Publications by authors named "Lisa M Christian"

57 Publications

Impaired vasodilation in pregnant African Americans: Preliminary evidence of potential antecedents and consequences.

Psychophysiology 2021 Jan 11;58(1):e13699. Epub 2020 Oct 11.

Department of Psychological Science, The University of California Irvine, Irvine, CA, USA.

Significant health disparities exist between African Americans (AA) and European Americans (EA) in hypertension and hypertension-related disorders. Evidence suggests that this is due to impaired vasodilation in AAs. Pregnancy is a potent systemic vasodilatory state. However, differences in vasodilation between AAs and EAs have not been investigated in pregnancy. We sought to examine the effects of pregnancy on vasodilation in AA and EA women and how this might be related to discrimination and low birth weight in their offspring. Hemodynamics [blood pressure (MAP), cardiac output (CO), total peripheral resistance (TPR)] and heart rate variability (HF-HRV) were examined at baseline in 40 pregnant AAs (n = 20) and EAs (n = 20) and matched nonpregnant women (n = 40). The Experiences of Discrimination scale and birth weight were also measured in the offspring of the pregnant participants. Whereas pregnancy was associated with decreased MAP independent of race, AAs showed impaired vasodilation independent of pregnancy status as indicated by greater TPR despite greater HF-HRV. In AAs, but not EAs, reports of fewer incidences of discrimination were associated with greater TPR. Finally, the HF-HRV of EA mothers was inversely related to the birth weight of their offspring but was uncorrelated in AAs. We report novel evidence of impaired vasodilation to an endogenous vasodilatory stimulus in AAs. Higher TPR was related to discrimination in AAs and higher HF-HRV was related to low birth weight in EAs. These findings have implications for understanding the intergenerational transmission of impaired vasodilation in AAs.
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http://dx.doi.org/10.1111/psyp.13699DOI Listing
January 2021

Sleep disturbances and inflammatory gene expression among pregnant women: Differential responses by race.

Brain Behav Immun 2020 08 28;88:654-660. Epub 2020 Apr 28.

Department of Psychiatry & Behavioral Health and The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Excessive inflammation in pregnancy predicts adverse birth outcomes, including shortened gestational length and lower birthweight, with African American women at greater risk. As substantial racial disparities in sleep quality, and evidence that African Americans have increased vulnerability for sleep-induced inflammatory dysregulation, sleep may be a critical, modifiable health behavior that contributes to racial disparities in birth outcomes. The present study examined sleep disturbance as a predictor of genome-wide transcriptome profiles of peripheral blood samples from 103 pregnant women (33 African American, 70 white) assessed at 18.7 ± 7.2 weeks gestation. We hypothesized that pregnant women with significant sleep disturbances would have gene expression profiles indicating over-expression of inflammatory pathways, with greater effects among African American compared to white women. Promoter-based bioinformatics analyses of differentially expressed genes indicated greater activation of NF-кB, AP1, and CREB transcription factors among African American women with sleep disturbances (all p < 0.05), and enhanced activation of AP1, but not NF-кB and reduced CREB activity among white women with sleep disturbances (p < 0.05). Differences in glucocorticoid receptor (GR) activity were also observed, in which African American women with sleep disturbances had reduced GR activity (p < 0.05), but white women with sleep disturbances showed a trend for enhanced GR activity (p = 0.11). Similarly, Interferon Response Factor (IRF) activity was reduced in African American women while increased in white women with sleep disturbances (p < 0.05). The current study provides novel evidence for gene expression related to inflammation, glucocorticoids, and anti-viral immunity among pregnant women with sleep disturbances, with differential effects by race. African Americans showed greater breadth and magnitude in these proinflammatory and anti-viral pathways than whites, with divergence in anti-inflammatory glucocorticoid, proinflammatory adrenergic-mediated cAMP, and anti-viral interferon responses. These data elucidate the role of sleep disturbances in intracellular inflammatory and anti-viral immunity in pregnancy and provide a potential target for intervention.
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http://dx.doi.org/10.1016/j.bbi.2020.04.065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526416PMC
August 2020

Early adversity and the regulation of gene expression: Implications for prenatal health.

Curr Opin Behav Sci 2019 Aug 29;28:111-118. Epub 2019 Mar 29.

Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH.

Early life, including prenatal development and childhood, is a period of sensitivity, with potential for developmental programming under conditions of adversity. The intergenerational effects of early adversity have received attention, most often studied in relation to fetal development according to maternal exposures. Less often considered but critically important is the effect of early adversity on future prenatal risk (e.g., risk for preeclampsia, preterm birth), which threatens the health of mother and infant. The body's ability to turn collections of genes "on" or "off" across a range of tissues via receptor-driven transcription factors and epigenetic mechanisms (i.e., chemical modifications to the genome) in response to the perceived environment may help to explain such associations. This review aims to summarize discoveries surrounding the effects of early adversity on gene expression, emphasizing prenatal populations. First, we review findings from gene expression studies examining the effects of early adversity on various tissues known to contribute to prenatal health in adulthood. Next, we review several gene regulatory mechanisms thought to underlie differences in gene expression. Finally, we discuss potential implications for prenatal risk among early adversity-exposed mothers according to our current understanding of the biology that contributes to the development of prenatal syndromes.
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http://dx.doi.org/10.1016/j.cobeha.2019.02.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6897329PMC
August 2019

The gut microbiome and mental health: Taking baby steps.

Authors:
Lisa M Christian

Brain Behav Immun 2019 10 5;81:22-23. Epub 2019 Aug 5.

The Department of Psychiatry & Behavioral Health and The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, United States.

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http://dx.doi.org/10.1016/j.bbi.2019.08.001DOI Listing
October 2019

Optimal timing of influenza vaccine during pregnancy: A systematic review and meta-analysis.

Influenza Other Respir Viruses 2019 09 5;13(5):438-452. Epub 2019 Jun 5.

Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.

