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Interleukin-17A and Chronic Stress in Pregnant Women at 24–28 Weeks Gestation

Moore, Tiffany A.; Case, Adam J.; Mathews, Therese L.; Epstein, Crystal Modde; Kaiser, Katherine Laux; Zimmerman, Matthew C.

doi: 10.1097/NNR.0000000000000334
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Background Allostatic load (AL) is a biopsychosocial model that suggests chronic psychosocial stress leads to physiological dysregulation and poor outcomes. The purpose of this study was to examine AL in pregnant women operationalized using proinflammatory cytokines and psychosocial indicators and perinatal outcomes.

Objectives The aim of the study was to identify relationships between circulating cytokines/chemokines and the Prenatal Distress Questionnaire, the Maternal Antenatal Attachment Scale, the Emotional Quotient Inventory, the Life Experiences Scale, and demographics in pregnant women.

Methods A cross-sectional design was used to recruit pregnant women between 24 and 28 weeks of gestation. Blood and stress/emotional indicators were obtained after informed consent. Plasma was abstracted to simultaneously measure 29 cytokines/chemokines using a multiplex array. Cytokine/chemokine levels were compared with continuous variables using Spearman’s rho and with categorical variables using Mann–Whitney U.

Results Twenty-five women with medically high-risk (n = 16) and low-risk (n = 9) pregnancies consented. Most women were White (68%) with a mean age of 29 years (SD = 5.9). Although several cytokines and chemokines showed significant correlations with the stress/emotional indicators, only interleukin-17A (IL-17A) was significantly associated with all of the indicators (Prenatal Distress Questionnaire: rs = .528, p = .012; Maternal Antenatal Attachment Scale: rs = −.439, p = .036; Emotional Quotient Inventory total: rs = −.545, p = .007), Life Experiences Scale (rs = .458, p = .032), birth weight (rs = −.499, p = .013), and race (p = .01).

Discussion Increased levels of IL-17A, a known cytokine associated with chronic stress and with poor perinatal outcomes, were associated with high prenatal distress, low maternal attachment, and lower emotional intelligence in pregnant women. Increased levels of IL-17A also were associated with lower birth weight and non-White race. Results support the model of AL in pregnant women and highlight IL-17A as a potential biomarker of AL during pregnancy.

Tiffany A. Moore, PhD, RN, is Assistant Professor, College of Nursing–Omaha Division, University of Nebraska Medical Center.

Adam J. Case, PhD, is Assistant Professor, Department of Cellular and Integrative Physiology, College of Medicine, University of Nebraska Medical Center, Omaha.

Therese L. Mathews, PhD, APRN-NP, BCBA-D, is Associate Professor, College of Nursing–Omaha Division, University of Nebraska Medical Center.

Katherine Laux Kaiser, PhD, PHCNS, BC, is Professor Emeritus, College of Nursing–Omaha Division, University of Nebraska Medical Center.

Matthew C. Zimmerman, PhD, is Associate Professor, Department of Cellular and Integrative Physiology, College of Medicine, University of Nebraska Medical Center, Omaha, and Director, Free Radicals in Medicine Program, Omaha, Nebraska.

Crystal Modde Epstein, PhD, APRN-NP, is a Post-Doctoral Scholar, School of Nursing, University of California, San Francisco.

Accepted for publication November 15, 2018.

The authors wish to thank the staff and patients at Nebraska Medicine and Olson Center, Dr. Margaret M. Kaiser, and Dr. Jonathon Buhrman from Mesoscale Discovery.

Research reported in this publication was supported by the National Institute of Nursing at the National Institutes of Health under Award K01NR014474 and a University of Nebraska Medical Center’s Edna Ittner Pediatric Support grant.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

This study received institutional review board approval from the University of Nebraska Medical Center: IRB 069-15-EP and 477-16-EP.

The authors have no conflicts of interest to report.

Corresponding author: Tiffany A. Moore, PhD, RN, College of Nursing–Omaha Division, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE 68198-5330 (e-mail: tamoore@unmc.edu).

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