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Am J Perinatol 2024; 41(09): 1282-1284
DOI: 10.1055/a-1798-1602
Commentary

Stress and Its Consequences—Biological Strain

David K. Stevenson
1   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
,
Ian H. Gotlib
2   Department of Psychology, Stanford University School of Humanities and Science, Stanford, California
,
Jessica L. Buthmann
2   Department of Psychology, Stanford University School of Humanities and Science, Stanford, California
,
Ivana Marié 
1   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
,
Nima Aghaeepour
3   Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
,
Brice Gaudilliere
3   Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
,
Martin S. Angst
3   Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
,
Gary L. Darmstadt
1   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
,
Maurice L. Druzin
4   Department of Obstetrics and Gynecology—Maternal-Fetal Medicine, Stanford University School of Medicine, Stanford, California
,
Ronald J. Wong 
1   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
,
Gary M. Shaw
1   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
,
Michael Katz
1   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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Abstract

Understanding the role of stress in pregnancy and its consequences is important, particularly given documented associations between maternal stress and preterm birth and other pathological outcomes. Physical and psychological stressors can elicit the same biological responses, known as biological strain. Chronic stressors, like poverty and racism (race-based discriminatory treatment), may create a legacy or trajectory of biological strain that no amount of coping can relieve in the absence of larger-scale socio-behavioral or societal changes. An integrative approach that takes into consideration simultaneously social and biological determinants of stress may provide the best insights into the risk of preterm birth. The most successful computational approaches and the most predictive machine-learning models are likely to be those that combine information about the stressors and the biological strain (for example, as measured by different omics) experienced during pregnancy.

Keywords

pregnancy - preterm birth - omics - machine learning


Publication History

Received: 06 December 2021

Accepted: 11 March 2022

Accepted Manuscript online:
15 March 2022

Article published online:
17 May 2022

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