Skip to main content

No associations of prenatal maternal psychosocial stress with fasting glucose metabolism in offspring at 5–6 years of age

  • A. E. van Dijk (a1) (a2), M. van Eijsden (a2) (a3), K. Stronks (a1), R. J. B. J. Gemke (a4) and T. G. M. Vrijkotte (a1)...

Highly prevalent maternal psychosocial complaints are accompanied by increases in glucocorticoid stress hormones, which may predispose the offspring for type 2 diabetes and cardiovascular disease later in adulthood. The aim of the current research is to study whether prenatal maternal psychosocial stress is associated with parameters of blood glucose metabolism in their children aged 5–6 years. The study design was a prospective birth cohort (the Amsterdam Born Children and their Development study, the Netherlands). Depressive symptoms, pregnancy-related anxiety, parenting daily hassles and job strain were recorded by questionnaire (gestational week 16). A cumulative score was also calculated. Possible sex differences in the associations were considered. The subjects were 1952 mother–child pairs. Outcome measures were fasting glucose (n=1952), C-peptide and insulin resistance (HOMA2-IR) (n=1478) in the children at the age of 5–6 years. The stress scales, single and cumulative, were not associated with glucose/C-peptide/insulin resistance (all P>0.05). We did not find evidence for sex differences. In conclusion, we did not find evidence for an association between psychosocial stress during early pregnancy and parameters of glucose metabolism in offspring at the age of 5–6 years. Differences emerging later in life or in response to a metabolic challenge should not be ruled out.

Corresponding author
*Address for correspondence: A. E. van Dijk, MSc, Academic Medical Center, Department of Public Health, P.O. Box 22660, 1100 DD Amsterdam, the Netherlands. (Email
Hide All
1.Schulze, MB, Hu, FB. Primary prevention of diabetes: what can be done and how much can be prevented? Annu Rev Public Health. 2005; 26, 445467.
2.Parker, L, Lamont, DW, Unwin, N, et al.A lifecourse study of risk for hyperinsulinaemia, dyslipidaemia and obesity (the central metabolic syndrome) at age 49–51 years. Diabet Med. 2003; 20, 406415.
3.Paarlberg, KM, Vingerhoets, AJ, Passchier, J, Dekker, GA, van Geijn, HP. Psychosocial factors and pregnancy outcome: a review with emphasis on methodological issues. J Psychosom Res. 1995; 39, 563595.
4.Paarlberg, KM, Vingerhoets, AJ, Passchier, J, et al. Psychosocial predictors of low birthweight: a prospective study. Br J Obstet Gynaecol. 1999; 106, 834841.
5.Wadhwa, PD, Sandman, CA, Garite, TJ. The neurobiology of stress in human pregnancy: implications for prematurity and development of the fetal central nervous system. In Progress in Brain Research, Vol. 133: The Maternal Brain (eds. Russell JA, Douglas AJ, Windle RJ, Ingram CD), 2001; pp. 131142. Elsevier: Amsterdam.
6.Hedegaard, M, Henriksen, TB, Sabroe, S, Secher, NJ. Psychological distress in pregnancy and preterm delivery. BMJ. 1993; 307, 234239.
7.Hedegaard, M, Henriksen, TB, Secher, NJ, Hatch, MC, Sabroe, S. Do stressful life events affect duration of gestation and risk of preterm delivery? Epidemiology. 1996; 7, 339345.
8.Littleton, HL, Breitkopf, CR, Berenson, AB. Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: a meta-analysis. Am J Obstet Gynecol. 2007; 196, 424432.
9.Littleton, HL, Bye, K, Buck, K, Amacker, A. Psychosocial stress during pregnancy and perinatal outcomes: a meta-analytic review. J Psychosom Obstet Gynaecol. 2010; 31, 219228.
10.Kensara, OA, Wootton, SA, Phillips, DI, et al. Fetal programming of body composition: relation between birth weight and body composition measured with dual-energy X-ray absorptiometry and anthropometric methods in older Englishmen. Am J Clin Nutr. 2005; 82, 980987.
11.Newsome, CA, Shiell, AW, Fall, CH, et al. Is birth weight related to later glucose and insulin metabolism? – A systematic review. Diabet Med. 2003; 20, 339348.
12.Hales, CN, Barker, DJ. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia. 1992; 35, 595601.
13.Barker, DJ, Hales, CN, Fall, CH, et al. Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993; 36, 6267.
14.Tse, AC, Rich-Edwards, JW, Koenen, K, Wright, RJ. Cumulative stress and maternal prenatal corticotropin-releasing hormone in an urban U.S. cohort. Psychoneuroendocrinology. 2012; 37, 970979.
15.D’mello, AP, Liu, Y. Effects of maternal immobilization stress on birth weight and glucose homeostasis in the offspring. Psychoneuroendocrinology. 2006; 31, 395406.
16.Gatford, KL, Wintour, EM, De Blasio, MJ, Owens, JA, Dodic, M. Differential timing for programming of glucose homoeostasis, sensitivity to insulin and blood pressure by in utero exposure to dexamethasone in sheep. Clin Sci (Lond). 2000; 98, 553560.
