Inflammatory Stress Response During Pregnancy as a Connecting Link in Intergenerational Risk Cascades

Abstract

Pregnancy represents a critical juncture for intergenerational transmission of stress-related health vulnerabilities when child-bearers’ history of maltreatment may precipitate stress responses that adversely impact maternal and fetal outcomes. We aimed to shed light on this path by testing hypotheses that (1) childhood maltreatment would predict oral inflammatory responses to acute stress in late pregnancy, and (2) these inflammatory responses would relate to subsequent obstetric complications. Hypotheses were tested in a community sample of women (n = 158) from a larger longitudinal study. Participants reported a history of maltreatment and completed the Trier Social Stress Test during the third trimester of pregnancy. Five saliva samples collected before and after the task were assayed for pro-inflammatory cytokines (IL1β, IL6, TNFα) and C-reactive protein (CRP) to index oral inflammation. At 3 months postnatal, women reported pregnancy and birth complications, and birth outcomes. Multilevel models of inflammatory response trajectories supported hypothesized paths: Greater childhood maltreatment—especially physical neglect and sexual abuse—predicted higher and/or extended inflammatory stress responses. In turn, higher inflammatory stress responses related to greater pregnancy and birth complications, and extended inflammatory responses related to a greater likelihood of preterm birth. Findings support oral inflammatory response to stress as a potential link to target in intergenerational health risk transmission.