New Research In
Physical Sciences
Social Sciences
Featured Portals
Articles by Topic
Biological Sciences
Featured Portals
Articles by Topic
- Agricultural Sciences
- Anthropology
- Applied Biological Sciences
- Biochemistry
- Biophysics and Computational Biology
- Cell Biology
- Developmental Biology
- Ecology
- Environmental Sciences
- Evolution
- Genetics
- Immunology and Inflammation
- Medical Sciences
- Microbiology
- Neuroscience
- Pharmacology
- Physiology
- Plant Biology
- Population Biology
- Psychological and Cognitive Sciences
- Sustainability Science
- Systems Biology
Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes
Edited by Bruce S. McEwen, Rockefeller University, New York, NY, and approved September 18, 2019 (received for review April 16, 2019)

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Significance
Despite decades of prenatal programming research showing that “the womb may be more important than the home” with respect to offspring health outcomes, no studies of which we are aware have considered multiple indicators of maternal stress to identify the types of maternal stress that most influence developing offspring. This study’s key contributions include the use of a data-driven procedure to specify types of maternal stress—psychological and subclinical physical health indicators—that predict offspring outcomes including sex at birth, risk of preterm birth, and fetal neurodevelopment. Social support is a key factor differentiating the stress groups and a malleable intervention target to improve offspring outcomes.
Abstract
Maternal prenatal stress influences offspring neurodevelopment and birth outcomes including the ratio of males to females born; however, there is limited understanding of what types of stress matter, and for whom. Using a data-driven approach with 27 variables from questionnaires, ambulatory diaries, and physical assessments collected early in the singleton pregnancies of 187 women, 3 latent profiles of maternal prenatal stress emerged that were differentially associated with sex at birth, birth outcomes, and fetal neurodevelopment. Most women (66.8%) were in the healthy group (HG); 17.1% were in the psychologically stressed group (PSYG), evidencing clinically meaningful elevations in perceived stress, depression, and anxiety; and 16% were in the physically stressed group (PHSG) with relatively higher ambulatory blood pressure and increased caloric intake. The population normative male:female secondary sex ratio (105:100) was lower in the PSYG (2:3) and PHSG (4:9), and higher in the HG (23:18), consistent with research showing diminished male births in maternal stress contexts. PHSG versus HG infants were born 1.5 wk earlier (P < 0.05) with 22% compared to 5% born preterm. PHSG versus HG fetuses had decreased fetal heart rate–movement coupling (P < 0.05), which may indicate slower central nervous system development, and PSYG versus PHSG fetuses had more birth complications, consistent with previous findings among offspring of women with psychiatric illness. Social support most strongly differentiated the HG, PSYG, and PHSG groups, and higher social support was associated with increased odds of male versus female births. Stress phenotypes in pregnant women are associated with male vulnerability and poor fetal outcomes.
Footnotes
- ↵1To whom correspondence may be addressed. Email: cem31{at}cumc.columbia.edu.
Author contributions: B.T., F.A.C., and C.M. designed research; C.A.M., H.S.K., S.M.O., E.A.W., G.L., and C.M. performed research; K.W., A.P., S.L., and T.F. analyzed data; and K.W., C.A.M., R.W., and C.M. wrote the paper.
The authors declare no competing interest.
This article is a PNAS Direct Submission.
See Commentary on page 23877.
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1905890116/-/DCSupplemental.
Published under the PNAS license.
Log in using your username and password
Purchase access
Subscribers, for more details, please visit our Subscriptions FAQ.
Please click here to log into the PNAS submission website.
Citation Manager Formats
Sign up for Article Alerts
Article Classifications
- Social Sciences
- Psychological and Cognitive Sciences
See related content: