Stress During Pregnancy and Epigenetic Modifications to Offspring DNA: A Systematic Review of Associations and Implications for Preterm Birth.
Alexandra L Nowak, Cindy M Anderson, Amy R Mackos and 2 others
PMID 32332443WHAT IT FOUND
Prenatal stress was associated with changes in newborn cord blood DNA methylation in many, but not all, studies.
The review does not show that reducing stress prevents preterm birth.
Key findings
01The review included 25 reports examining maternal stress during pregnancy and offspring cord blood DNA methylation at birth.
02Anxiety and depressive symptoms during pregnancy were associated with offspring cord blood DNA methylation at multiple sites and regions.
03Several studies found no association between emotional responses to stress during pregnancy and offspring cord blood DNA methylation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review synthesized observational studies, so it cannot show that stress caused epigenetic changes or preterm birth. Findings were inconsistent across stress measures and DNA methylation sites, and some studies found no association. Many included studies had missing data, used convenience samples, and did not fully account for smoking or body mass index. The review did not test a clinical intervention or measure whether stress reduction improves preterm birth outcomes.
Declared interests
The authors declared no conflicts of interest. No funding source is reported in the supplied text.
The easy way to misread this
Do not conclude that reducing prenatal stress prevents preterm birth or that cord blood methylation should guide care. This review only found associations, many were inconsistent, and no intervention was tested.