Background: Pregnant women have an elevated risk of illness and hospitalisation from influenza. Pregnant women are recommended to be prioritised for influenza vaccination during any stage of pregnancy. The risk of seasonal influenza varies substantially throughout the year in temperate climates; however, there is limited knowledge of how vaccination timing during pregnancy impacts the benefits received by the mother and foetus.

Objectives: To compare antenatal vaccination timing with regard to influenza vaccine immunogenicity during pregnancy and transplacental transfer to their newborns.

Methods: Studies were eligible for inclusion if immunogenicity to influenza vaccine was evaluated in women stratified by trimester of pregnancy. Haemagglutination inhibition (HI) titres, stratified by trimester of vaccination, had to be measured at either pre-vaccination and within one month post-vaccination, post-vaccination and at delivery in the mother, or in cord/newborn blood. Authors searched PubMed, Scopus, Web of Science and EMBASE databases from inception until June 2016 and authors of identified studies were contacted for additional data. Extracted data were tabulated and summarised via random-effect meta-analyses and qualitative methods.

Results: Sixteen studies met the inclusion criteria. Meta-analyses found that compared with women vaccinated in an earlier trimester, those vaccinated in a later trimester had a greater fold increase in HI titres (1.33- to 1.96-fold) and higher HI titres in cord/newborn blood (1.21- to 1.64-fold).

Conclusions: This review provides comparative analysis of the effect of vaccination timing on maternal immunogenicity and protection of the infant that is informative and relevant to current vaccine scheduling for pregnant women.
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http://dx.doi.org/10.1111/irv.12649DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6692549PMC
September 2019

Sleep quality across pregnancy and postpartum: effects of parity and race.

Sleep Health 2019 08 20;5(4):327-334. Epub 2019 May 20.

Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, USA.

Background: Despite high prevalence and clinical implications of disturbed sleep during pregnancy, information on changes in sleep across pregnancy and postpartum is incomplete. Moreover, predictors of differential patterns of sleep quality across the perinatal period are poorly defined.

Methods: This study examined subjective sleep quality using the Pittsburgh Sleep Quality Index during each trimester of pregnancy and at 4-11 weeks postpartum among 133 women inclusive of nulliparous and multiparous African Americans and Whites.

Results: At any given assessment, 53%-71% of women reported poor overall sleep quality (Pittsburgh Sleep Quality Index total score > 5). Moreover, 92% reported poor overall sleep quality during at least 1 assessment, including 88% at some time during gestation. Compared to nulliparous women, multiparous women reported poorer overall sleep quality, shorter sleep duration, and poorer sleep efficiency during the first trimester; poorer overall sleep quality and longer sleep latency in the second trimester; and more frequent sleep disturbances (eg, night time and early morning awakenings) during the third trimester. Among nulliparous as well as multiparous women, specific aspects of sleep (eg, subjective sleep quality, sleep disturbances, sleep efficiency) were poorer in African American compared to White women at different time points during pregnancy. No effects of race or parity were observed on sleep parameters at postpartum.

Conclusions: Poor sleep quality during pregnancy as well as early postpartum is highly prevalent among both African American and White women. Both multiparous status and African American race are associated with more disturbed sleep at some time points during pregnancy. These individual differences should be considered in future research and clinical efforts to promote perinatal sleep health.
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http://dx.doi.org/10.1016/j.sleh.2019.03.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689436PMC
August 2019

At the forefront of psychoneuroimmunology in pregnancy: Implications for racial disparities in birth outcomes PART 1: Behavioral risks factors.

Authors:
Lisa M Christian

Neurosci Biobehav Rev 2020 10 18;117:319-326. Epub 2019 Apr 18.

Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Psychology, The Ohio State University, Columbus, OH, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address:

Birth prior to full term is a substantial public health issue. In the US, ˜400,000 babies per year are born preterm (<37 weeks), while>1 million are early term (37-38 weeks). Birth prior to full term confers risk both immediate and long term, including neonatal intensive care, decrements in school performance, and increased mortality risk from infancy through young adulthood. Risk for low birth weight and preterm birth are 1.5-2 times greater among African Americans versus Whites. Psychosocial stress related to being a member of a discriminated racial minority group contributes substantially to these racial disparities. Providing promising targets for intervention, depressed mood, anxiety, and poor sleep are each linked with exposure to chronic stress, including racial discrimination. A rigorous transdisciplinary approach addressing these gaps holds great promise for clinical impact in addressing racial disparities as well as ameliorating effects of stress on perinatal health more broadly. As will be reviewed in a companion paper, the mechanistic roles of physiological sequelae to stress - including neuroendocrine, inflammatory regulation, biological aging, and the microbiome - also require delineation.
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http://dx.doi.org/10.1016/j.neubiorev.2019.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800611PMC
October 2020

At the forefront of psychoneuroimmunology in pregnancy: Implications for racial disparities in birth outcomes: PART 2: Biological mechanisms.

Authors:
Lisa M Christian

Neurosci Biobehav Rev 2020 10 15;117:327-333. Epub 2019 Mar 15.

Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA; Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA. Electronic address:

As reviewed in Part 1 of this two part review, birth prior to full term is a substantial public health issue. In the US, ˜400,000 babies per year are born preterm (< 37 weeks), while>1 million are early term (37-38 weeks) and remarkable racial disparities in shortened gestation are observed among African Americans as compared to Whites. Biomechanisms linking stressor exposures with birth outcomes are increasingly being explicated. The current paper reviews the mechanistic role of maternal biological functioning in the link between behavioral exposures and birth outcomes. These include the inter-related roles of neuroendocrine function, inflammatory regulation, biological aging, and the microbiome. An integrative approach which addresses both behavioral and biological factors within the same study, carefully considers the role of race/ethnicity, and rigorously defines birth outcomes (e.g., spontaneous versus medically-indicated and inclusive of early term birth) is needed to move research in this field toward better mechanistic understanding and clinical application.
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http://dx.doi.org/10.1016/j.neubiorev.2019.03.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928440PMC
October 2020

Repetitive negative thinking, meaning in life, and serum cytokine levels in pregnant women: varying associations by socioeconomic status.