17.Moss, TJ, Sloboda, DM, Gurrin, LC, et al. Programming effects in sheep of prenatal growth restriction and glucocorticoid exposure. Am J Physiol Regul Integr Comp Physiol. 2001; 281, R960R970.
18.Lindsay, RS, Lindsay, RM, Waddell, BJ, Seckl, JR. Prenatal glucocorticoid exposure leads to offspring hyperglycaemia in the rat: studies with the 11 beta-hydroxysteroid dehydrogenase inhibitor carbenoxolone. Diabetologia. 1996; 39, 12991305.
19.Nyirenda, MJ, Lindsay, RS, Kenyon, CJ, Burchell, A, Seckl, JR. Glucocorticoid exposure in late gestation permanently programs rat hepatic phosphoenolpyruvate carboxykinase and glucocorticoid receptor expression and causes glucose intolerance in adult offspring. J Clin Invest. 1998; 101, 21742181.
20.Dalziel, SR, Walker, NK, Parag, V, et al. Cardiovascular risk factors after antenatal exposure to betamethasone: 30-year follow-up of a randomised controlled trial. Lancet. 2005; 365, 18561862.
21.Woods, SM, Melville, JL, Guo, Y, Fan, MY, Gavin, A. Psychosocial stress during pregnancy. Am J Obstet Gynecol. 2010; 202, 61.e161.e7.
22.O’Donnell, K, O’Connor, TG, Glover, V. Prenatal stress and neurodevelopment of the child: focus on the HPA axis and role of the placenta. Dev Neurosci. 2009; 31, 285292.
23.Glover, V, O’Connor, TG, O’Donnell, K. Prenatal stress and the programming of the HPA axis. Neurosci Biobehav Rev. 2010; 35, 1722.
24.Miller, DB, O’Callaghan, JP. Neuroendocrine aspects of the response to stress. Metabolism. 2002; 51(Suppl. 1), 510.
25.Ertel, KA, Koenen, KC, Rich-Edwards, JW, Gillman, MW. Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity. Paediatr Perinat Epidemiol. 2010; 24, 179189.
26.Li, J, Olsen, J, Vestergaard, M, et al. Prenatal stress exposure related to maternal bereavement and risk of childhood overweight. PLoS One. 2010; 5, e11896.
27.Entringer, S, Wust, S, Kumsta, R, et al. Prenatal psychosocial stress exposure is associated with insulin resistance in young adults. Am J Obstet Gynecol. 2008; 199, 498.e1498.e7.
28.Clifton, VL. Review: sex and the human placenta: mediating differential strategies of fetal growth and survival. Placenta. 2010; 31(Suppl.), S33S39.
29.Clifton, VL, Murphy, VE. Maternal asthma as a model for examining fetal sex-specific effects on maternal physiology and placental mechanisms that regulate human fetal growth. Placenta. 2004; 25(Suppl. A), S45S52.
30.Bruckner, TA, Catalano, R, Ahern, J. Male fetal loss in the U.S. following the terrorist attacks of September 11, 2001. BMC Public Health 2010; 10, 273.
31.Bekedam, DJ, Engelsbel, S, Mol, BW, Buitendijk, SE, van der Pal-de Bruin, KM. Male predominance in fetal distress during labor. Am J Obstet Gynecol. 2002; 187, 16051607.
32.Owen, D, Matthews, SG. Glucocorticoids and sex-dependent development of brain glucocorticoid and mineralocorticoid receptors. Endocrinology. 2003; 144, 27752784.
33.Van Eijsden, M, Vrijkotte, TG, Gemke, RJ, van der Wal, MF. Cohort Profile: The Amsterdam Born Children and their Development (ABCD) Study. Int J Epidemiol. 2011; 40, 11761186.
34.Loomans, EM, van Dijk, AE, Vrijkotte, TG, et al. Psychosocial stress during pregnancy is related to adverse birth outcomes: results from a large multi-ethnic community-based birth cohort. Eur J Public Health. 2013; 23, 485491.
35.van Dijk, AE, van Eijsden, M, Stronks, K, Gemke, RJ, Vrijkotte, TG. Prenatal stress and balance of the child's cardiac autonomic nervous system at age 5-6 years. PLoS One. 2012; 7, e30413.
36.van Dijk, AE, van Eijsden, M, Stronks, K, Gemke, RJ, Vrijkotte, TG. The association between prenatal psychosocial stress and blood pressure in the child at age 5–7 years. PLoS One. 2012; 7, e43548.
37.van Dijk, AE, van Eijsden, M, Stronks, K, Gemke, RJ, Vrijkotte, TG. Cardio-metabolic risk in 5-year-old children prenatally exposed to maternal psychosocial stress: the ABCD study. BMC Public Health. 2010; 10, 251.
38.van der Ploeg, HM, Defares, PB, Spielberger, CD. Een nederlandstalige bewerking van de Spielberger State-Trait Anxiety Inventory: de Zelf-Beoordelings Vragenlijst. De Psycholoog. 1980; 15, 460467.
