Stress increases health risks to mother and fetus

At Emory’s fifth annual predictive health symposium “Human Health: Molecules to Mankind,” Emory GYN/OB Sarah L. Berga, MD, discussed the state of childbirth in the United States and how maternal stress affects pregnant women and their fetuses.

Berga is McCord professor and chair of the Department of Gynecology and Obstetrics at Emory School of Medicine. Sadly, Berga has seen maternal mortality rise steadily since the 1980s when she entered her medical residency. Georgia, she says, has the worse maternal mortality in the country. And the United States fares worse than many countries when it comes to maternal mortality.

Despite the unfortunate rise in maternal mortality of late, the good news is physicians have now started to pay more attention to the effect of stress—both the physical and emotional kind—on women and their fetuses. Recent research shows stress has the same negative effect on the body as do organic diseases, such as thyroid disease. In fact, too much stress reduces thyroxine levels by about 50 percent, says Berga. But because there’s no clinical recognition of this, tests are needed to determine if thyroxine levels are indeed insufficient.

That’s because when thyroxine levels are low in pregnant women, this adversely affects fetuses. The mother, Berga explains, is the only source of thyroid for the first trimester of pregnancy and the predominant source of thyroid for both the second and third trimesters. Thus, the maternal thyroid determines fetal thyroid.

“People come in all the time to see me when they don’t feel quite right,” Berga says. “If you’re an obstetrician or a gynecologist, you need to know about this. Because if you don’t, the women in your practice will be at increased risk for anovulation, infertility, miscarriage, pregnancy induced hypertension, preterm delivery, and compromised fetal neurodevelopment. And we believe the compromised fetal neurodevelopment actually puts the offspring at risk for autism spectrum disorders and schizophrenia mood disorders.”

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Robin Tricoles

Science Writer, Research Communications rtricol@emory.edu 404-727-0532 Office

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