J Behav Med 2019 Oct 8;42(5):960-972. Epub 2019 Mar 8.

Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Elevated proinflammatory cytokines and decreased antiinflammatory cytokines are important in the context of perinatal health, and immune dysregulation has been found among perinatal women with low socioeconomic status (SES). Data examining psychological factors that may contribute to cytokines in pregnancy are lacking. Of importance, these associations may be most evident among women with low SES. This study examined the moderating role of SES on associations among presence of meaning in life and repetitive negative thinking with cytokine levels among 67 pregnant women. A cumulative SES index was calculated using income, education, perceived social class, and receipt of governmental support. Measures included the Perseverative Thinking Questionnaire, Meaning in Life Questionnaire, and serum interleukin (IL)-6 as well as IL-4. Using PROCESS, moderation analyses showed significant interactions between psychological factors and SES in predicting serum cytokines. In the context of high SES only, greater repetitive negative thinking was associated with higher levels of the proinflammatory cytokine IL-6 (p = 0.056) while greater meaning in life was associated with higher levels of the antiinflammatory cytokine IL-4 (p = 0.02). Findings from this study suggest that the benefits of these psychological factors on cytokine levels may be most readily observable among women with greater economic stability. Identifying psychological factors that positively contribute to biological functioning in women experiencing heightened economic distress will be crucial in addressing SES-related disparities in perinatal health.
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http://dx.doi.org/10.1007/s10865-019-00023-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726578PMC
October 2019

Maternal Sleep in Pregnancy and Postpartum Part II: Biomechanisms and Intervention Strategies.

Curr Psychiatry Rep 2019 03 2;21(3):19. Epub 2019 Mar 2.

Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Purpose Of Review: As described in Part I of this two-part review, maternal sleep has wide-ranging implications for maternal health and overall family functioning. In addition, poor sleep quality and insufficient sleep are highly prevalent and characterized by considerable racial disparities.

Recent Findings: Part II of this review discusses physiological mechanisms, including inflammation and appetite hormones, by which sleep impacts multiple facets of women's health during pregnancy and postpartum. These mechanisms are increasingly being delineated, but require further study and better integration with studies of behavioral and physical health outcomes. Further, there are multiple potential strategies for improving maternal sleep, providing the opportunity to tailor treatment approaches to individual needs. Ultimately, as a critical health behavior that is amenable to intervention, sleep provides a promising future direction for measurably impacting clinically relevant health parameters in women of childbearing age.
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http://dx.doi.org/10.1007/s11920-019-1000-9DOI Listing
March 2019

Maternal Sleep in Pregnancy and Postpartum Part I: Mental, Physical, and Interpersonal Consequences.

Curr Psychiatry Rep 2019 03 2;21(3):20. Epub 2019 Mar 2.

Department of Psychiatry, The University of Pittsburgh, Pittsburgh, PA, USA.

Purpose Of Review: Sleep is a critical restorative behavior which occupies approximately one third of people's lives. Extensive data link sleep health with disease and mortality risk in the general population. During pregnancy and following childbirth, unique factors contribute to overall sleep health. In addition, there are unique implications of poor sleep during these time periods.

Recent Findings: Poor maternal sleep may contribute to risk for adverse birth outcomes as well as poor maternal physical and mental health in pregnancy, postpartum, and longer term during childrearing. Moreover, the extent to which notable racial disparities in sleep contribute to disparities in adverse perinatal health outcomes remains to be fully explicated. Part I of this two-part review details these implications of poor sleep for mental health, physical health outcomes, and relationship functioning, while Part II delves into biological mechanisms as well as treatment approaches.
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http://dx.doi.org/10.1007/s11920-019-0999-yDOI Listing
March 2019

Pathways linking childhood abuse history and current socioeconomic status to inflammation during pregnancy.

Brain Behav Immun 2018 11 11;74:231-240. Epub 2018 Sep 11.

Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210 United States; Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States; Department of Psychology, The Ohio State University, Columbus, OH 43210, United States; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States. Electronic address:

Women who have experienced significant adversities during childhood and adulthood are at risk for excessive inflammation during pregnancy, but the mechanisms are unclear. Using structural equation modeling, we examined pathways from childhood abuse history and current socioeconomic status (SES) to inflammatory markers through indicators of health risk, recent stressors, and psychological distress in 214 women assessed at mid-pregnancy (5-31 weeks gestation). Self-reported data on socioeconomic indicators, childhood trauma history, pre-pregnancy body mass index (BMI), smoking, sleep quality, interpersonal conflict, recent life events, perceived stress, and depressive symptoms were collected, and serum levels of C-reactive protein (CRP) and interleukin (IL)-6 were determined. In separate models, pre-pregnancy BMI, sleep quality, and interpersonal conflict statistically explained the relationship between adversity and inflammation. These three intermediate variables were then entered into a multiple mediation analysis to examine unique effects. Childhood abuse history and current SES both demonstrated significant indirect effects on CRP through pre-pregnancy BMI, and current SES showed a significant indirect effect on IL-6 through all intermediate variables. When examining each indirect pathway individually, pre-pregnancy BMI and interpersonal conflict emerged as parallel pathways by which low current SES leads to elevated IL-6; the indirect pathway through sleep quality was no longer significant. Pre-pregnancy BMI and interpersonal conflict are two independent mechanisms by which adversity is associated with increased inflammation during pregnancy. Women who have been exposed to significant adversity may be at particular risk for obesity, sleep disruption, and interpersonal conflict, with implications for immune dysregulation during pregnancy.
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http://dx.doi.org/10.1016/j.bbi.2018.09.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289854PMC
November 2018

Maternal parity and perinatal cortisol adaptation: The role of pregnancy-specific distress and implications for postpartum mood.

Psychoneuroendocrinology 2018 11 5;97:86-93. Epub 2018 Jul 5.

Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States. Electronic address:

Introduction: Compared to women who have given birth before (i.e., multiparas), those giving birth for the first time (i.e., primiparas) show higher cortisol levels. Psychological factors may play a role; hypothalamic-pituitary-adrenal activation is a well-described stress response. Primiparity also predicts greater risk for postpartum depression, which may be related to greater correspondence between cortisol and mood following prenatal cortisol elevations. The current study examined associations among parity, perinatal cortisol adaptation, pregnancy-specific distress, and postpartum mood.

