{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:06:06Z","timestamp":1787069166944,"version":"build-2736575974"},"reference-count":104,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000052","name":"NIH Office of the Director","doi-asserted-by":"publisher","award":["UH3OD023279"],"award-info":[{"award-number":["UH3OD023279"]}],"id":[{"id":"10.13039\/100000052","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:p>Allostatic load provides a valuable framework for examining how cumulative stress impacts multiple physiological systems simultaneously, making it a powerful tool for understanding the mechanisms through which stress contributes to adverse pregnancy outcomes. This multisystem perspective is especially important during pregnancy, a period characterized by heightened vulnerability to stress and significant physiological changes that can themselves contribute to allostatic load. Although the impact of allostatic load during pregnancy is well documented, the mechanisms and moderators involved by trimester remain unclear, particularly given wide variation in social, cultural, and structural determinants of maternal health worldwide. In this review, we discuss the progress that has been made over the past two decades in studying prenatal allostatic load and describe the clinical implications of this by highlighting sensitive periods of interest throughout gestation. Despite these advances, key questions remain regarding the intergenerational transmission of risk, the specificity of findings to the pregnancy period, and the role of factors that often accompany elevated allostatic load, such as poor sleep, limited social support, systemic inequities, and comorbid mental or physical health conditions, which may manifest differently across global contexts. Most existing studies have been conducted in high-income settings, yet the burden of adverse pregnancy outcomes is greatest in low- and middle-income countries, where structural, environmental, and social stressors are pervasive. Expanding this framework to include diverse global contexts is essential for understanding how social inequities and chronic stressors shape maternal physiology worldwide. We discuss these issues and offer directions for future research, including the goal of developing a standardized metric for measuring allostatic load \u2013 one that we believe will advance the field's understanding of how prenatal allostatic load markers by trimester relate to maternal and infant outcomes.<\/jats:p>","DOI":"10.3389\/fgwh.2025.1725275","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T06:34:33Z","timestamp":1767854073000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["The role of allostatic load in adverse pregnancy outcomes: a multisystem, developmental perspective"],"prefix":"10.3389","volume":"6","author":[{"given":"Lauren A.","family":"Costello","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Banker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Morales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Barber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Hockett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lacey","family":"McCormack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia A.","family":"Rauth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy J.","family":"Elliott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren C.","family":"Shuffrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1037\/0022-3514.46.4.939","article-title":"Toward an integrative approach to the study of stress","volume":"46","author":"Fleming","year":"1984","journal-title":"J Pers Soc Psychol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1038\/nrn2639","article-title":"Effects of stress throughout the lifespan on the brain, behaviour and cognition","volume":"10","author":"Lupien","year":"2009","journal-title":"Nat Rev Neurosci"},{"key":"B3","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/j.neuroimage.2009.05.071","article-title":"The brain is the central organ of stress and adaptation","volume":"47","author":"McEwen","year":"2009","journal-title":"NeuroImage"},{"key":"B4","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1749-6632.1998.tb09546.x","article-title":"Stress, adaptation, and disease: allostasis and allostatic load","volume":"840","author":"McEwen","year":"1998","journal-title":"Ann N Y Acad Sci"},{"key":"B5","first-page":"629","article-title":"Allostasis: a new paradigm to explain arousal pathology","volume-title":"Handbook of Life Stress, Cognition and Health","author":"Sterling","year":"1988"},{"key":"B6","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1080\/10253890.2018.1456526","article-title":"Mineralocorticoid and glucocorticoid receptor-mediated control of genomic responses to stress in the brain","volume":"21","author":"Mifsud","year":"2018","journal-title":"Stress"},{"key":"B7","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.physbeh.2011.08.019","article-title":"Adverse childhood experiences, allostasis, allostatic load, and age-related disease","volume":"106","author":"Danese","year":"2012","journal-title":"Physiol Behav"},{"key":"B8","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1038\/nrn2632","article-title":"The neuro-symphony of stress","volume":"10","author":"Jo\u00ebls","year":"2009","journal-title":"Nat Rev Neurosci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1053\/meta.2002.33184","article-title":"Neuroendocrine aspects of the response to stress","volume":"51","author":"Miller","year":"2002","journal-title":"Metab Clin Exp"},{"key":"B10","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1038\/378284a0","article-title":"Displacement of corticotropin releasing factor from its binding protein as a possible treatment for Alzheimer\u2019s disease","volume":"378","author":"Behan","year":"1995","journal-title":"Nature"},{"key":"B11","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.brainresrev.2007.04.005","article-title":"The stress system in depression and neurodegeneration: focus on the human hypothalamus","volume":"57","author":"Bao","year":"2008","journal-title":"Brain Res Rev"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e0301473","DOI":"10.1371\/journal.pone.0301473","article-title":"Susceptibility to stress and nature exposure: unveiling differential susceptibility to physical environments; a randomized