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Prenatal allostatic load and preterm birth: A systematic review
Shahirose Sadrudin Premji1, Gianella Santos Pana2, Alexander Cuncannon3
1School of Nursing, Faculty of Health, York University, Toronto, ON, Canada.
Frontiers in Psychology
|October 21, 2022
Summary
This systematic review found mixed evidence on the link between prenatal allostatic load, a measure of cumulative stress burden, and preterm birth risk. Further research is needed to clarify this association.
Area of Science:
- Reproductive Health
- Perinatal Epidemiology
- Stress Physiology
Background:
- Allostatic load, representing cumulative neuroendocrine burden, is theorized to influence stress responses and potentially impact preterm birth risk.
- Understanding the relationship between prenatal stress exposure and adverse birth outcomes is crucial for maternal and infant health.
Approach:
- A systematic review was conducted, searching seven databases for observational and mixed-methods studies up to August 2022.
- Studies were included if they measured allostatic load during pregnancy and observed preterm birth (< 37 weeks' gestational age).
- Risk of bias was assessed using the Quality In Prognosis Studies tool, followed by a narrative synthesis.
Key Points:
- Three prospective cohort studies were identified, yielding inconsistent findings regarding the association between allostatic load and preterm birth.
- One study reported a significant association, while two others found little to no evidence.
- Heterogeneity in measurement of allostatic load, study design limitations, and cohort characteristics may explain the mixed results.
Conclusions:
- The review highlights the need for further research into factors influencing the allostatic load-preterm birth association, including biomarker heterogeneity and measurement algorithms.
- Investigating pregnancy-specific considerations for allostatic load measurement is essential.
- Future studies should explore the allostatic load framework within perinatal mental health to improve maternal and child health outcomes.
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