-3 polyunsaturated fatty acids, docosahexaenoic acid, eicosapentaenoic acid, dietary intake, Prevotella, cortisol, C-reactive protein, Trier Social Stress Test, early life stress
- MeSH terms
- Gastrointestinal Microbiome, Adverse Childhood Experiences, Adult, C-Reactive Protein, Diet, Fatty Acids, Unsaturated, Feces, Female, Humans, Hydrocortisone, Inflammation, Pregnancy, RNA, Ribosomal, 16S, Stress, Psychological, Tumor Necrosis Factor-alpha, Fatty Acids, Omega-3, Interleukin-6, Cytokines, Interleukin-1beta
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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