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Title: Cardio-metabolic risk in 5-year-old children prenatally exposed to maternal psychosocial stress: the ABCD study
Author(s): A.E. van Dijk, Van Eijsden M., K. Stronks, R.J. Gemke and T.G. Vrijkotte
Journal: BMC Public Health
Year: 2010
Volume: 10
Pages: 251--
Publisher address: Department of Public Health, Academic Medical Center - University of Amsterdam, Amsterdam, the Netherlands. a.e.vandijk@amc.uva.nl
File URL: vuams-pubs/Van_Dijk_2010.pdf
Keywords: Adult, analysis, Anxiety, Autonomic Nervous System, Birth Weight, blood, Blood Glucose, Blood Pressure, Body Composition, Body Mass Index, Child, Disease, Gestational Age, Infant, Netherlands, Pregnancy, Pressure, Prospective Studies, Questionnaires
Abstract: BACKGROUND: Recent evidence, both animal and human, suggests that modifiable factors during fetal and infant development predispose for cardiovascular disease in adult life and that they may become possible future targets for prevention. One of these factors is maternal psychosocial stress, but so far, few prospective studies have been able to investigate the longer-term effects of stress in detail, i.e. effects in childhood. Therefore, our general aim is to study whether prenatal maternal psychosocial stress is associated with an adverse cardio-metabolic risk profile in the child at age five. METHODS/DESIGN: Data are available from the Amsterdam Born Children and their Development (ABCD) study, a prospective birth cohort in the Netherlands. Between 2003-2004, 8,266 pregnant women filled out a questionnaire including instruments to determine anxiety (STAI), pregnancy related anxiety (PRAQ), depressive symptoms (CES-D), parenting stress (PDH scale) and work stress (Job Content Questionnaire). Outcome measures in the offspring (age 5-7) are currently collected. These include lipid profile, blood glucose, insulin sensitivity, body composition (body mass index, waist circumference and bioelectrical impedance analysis), autonomic nervous system activity (parasympathetic and sympathetic measures) and blood pressure. Potential mediators are maternal serum cortisol, gestational age and birth weight for gestational age (intrauterine growth restriction). Possible gender differences in programming are also studied. DISCUSSION: Main strengths of the proposed study are the longitudinal measurements during three important periods (pregnancy, infancy and childhood), the extensive measurement of maternal psychosocial stress with validated questionnaires and the thorough measurement of the children's cardio-metabolic profile. The availability of several confounding factors will give us the opportunity to quantify the independent contribution of maternal stress during pregnancy to the cardio-metabolic risk profile of her offspring. Moreover, the mediating role of maternal cortisol, intrauterine growth, gestational age and potential gender differences can be explored extensively. If prenatal psychosocial stress is indeed found to be associated with the offspring's cardio-metabolic risk, these results support the statement that primary prevention of cardiovascular disease may start even before birth by reducing maternal stress during pregnancy

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