Impact of maternal stress on outcome of new born


  • Ramya H. S. Department of Pediatrics, KIMS, Bangalore, Karnataka, India
  • Rajendra Prasad T. C. Department of Pediatrics, KIMS, Bangalore, Karnataka, India
  • Murgesh Awati Department of Pediatrics, KIMS, Bangalore, Karnataka, India



Maternal stress, Maternal outcomes, Perinatal outcomes


Background: Maternal stress which may include emotional, social, health and economy may have impact on newborn. Risks factors predisposing to maternal stress are preventable by taking appropriate measures at right time and hence may have a better outcome of newborn. Maternal risk factors such as stress and depression have been associated with preterm birth and low birth weight. Relatively few studies have been made on impact prenatal maternal stress on neonatal outcome till date. The aim of our study is to asses the impact of maternal stress on fetal outcome.

Methods: This study is an observational clinical study, undertaken in Kempegowda Institute of Medical Sciences hospital, Bangalore, Karnataka, between April 2017 to September 2017. Perceived stress scale(PSS) was used to assess the stress levels of mothers.

Results: The association of moderate stress with low birth weight and preterm gestational age was statistically significant (p value <0.001). The amount of stress in relation to maternal age was highest in 20 to30 years (81.5%) of age group. Primigravida were found to have a statistically significant association with maternal stress (p value-0.022). Higher stress levels were observed in lower middle socioeconomic status which was statistically significant (p value-0.050).

Conclusions: More than 50% of the pregnant women in our setting were exposed to stress. In stressed pregnant mothers, low birth weight and preterm deliveries were the outcome. Lower socioeconomic status was associated significantly with stress. All pregnant mothers should be counselled to consume nutritious diet to deliver a normal healthy baby.


Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol. 2008;51(2):333-48.

Abou-Zahr CL, Wardlaw TM. Antenatal Care in Developing Countries: Promises, Achievements and Missed Opportunities: An Analysis of Trends, Levels and Differentials, 1990-2001. World Health Organization, 2003.

Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. The lancet. 2006 Apr 1;367(9516):1066-74.

Firoz T, Chou D, von Dadelszen P, Agrawal P, Vanderkruik R, Tunçalp O, Magee LA, van Den Broek N, Say L. Measuring maternal health: focus on maternal morbidity. Bulletin of the World Health Organization. 2013 Aug 6;91:794-6.

Class QA, Lichtenstein P, Långström N, D'onofrio BM. Timing of prenatal maternal exposure to severe life events and adverse pregnancy outcomes: a population study of 2.6 million pregnancies. Psychosomatic Med. 2011 Apr;73(3):234.

Latendresse G. The interaction between chronic stress and pregnancy: preterm birth from a biobehavioral perspective. J Midwifery women’s health. 2009 Jan 2;54(1):8-17.

Latendresse G, Ruiz RJ, Wong B. Psychological Distress and SSRI Use Predict Variation in Inflammatory Cytokines during Pregnancy. Open J Obstet Gynecol. 2013;3:184-91.

Elenkov IJ, Chrousos GP. Stress hormones, Th1/Th2 patterns, pro/anti-inflammatory cytokines and susceptibility to disease. Trends in Endocrinol Metab. 1999 Nov 1;10(9):359-68.

Raison CL, Miller AH. When not enough is too much: the role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders. Am J Psychiatry. 2003;160(9):1554-65.

Folkman S. Stress: appraisal and coping. In Encyclopedia of behavioral medicine 2013 (pp. 1913-1915). Springer New York.

Sorokin Y, Romero R, Mele L, Wapner RJ, Iams JD, Dudley DJ, et al. Maternal serum interleukin-6, C-reactive protein, and matrix metalloproteinase-9 concentrations as risk factors for preterm birth <32 weeks and adverse neonatal outcomes. Am J Perinatol. 2010 Sep;27(8):631.

Casanueva E, Viteri FE. Iron and oxidative stress in pregnancy. J Nutrit. 2003;133(5):1700S-8S.

Tandu-umbaetal B, Dedetemo DK, Mananga GL. Maternal stress and pregnancy outcomes. Open J Obstet Gynecol. 2014;4:361.

Sykes L, MacIntyre DA, Yap XJ, Teoh TG, Bennett PR. The Th1: th2 dichotomy of pregnancy and preterm labour. Mediators of inflammation. 2012;2012.

Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss III JF, Petraglia F. Inflammation and pregnancy. Reproduct Sci. 2009;16(2):206-15.

Zaretsky MV, Alexander JM, Byrd W, Bawdon RE. Transfer of inflammatory cytokines across the placenta. Obstet Gynecol. 2004;103(3):546-50.

Gupta S, Agarwal A, Banerjee J, Alvarez JG. The role of oxidative stress in spontaneous abortion and recurrent pregnancy loss: a systematic review. Obstet Gynecol Survey. 2007 May 1;62(5):335-47.

Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P. Maternal stress and preterm birth. Am J Epidemiol. 2003;157(1):14-24.

Khashan AS, McNamee R, Abel KM, Pedersen MG, Webb RT, Kenny LC, et al. Reduced infant birthweight consequent upon maternal exposure to severe life events. Psychosomatic Med. 2008 Jul 1;70(6):688-94.

Tegethoff M, Greene N, Olsen J, Meyer AH, Meinlschmidt G. Maternal psychosocial adversity during pregnancy is associated with length of gestation and offspring size at birth: evidence from a population-based cohort study. Psychosomatic Med. 2010 May 1;72(4):419-26.

Lee SY, Park KH, Jeong EH, Oh KJ, Ryu A, Park KU. Relationship between maternal serum C-reactive protein, funisitis and early-onset neonatal sepsis. J Korean Med Sci. 2012;27(6):674-80.

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Social Behaviour. 1983;385-96.

Dole N, Savitz DA, Hertz-Picciotto I, Siega-Riz AM, McMahon MJ, Buekens P. Maternal stress and preterm birth. Am J Epidemiol. 2003;157(1):14-24.

Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacognosy reviews. 2010 Jul;4(8):118.






Original Research Articles