Methods: This longitudinal study assayed serum cortisol levels among 137 women at early, mid-, and late pregnancy and postpartum. Pregnancy-specific distress and depressive symptoms were assessed. Maternal age, race, body mass index, sleep quality, depressive symptoms, and sampling time of day were statistically controlled.

Results: Primiparous women showed higher cortisol levels than multiparous women during mid- (χ = 11.8, p < 0.01) and late pregnancy (χ = 18.9, p < 0.01) and higher distress across pregnancy (F = 22.1, p < 0.01). Mediation analyses demonstrated that the association between parity and prenatal cortisol (per area under the curve; AUC) was partially accounted for by distress (ab = 1.0, 95%CI [0.05, 2.9]). Prenatal cortisol (per AUC) did not predict postpartum depressive symptoms (b* = 0.03, p = 0.81), with no difference by parity (b* = 0.03, p = 0.91). At postpartum, a significant interaction between parity and cortisol (b* = 0.40, p = 0.03) revealed no significant association between cortisol and mood among multiparas (b* = -0.11, p = 0.28) but a trend toward a positive association among primiparas (b* = 0.24, p = 0.06).

Discussion: Cortisol levels and pregnancy-specific distress are higher in primiparas versus multiparas, with pregnancy-specific distress partially mediating the association between parity and cortisol levels. Cortisol levels and mood display correspondence at postpartum in primiparous but not multiparous women. While observational studies must be interpreted with caution due to potential unmeasured confounders, these findings suggest that future studies examining mechanisms underlying perinatal and postpartum hypothalamic-pituitary-adrenal perturbations and designing interventions aimed at preventing related complications should carefully consider potential differences by parity.
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http://dx.doi.org/10.1016/j.psyneuen.2018.07.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582962PMC
November 2018

Associations of Maternal Beliefs and Distress in Pregnancy and Postpartum With Breastfeeding Initiation and Early Cessation.

J Hum Lact 2019 Feb 3;35(1):49-58. Epub 2018 Jul 3.

3 Department of Psychiatry & Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA.

Background:: Breastfeeding plays an important role in both maternal and infant health and well-being. While researchers have examined the relationship between postpartum psychological distress and breastfeeding behaviors, few have investigated links between prenatal distress, postpartum distress, and breastfeeding behaviors over time.

Research Aim:: We aimed to determine if prenatal breastfeeding beliefs and psychological distress during and after pregnancy were associated with initiation and early cessation rates of breastfeeding.

Methods:: In our secondary data analysis, a nonexperimental longitudinal one-group design was used. We assessed pregnant women ( N = 70) during four perinatal visits (early, mid, and late pregnancy and 7-10 weeks postpartum). Participants completed self-report surveys about psychological distress and depressive symptoms at each visit, breastfeeding beliefs during the third visit, and breastfeeding behaviors at the postpartum visit.

Results:: Participants who breastfed for ⩾8 weeks had more positive beliefs about breastfeeding prior to delivery than participants with early cessation, who in turn had more positive beliefs than those who never initiated. Participants with early cessation reported heightened levels of pregnancy-specific distress in early pregnancy compared to those who continued breastfeeding or never initiated. Participants who continued breastfeeding for ⩾8 weeks reported less general anxiety and depressive symptoms in postpartum than those who discontinued or never initiated.

Conclusions:: Prenatal beliefs about breastfeeding, pregnancy-specific distress in early pregnancy, and general anxiety and depressive symptoms in postpartum are associated with breastfeeding initiation and continuation. Of clinical relevance, addressing prenatal and postpartum distress in the implementation of breastfeeding practice interventions could improve breastfeeding rates.
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http://dx.doi.org/10.1177/0890334418767832DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924271PMC
February 2019

Associations of postpartum sleep, stress, and depressive symptoms with LPS-stimulated cytokine production among African American and White women.

J Neuroimmunol 2018 03 10;316:98-106. Epub 2018 Jan 10.

Center for Biostatistics, The Ohio State University, Columbus, OH, United States.

Background: Postpartum is a period of unique psychosocial stress characterized by sleep disturbance, risk for depressed mood, and heightened parenting stress. However, data on effects of these exposures on inflammatory immune function are limited.

Methods: This study examined associations among sleep, psychosocial stress (i.e., parenting stress, general perceived stress), mood (i.e., depressive symptoms), serum cytokine levels, and LPS-stimulated proinflammatory cytokine production among 69 women (32 African American, 37 White) assessed at 7-10weeks postpartum.

Results: No associations between behavioral measures and serum cytokine levels were observed among women of either race. In African American women, but not Whites, poorer sleep quality, greater parenting stress, and greater depressive symptoms were associated with greater LPS-stimulated IL-6 and IL-8 production (ps≤0.05). Also in African Americans, greater general perceived stress was associated with greater IL-8 production, and greater depressive symptoms with greater stimulated TNF-α production (ps≤0.05). Simple mediation models highlighted the bidirectional relationship between stress and sleep in relation to inflammation among African American women.

Conclusions: Significant effects of both stress/distress and poor sleep quality on proinflammatory cytokine production during postpartum were observed uniquely among African American women. These data are consistent with an allostatic load model which predicts that conditions of chronic stress impart vulnerability to dysregulated responses to novel stressor exposures. The bidirectional nature of the stress-sleep relationship has clinical relevance. Studies examining whether interventions focused on one or both of these psychological factors during postpartum is beneficial for inflammatory profiles would be informative. In addition, examination of these models in relation to maternal health at postpartum, including delivery related wounds and other infections, is warranted.
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http://dx.doi.org/10.1016/j.jneuroim.2017.12.020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806133PMC
March 2018

Childhood adversity, social support, and telomere length among perinatal women.

Psychoneuroendocrinology 2018 Jan 5;87:43-52. Epub 2017 Oct 5.

Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Psychology, The Ohio State University, Columbus, OH, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH USA. Electronic address:

Adverse perinatal health outcomes are heightened among women with psychosocial risk factors, including childhood adversity and a lack of social support. Biological aging could be one pathway by which such outcomes occur. However, data examining links between psychosocial factors and indicators of biological aging among perinatal women are limited. The current study examined the associations of childhood socioeconomic status (SES), childhood trauma, and current social support with telomere length in peripheral blood mononuclear cells (PBMCs) in a sample of 81 women assessed in early, mid, and late pregnancy as well as 7-11 weeks postpartum. Childhood SES was defined as perceived childhood social class and parental educational attainment. Measures included the Childhood Trauma Questionnaire, Center for Epidemiologic Studies-Depression Scale, Multidimensional Scale of Perceived Social Support, and average telomere length in PBMCs. Per a linear mixed model, telomere length did not change across pregnancy and postpartum visits; thus, subsequent analyses defined telomere length as the average across all available timepoints. ANCOVAs showed group differences by perceived childhood social class, maternal and paternal educational attainment, and current family social support, with lower values corresponding with shorter telomeres, after adjustment for possible confounds. No effects of childhood trauma or social support from significant others or friends on telomere length were observed. Findings demonstrate that while current SES was not related to telomeres, low childhood SES, independent of current SES, and low family social support were distinct risk factors for cellular aging in women. These data have relevance for understanding potential mechanisms by which early life deprivation of socioeconomic and relationship resources affect maternal health. In turn, this has potential significance for intergenerational transmission of telomere length. The predictive value of markers of biological versus chronological age on birth outcomes warrants investigation.
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http://dx.doi.org/10.1016/j.psyneuen.2017.10.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705286PMC
January 2018

Examination of the role of obesity in the association between childhood trauma and inflammation during pregnancy.

Health Psychol 2018 02 2;37(2):114-124. Epub 2017 Oct 2.

Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center.

Objective: Childhood trauma is associated with negative perinatal health outcomes including mood disorders and shorter gestation. However, effects of early life exposures on maternal biology are poorly delineated. This study examined associations between childhood trauma and inflammation, as well as the mediating role of obesity in this relationship.

Method: This study examined a racially diverse sample of 77 pregnant women assessed in early, mid, and late pregnancy. Assessments included the Childhood Trauma Questionnaire, Center for Epidemiologic Studies-Depression Scale, serum CRP, IL-6, and TNF-α, and prepregnancy BMI.

Results: Per linear mixed models, while no direct relationships were observed between childhood trauma with IL-6 or TNF-α, physical (95% CI: 0.007, 0.080) and emotional (95% CI: 0.005, 0.046) abuse as well as emotional neglect (95% CI: 0.010, 0.051) predicted elevated CRP. Effects remained after adjustment for race, income, education, smoking status, medical conditions, and depressive symptoms. PROCESS analyses showed BMI mediated the relationship between physical abuse and both serum CRP (95% CI: 0.014, 0.062) and IL-6 (95% CI: 0.009, 0.034).

Conclusions: Exposure to childhood trauma, particularly emotional abuse, physical abuse, and emotional neglect, is associated with inflammation in pregnant women. Obesity served as 1 pathway by which physical abuse contributed to elevations in serum CRP and IL-6. Interventions targeting maternal obesity prior to pregnancy may help mitigate the effects of childhood trauma on perinatal health. These findings have relevance for understanding biological and behavioral pathways by which early life exposures contribute to maternal health. (PsycINFO Database Record
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http://dx.doi.org/10.1037/hea0000559DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794605PMC
February 2018

The Effect of Perceived Stress on Epstein-Barr Virus Antibody Titers in Appalachian Ohio Women.

Neuroimmunomodulation 2017 22;24(2):67-73. Epub 2017 Sep 22.

Internal Medicine-Pediatric Residency Program, University of Illinois College of Medicine, Chicago, IL, USA.

Objective: The Appalachian population suffers a disparate burden of chronic stress leading to high perceived stress. The study aim was to determine the association between perceived stress and Epstein-Barr virus (EBV) antibody titers, along with the impact of perceived social support, Appalachian self-identify, and health behaviors.

Methods: Serum EBV VCA-IgG antibody titer levels from 169 female Appalachian residents (aged 18-26 years) were examined. Perceived stress, perceived social support, Appalachian self-identity, and health behaviors were assessed via self-administered questionnaires.

Results: There were 169 of 185 women positive for EBV. Among these women, the median EBV antibody titer level was 404 U/mL (range 101-6,464), and the overall geometric mean was 563.2 (95% CI 486.6-651.9). For a 1-point increase in perceived stress, the EBV antibody titer increased by 1.92% (95% CI 0.04-3.76%). For every point increase in perceived social support, the EBV antibody titer decreased by 1.00% (95% CI 0.06-1.98%). Perceived stress was significantly associated with sleep quality, BMI, and current smoking status, but not with binge-drinking, drug use, or Appalachian self-identity. No mediating effects of sleep quality, BMI, binge-drinking, current drug use, or >4 sexual partners were observed in the relationship between perceived stress and EBV titer level.

Conclusion: Young Appalachian women reported high levels of perceived stress that were significantly associated with higher EBV titers. Higher perceived social support was associated with lower EBV titers. Health behaviors and Appalachian self-identity did not impact the relationship between perceived stress and EBV titers.
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http://dx.doi.org/10.1159/000478658DOI Listing
June 2018

Effects of prior influenza virus vaccination on maternal antibody responses: Implications for achieving protection in the newborns.

Vaccine 2017 09 1;35(39):5283-5290. Epub 2017 Aug 1.

Division of Infectious Diseases and Center for Vaccines and Immunity, Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University, Columbus, OH, USA.

Background: In the US, influenza vaccination is recommended annually to everyone ≥6months. Prior receipt of influenza vaccine can dampen antibody responses to subsequent vaccination. This may have implications for pregnant women and their newborns, groups at high risk for complications from influenza infection.

