Women Who Experienced Higher Levels of Trauma and Increased Cortisol Gave Birth to Significantly Smaller Male Babies
In the first study of its kind, researchers from the Icahn School of Medicine at Mount Sinai have found significantly lower birth weights in male infants—an average decrease of 38 grams, or approximately 1.3 ounces—born to women who had been exposed to trauma at some point in their lives and who secreted higher levels of cortisol, a hormone related to stress, in late pregnancy.
The study was published in The Journal of Pediatrics.
Only women who had both a history of trauma and higher levels of cortisol secretion experienced lower birth weights; trauma alone was not sufficient. The association was also only seen among male babies. This is consistent with other data that shows that male fetuses are more susceptible to effects of maternal stress on intrauterine growth.
The Programming of Intergenerational Stress Mechanisms (PRISM) study provided data for the research. Information was gathered from 314 pregnant women receiving prenatal care and their children. The women provided information on their medical history and exposure to traumatic and stressful events using the Life Stressor Checklist-Revised (LSC-R), a commonly used tool to measure lifetime exposure to stressful events particularly relevant to women. At delivery, the subjects provided hair samples which were used to measure cortisol. Birth weight and sex of the infant were recorded.
While the mechanisms remain unclear, trauma-related stress, even when occurring long before the woman becomes pregnant, can have lasting effects on regulatory systems involved in her day-to-day response to stress, including processes related to cortisol production. Not everyone who experiences trauma develops disruption in their biological stress response systems but if they do, there can be health implications for both the woman and her child. Therefore, knowing about a pregnant woman’s history of trauma together with stress hormone levels may identify at-risk pregnancies that may be complicated by low birth weight.
“Our study highlights that experiences prior to pregnancy can shape the health of subsequent generations through altered fetal development and pregnancy outcomes,” said the study’s senior author, Rosalind Wright, MD, MPH, Dean for Translational Biomedical Sciences at the Icahn School of Medicine at Mount Sinai. “Given the disproportionate exposure to stressors among racial minorities and women of lower socioeconomic status, there are important implications for understanding intergenerational perpetuation of health disparities and for understanding how to intervene.”
Size at birth is a determinant of lifelong function, health, and disease. Minority women and those of disadvantaged socio-economic status are more likely to have low-birthweight infants. Chronic lifetime stress contributes to this risk.
“Identifying a prior history of trauma and providing interventions, for example treatment for associated mood disturbances, could lead to improved perinatal outcomes that have lifelong implications for health of mother and baby,” said the study’s first author, Julie Flom, MD, MPH, fellow in the Department of Allergy and Immunology at Icahn School of Medicine at Mount Sinai.
Other institutions involved in this study include the Harvard T.H.Chan School of Public Health, University of Cincinnati College of Medicine, Boston Children’s Hospital, and Harvard Medical School.
This study was supported by grants from the National Institute of Health.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in 4 out of 10 pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.