Acute maternal stress in pregnancy and cardiovascular risk factors in adolescent offspring: a birth-cohort study

Cardiometabolic risk factors are major contributors to poor health outcomes and premature mortality. While the effect of prenatal exposure to stress on cardiometabolic outcomes has been examined, the findings remain inconsistent across studies, and even more so with regard to the timing of exposure. In the present study, we aimed to explore the association of short-term prenatal exposure to the acute stress of the 1967 Six-Day War with cardiovascular and anthropometric risk factors in adolescent offspring.

Using a population-based birth cohort, we examined data from 61 237 offspring born in Jerusalem during 1964-76, linked to their military-draft records at age 17 years. These provided information on those exposed to acute prenatal stress and the timing of exposure within the pregnancy (N = 2471) as well as on height, weight, heart rate (HR), and blood pressure (BP) in adolescence. Linear regression models estimated the associations between prenatal stress and measurements at age 17 years, controlling for potential confounders.

Prenatal exposure to acute stress was associated with increased systolic blood pressure (SBP) and diastolic blood pressure (DBP) [SBP: B = 1.85, 95% confidence interval (CI): 1.15, 2.56; DBP: B = 1.89, 95% CI: 1.40, 2.38] and a decreased HR (B = -1.39, CI: -1.88, -0.91) but not with anthropometric outcomes. Furthermore, gestational age at exposure modified these associations: the associations with DBP and mean arterial pressure tended to increase and with HR to decrease the later the exposure occurred during the pregnancy.

Findings suggest that acute maternal stress during pregnancy is associated with cardiovascular risk factors in offspring in adolescence and is modulated by the timing of the exposure.