Objective: This study examined effects of prior vaccination on maternal and cord blood antibody levels in a cohort of pregnant women in the US.

Study Design: Influenza antibody titers were measured in 141 pregnant women via the hemagglutination inhibition (HAI) assay prior to receipt of quadrivalent influenza vaccine, 30days post-vaccination, and at delivery (maternal and cord blood). Logistic regression analyses adjusting for age, BMI, parity, gestational age at vaccination, and year of vaccination compared HAI titers, seroprotection, and seroconversion in women with versus without vaccination in the prior year.

Results: Compared to those without vaccination in the previous year (n=50), women with prior vaccination (n=91) exhibited higher baseline antibody titers and/or seroprotection rates against all four strains after controlling for covariates. Prior vaccination also predicted lower antibody responses and seroconversion rates at one month post-vaccination. However, at delivery, there were no significant differences in antibody titers or seroprotection rates in women or newborns, and no meaningful differences in the efficiency of antibody transfer, as indicated by the ratio of cord blood to maternal antibody titers at the time of delivery.

Conclusion: In this cohort of pregnant women, receipt of influenza vaccine the previous year predicted higher baseline antibody titers and decreased antibody responses at one month post-vaccination against all influenza strains. However, prior maternal vaccination did not significantly affect either maternal antibody levels at delivery or antibody levels transferred to the neonate. This study is registered with the NIH as a clinical trial (NCT02148874).
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http://dx.doi.org/10.1016/j.vaccine.2017.05.050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5657512PMC
September 2017

Erratum to: Financial strain and birth weight: the mediating role of psychological distress.

Arch Womens Ment Health 2017 10;20(5):711

Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

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http://dx.doi.org/10.1007/s00737-017-0756-3DOI Listing
October 2017

Childhood stress and birth timing among African American women: Cortisol as biological mediator.

Psychoneuroendocrinology 2017 Oct 15;84:32-41. Epub 2017 Jun 15.

Department of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA. Electronic address:

Preterm birth (PTB) occurs among 1:11U.S. white women and 1:7.5 African American women and is a significant driver of racial disparities in infant mortality. Maternal stress is the most common clinical phenotype underlying spontaneous PTB. Specific patterns of stress and biological mediators driving PTB remain unclear. We examined the effect of childhood stress on birth timing among African American women and evaluated maternal cortisol elevation as a biological mediator. A prospective observational design was employed, with a single study visit at 28-32 weeks gestation and medical record review. The Stress and Adversity Inventory was administered, which provides a comprehensive estimate of childhood stress, stress in adulthood, and five core characteristic subscales (interpersonal loss, physical danger, humiliation, entrapment, role disruption). Venipuncture was performed between 11:00am and 4:00pm and plasma cortisol quantified by ELISA. Analyses controlled for stress in adulthood. Among a final sample of 89, cumulative childhood stress predicted birth timing (p=0.01). The association was driven by stress related to interpersonal loss and physical danger, with support for maternal cortisol as a biological mediator (ab=0.02, 95% CI [0.001, 0.045]; ab=0.02, 95% CI [0.001, 0.043], respectively). Results were similar, overall, in sub-group analyses among spontaneously laboring women (n=53); however, role disruption arose as an additional predictor, as mediated by cortisol elevations (ab=0.03, 95% CI [0.005, 0.074]). Of note, cortisol was no longer supported as a mediator linking physical danger to birth timing after adjusting for sleep quality and hours awake prior to venipuncture (ab=0.02, 95% CI [-0.0001, 0.046]). We provide preliminary evidence that, independent of stress in adulthood, childhood stress of specific core characteristics may shape birth timing, with cortisol elevation as a biological mediator. Further investigation is warranted and may bolster the development of biologically-informed screening tools for the prediction and targeted prevention of stress-related PTB.
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http://dx.doi.org/10.1016/j.psyneuen.2017.06.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550339PMC
October 2017

Body weight affects ω-3 polyunsaturated fatty acid (PUFA) accumulation in youth following supplementation in post-hoc analyses of a randomized controlled trial.

PLoS One 2017 5;12(4):e0173087. Epub 2017 Apr 5.

Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America.

Guidelines for suggested intake of ω-3 polyunsaturated fatty acids (PUFAs) are limited in youth and rely primarily on age. However, body weight varies considerably within age classifications. The current analyses examined effects of body weight and body mass index (BMI) on fatty acid accumulation in 64 youth (7-14 years) with a diagnosed mood disorder in a double-blind randomized-controlled trial (2000mg ω-3 supplements or a control capsule) across 12 weeks. Weight and height were measured at the first study visit and EPA and DHA levels were determined using fasting blood samples obtained at both the first and end-of-study visits. In the ω-3 supplementation group, higher baseline body weight predicted less plasma accumulation of both EPA [B = -0.047, (95% CI = -0.077; -0.017), β = -0.54, p = 0.003] and DHA [B = -0.02, (95% CI = -0.034; -0.007), β = -0.52, p = 0.004]. Similarly, higher BMI percentile as well as BMI category (underweight, normal weight, overweight/obese) predicted less accumulation of EPA and DHA (ps≤0.01). Adherence to supplementation was negatively correlated with BMI percentile [B = -0.002 (95% CI = -0.004; 0.00), β = -0.44, p = 0.019], but did not meaningfully affect observed associations. As intended, the control supplement exerted no significant effect on plasma levels of relevant fatty acids regardless of youth body parameters. These data show strong linear relationships of both absolute body weight and BMI percentile with ω-3 PUFA accumulation in youth. A dose-response effect was observed across the BMI spectrum. Given increasing variability in weight within BMI percentile ranges as youth age, dosing based on absolute weight should be considered. Moreover, effects of weight should be incorporated into statistical models in studies examining clinical effects of ω-3 PUFAs in youth as well as adults, as weight-related differences in effects may contribute meaningfully to inconsistencies in the current literature.

Trial Registration: WHO International Clinical Trial Registry Platform NCT01341925 and NCT01507753.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173087PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381773PMC
August 2017

Interleukin-1 Receptor Antagonist Polymorphism and Birth Timing: Pathway Analysis Among African American Women.

