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SMJ // Article

Original Article

Association Between Maternal-Perceived Psychological Stress and Fetal Telomere Length

Authors: Hamisu M. Salihu, MD, PhD, Lindsey M. King, MPH, CHES, CCRP, CTTS, Chiaka Nwoga, MPH, CPH, CCRP, Arnut Paothong, PhD, Anupam Pradhan, PhD, Phillip J. Marty, PhD, Rana Daas, BS, Valerie E. Whiteman, MD

Abstract

Objective: Our study aimed to investigate the association between maternal-perceived psychological stress and fetal telomere length.

Methods: We recruited women in labor upon hospital delivery admission. Based on responses to the Perceived Stress Scale, we categorized participants as having “high,” “normal,” or “low” perceived stress. We collected umbilical cord blood samples (N = 71) and isolated genomic DNA from cord blood leukocytes using quantitative polymerase chain reaction. We used a ratio of relative telomere length derived by telomere-to-single-copy gene ratio (T/S ratio). We applied analysis of variance and bootstrapping statistical procedures.

Results: Sixteen (22.5%) women were classified as having low perceived stress, 42 (59.2%) were classified as having normal perceived stress, and 13 (18.3%) were classified as having high perceived stress. Fetal telomere length differed significantly across the three stress groups in a dose–response pattern (T/S ratio of those with low perceived stress was greater than those with normal perceived stress, which was greater than those with high perceived stress [P < 0.05]).

Conclusions: Our findings support our hypothesis that maternalperceived psychological stress during pregnancy is associated with shorter fetal telomere length and suggest maternal stress as a possible marker for early intrauterine programming for accelerated chromosomal aging.

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References

1. Woods SM, Melville JL, Guo Y, et al. Psychosocial stress during pregnancy. Am J Obstet Gynecol 2010;202:e1-e7.
 
2. Norbeck JS, Tilden VP. Life stress, social support, and emotional disequilibrium in complications of pregnancy: a prospective, multivariate study. J Health Soc Behav 1983;24:30-46.
 
3. Mulder EJ, Robles de Medina PG, Huizink AC, et al. Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev 2002;70:3-14.
 
4. Martini J, Knappe S, Beesdo-Baum K, et al. Anxiety disorders before birth and self-perceived distress during pregnancy: associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum Dev 2010;86:305-310.
 
5. Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry 2012;25:141-148.
 
6. O'Donnell TG, Glover V. Prenatal stress and neurodevelopment of the child: focus on the HPA axis and role of the placenta. Dev Neurosci 2009;31:285-292.
 
7. DiPietro J. The role of prenatal maternal stress in child development. Curr Dir Psychol Sci 2004;13:71-74.
 
8. Wright WE, Shay JW. Telomere biology in aging and cancer. J Am Geriatr Soc 2005;53(9 Suppl):S292-S294.
 
9. Frenck RW, Jr Blackburn EH, Shannon KM. The rate of telomere sequence loss in human leukocytes varies with age. Proc Natl Acad Sci USA 1998;95:5607-5610.
 
10. Bojesen SE. Telomeres and human health. J Intern Med 2013;274:399-413.
 
11. Shalev I, Entringer S, Wadhwa PD, et al. Stress and telomere biology: a lifespan perspective. Psychoneuroendocrinology 2013;38:1835-1842.
 
12. Epel ES, Blackburn EH, Lin J, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA 2004;101:17312-17315.
 
13. Savolainen K, Eriksson JG, Kananen L, et al. Associations between early life stress, self-reported traumatic experiences across the lifespan and leukocyte telomere length in elderly adults. Biol Psychol 2014;97:35-42.
 
14. Shalev I, Moffitt TE, Sugden K, et al. Exposure to violence during childhood is associated with telomere erosion from 5 to 10 years of age: a longitudinal study. Mol Psychiatry 2013;18:576-581.
 
15. Entringer S, Epel ES, Lin J, et al. Maternal psychosocial stress during pregnancy is associated with newborn leukocyte telomere length. Am J Obstet Gynecol 2013;208:134.e1-134.e7.
 
16. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385-396.
 
17. Cawthon RM. Telomere measurement by quantitative PCR. Nucleic Acids Res 2002;30:e47.
 
18. Aviv A, Hunt SC, Lin J, et al. Impartial comparative analysis of measurement of leukocyte telomere length/DNA content by Southern blots and qPCR. Nucleic Acids Res 2011;39:e134.
 
19. Drury SS, Theall K, Gleason MM, et al. Telomere length and early severe social deprivation: linking early adversity and cellular aging. Mol Psychiatry 2012;17:719-727.
 
20. Porter S, Rao ST, Ku J, et al. Small sample properties of nonparametric bootstrap confidence intervals. J Air Waste Manage Assoc 1997;47:1197-1203.
 
21. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 2008;40:879-891.
 
22. Efron B. Bootstrap methods: another look at the jackknife. Ann Stat 1979;7:1-26.
 
23. Price LH, Kao HT, Burgers DE, et al. Telomeres and early-life stress: an overview. Biol Psychiatry 2013;73:15-23.
 
24. Entringer S, Epel ES, Kumsta R, et al. Stress exposure in intrauterine life is associated with shorter telomere length in young adulthood. Proc Natl Acad Sci USA 2011;108:E513-E518.
 
25. Kiefer A, Lin J, Blackburn E, et al. Dietary restraint and telomere length in pre- and postmenopausal women. Psychosom Med 2008;70:845-849.
 
26. von Zglinicki T. Oxidative stress shortens telomeres. Trends Biochem Sci 2002;27:339-344.
 
27. Barnes SK, Ozanne SE. Pathways linking the early environment to long-term health and lifespan. Prog Biophys Mol Biol 2011;106:323-336.
 
28. Wadhwa PD. Psychoneuroendocrine processes in human pregnancy influence fetal development and health. Psychoneuroendocrinology 2005;30:724-743.
 
29. Huizink AC, Mulder EJ, Buitelaar JK. Prenatal stress and risk for psychopathology: specific effects or induction of general susceptibility? Psychol Bull 2004;130:115-142.
 
30. Puterman E, Epel E. An intricate dance: life experience, multisystem resiliency, and rate of telomere decline throughout the lifespan. Soc Personal Psychol Compass 2012;6:807-825.
 
31. Epel E, Daubenmier J, Moskowitz JT, et al. Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Ann N Y Acad Sci 2009;1172:34-53.