Stress and Pregnancy

By Madhavi Gupta, MD

Stress and Pregnancy

There’s no avoiding it—stress is part of everyday life. When stress becomes intense or chronic during pregnancy, it can have negative effects on your health and your baby’s. Stress in pregnancy can lead to preterm labor and low birth weight (1) along with other negative effects.  The good news is that there are ways to reduce stress and take control over the effects of stress on your health.

 

How stress affects development

Ongoing research continues to show the many associations between stress and your baby’s development. The effects of prenatal stress can occur directly through the influence of stress-related physiological changes on the developing baby, or by affecting your own health and the pregnancy outcome, indirectly affecting infant health and development. Studies suggest that activation of the maternal stress response and resulting changes in endocrine and inflammatory activity play a role in the causation of these negative effects (2). 

 

Gut and brain

Stress alters baby’s gut and brain. Stress during the first trimester of pregnancy alters the population of microbes living in a mother’s vagina. Those changes are passed on to newborns during birth. Research suggests that the maternal vaginal microbiome is one of the ways that a mother’s stress during pregnancy can alter the baby’s gut microbiome as well as their brain development. These early interactions occur during a critical window of neurodevelopment (3).

 

Brain growth and biochemistry

Maternal psychological distress may have an adverse association with brain structure and biochemistry in utero. Studies have shown a relationship between prenatal psychological distress and impaired fetal hippocampal development during the late second and third trimesters and altered fetal cortical gyrification in the frontal and temporal lobes (4). 

 

Stress and the nervous system

When mom experiences stress during the second trimester of pregnancy it may influence the nervous system of the developing child, both before and after birth. Studies indicate this may have subtle effects on temperament, noticed in less smiling and engagement, as well as a diminished ability to regulate emotions (5).

 

Stress and preterm labor

Women with higher levels of stress during the first trimester and second trimester show an increased risk of preterm birth and a decrease in infant birth weight. Prenatal severe life events, especially in the first trimester, may play an important role in increasing the risk of preterm birth and low birth weight (6).

 

Increased risk of preeclampsia

Hypertensive disorders during pregnancy are an important concern. In several studies, mental stress was associated with an increased risk of gestational hypertension and preeclampsia (7).

 

Stress and gestational diabetes

Research indicates an association between stress and the chance of developing gestational diabetes. In one study, participants with an increase in stress from early to mid-pregnancy had a 2.6-fold increased odds of gestational diabetes mellitus (8). Oxidative stress is known to increase the risk of insulin resistance.

 

Stress and baby sleep issues

A new study suggests that a mother’s anxiety or depression during pregnancy may affect her child’s sleep patterns early in life. Researchers found that babies and toddlers whose mothers had anxiety and depression symptoms during pregnancy tended to have more sleep problems than other young children. The investigators suspect that the related elevated stress hormones may shape fetal brain development in a way that disturbs early-life sleep patterns (9).

 

Stress and infant infections

Evidence shows that maternal stress can have adverse consequences on immune functioning and infant infections. In studies, prenatal anxiety and stress predicted an increase in infant illnesses and antibiotic use (10-11).

 

Stress and cognitive development

Pregnancy-specific stress can influence the development of the baby’s brain even more than general stress. This is due to a reduction of the prefrontal cortex’s grey matter which can modify the development of cognitive capacities. Higher cortisol levels in amniotic fluid have been associated with slower rates of cognitive development (12).

 

Stress and ADHD

Researchers found that mothers exposed to high levels of stress during pregnancy have kids who are more than twice as likely to have chronic symptoms of hyperactivity and conduct disorder. Reducing prenatal stress can reduce the risk of behavioral issues such as ADHD (13, 14).

 

Don’t stress too much about stress

It’s important to note, the above studies focus on intense levels of stress and psychological distress. Some stress is normal for everyone and can even be helpful in prompting you to pay attention to your health. To reduce your stress level, pay attention to your body and emotions, control the elements you can, and try to let go of worrying too much about what you can’t.

 

DHA, the superhero nutrient to combat stress

Good nutrition is an essential tool for helping you stay healthy and happy during pregnancy. One nutrient linked to fighting the effects of stress is DHA, an important omega-3 fatty acid. Omega-3s have a profound effect on decreasing rates of inflammation in the body, especially in the brain. Inflammation can cause changes to your mood and feelings of depression (15).

Emerging evidence from pregnancy studies suggests that omega-3 PUFA may play a critical role, not only in baby’s neurodevelopment, but also in supporting mom’s positive mood and decreased feelings of stress, anxiety, and depression. 

 

DHA Supplements

You can get DHA from your diet but many experts recommend DHA supplementation, especially during pregnancy when it can be challenging to get enough from sources like deep-sea fish. Women taking DHA supplementation reported reduced perceived stress and lower levels of stress hormones (16).

One Fish, Two Fish Prenatal DHA provides potent DHA and purified omega-3 made from real triglyceride oil—the form naturally found in fish, and the form your body most easily absorbs.

No Fish, No Fish Vegan Prenatal DHA provides potent DHA and purified omega-3 made from algae for a sustainable, fish-free alternative for vegetarians, vegans, and expecting mothers who prefer not to eat fish.

 

How to Reduce Stress

Some stress is inevitable, but there are ways to help manage things and reduce the stress in your life. Dr. Calvin Hobel, the Miriam Jacobs Chair in Maternal-Fetal Medicine at Cedars Sinai Hospital in Los Angeles advises that pregnant women benefit from learning how to recognize the effects of stress and some of the simple things they can do to make a difference (17).

    1. Get Moving. To reduce stress, stick to a regular exercise routine. According to the Mayo Clinic, “[v]irtually any form of exercise from aerobics to yoga, can act as a stress reliever.” Exercise boosts endorphins, or feel-good chemicals, in your brain and helps you forget the worries of the day (18).

    2. Zen Out. Always wanted to try yoga or meditation? Now’s the time to start. Prenatal yoga has lots of benefits including reducing stress, improving sleep, and increasing strength. Avoid hot yoga, though, which can raise your body temperature too high (19). Many women find meditation boosts their mood and energy, keeps them calm, helps them sleep, and even reduces fear of childbirth (20).

    3. Assemble Your Team. A support system is crucial. Think ahead of time about friends and family you can reach out to if you start to feel overwhelmed. Who’s a good listener? Who can pitch in with errands or bring you a meal in an emergency? Who will let you cry messy tears on their shoulder? Your healthcare provider is part of your team, too. Bring up any worries or concerns you have at your prenatal visits or call if something is troubling you.

    4. Stabilize Your Mood with Food. Staying well-nourished is a known way to help stabilize your mood through the ups and downs of preconception and pregnancy. A balanced diet of protein, complex carbohydrates (such as fruits, vegetables, and whole grains), and healthy fats is key. In fact, researchers in New Zealand discovered that no food they studied boosts mood or energy as effectively as fruits and vegetables (21).

    5. Get Your Bs. B vitamins can also help alleviate occasional stress (22). To make sure you’re getting plenty of Bs, eat brewer’s yeast, eggs, leafy green vegetables, legumes, liver, poultry, seafood, and sunflower seeds (23). You’ll also find them in your prenatal vitamins.

Knowing that reducing your stress has so many benefits for you and your baby will help you make the space you need to care for your mind and body during this exciting time. Be aware of signs of stress, take a deep breath, and get back on track.


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