SMFM 2025:
Stress, Resilience, and
Adverse Placentally Mediated Outcomes
(presented in oral format in Fellows Plenary)
Abstract as printed in the SMFM 2025 abstract book:
Patterns of perceived and everyday stress, resilience, and adverse placentally mediated outcomes
Prenatal stress is common. However, the quantity and type of stress throughout pregnancy remains poorly defined, and the magnitude of the association between stress, resilience, and hypertensive disorders of pregnancy (HDOP) remains poorly understood.
Primary analysis of 2 prospective cohorts, 2017-2022. Patients were recruited <28 weeks’ and completed the Perceived Stress Scale (PSS, range 0-40; ‘high’ stress is ≥ 21), Everyday Stress Index (ESI, range 0-60; higher values = higher stress), and the Brief Resilience Scale (BRS, range 1-5; ‘low’ resilience is <3) surveys. The primary outcome was plac-comps defined as hypertensive disorders of pregnancy ± birthweight < 10% for GA and sex, ± placental abruption). We evaluated whether survey scores in early pregnancy (<24 weeks) were associated with the eventual development of plac-comps. Linear regression was used to evaluate whether survey results <24 weeks assessing stress (by PSS, ESI, or both) and/or resilience were associated with the eventual development of plac-comps.
1,133 individuals met inclusion criteria; 267 (24%) had plac-comps. Cohort characteristics are shown in Table 1. In general, stress, as quantified by the PSS and ESI, tended to decrease with increasing gestational age, while resilience increased (Figure 1). Overall scores were similar for those with and without plac-comps. However, when considering survey results <24 weeks, PSS scores were higher and BRS lower among those who developed plac-comps compared to those who did not. In regression models controlling for CHTN, pre-gestational DM, pre-pregnancy BMI, maternal race, and history of PTB, increased resilience (quantified by BRS <24 weeks) was associated with a reduced odds of plac-comps (aOR 0.73, 95% CI 0.56, 0.95). Neither the stress score was associated with plac-comps in regression models.
Overall, stress decreases and resilience increases throughout gestation. Increased resilience in early pregnancy is associated with reduced placentally-mediated adverse outcomes.
Patterns of perceived and everyday stress, resilience, and adverse placentally mediated outcomes
Prenatal stress is common. However, the quantity and type of stress throughout pregnancy remains poorly defined, and the magnitude of the association between stress, resilience, and hypertensive disorders of pregnancy (HDOP) remains poorly understood.
Primary analysis of 2 prospective cohorts, 2017-2022. Patients were recruited <28 weeks’ and completed the Perceived Stress Scale (PSS, range 0-40; ‘high’ stress is ≥ 21), Everyday Stress Index (ESI, range 0-60; higher values = higher stress), and the Brief Resilience Scale (BRS, range 1-5; ‘low’ resilience is <3) surveys. The primary outcome was plac-comps defined as hypertensive disorders of pregnancy ± birthweight < 10% for GA and sex, ± placental abruption). We evaluated whether survey scores in early pregnancy (<24 weeks) were associated with the eventual development of plac-comps. Linear regression was used to evaluate whether survey results <24 weeks assessing stress (by PSS, ESI, or both) and/or resilience were associated with the eventual development of plac-comps.
1,133 individuals met inclusion criteria; 267 (24%) had plac-comps. Cohort characteristics are shown in Table 1. In general, stress, as quantified by the PSS and ESI, tended to decrease with increasing gestational age, while resilience increased (Figure 1). Overall scores were similar for those with and without plac-comps. However, when considering survey results <24 weeks, PSS scores were higher and BRS lower among those who developed plac-comps compared to those who did not. In regression models controlling for CHTN, pre-gestational DM, pre-pregnancy BMI, maternal race, and history of PTB, increased resilience (quantified by BRS <24 weeks) was associated with a reduced odds of plac-comps (aOR 0.73, 95% CI 0.56, 0.95). Neither the stress score was associated with plac-comps in regression models.
Overall, stress decreases and resilience increases throughout gestation. Increased resilience in early pregnancy is associated with reduced placentally-mediated adverse outcomes.
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Images from Dr. Jones' presentation!
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