Antepartum stress status may be shaped by maternal and fetal cholinesterase balance

CAMILA ZELGERT; SCHMIDT, G.; BIBIANA FABRE; FRASCH, M. G.; SHANI VAKNINE; ALEXANDER MUELLER; BERG, G.; HERMONA SOREQ; LOBMAIER, SILVIA M.; JOY WEYRICH; HALLER, B.; HAUTIENG WU; ANTONELLI, MARTA C.

Simposio; Epigenetics of the incubation of stress and addiction disorders; 2019

Maternal stress during pregnancy and early parenting may program physiological responses and cognitive functions of the infant, interact with genetic liabilities and early-life challenges and contribute to ultimate health status. Identifying measurable criteria and analysis tools for predicting those effects during pregnancy will prove helpful in providing more suitable support for the stress-affected newborns. Cholinergic signaling is a major determinant of cognition and inflammation, both subject to regulation by stressful situations. In adults, activity levels of circulating acetyl- and butyrylcholinesterases (AChE, BChE) reflect the global cholinergic tone and chronic stress exposure. To assess chronic maternal stress during pregnancy and its effects on the newborn, we quantified the acetylthiocholine hydrolytic activity of AChE and BChE in maternal and newborn serum samples as compared to maternal hair cortisol levels and to non-invasively measured maternal and fetal molecular and biophysical biomarkers. During the early third trimester we matched stressed mothers with controls for parity, and noted maternal age and gestational age at study entry. Psychosocial stress was assessed with the Cohen Perceived Stress Scale questionnaire (PSS-10), which categorized stressed mothers with PSS-10 score ≥19. Parallel coupling between maternal and fetal heart rate (mHR, fHR) derived from maternal abdominal ECG provided a bivariate phase-rectified signal averaging algorithm (BPRSA) to yield fetal stress index (FSI) values. At the group level, cortisol and FSI were increased in the cohort of the stressed mothers/fetuses supporting the initial behaviorally (PSS-10) driven grouping. Machine learning approaches indicated that the fetal AChE/BChE ratio was predicted best by the joint fetal-maternal stress biomarker FSI, but not by maternal stress levels alone (i.e., as measured by PSS, or cortisol or maternal AChE/BChE ratio). In conclusion, antepartum stress status may be shaped by both maternal cortisol and the maternal and fetal AChE/BChE balance, and ECG/HR monitoring may help predict maternal and fetal stress status at birth.