Mothers’ childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways

Gregory E. Miller*, Jennifer Culhane, William Grobman, Hyagriv Simhan, Douglas E. Williamson, Emma K. Adam, Claudia Buss, Sonja Entringer, Kwang Youn Kim, J. Felipe Garcia-Espana, Lauren Keenan-Devlin, Thomas W. McDade, Pathik D. Wadhwa, Ann Borders

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Research suggests the health consequences of economic hardship can be transmitted across generations. Some of these disparities are thought to be passed to offspring during gestation. But this hypothesis has not been tested in contemporary American samples, and the mechanisms of transmission have not been characterized. Accordingly, this study had two goals: first, to determine if women exposed to economic hardship during childhood showed higher rates of adverse birth outcomes; and second, to evaluate the contribution of inflammation, psychosocial, lifestyle, and obstetric characteristics to this phenomenon. This prospective study enrolled 744 women with singleton pregnancies (59.1% White; 16.3% Black; 18.7% Latina; 5.9% Other). Childhood economic hardship was measured by self-report. Birth outcomes included length of gestation and incidence of preterm birth; birth weight percentile and small for gestational age; length of hospital stay and admission to Special Care Nursery. Analyses revealed that mothers’ childhood economic hardship was independently associated with multiple adverse birth outcomes, even following adjustment for demographics, maternal education, and obstetrical confounders. Women raised in economically disadvantaged conditions had shorter gestation length and higher preterm delivery rates. Their babies had lower birth weights, were more likely to be small for gestational age, stayed in the hospital longer, and had more Special Care Nursery admissions. Mediation analyses suggested these associations arose through multiple pathways, and highlighted roles for inflammation, education, adiposity, and obstetric complications. Collectively, these findings suggest that childhood economic hardship predisposes women to adverse birth outcomes, and highlights likely behavioral and biological mechanisms.

Original languageEnglish (US)
Pages (from-to)11-19
Number of pages9
JournalBrain, Behavior, and Immunity
StatePublished - Oct 2017


  • Health disparities
  • Inflammation
  • Inter-generational
  • Pregnancy
  • Socioeconomic status

ASJC Scopus subject areas

  • Immunology
  • Endocrine and Autonomic Systems
  • Behavioral Neuroscience


Dive into the research topics of 'Mothers’ childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways'. Together they form a unique fingerprint.

Cite this