Damaging in utero effects of low socioeconomic status.

Gilman et al. make another addition to the list of how low socioeconomic status can damage our biological development, showing maternal immune activity in response to stressful conditions during pregnancy can cause neurologic abnormalities in offspring.

Significance

Children raised in economically disadvantaged households face increased risks of poor health in adulthood, suggesting early origins of socioeconomic inequalities in health. In fact, maternal immune activity in response to stressful conditions during pregnancy has been found to play a key role in fetal brain development. Here we show that socioeconomic disadvantage is associated with lower concentrations of the pro-inflammatory cytokine IL-8 during the third trimester of pregnancy and, in turn, with offspring’s neurologic abnormalities during the first year of life. These results suggest stress–immune mechanisms as one potential pathophysiologic pathway involved in the early origins of population health inequalities.

Abstract

Children raised in economically disadvantaged households face increased risks of poor health in adulthood, suggesting that inequalities in health have early origins. From the child’s perspective, exposure to economic hardship may begin as early as conception, potentially via maternal neuroendocrine–immune responses to prenatal stressors, which adversely impact neurodevelopment. Here we investigate whether socioeconomic disadvantage is associated with gestational immune activity and whether such activity is associated with abnormalities among offspring during infancy. We analyzed concentrations of five immune markers (IL-1β, IL-6, IL-8, IL-10, and TNF-α) in maternal serum from 1,494 participants in the New England Family Study in relation to the level of maternal socioeconomic disadvantage and their involvement in offspring neurologic abnormalities at 4 mo and 1 y of age. Median concentrations of IL-8 were lower in the most disadvantaged pregnancies [−1.53 log(pg/mL); 95% CI: −1.81, −1.25]. Offspring of these pregnancies had significantly higher risk of neurologic abnormalities at 4 mo [odds ratio (OR) = 4.61; CI = 2.84, 7.48] and 1 y (OR = 2.05; CI = 1.08, 3.90). This higher risk was accounted for in part by fetal exposure to lower maternal IL-8, which also predicted higher risks of neurologic abnormalities at 4 mo (OR = 7.67; CI = 4.05, 14.49) and 1 y (OR = 2.92; CI = 1.46, 5.87). Findings support the role of maternal immune activity in fetal neurodevelopment, exacerbated in part by socioeconomic disadvantage. This finding reveals a potential pathophysiologic pathway involved in the intergenerational transmission of socioeconomic inequalities in health.