TY - JOUR
T1 - Mothers’ childhood hardship forecasts adverse pregnancy outcomes
T2 - Role of inflammatory, lifestyle, and psychosocial pathways
AU - Miller, Gregory E.
AU - Culhane, Jennifer
AU - Grobman, William
AU - Simhan, Hyagriv
AU - Williamson, Douglas E.
AU - Adam, Emma K.
AU - Buss, Claudia
AU - Entringer, Sonja
AU - Kim, Kwang Youn
AU - Felipe Garcia-Espana, J.
AU - Keenan-Devlin, Lauren
AU - McDade, Thomas W.
AU - Wadhwa, Pathik D.
AU - Borders, Ann
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/10
Y1 - 2017/10
N2 - 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.
AB - 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.
KW - Health disparities
KW - Inflammation
KW - Inter-generational
KW - Pregnancy
KW - Socioeconomic status
UR - http://www.scopus.com/inward/record.url?scp=85018174477&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018174477&partnerID=8YFLogxK
U2 - 10.1016/j.bbi.2017.04.018
DO - 10.1016/j.bbi.2017.04.018
M3 - Article
C2 - 28450221
AN - SCOPUS:85018174477
SN - 0889-1591
VL - 65
SP - 11
EP - 19
JO - Brain, Behavior, and Immunity
JF - Brain, Behavior, and Immunity
ER -