Effects of stress and depression on inflammatory immune parameters in pregnancy

There is a substantial body of literature that links psychological stress to adverse pregnancy outcomes, particularly preterm birth. Comparatively few studies have examined potential biologic mechanisms that explain these associations. Attention to inflammatory processes is warranted. This article describes emerging studies that demonstrate that, as in nonpregnant humans and animals, psychological stress and distress (ie, depressive symptoms) predict dysregulation of inflammatory processes in human pregnancy. This includes elevations in circulating inflammatory cytokines, exaggerated inflammatory responses to in vivo biologic challenges, and more robust inflammatory responses to psychological challenges. Continued research in this area is needed to determine the implications of such stress-induced immune dysregulation for birth outcomes and for maternal health and fetal development.