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Cited by 486Maternal Mental Health During Pregnancy and PostpartumPreterm Birth and ChorioamnionitisInfant Development and Preterm Care

The Contribution of Maternal Stress to Preterm Birth: Issues and Considerations

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Wadhwa, Pathik D., Entringer, Sonja, Buss, Claudia, Lu, Michael C.·2011·Clinics in Perinatology
DOI 10.1016/j.clp.2011.06.007PMC PMC3179976
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Abstract

Preterm birth represents the most significant problem in maternal-child health, with maternal stress identified as a variable of interest. The effects of maternal stress on risk of preterm birth may vary as a function of context. This article focuses on select key issues and questions highlighting the need to develop a better understanding of which particular subgroups of pregnant women may be especially vulnerable to the potentially detrimental effects of maternal stress, and under what circumstances and at which stages of gestation. Issues related to the characterization and assessment of maternal stress and candidate biologic mechanisms are addressed.

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Crossref · 10.1016/j.clp.2011.06.007

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  • Acute glucocorticoid signaling induces adaptive gene expression, whereas chronic exposure often reduces glucocorticoid sensitivity through epigenetic mechanisms.

    “Acute glucocorticoid (GC) signaling induces adaptive gene expression, whereas chronic exposure often reduces glucocorticoid sensitivity through epigenetic mechanisms [30].”

    From Comparative Analysis of HPA-Axis Dysregulation and Dynamic Molecular Mechanisms in Acute Versus Chronic Social Defeat Stress (2025) · cites this paper as [30]

    Section 7 (page not provided) says chronic or repeated stress may dysregulate HPA responses through down-regulation of glucocorticoid receptors. It separately suggests that stress exposure during early development may cause epigenetic changes in the glucocorticoid receptor gene. It does not link chronic exposure to reduced sensitivity through epigenetic mechanisms or describe acute signaling as inducing adaptive gene expression. (LLM, conf=0.86)

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  • Psychological factors appear to be important predictors of PTB that are potentially modifiable.

    “Psychological factors appear to be important predictors [9] [1, 10, 11] that are potentially modifiable.”

    From The mastery lifestyle intervention to reduce biopsychosocial risks for pregnant Latinas and African Americans and their infants: protocol for a randomized controlled trial (2022) · cites this paper as [11]

    Section 3.2 says pregnancy-specific anxiety measures seem to be stronger predictors of preterm birth risk than general anxiety measures, and Section 2 reports increased risk among women with high psychosocial stress. The paper discusses developing future prevention interventions, but does not establish that the psychological predictors themselves are modifiable. No page numbers were provided in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • The placenta can receive, process, and respond to certain stimuli, and thus may act as the central nervous system in the stress response.

    “Wadhwa [11, 18] states that the placenta can receive, process, and respond to certain stimuli, and thus may act as the central nervous system in the stress response.”

    From The mastery lifestyle intervention to reduce biopsychosocial risks for pregnant Latinas and African Americans and their infants: protocol for a randomized controlled trial (2022) · cites this paper as [11]

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Research works printed but not linked: 2

  1. [22]Institute of Medicine Committee on Understanding Premature Birth and Assuring Healthy Outcomes, Board on Health Sciences Policy Preterm birth: Causes, consequences, and prevention Washington DC The National Academies Press 2007
  2. [168]Huneke B Ude C Uteroplacental and fetal arterial Ultrasound Doppler Flow Velocity measurements in unselected pregnancies as a screening test at 32 to 34 gestational weeks Z Geburtshilfe Neonatol Apr 2002 206 2 57 64 12015636

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Authors
Wadhwa, P. D., Entringer, S., Buss, C., & Lu, M. C.
Affiliations
  • University of California, Irvine (US)
  • University of California, Los Angeles (US)
Corresponding author
Wadhwa, Pathik D.
ORCID
Venue
Clinics in Perinatology
Publisher
Elsevier BV
Published
2011-09
Volume
38
Issue
3
Pages
351-384
ISSN
0095-5108 (ISSN-L)
DOI
10.1016/j.clp.2011.06.007
PMC
PMC3179976
OpenAlex
W1980122541
Cited by
486
References
258
Citations by year
2026: 29 · 2025: 35 · 2024: 34 · 2023: 39 · 2022: 34 · 2021: 37 · 2020: 88 · 2019: 37 · 2018: 24 · 2017: 22 · 2016: 29 · 2015: 21 · 2014: 22 · 2013: 23 · 2012: 11
FWCI
2.81
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinics in Perinatology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (R01MH091351)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD065825, R01HD060628, P01HD047609)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Keywords
maternal stress, preterm birth, preterm labor, pregnancy, stress measurement, vulnerable subgroups, pregnancy stage, biological mechanisms, maternal and child health
MeSH terms
Female, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Obstetric Labor, Premature, Mothers, Pregnancy, Pregnancy Complications, Stress, Psychological, United States, Premature Birth

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