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 nation’s leading integrated academic health systems and one of the largest in the New York metropolitan area. Its comprehensive system includes seven hospitals, more than 400 outpatient practices, over 600 research and clinical laboratories, the Icahn School of Medicine at Mount Sinai, the Graduate School of Biomedical Sciences, and the Mount Sinai Phillips School of Nursing. Together, the Health System comprises approximately 48,000 employees, more than 9,000 physicians, and 8,600 nurses.
As a leading learning health system, Mount Sinai combines clinical expertise with scientific discovery to improve patient care while training the next generation of health care and biomedical leaders. The Health System provides care across every stage of life, from prenatal care through geriatrics, while advancing personalized medicine through artificial intelligence, data science, and biomedical research.
Mount Sinai is consistently recognized among the nation’s leading academic health systems for patient care, research, and education. The Mount Sinai Hospital is ranked No. 1 in New York by Newsweek and No. 5 on the magazine’s World’s Best Hospitals list. The Icahn School of Medicine at Mount Sinai ranks No. 11 among U.S. medical schools and No. 1 among freestanding medical schools for National Institutes of Health funding, reflecting the strength of its scientific enterprise and leadership in biomedical research.