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Does Maternal Depression or Stress Affect Fetal Growth?


  • Intrauterine fetal growth restriction (FGR or IUGR), defined as weight below the 10th percentile, has been associated with excessive maternal stress 
  • Most studies are based on birth weight, and therefore cannot fully assess timing of various exposures in addition to confounders  
  • Grobman et al. (Journal of Ultrasound in Medicine, 2017) sought to determine whether women reporting greater perceived stress or depression symptoms at start of or during pregnancy would demonstrate altered longitudinal fetal growth 


  • NICHD Fetal Growth Study multicenter prospective (2009 – 2013) 
  • Women screened at 8 weeks and 13 weeks 6 days gestation for stress/depression status and underwent serial sonographic examinations
  • Definition of high risk 
    • Cohen Perceived Stress Scale (PSS):  Score ≥ 15
    • Edinburgh Postpartum Depression Survey (EPDS): Score of ≥ 10 (13 used for sensitivity analysis)
  • Fetal weight growth curves and individual biometric parameters were created using serial sonographic data  
  • Interaction between race/ethnicity and stress/depression scores were assessed 


  • Multicenter longitudinal study of 2334 women 
  • 89% and 90% of women completed PSS and EPDS, respectively, at least once in all trimesters 
  • Despite participant’s reported PSS or EPDS score, longitudinal growth curves and fetal weight were similar 
  • Race/ethnicity did not modify biometric parameters 


  • Quantified depressive symptoms and greater perceived stress are not associated with alterations in fetal growth throughout all three trimesters 
  • Authors recommend further research to determine whether combination of stress and/or depression with environmental factors may alter fetal growth 
  • This paper complements the Wing et al. study that likewise did not find an association between perceived maternal stress and neonatal growth measurements (summarized in ‘Related ObG Topics’ below) 

Learn More – Primary Sources:  

Maternal Depressive Symptoms, Perceived Stress, and Fetal Growth