Eick Stephanie M, Meeker John D, Brown Phil, Swartzendruber Andrea, Rios-McConnell Rafael, Shen Ye, Milne Ginger L, Vélez Vega Carmen, Rosario Zaira, Alshawabkeh Akram, Cordero José F, Ferguson Kelly K
Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 101 Buck Road, Athens, GA, 30329, United States.
Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Hts, Ann Arbor, MI, 48109, United States.
Free Radic Biol Med. 2019 Nov 1;143:95-100. doi: 10.1016/j.freeradbiomed.2019.07.032. Epub 2019 Jul 29.
Lower socioeconomic status (SES) and psychosocial stress during pregnancy have been associated with adverse birth outcomes. While hypothalamic-pituitary-axis activation is thought to be the primary driver, oxidative stress may also be involved mechanistically. We used data from the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) cohort (N=476) to examine associations between self-reported psychosocial stress measures, SES indicators, and urinary oxidative stress biomarker concentrations, hypothesizing that women with lower SES and increased psychosocial stress would have elevated oxidative stress biomarkers.
Maternal age, education, marital status, insurance status, alcohol use and smoking status were obtained via self-reported questionnaires and were used as indicators of SES. Perceived stress, depression, negative life experiences, neighborhood perceptions, and social support were self-reported in questionnaires administered during pregnancy. Responses were grouped into tertiles for analysis, where the highest tertile corresponded to highest level of psychosocial stress. Urinary concentrations of 8-iso-prostaglandin F (8-iso-PGF) and its primary metabolite were measured at three study visits (median 18, 24, 28 weeks gestation) and averaged to reflect oxidative stress across pregnancy. Linear models were used to examine associations between SES indicators, tertiles of psychosocial stress and oxidative stress biomarkers.
Average levels of 8-iso-PGF and the 8-iso-PGF metabolite were higher among pregnant women who were younger, who had public compared to private insurance, and who were unemployed compared to employed. However, no associations were observed between psychosocial stress measures and biomarker concentrations in adjusted analyses.
Psychosocial stress during pregnancy, as indicated by self-reported questionnaire measures, was not associated with biomarkers of oxidative stress in the PROTECT study. However, results suggest that these biomarkers are elevated among women of lower SES, which is typically associated with stress. Notably, compared to other populations, self-reported psychosocial stress measures were lower in PROTECT compared to other populations.
孕期社会经济地位较低（SES）和心理社会压力与不良出生结局相关。虽然下丘脑 - 垂体轴激活被认为是主要驱动因素，但氧化应激在机制上可能也有涉及。我们使用来自波多黎各污染威胁探索试验点（PROTECT）队列（N = 476）的数据，来研究自我报告的心理社会压力测量指标、SES指标与尿氧化应激生物标志物浓度之间的关联，假设SES较低且心理社会压力增加的女性氧化应激生物标志物水平会升高。
通过自我报告问卷获取产妇年龄、教育程度、婚姻状况、保险状况、饮酒和吸烟状况，并将其用作SES指标。在孕期问卷调查中自我报告感知压力、抑郁、负面生活经历、邻里认知和社会支持情况。将回答分为三个三分位数进行分析，其中最高三分位数对应最高水平的心理社会压力。在三次研究访视（妊娠中位数为18、24、28周）时测量尿中8 - 异前列腺素F（8 - iso - PGF）及其主要代谢物的浓度，并取平均值以反映整个孕期的氧化应激情况。使用线性模型来研究SES指标、心理社会压力三分位数与氧化应激生物标志物之间的关联。
年龄较小、拥有公共保险而非私人保险、失业而非就业的孕妇中，8 - iso - PGF及其代谢物的平均水平较高。然而，在调整分析中未观察到心理社会压力测量指标与生物标志物浓度之间的关联。
在PROTECT研究中，自我报告问卷测量所表明的孕期心理社会压力与氧化应激生物标志物无关。然而，结果表明这些生物标志物在SES较低的女性中升高，而SES较低通常与压力相关。值得注意的是，与其他人群相比，PROTECT中自我报告的心理社会压力测量指标较低。
