(357) Maternal psychosocial stress and biologic determinants of placental angiogenic factors in a large pregnancy cohort

Maternal psychosocial stress may be a risk factor for adverse pregnancy outcomes. However, little is known about how pre- and early-pregnancy stress impact placental angiogenesis. We identified classes of psychosocial stressors among pregnant women and evaluated their association with placental proteins.

Study Design:

We performed a secondary-analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be cohort. Latent class analysis was used to identify classes of social stressors based on psychological (stress, anxiety, resilience, depression) and sociocultural (social support, economic, discrimination) indicators within the full cohort (n = 8,491). We used a nested case-control population to evaluate four placental proteins: soluble fms-Like Tyrosine Kinase-1, placental growth factor (PlGF), endoglin, vascular endothelial growth factor measured at Study Visit 1 (SV1) and 2 (SV2). To estimate the association between psychosocial stress and placental proteins, we used multivariable linear regression weighted for the sampling fraction and adjusted for confounders.


Results:

We identified five classes reflective of psychosocial wellbeing (Class 1 to Class 5), where increasing latent class number indicates exposure to greater psychosocial stress. Women in Class 5 tended to be younger (p < 0.001), non-Hispanic Black (p = 0.025), and have lower educational levels (p < 0.001) than those in Class 1.

 


Class 5 had decreased endoglin (adjusted mean difference [95% confidence interval]: -0.05 (-0.10, -0.01)) compared to Class 1 at SV1 (median gestational age (GA) = 12.4 weeks) (Table 1). Compared to Class 1, both Class 2 and Class 4 had decreased endoglin and increased PlGF at SV1. At SV2 (median GA = 19.0 weeks), we observed no difference in placental biomarkers between classes. 



 

Conclusion:

Increased maternal psychosocial stress was associated with levels of placental proteins in the first and early second trimester of pregnancy, but this association did not persist in later pregnancy. More research is needed to characterize how psychosocial stress affects biological processes in pregnancy.