(1237) Psychosocial stressors and prenatal inflammation in the Chicago Perinatal Origins of Disease Cohort

To evaluate the association of antenatal psychosocial stressors with inflammatory biomarkers in pregnancy.

Study Design:

Secondary analysis of data from the prospective Chicago Perinatal Origins of Disease (CPOD) cohort of pregnant people with singleton gestations at a large academic center. Exposures were participant scores on the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) at 8-24 weeks (Table 1), and the Perceived Stress Scale (PSS-10) and the Everyday Discrimination Scale (EDS) at 18-36 weeks (Table 2), completed via electronic survey. Outcomes were log-transformed concentrations of plasma inflammatory cytokines (IL1β, IL2, IL6, IL8, IL10, IFNγ, TNFα) and cytokine-induced cell adhesion molecules (ICAM1, VCAM1), measured via Meso Scale Discovery immunoassay. Student’s t-tests compared mean differences in biomarker concentrations, and linear regression models generated beta (ß)-coefficients adjusted for pre-pregnancy body mass index.

Results:

Of 118 enrolled participants, 99 completed the above psychosocial stress screeners and provided a plasma sample, with 22% and 26% identifying as Black or Hispanic, respectively. Median gestational age at plasma sample collection was 28.7 weeks’ gestation (IQR 26.1, 32.4). PHQ-9 (mean difference 0.73 pg/mL; p-value 0.02) and GAD-7 scores ≥5 (mean difference 0.64 pg/mL; p-value 0.03), indicating at least mild depressive and/or anxiety symptoms, were associated with higher IL6 concentrations, and a PHQ-9 score ≥5 (vs. < 5) was associated with higher ICAM1 concentrations. When assessed as continuous measures, higher PSS scores were associated with lower IL1ß (adj. ß -0.57; 95% CI -0.03, -1.12) and IL10 (adj. ß -0.52; 95% CI -0.05, -0.98). Higher EDS scores were associated with lower IFNγ (adj. ß -0.031; 95% CI -0.01, -0.05).

Conclusion:

In the CPOD cohort, anxiety and depressive symptoms were positively associated with the pro-inflammatory IL6, while greater perceived stress and discrimination in pregnancy were associated with suppression of anti-inflammatory IL10 and IFNγ, a regulator of anti-inflammatory processes.