Anxious pregnant patients whose immune system has been impaired

Summary: Pregnant women with anxiety have higher levels of cytotoxic T cells and a difference in the activity of immune markers circulating in the blood compared to pregnant women without anxiety.

Source: Weill Cornell University

The immune system of pregnant women with anxiety is biologically different from that of pregnant women without anxiety, according to a new study by researchers from Weill Cornell Medicine, Johns Hopkins University School of Medicine and Columbia University Irving Medical Center.

The study, published on September 14, 2022 in Brain, behavior and immunity, shows that pregnant women with anxiety have higher levels of certain immune cells called cytotoxic T cells; these cells attack infected or otherwise compromised cells in the body.

The anxious women also showed differences in the activity of immune markers that circulate in the blood.

This is the first known study to assess the relationship between anxiety and the trajectory of immune changes during pregnancy and the postpartum period.

“Anxious women seem to have an immune system that behaves differently than healthy women during pregnancy and after childbirth,” said lead researcher Dr. Lauren M. Osborne, vice president of clinical research. from the Department of Obstetrics and Gynecology at Weill Cornell. Medicine, who conducted the research while on medical school at Johns Hopkins University.

“During pregnancy, a delicate dance is believed to occur in which the immune system changes to not reject the fetus but remains strong enough to ward off foreign pathogens.”

This study could encourage better treatment of anxiety in pregnant patients, said Dr. Osborne, who is also a reproductive psychiatrist at NewYork-Presbyterian/Weill Cornell Medical Center. As a clinician, she finds that anxious women may resist taking anti-anxiety medications because they fear the drugs will harm the baby, despite evidence that they are compatible with pregnancy.

Anxiety during pregnancy, which is self-reported by more than 20% of people, researchers say, is already known to be detrimental to both parent and child. For example, it can increase the risk of preterm delivery and lower birth weight for the newborn.

It shows a pregnant woman
Anxiety during pregnancy, which is self-reported by more than 20% of people, researchers say, is already known to be detrimental to both parent and child. Image is in public domain

For this study, Dr. Osborne and colleagues assessed a group of 107 pregnant women, 56 with anxiety and 51 without anxiety, during their second and third trimesters and at six weeks postpartum. The researchers assessed blood samples for immune activity and performed psychological assessments to detect clinical anxiety.

They found that in anxious women, levels of cytotoxic T cells were elevated during pregnancy and then declined in the weeks following delivery. In women without anxiety, the activity of these cells decreased during pregnancy and continued to decrease after birth.

The researchers also observed that the activity of broadly pro-inflammatory cytokines, or substances secreted by cells as part of the immune system response, was suppressed during pregnancy in anxious women and then increased after childbirth. while healthy women showed the opposite pattern.

“The takeaway is that this is the first clear evidence that immune activity differs in pregnant women depending on their state of anxiety. immune system is a first step towards understanding the biological factors linked to anxiety during pregnancy and a first step towards developing new treatments,” said Dr. Osborne.

“We know that anxiety must be addressed to ensure healthy outcomes for mother and child.”

About This Pregnancy and Anxiety Research News

Author: Press office
Source: Weill Cornell University
Contact: Press Office – Weill Cornell University
Picture: Image is in public domain

See also

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Original research: Free access.
“The immune phenotype of perinatal anxiety” by Morgan L. Sherer et al. Brain behavior and immunity


The immune phenotype of perinatal anxiety


Immune dysregulation has been linked to both psychiatric illnesses and pregnancy morbidity, including perinatal depression, but little is known about the immune phenotype of perinatal anxiety. Here, we sought to identify the unique immune profile of prenatal anxiety.

Materials and methods

Pregnant women (n = 107) were followed prospectively in the 2nd and 3rd trimesters (T2, T3) and at 6 weeks postpartum (PP6). Each visit included a blood draw and psychological assessment, with clinical anxiety assessed using the Spielberg State-Trait Anxiety Scale. We recruited both healthy controls and participants with only anxiety; those with comorbid depression were excluded. Multiplex cytokine assays and flow cytometry were used to examine the association of anxiety symptoms with secreted immune markers and PBMC-derived immune cells.


Group K means that three groups of anxiety symptoms were revealed; due to low numbers in the highest severity anxiety group, these were grouped into two groups: non-anxiety and anxious. Principal component analysis revealed two distinct groups of cytokine secretion, one of which was composed of numerous innate immune cytokines and differed between groups. Compared to women in the non-anxious group, women in the anxious group had lower cytokine expression levels during pregnancy and increased levels postpartum, while non-anxious women experienced a time-dependent decline. Immune cell populations also differed between our two groups, with the Anxiety group showing a decrease in the ratio of B cells to T cells from pregnancy to postpartum, while the non-anxious women showed an increase in this ratio over time. time. Women in the Anxiety group also demonstrated an increased ratio of cytotoxic to helper T cells throughout pregnancy, a modest increase in the Th1:Th2 ratio throughout pregnancy, and a lower ratio of Th17:TREG cells in the postpartum period compared to women without anxiety.


These data suggest that the immune response throughout the prenatal period differs in women with symptoms of anxiety compared to those without, suggesting a unique immune phenotype of perinatal anxiety.

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