ArticlePloS one2018
Maternal stress and placental function, a study using questionnaires and biomarkers at birth.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- From placenta to the foetus: a systematic review of in vitro models of stress- and inflammation-induced depression in pregnancy.Molecular psychiatry · 2025Pooled it
- Measurement of Hair Cortisol Throughout Gestation.Journal of clinical medicine · 2026Article
- Hurricane María and prenatal maternal mental health: Variations in stress, social support, and depression across disaster recovery periods in Puerto Rico.Environmental research · 2026Article
- Long-term consequences of unintended pregnancy: Impacts on early childhood growth and development in a multicenter study.World journal of clinical pediatrics · 2025Article
- The Effect of Maternal Stress on 11beta-Hydroxysteroid Dehydrogenase Activity During Pregnancy: Evidence for Potential Pregnancy Complications and Consequences on Fetal Development and Metabolism.International journal of molecular sciences · 2025Review
- Placental nanoparticle-mediated IGF1 gene therapy corrects fetal growth restriction in a guinea pig model.Gene therapy · 2025Article
- Exploring stress and depressive symptoms in pregnancy and the IL-1β, IL-6, and C-reactive protein pathway: Looking for possible biomarker targets.Comprehensive psychoneuroendocrinology · 2025Article
- ITRAQ Based Proteomics Reveals the Potential Mechanism of Placental Injury Induced by Prenatal Stress.International journal of molecular sciences · 2024Article
- Reproductive and Social Policies, Sociopolitical Stress, and Implications for Maternal and Child Health Equity.Current environmental health reports · 2024Review
- Article
- Regulation of sexually dimorphic placental adaptation in LPS exposure-induced intrauterine growth restriction.Molecular medicine (Cambridge, Mass.) · 2023Article
- Evidence of Increased Oxidative Stress in the Placental Tissue of Women Who Suffered an Episode of Psychosis during Pregnancy.Antioxidants (Basel, Switzerland) · 2023Article
- The Placentas of Women Who Suffer an Episode of Psychosis during Pregnancy Have Increased Lipid Peroxidation with Evidence of Ferroptosis.Biomolecules · 2023Article
- Review
- Maternal Stressful Life Events during Pregnancy and Atopic Dermatitis in Children Aged Approximately 4-6 Years.International journal of environmental research and public health · 2021Article
- Adverse Pregnancy Outcomes Following the Assassination of John F. Kennedy in 1963.Maternal and child health journal · 2021Article
- Article
- Influence of labor on direct and indirect determinants of placental 11beta-hydroxysteroid dehydrogenase activity.Archives of gynecology and obstetrics · 2021Article
- Urban-Related Environmental Exposures during Pregnancy and Placental Development and Preeclampsia: a Review.Current hypertension reports · 2020Review
- Does the Caesarean Section Impact on 11β HSD2 and Fetal Cortisol?International journal of environmental research and public health · 2020Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrenatal stress affects the health of the pregnant woman and the fetus. Cortisol blood levels are elevated in pregnancy, and fetal exposure to cortisol is regulated by the placenta enzyme 11β-HSD2. A decrease in enzyme activity allows more maternal cortisol to pass through the placental barrier. Combining the fetal and maternal cortisol to cortisone ratio into the adjusted fetal cortisol exposure (AFCE) represents the activity of the enzyme 11β-HSD2 in the placenta.
aimTo investigate the effect of prenatal maternal stress on the ratio of cortisol and cortisone in maternal and fetal blood at birth in a normal population.
methodMaternal self-reported stress was assessed at one time-point, as late in the pregnancy as convenient for the participant, using the Depression Anxiety Stress Scales (DASS-42), Pregnancy Related Anxiety (PRA), and Major Life Events during pregnancy. The study included 273 participants from Copenhagen University Hospital. Maternal and umbilical cord blood was sampled directly after birth and cortisol and cortisone concentrations were quantified using UPLC chromatography. Data were analyzed in a five-step regression model with addition of possible confounders. The primary outcome was AFCE, and plasma concentrations of maternal and fetal cortisol and cortisone were secondary outcomes.
resultsSignificant associations were seen for the primary outcome AFCE and the plasma concentrations of maternal cortisol and fetal cortisone with exposure to Pregnancy Related Anxiety (PRA), though the associations were reduced when adjusting for birth related variables, especially delivery mode. The weight of the placenta affected the associations of exposures on AFCE, but not plasma concentrations of cortisol and cortisone in mother and fetus. Moreover, the study demonstrated the importance of delivery mode and birth strain on cortisol levels right after delivery.
conclusionOur main finding was associations between PRA and AFCE, which shows the effect of maternal stress on placental cortisol metabolism.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.