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Prenatal stress perturbs fetal iron homeostasis in a sex specific manner
Peter Zimmermann1, Marta C Antonelli1,2, Ritika Sharma1,3
1Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Insights
Maternal prenatal stress (PS) impacts fetal iron. Stressed mothers had lower fetal ferritin and higher Fetal Stress Index (FSI), indicating a need for early interventions.
Area of Science:
- Neurodevelopmental Biology
- Prenatal Health
- Iron Metabolism
Background:
- Maternal prenatal stress (PS) negatively affects child neurodevelopment.
- Early identification of at-risk fetuses is crucial for timely interventions.
- Biomarkers for prenatal stress are needed to guide therapeutic strategies.
Purpose of the Study:
- To identify biomarkers for prenatal stress.
- To investigate the effect of prenatal stress on fetal iron homeostasis.
- To explore the role of Fetal Stress Index (FSI) in detecting stress-related fetal conditions.
Main Methods:
- Prospective matched double cohort study of 164 pregnant women.
- Cohen Perceived Stress Scale-10 (PSS-10) questionnaire for stress assessment.
- Fetal cord blood iron parameters and transabdominal electrocardiogram-based Fetal Stress Index (FSI) were measured.
Main Results:
- Prenatal stress was associated with a 15% decrease in fetal ferritin levels.
- Lower transferrin saturation was observed in male neonates from stressed mothers.
- Higher mean FSI was found in the stressed group compared to the control group.
Conclusions:
- Prenatal stress significantly impacts fetal iron homeostasis.
- FSI can aid in the early detection of fetuses affected by prenatal stress.
- Early iron supplementation and neurodevelopmental follow-up are recommended for affected infants.
Abstract:
The adverse effects of maternal prenatal stress (PS) on child's neurodevelopment warrant the establishment of biomarkers that enable early interventional therapeutic strategies. We performed a prospective matched double cohort study screening 2000 pregnant women in third trimester with Cohen Perceived Stress Scale-10 (PSS-10) questionnaire; 164 participants were recruited and classified as stressed and control group (SG, CG). Fetal cord blood iron parameters of 107 patients were measured at birth. Transabdominal electrocardiograms-based Fetal Stress Index (FSI) was derived. We investigated sex contribution to group differences and conducted causal inference analyses to assess the total effect of PS exposure on iron homeostasis using a directed acyclic graph (DAG) approach. Differences are reported for p < 0.05 unless noted otherwise. Transferrin saturation was lower in male stressed neonates. The minimum adjustment set of the DAG to estimate the total effect of PS exposure on fetal ferritin iron biomarkers consisted of maternal age and socioeconomic status: SG revealed a 15% decrease in fetal ferritin compared with CG. Mean FSI was higher among SG than among CG. FSI-based timely detection of fetuses affected by PS can support early individualized iron supplementation and neurodevelopmental follow-up to prevent long-term sequelae due to PS-exacerbated impairment of the iron homeostasis.
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