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      Marital Quality and Stress in Pregnancy Predict the Risk of Infectious Disease in the Offspring: The Norwegian Mother and Child Cohort Study

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          The aim of this study was to explore the degree to which couples’ relationship dissatisfaction and stressful life events during pregnancy predict the risk of infectious disease in the offspring during their first year of life.


          Data were obtained from the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health. Pregnant women completed questionnaires in week 30 of pregnancy concerning the couples’ relationship satisfaction and stressful life events. In follow-up questionnaires, the women reported whether their children (n = 74,801) had been subject to various categories of infectious disease: the common cold, throat infection, bronchitis, RS virus, pneumonia, pseudocroup, gastric flu, ear infection, conjunctivitis and urinary tract infection. Reports from two age groups of infants were used. Associations between the predictor and outcome variables were assessed via logistic regression and linear regression analyses.


          Separate logistic regression analyses for each disease and age group showed that prenatal relationship dissatisfaction and stressful life events were significantly associated with all reported categories of infectious disease. After controlling for socioeconomic factors, social support, smoking, breastfeeding, maternal depression, the sex of the offspring, and use of child care, 29 out of 32 tested associations were statistically significant. Finally, multivariate linear regression analyses showed that prenatal relationship dissatisfaction and stressful life events were significantly associated with the frequency, as well as the variety, of infectious disease in the offspring.

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          Most cited references 25

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          Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk.

          We propose a model wherein chronic stress results in glucocorticoid receptor resistance (GCR) that, in turn, results in failure to down-regulate inflammatory response. Here we test the model in two viral-challenge studies. In study 1, we assessed stressful life events, GCR, and control variables including baseline antibody to the challenge virus, age, body mass index (BMI), season, race, sex, education, and virus type in 276 healthy adult volunteers. The volunteers were subsequently quarantined, exposed to one of two rhinoviruses, and followed for 5 d with nasal washes for viral isolation and assessment of signs/symptoms of a common cold. In study 2, we assessed the same control variables and GCR in 79 subjects who were subsequently exposed to a rhinovirus and monitored at baseline and for 5 d after viral challenge for the production of local (in nasal secretions) proinflammatory cytokines (IL-1β, TNF-α, and IL-6). Study 1: After covarying the control variables, those with recent exposure to a long-term threatening stressful experience demonstrated GCR; and those with GCR were at higher risk of subsequently developing a cold. Study 2: With the same controls used in study 1, greater GCR predicted the production of more local proinflammatory cytokines among infected subjects. These data provide support for a model suggesting that prolonged stressors result in GCR, which, in turn, interferes with appropriate regulation of inflammation. Because inflammation plays an important role in the onset and progression of a wide range of diseases, this model may have broad implications for understanding the role of stress in health.
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            Lending a hand: social regulation of the neural response to threat.

            Social contact promotes enhanced health and well-being, likely as a function of the social regulation of emotional responding in the face of various life stressors. For this functional magnetic resonance imaging (fMRI) study, 16 married women were subjected to the threat of electric shock while holding their husband's hand, the hand of an anonymous male experimenter, or no hand at all. Results indicated a pervasive attenuation of activation in the neural systems supporting emotional and behavioral threat responses when the women held their husband's hand. A more limited attenuation of activation in these systems occurred when they held the hand of a stranger. Most strikingly, the effects of spousal hand-holding on neural threat responses varied as a function of marital quality, with higher marital quality predicting less threat-related neural activation in the right anterior insula, superior frontal gyrus, and hypothalamus during spousal, but not stranger, hand-holding.
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              How stress influences the immune response.


                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                30 September 2015
                : 10
                : 9
                Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway
                University of Rennes-1, FRANCE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: REH FT. Performed the experiments: REH. Analyzed the data: REH. Contributed reagents/materials/analysis tools: REH FT. Wrote the paper: REH.


                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                Page count
                Figures: 0, Tables: 3, Pages: 12
                The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health and the Ministry of Education and Research (NIH/NIEHS contract no. NO1-ES-75558, NIH/NINDS grant no.1 UO1 NS 047537-01 and grant no. 2 UO1 NS047537-06A1) and the Norwegian Research Council/FUGE (grant no. 151918/S10). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript, and the authors received no specific funding for this work.
                Research Article
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                Data are unsuitable for public deposition due to ethical restrictions from the Norwegian Institute of Public Health (NIPH). Before data can be released, a full application must be submitted and, in most cases, a contract must be signed with the NIPH. To apply for statistical data in the form of ready-made tables, this form should be used: Additional information about access to data from the Norwegian Mother and Child Cohort Study are obtained from the NIPH: All enquiries about access to data should be sent to: datatilgang@ . The persons responsible for handling enquiries sent to this address are Anita Haugan and Kristine Vejrup, Division of Epidemiology, Norwegian Institute of Public Health.



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