Nurs Res 2017 Mar/Apr;66(2):95-104

Shannon L. Gillespie, PhD, MS, RN, is Postdoctoral Researcher, College of Nursing, The Ohio State University, Columbus. Jeremy L. Neal, PhD, CNM, RN, is Assistant Professor, School of Nursing, Vanderbilt University, Nashville, Tennessee. Lisa M. Christian, PhD, is Associate Professor, Department of Psychiatry and Behavioral Health, The Institute for Behavioral Medicine Research, and Department of Obstetrics and Gynecology, Wexner Medical Center, Department of Psychology, The Ohio State University, Columbus. Laura A. Szalacha, EdD, is Professor, College of Nursing, University of Arizona, Tucson. Donna O. McCarthy, PhD, RN, FAAN, is Professor, Marquette University, Milwaukee, Wisconsin. Pamela J. Salsberry, PhD, RN, FAAN, is Professor, Department of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus.

Background: Timing of birth is a major determinant of newborn health. African American women are at increased risk for early birth, particularly via the inflammatory pathway. Variants of the IL1RN gene, which encode the interleukin-1 receptor antagonist (IL-1Ra) protein, are implicated in early birth. The biological pathways linking these variables remain unclear. Evidence also suggests that inflammatory pathways differ by race; however, studies among African American women are lacking.

Objectives: We assessed whether an IL1RN variant was associated with timing of birth among African American women and whether this relationship was mediated by lower anti-inflammatory IL-1Ra production or related to a decrease in inhibition of proinflammatory IL-1β production.

Methods: A candidate gene study using a prospective cohort design was used. We collected blood samples at 28-32 weeks of gestation among African American women experiencing an uncomplicated pregnancy (N = 89). IL1RN single-nucleotide polymorphism (SNP) rs2637988 was genotyped, and lipopolysaccharide-stimulated IL-1Ra and IL-1β production was quantified. Medical record review determined timing of birth.

Results: Women with GG genotype gave birth earlier than women with AA/AG genotypes (b* = .21, p = .04). There was no indirect effect of IL1RN SNP rs2637988 allele status on timing of birth through IL-1Ra production, as evidenced by a nonsignificant product of coefficients in mediational analyses (ab = .006, 95% CI [-0.05, 0.13]). Women with GG genotype showed less inhibition of IL-1β production for a unit positive difference in IL-1Ra production than women with AA/AG genotypes (b* = .93, p = .03). Greater IL-1β production at 28-32 weeks of pregnancy was marginally associated with earlier birth (b* = .21, p = .05).

Discussion: Women with GG genotype may be at risk for earlier birth because of diminished IL-1β inhibition, allowing for initiation of a robust inflammatory response upon even mild immune challenge. Study of inflammatory contributions to early birth among African American women may be key to identifying potential prognostic markers of risk and targeted preventive interventions.
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http://dx.doi.org/10.1097/NNR.0000000000000200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334774PMC
May 2017

Financial strain and birth weight: the mediating role of psychological distress.

Arch Womens Ment Health 2017 02 13;20(1):201-208. Epub 2016 Dec 13.

Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

The effects of financial strain during pregnancy have received limited attention. In addition, data examining the pathways by which SES indicators contribute to birth weight are lacking. The objective of the current study was to examine the potential pathway of psychological distress in the relationship between financial strain and birth weight. Participants consisted of 138 pregnant women who completed measures assessing financial strain, depressive symptoms, pregnancy-specific distress, perceived stress, and general anxiety during pregnancy (mean gestational age = 18.5, SD = 7.2). Birth outcome data were obtained via medical record review. Simple and parallel mediation models were conducted using PROCESS. Simple mediation models showed that depressive symptoms (95% CI -24.65, -0.90) and pregnancy-specific distress (95% CI -37.31, -5.91), but not perceived stress (95% CI -31.17, 4.69) or anxiety (95% CI -25.84, 5.57), served as mediators in the relationship between financial strain and birth weight. When depressive symptoms and pregnancy-specific distress were included in the same mediation model, only pregnancy-specific distress remained significant. Financial strain was positively associated with all facets of psychological distress and negatively associated with birth weight during pregnancy. The current study demonstrated the mechanistic role of pregnancy-specific distress in the link between financial strain and birth weight in a racially diverse sample. Interventions targeting pregnancy-specific distress may mitigate the effects of financial strain on birth weight. Studies examining whether pregnancy-specific distress accounts for the relationship between other types of stressor exposures and birth weight would be informative.
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http://dx.doi.org/10.1007/s00737-016-0696-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5239729PMC
February 2017

Serum brain-derived neurotrophic factor (BDNF) across pregnancy and postpartum: Associations with race, depressive symptoms, and low birth weight.

Psychoneuroendocrinology 2016 12 27;74:69-76. Epub 2016 Aug 27.

Center for Biostatistics, The Ohio State University, Columbus, OH, USA.

Background: Brain-derived neurotrophic factor (BDNF) is implicated as a causal factor in major depression and is critical to placental development during pregnancy. Longitudinal data on BDNF across the perinatal period are lacking. These data are of interest given the potential implications for maternal mood and fetal growth, particularly among Black women who show ∼2-fold greater risk for delivering low birth weight infants.

Methods: Serum BDNF, serum cortisol, and depressive symptoms (per CES-D) were assessed during each trimester and 4-11 weeks postpartum among 139 women (77 Black, 62 White). Low birth weight (<2500g) was determined via medical record.

Results: Serum BDNF declined considerably from 1st through 3rd trimesters (ps≤0.008) and subsequently increased at postpartum (p<0.001). Black women exhibited significantly higher serum BDNF during the 1st trimester, 2nd trimester, and postpartum (ps≤0.032) as well as lower serum cortisol during the 2nd and 3rd trimester (ps≤0.01). Higher serum cortisol was concurrently associated with lower serum BDNF in the 2nd trimester only (p<0.05). Controlling for race, serum BDNF at both the 2nd and 3rd trimester was negatively associated with 3rd trimester depressive symptoms (ps≤0.02). In addition, women delivering low versus healthy weight infants showed significantly lower serum BDNF in the 3rd trimester (p=0.004). Women delivering low versus healthy weight infants did not differ in depressive symptoms at any time point during pregnancy (ps≥0.34).

