Many people are familiar with the stress of pregnancy, especially as the due date approaches. But what about the stress before pregnancy even begins? Can stress affect your chances of conceiving or the outcome of your pregnancy?
The average age for having a first child has risen in Western societies, which coincides with a decrease in fertility as people age. This shift leads to higher stress levels for couples even before they conceive.
Dr. Lidia Mínguez-Alarcón, a researcher at Mass General Brigham, has explored the impact of environmental factors like diet and chemical exposure on fertility. Through the Environment and Reproductive Health (EARTH) Study, launched in 2004 at the Massachusetts General Hospital Fertility Center, her team made a surprising discovery about pre-pregnancy stress.
“Originally, the study wasn’t focused on stress, but using our data, we found for the first time that stress before conception can affect pregnancy outcomes and even have long-term consequences for both mother and child,” Dr. Mínguez-Alarcón said.
The Role of Stress Before Pregnancy
While stress during pregnancy is well-documented, known to increase the risk of premature birth and low-birth-weight babies—there was little research on the effects of stress before conception until the EARTH study.
The study included over 1,000 women, with 398 reporting their stress levels through a questionnaire called the Perceived Stress Scale 4 (PSS-4). Participants also shared details about their medical history, lifestyle, diet, and exposure to chemicals.
The women in the study were undergoing two types of fertility treatments:
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Intrauterine insemination (IUI): A procedure where sperm is placed directly in the uterus to improve the chances of fertilization.
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In vitro fertilization (IVF): A process where eggs are fertilized outside the body before being implanted into the uterus.
Fertility treatments are often emotionally taxing, and many participants were already stressed by the time they sought help. Dr. Mínguez-Alarcón points out that the stress of multiple IVF cycles can intensify emotional strain.
Findings on Preconception Stress
The study revealed that higher levels of stress before pregnancy lowered the chances of having a live birth. Notably, stress had a greater negative impact on IVF outcomes compared to IUI.
Women with higher pre-pregnancy stress also had a higher likelihood of elevated blood glucose levels during pregnancy, which is a key marker for heart health. Dr. Mínguez-Alarcón warns that high blood sugar can have long-term health consequences, increasing the risk for conditions like type 2 diabetes and heart disease for both the mother and baby.
Managing Stress Before Pregnancy
“Managing stress before pregnancy can increase the likelihood of a healthy pregnancy and reduce long-term health risks,” says Dr. Mínguez-Alarcón. She offers several strategies for stress management before conception:
- Consider therapy or counseling.
- Maintain a healthy diet to support both mood and overall health.
- Exercise regularly.
- Practice meditation to reduce anxiety.
- Ensure adequate, high-quality sleep.
- Stay connected with a supportive social network.
- Join a support group for people dealing with infertility.
Dr. Mínguez-Alarcón also emphasizes the importance of mental health, pointing out the strong links between depression, loneliness, and stress. Support from family and friends can play a crucial role in reducing stress.
If you’re struggling with anxiety, depression, or stress during any phase of pregnancy, seeking help from a healthcare provider is vital for both your mental and physical well-being.
The EARTH study team is planning further research to explore how preconception stress affects cholesterol levels, another risk factor for heart disease. They also aim to investigate how stress in male partners influences fertility treatment outcomes and expand the study to include more diverse participants to understand the role of socioeconomic factors.
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