Leukocyte telomere dynamics across gestation in uncomplicated pregnancies and associations with stress

Danielle M Panelli; Stephanie A Leonard; Ronald J Wong; Martin Becker; Jonathan A Mayo; Erica Wu; Anna I Girsen; Ian H Gotlib; Nima Aghaeepour; Maurice L Druzin; Gary M Shaw; David K Stevenson; Katherine Bianco

doi:10.1186/s12884-022-04693-0

Lifestyle and Environment Stress and Allostatic Load

Leukocyte telomere dynamics across gestation in uncomplicated pregnancies and associations with stress

Panelli DM, Leonard SA, Wong RJ, Becker M, Mayo JA, Wu E, Girsen AI, Gotlib IH, Aghaeepour N, Druzin ML, Shaw GM, Stevenson DK, Bianco K

Published May 2, 2022 BMC pregnancy and childbirth

DOI 10.1186/s12884-022-04693-0 PMID 35501726 PMC PMC9063069

RRM Academy Synopsis

Telomere length showed no significant change in healthy pregnancies

In a Stanford pilot study of 46 first-time mothers with healthy term pregnancies, telomere length showed no significant change from early pregnancy to after birth. Telomeres were shorter after cesarean birth. Poor sleep was associated with shorter telomeres.

Key Findings

The cohort included 46 women with 115 blood samples; 18 (39.1%) delivered by cesarean.
Within-woman telomere length showed no significant difference between early and mid pregnancy (p = 0.39), mid pregnancy and postpartum (p = 0.38), or early pregnancy and postpartum (p = 0.06).
Postpartum telomere length was shorter after cesarean than after vaginal birth (0.94 ± 0.12 versus 1.12 ± 0.21, p = 0.01).
The cesarean difference held after adjusting for maternal age (beta − 0.18, 95% CI − 0.30 to − 0.05, p = 0.006).
Poor sleep quality went with shorter first-trimester telomere length (p = 0.02) and shorter average length across all timepoints (p = 0.03).

Interpretation

The study is a pilot cohort at one institution, with blood samples grouped into three windows from early pregnancy to 9 weeks after birth. The women were having a first baby, had uncomplicated term births, and were mostly college-educated and privately insured. Telomere length is a marker linked to stress and illness outside pregnancy. The authors note that the small sample limited adjustment for other factors.

RRM Context

RRM treats sleep, stress and general health as part of reproductive care. The cohort gives baseline telomere data from healthy pregnancies. Sleep quality is a marker worth following in larger studies.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

Short leukocyte telomere length is a biomarker associated with stress and morbidity in non-pregnant adults. Little is known, however, about maternal telomere dynamics in pregnancy. To address this, we examined changes in maternal leukocyte telomere length (LTL) during uncomplicated pregnancies and explored correlations with perceived stress.

Methods

In this pilot study, maternal LTL was measured in blood collected from nulliparas who delivered live, term, singleton infants between 2012 and 2018 at a single institution. Participants were excluded if they had diabetes or hypertensive disease. Samples were collected over the course of pregnancy and divided into three time periods: < 200/7 weeks (Timepoint 1); 201/7 to 366/7 weeks (Timepoint 2); and 370/7 to 9-weeks postpartum (Timepoint 3). All participants also completed a survey assessing a multivariate profile of perceived stress at the time of enrollment in the first trimester. LTL was measured using quantitative polymerase chain reaction (PCR). Wilcoxon signed-rank tests were used to compare LTL differences within participants across all timepoint intervals. To determine whether mode of delivery affected LTL, we compared postpartum Timepoint 3 LTLs between participants who had vaginal versus cesarean birth. Secondarily, we evaluated the association of the assessed multivariate stress profile and LTL using machine learning analysis.

Results

A total of 115 samples from 46 patients were analyzed. LTL (mean ± SD), expressed as telomere to single copy gene (T/S) ratios, were: 1.15 ± 0.26, 1.13 ± 0.23, and 1.07 ± 0.21 for Timepoints 1, 2, and 3, respectively. There were no significant differences in LTL between Timepoints 1 and 2 (LTL T/S change - 0.03 ± 0.26, p = 0.39); 2 and 3 (- 0.07 ± 0.29, p = 0.38) or Timepoints 1 and 3 (- 0.07 ± 0.21, p = 0.06). Participants who underwent cesareans had significantly shorter postpartum LTLs than those who delivered vaginally (T/S ratio: 0.94 ± 0.12 cesarean versus 1.12 ± 0.21 vaginal, p = 0.01). In secondary analysis, poor sleep quality was the main stress construct associated with shorter Timepoint 1 LTLs (p = 0.02) and shorter mean LTLs (p = 0.03).

Conclusions

In this cohort of healthy pregnancies, maternal LTLs did not significantly change across gestation and postpartum LTLs were shorter after cesarean than after vaginal birth. Significant associations between sleep quality and short LTLs warrant further investigation.

Topics

Lifestyle and Environment

Stress and Allostatic Load Stress and Ovulation

Lifestyle and Environment › Stress and Allostatic Load › Stress and Ovulation

Danielle M Panelli, Stephanie A Leonard, Ronald J Wong, Martin Becker, Jonathan A Mayo, Erica Wu, Anna I Girsen, Ian H Gotlib, Nima Aghaeepour, Maurice L Druzin, Gary M Shaw, David K Stevenson, Katherine Bianco

D Panelli, S Leonard, Ron Wong, R Wong, M Becker, Jon Mayo, J Mayo, E Wu, A Girsen, I Gotlib, N Aghaeepour, M Druzin, G Shaw, Dave Stevenson, D Stevenson, Kathy Bianco, Kate Bianco, Katie Bianco, K Bianco

PMID 35501726 35501726 DOI 10.1186/s12884-022-04693-0 10.1186/s12884-022-04693-0 Panelli et al. 2022, Panelli 2022

Leukocyte telomere dynamics across gestation in uncomplicated pregnancies and associations with stress

Telomere length showed no significant change in healthy pregnancies

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research