Conclusions: Serum BDNF declines considerably across pregnancy in Black and White women, with overall higher levels in Blacks. Lower serum BDNF in late pregnancy corresponds with higher depressive symptoms and risk for low birth weight in Black and White women. However, the predictive value of serum BDNF in pregnancy is specific to within-race comparisons. Potential links between racial differences in serum BDNF and differential pregnancy-related cortisol adaptation require further investigation.
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http://dx.doi.org/10.1016/j.psyneuen.2016.08.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5166606PMC
December 2016

Body Mass Index as a Measure of Obesity: Racial Differences in Predictive Value for Health Parameters During Pregnancy.

J Womens Health (Larchmt) 2016 12 3;25(12):1210-1218. Epub 2016 Aug 3.

2 Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center , Columbus, Ohio.

Background: As a measure of obesity, body mass index (BMI; kg/m) is an imperfect predictor of health outcomes, particularly among African Americans. However, BMI is used to guide prenatal care. We examined racial differences in the predictive value of maternal BMI for physiologic correlates of obesity, serum interleukin (IL)-6 and C-reactive protein (CRP), as well as cesarean section and infant birth weight.

Methods: One hundred five pregnant women (40 European American, 65 African American) were assessed during the second trimester. BMI was defined as per prepregnancy weight. Electrochemiluminescence and enzyme-linked immunosorbent assays were used to quantify IL-6 and CRP, respectively. Birth outcomes were determined by medical record review.

Results: Women of both races classified as obese had higher serum IL-6 and CRP than their normal-weight counterparts (ps ≤ 0.01). However, among women with overweight, elevations in IL-6 (p < 0.01) and CRP (p = 0.06) were observed among European Americans, but not African Americans (ps ≥ 0.61). Maternal obesity was a significantly better predictor of cesarean section among European Americans versus African Americans (p = 0.03) and BMI was associated with infant birth weight among European Americans (p < 0.01), but not African Americans (p = 0.94). Effects remained after controlling for gestational age at delivery, gestational diabetes, and gestational weight gain as appropriate.

Conclusions: BMI may be a less valid predictor of correlates of overweight/obesity among African Americans versus European Americans during pregnancy. This should be considered in epidemiological studies of maternal-child health. In addition, studies examining the comparative validity of alternative/complementary measures to define obesity in pregnancy are warranted to inform clinical care.
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http://dx.doi.org/10.1089/jwh.2016.5761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175427PMC
December 2016

Smoking, pregnancy and the subgingival microbiome.

Sci Rep 2016 07 27;6:30388. Epub 2016 Jul 27.

Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.

The periodontal microbiome is known to be altered during pregnancy as well as by smoking. However, despite the fact that 2.1 million women in the United States smoke during their pregnancy, the potentially synergistic effects of smoking and pregnancy on the subgingival microbiome have never been studied. Subgingival plaque was collected from 44 systemically and periodontally healthy non-pregnant nonsmokers (control), non-pregnant smokers, pregnant nonsmokers and pregnant smokers and sequenced using 16S-pyrotag sequencing. 331601 classifiable sequences were compared against HOMD. Community ordination methods and co-occurrence networks were used along with non-parametric tests to identify differences between groups. Linear Discriminant Analysis revealed significant clustering based on pregnancy and smoking status. Alpha diversity was similar between groups, however, pregnant women (smokers and nonsmokers) demonstrated higher levels of gram-positive and gram-negative facultatives, and lower levels of gram-negative anaerobes when compared to smokers. Each environmental perturbation induced distinctive co-occurrence patterns between species, with unique network anchors in each group. Our study thus suggests that the impact of each environmental perturbation on the periodontal microbiome is unique, and that when they are superimposed, the sum is greater than its parts. The persistence of these effects following cessation of the environmental disruption warrants further investigation.
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http://dx.doi.org/10.1038/srep30388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961950PMC
July 2016

Fetal sex is associated with maternal stimulated cytokine production, but not serum cytokine levels, in human pregnancy.

Brain Behav Immun 2017 Feb 29;60:32-37. Epub 2016 Jun 29.

The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Department of Psychology, The Ohio State University, United States. Electronic address:

Some studies suggest that fetal sex plays a role in maternal physiological processes during pregnancy including glycemic control, blood pressure, and cortisol regulation. However, data examining fetal sex-specific differences in maternal immune parameters is lacking. In the current study, serum levels of interleukin(IL)-6, IL-8, and tumor necrosis factor(TNF)-α as well as LPS-stimulated production of IL-6, IL-8, TNF-α, and IL-1β by PBMCs incubated for 24h were assessed in early, mid, and late pregnancy among 80 women (46 with male and 34 with female fetuses). Linear mixed models showed that women carrying females versus males exhibited greater stimulated production of IL-6 at each timepoint (ps⩽0.03), TNF-α in early pregnancy (p=0.04), and IL-1β in mid- and late pregnancy (ps⩽0.05). Despite changes in serum levels of IL-8 (p=0.002) and TNF-α (p<0.0001) across pregnancy, no differences in any serum cytokines were observed in relation to fetal sex (ps>0.85). In conclusion, in pregnant women, those carrying female versus male fetuses exhibited greater stimulated cytokine production across pregnancy. Differential inflammatory responses could affect maternal health and fetal development. Fetal sex should be considered as a factor in studies of maternal inflammation. These findings have relevance both clinically and conceptually. For example, maternal asthma is exacerbated among women carrying female versus male fetuses. In addition, data on associations between fetal sex and maternal immune function among women with health conditions (e.g., preeclampsia) and adverse pregnancy outcomes (e.g., preterm birth) would be informative.
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http://dx.doi.org/10.1016/j.bbi.2016.06.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558889PMC
February 2017