Maternal adversity and peripheral proinflammatory cytokine concentrations in pregnancy

Psychosocial stressors such as adverse childhood experiences (ACEs) and financial hardship have been linked to inflammatory phenotypes. Few studies have investigated the role of childhood and current stressors on inflammatory marker concentrations in pregnancy, a period marked by shifts in immune activity. This study examined the associations among ACEs, financial stress, and concentrations of three cytokines: TNF-α, IL-6, and IL-8 in pregnant people. Additionally, we explored whether current financial stress amplified relations between ACEs and immune activity, and, in contrast, whether current social support served as a potential buffer.

Pregnant people (n = 304) ages 18+ were enrolled from two prospective pregnancy cohorts in North Carolina and Florida between April 2018 and March 2020. Participant demographics, health behaviors, current health conditions, and documented medical and social histories were collected via survey and obstetric record abstraction. Venous blood samples were drawn and assayed for cytokines using commercially available multiplex kits. Associations between ACEs, financial stress, and cytokines were evaluated using multivariable tobit regression to account for left censoring of cytokine concentrations.

The mean age of the sample was 30 years and mean gestational age at blood collection was 26.8 weeks. Nearly three-fourths of participants had <2 ACEs, 61.5% were White, 38.5% were Black, and 24.0% were Hispanic. In both bivariate and multivariable analyses, IL-6 levels were decreased in the 2+ ACE group vs. the <2 ACE group (Exponentiated β = 0.39, p-value = 0.04). Financial stress significantly moderated the relationship between ACEs and IL-8 levels (Exponentiated β = 1.12, p-value = 0.04), revealing a negative association between financial stress and IL-8 levels in the <2 ACEs group and a positive association in the 2+ ACEs group.

Our results suggest ACEs may have an immunosuppressive role in pregnant people. This relationship may be moderated by current social stressors. These results underscore the need for additional research to understand how life course experiences influence health and wellbeing for pregnant people, with implications for their children.