39.Spielberger, CD, Gorsuch, RL, Lushene, RE. STAI Manual for the State-Trait Anxiety Inventory. 1970. Consulting Psychologists Press: Palo Alto, California, USA.
40.Hanewald, GJFP. CES-D: De Nederlandse versie. Een onderzoek naar de betrouwbaarheid en validiteit. 1987. University of Amsterdam, Department of Clinical Psychology: Amsterdam.
41.Radloff, LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measurement. 1977; 1, 385401.
42.Huizink, AC, Mulder, EJ, Robles de Medina, PG, Visser, GH, Buitelaar, JK. Is pregnancy anxiety a distinctive syndrome? Early Hum Dev. 2004; 79, 8191.
43.Van den Bergh, B. The influence of maternal emotions during pregnancy on fetal and neonatal behavior. Pre Perinat Psychol J. 1990; 5, 119130.
44.Groenendaal, JH, Gerrits, LA. Dagelijkse Beslommeringen Lijst (DBL). 1996. Universiteit Utrecht: Utrecht, the Netherlands.
45.Crnic, KA, Greenberg, MT. Minor parenting stresses with young children. Child Dev 1990; 61, 16281637.
46.Karasek, R, Brisson, C, Kawakami, N, et al. The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998; 3, 322355.
47.Houtman, IL, Goudswaard, A, Dhondt, S, et al. Dutch monitor on stress and physical load: risk factors, consequences, and preventive action. Occup Environ Med. 1998; 55, 7383.
48.Gootjes, J, Tel, RM, Bergkamp, FJ, Gorgels, JP. Laboratory evaluation of a novel capillary blood sampling device for measuring eight clinical chemistry parameters and HbA1c. Clin Chim Acta. 2009; 401, 152157.
49.van den Berg, G, van Eijsden, M, Vrijkotte, TG, Gemke, RJ. Socioeconomic inequalities in lipid and glucose metabolism in early childhood in a population-based cohort: the ABCD-Study. BMC Public Health. 2012; 1, 591. Hoog, ML, van Eijsden, M, Stronks, K, Gemke, RJ, Vrijkotte, TG. The role of infant feeding practices in the explanation for ethnic differences in infant growth: the Amsterdam Born Children and their Development study. Br J Nutr. 2011; 106, 15921601.
51.Baron, RM, Kenny, DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986; 51, 11731182.
52.Lesage, J, Del-Favero, F, Leonhardt, M, et al. Prenatal stress induces intrauterine growth restriction and programmes glucose intolerance and feeding behaviour disturbances in the aged rat. J Endocrinol. 2004; 181, 291296.
53.Glover, V, Bergman, K, Sarkar, P, O’Connor, TG. Association between maternal and amniotic fluid cortisol is moderated by maternal anxiety. Psychoneuroendocrinology. 2009; 34, 430435.
54.Entringer, S, Kumsta, R, Hellhammer, DH, Wadhwa, PD, Wust, S. Prenatal exposure to maternal psychosocial stress and HPA axis regulation in young adults. Horm Behav. 2009; 55, 292298.
55.Coussons-Read, ME, Okun, ML, Nettles, CD. Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy. Brain Behav Immun. 2007; 21, 343350.
56.Rogers, LK, Velten, M. Maternal inflammation, growth retardation, and preterm birth: insights into adult cardiovascular disease. Life Sci. 2011; 89, 417421.
57.van Dijk, AE, van Eijsden, M, Stronks, K, Gemke, RJ, Vrijkotte, TG. The relation of maternal job strain and cortisol levels during early pregnancy with body composition later in the 5-year-old child: the ABCD study. Early Hum Dev. 2012; 88, 351356.
58.Tromp, M, Van Eijsden, M, Ravelli, ACJ, Bonsel, GJ. Non-response analysis in the ABCD cohort study enabled by probabilistic record linkage. Paediatr Perinat Epidemiol. 2009; 23, 264272.
59.Lobel, M. Conceptualizations, measurement, and effects of prenatal maternal stress on birth outcomes. J Behav Med. 1994; 17, 225272.
60.Piper, K, Brickwood, S, Turnpenny, LW, et al. Beta cell differentiation during early human pancreas development. J Endocrinol. 2004; 181, 1123.
61.Fasting, MH, Oken, E, Mantzoros, CS, et al. Maternal levels of corticotropin-releasing hormone during pregnancy in relation to adiponectin and leptin in early childhood. J Clin Endocrinol Metab. 2009; 94, 14091415.
62.Meier, U, Gressner, AM. Endocrine regulation of energy metabolism: review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clin Chem. 2004; 50, 15111525.
63.Tamashiro, KL, Terrillion, CE, Hyun, J, Koenig, JI, Moran, TH. Prenatal stress or high-fat diet increases susceptibility to diet-induced obesity in rat offspring. Diabetes. 2009; 58, 11161125.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of Developmental Origins of Health and Disease
  • ISSN: 2040-1744
  • EISSN: 2040-1752
  • URL: /core/journals/journal-of-developmental-origins-of-health-and-disease
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed