Does Maternal Depression or Stress Affect Fetal Growth?

BACKGROUND AND PURPOSE:

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)