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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
PubMed

Insights

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.
Abstract

Keywords:
MiGHTperinatal distressperinatal mental healthpregnancypremature birthprenatal allostatic loadstress

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