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Brain Behav Immun. 2017 Oct;65:11-19. doi: 10.1016/j.bbi.2017.04.018. Epub 2017 Apr 25.

Mothers' childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways.

Author information

1
Department of Psychology, Northwestern University, United States; Institute for Policy Research, Northwestern University, United States. Electronic address: greg.miller@northwestern.edu.
2
Children's Hospital of Philadelphia, Division of Adolescent Medicine, United States; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, United States.
3
Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, United States; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, United States.
4
Division of Maternal-Fetal Medicine, University of Pittsburgh School of Medicine, United States; Division of Obstetrical Services, Magee Women's Hospital, United States.
5
Department of Psychiatry and Behavioral Science, Duke University, United States.
6
Institute for Policy Research, Northwestern University, United States; School of Education and Social Policy, Northwestern University, United States.
7
Development, Health and Disease Research Program, University of California, Irvine, United States; Institute of Medical Psychology, Charite University of Medicine, Berlin, Germany.
8
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States.
9
Children's Hospital of Philadelphia Research Institute, United States.
10
Department of Obstetrics and Gynecology, NorthShore University Health System, University of Chicago, Pritzker School of Medicine, United States.
11
Institute for Policy Research, Northwestern University, United States; Department of Anthropology, Northwestern University, United States.
12
Development, Health and Disease Research Program, University of California, Irvine, United States.
13
Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, United States; Department of Obstetrics and Gynecology, NorthShore University Health System, University of Chicago, Pritzker School of Medicine, United States; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States.

Abstract

Research suggests the health consequences of economic hardship can be transmitted across generations. Some of these disparities are thought to be passed to offspring during gestation. But this hypothesis has not been tested in contemporary American samples, and the mechanisms of transmission have not been characterized. Accordingly, this study had two goals: first, to determine if women exposed to economic hardship during childhood showed higher rates of adverse birth outcomes; and second, to evaluate the contribution of inflammation, psychosocial, lifestyle, and obstetric characteristics to this phenomenon. This prospective study enrolled 744 women with singleton pregnancies (59.1% White; 16.3% Black; 18.7% Latina; 5.9% Other). Childhood economic hardship was measured by self-report. Birth outcomes included length of gestation and incidence of preterm birth; birth weight percentile and small for gestational age; length of hospital stay and admission to Special Care Nursery. Analyses revealed that mothers' childhood economic hardship was independently associated with multiple adverse birth outcomes, even following adjustment for demographics, maternal education, and obstetrical confounders. Women raised in economically disadvantaged conditions had shorter gestation length and higher preterm delivery rates. Their babies had lower birth weights, were more likely to be small for gestational age, stayed in the hospital longer, and had more Special Care Nursery admissions. Mediation analyses suggested these associations arose through multiple pathways, and highlighted roles for inflammation, education, adiposity, and obstetric complications. Collectively, these findings suggest that childhood economic hardship predisposes women to adverse birth outcomes, and highlights likely behavioral and biological mechanisms.

KEYWORDS:

Health disparities; Inflammation; Inter-generational; Pregnancy; Socioeconomic status

PMID:
28450221
PMCID:
PMC5537016
DOI:
10.1016/j.bbi.2017.04.018
[Indexed for MEDLINE]
Free PMC Article

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