"If the mother has inflammation she can't fight off, there may be invasion of the fetal compartment, which leads to an inflammatory response in the fetus that starts premature labor or may harm developing organs," Auten said.

The researchers caution that because individuals respond differently to stress, not every woman who experiences the risk factors studied is automatically at risk for premature labor or a sick newborn.

"In our study, some premature newborns recovered quickly and did well, while others went on to develop other inflammatory disorders such as brain injuries or chronic lung disease," Hofheimer said.

On the other hand, a significant number of full-term infants of mothers with the risk factors of high stress, high inflammation, and/or substance use required neonatal intensive care for respiratory disorders.

Of the 675 women who participated in the study, 444 reported no substance use; 78 were smokers; 88 reported drinking alcohol; 33 used both alcohol and tobacco; and 32 used cocaine, marijuana, alcohol and tobacco. The researchers measured social risks through confidential interviews. The risk factors included low income; minority ethnicity, family violence in the home; absence of the mother's relationship partner; absence of childcare assistance in the home; mother's age less than 18 years; less than a high school education; and a history of mental illness or psychological disorder.

The researchers found an association of substance abuse, social stress and high levels of cytokines with prematurity, brain and lung injuries in infants and respiratory disorders in full-term babies. The researchers measured inflammatory cytokines in maternal blood samples taken at enrollment in the
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Contact: Becky Oskin
becky.oskin@duke.edu
919-684-4148
Duke University Medical Center
3-May-2004