controlled trial","volume":"19","author":"Eisen","year":"2024","journal-title":"PLoS One"},{"key":"B13","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1056\/NEJM199801153380307","article-title":"Protective and damaging effects of stress mediators","volume":"338","author":"McEwen","year":"1998","journal-title":"N Engl J Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/S0018-506X(02)00024-7","article-title":"The concept of allostasis in biology and biomedicine","volume":"43","author":"McEwen","year":"2003","journal-title":"Horm Behav"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1001\/archinte.1993.00410180039004","article-title":"Stress and the individual: mechanisms leading to disease","volume":"153","author":"McEwen","year":"1993","journal-title":"Arch Intern Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.yhbeh.2009.09.011","article-title":"What\u2019s in a name? Integrating homeostasis, allostasis and stress","volume":"57","author":"McEwen","year":"2010","journal-title":"Horm Behav"},{"key":"B17","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11524-019-00345-5","article-title":"Allostatic load: importance, markers, and score determination in minority and disparity populations","volume":"96","author":"Rodriquez","year":"2019","journal-title":"J Urban Health"},{"key":"B18","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1159\/000510696","article-title":"Allostatic load and its impact on health: a systematic review","volume":"90","author":"Guidi","year":"2020","journal-title":"Psychother Psychosom"},{"key":"B19","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.ejphar.2007.11.071","article-title":"Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators","volume":"583","author":"McEwen","year":"2008","journal-title":"Eur J Pharmacol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1196\/annals.1314.002","article-title":"Allostatic load, perceived stress, and health: a prospective study in two age groups","volume":"1032","author":"Hellhammer","year":"2004","journal-title":"Ann N Y Acad Sci"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.neubiorev.2009.10.002","article-title":"Allostatic load biomarkers of chronic stress and impact on health and cognition","volume":"35","author":"Juster","year":"2010","journal-title":"Neurosci Biobehav Rev"},{"key":"B22","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1159\/000337200","article-title":"A clinimetric evaluation of allostatic overload in the general population","volume":"81","author":"Tomba","year":"2012","journal-title":"Psychother Psychosom"},{"key":"B23","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1080\/10253890.2020.1813711","article-title":"Allostatic load and mental health: a latent class analysis of physiological dysregulation","volume":"24","author":"Carbone","year":"2021","journal-title":"Stress"},{"key":"B24","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.physbeh.2011.02.027","article-title":"Allostatic load associations to acute, 3-year and 6-year prospective depressive symptoms in healthy older adults","volume":"104","author":"Juster","year":"2011","journal-title":"Physiol Behav"},{"key":"B25","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.physbeh.2013.10.014","article-title":"Depressive symptoms are associated with allostatic load among community-dwelling older adults","volume":"123","author":"Kobrosly","year":"2014","journal-title":"Physiol Behav"},{"key":"B26","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1080\/13557858.2013.771147","article-title":"Determinants of self-rated health and the role of acculturation: implications for health inequalities","volume":"18","author":"Todorova","year":"2013","journal-title":"Ethn Health"},{"key":"B27","doi-asserted-by":"publisher","first-page":"104369","DOI":"10.1016\/j.psyneuen.2019.06.020","article-title":"Allostatic load in the association of depressive symptoms with incident coronary heart disease: the Jackson heart study","volume":"109","author":"Gillespie","year":"2019","journal-title":"Psychoneuroendocrinology"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.1016\/j.sleep.2014.07.013","article-title":"Impaired sleep and allostatic load: cross-sectional results from the Danish Copenhagen aging and midlife biobank","volume":"15","author":"Clark","year":"2014","journal-title":"Sleep Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1097\/AOG.0000000000004971","article-title":"Allostatic load and adverse pregnancy outcomes","volume":"140","author":"Lueth","year":"2022","journal-title":"Obstet Gynecol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1007\/s10995-014-1543-7","article-title":"A potential role for allostatic load in preeclampsia","volume":"19","author":"Hux","year":"2015","journal-title":"Matern Child Health J"},{"key":"B31","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1177\/1559827619879694","article-title":"The developmental origins of health and disease (DOHaD)","volume":"14","author":"Lacagnina","year":"2019","journal-title":"Am J Lifestyle Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"105868","DOI":"10.1016\/j.psyneuen.2022.105868","article-title":"Prospective association between maternal allostatic load during pregnancy and child mitochondrial content and bioenergetic capacity","volume":"144","author":"Gyllenhammer","year":"2022","journal-title":"Psychoneuroendocrinology"},{"key":"B33","doi-asserted-by":"publisher","first-page":"4770","DOI":"10.1073\/pnas.081072698","article-title":"Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging","volume":"98","author":"Seeman","year":"2001","journal-title":"Proc Natl Acad Sci U S A"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2259","DOI":"10.1001\/archinte.1997.00440400111013","article-title":"Price of adaptation\u2014allostatic load and its health consequences: MacArthur studies of successful aging","volume":"157","author":"Seeman","year":"1997","journal-title":"Arch Intern Med"},{"key":"B35","doi-asserted-by":"crossref","DOI":"10.1002\/9780470015902.a0001401.pub2","article-title":"Adrenaline and noradrenaline","volume-title":"Encyclopedia of Life Sciences [Internet]","author":"Goldstein","year":"2010"},{"key":"B36","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.tem.2008.01.009","article-title":"Dissociation of ACTH and glucocorticoids","volume":"19","author":"Bornstein","year":"2008","journal-title":"Trends Endocrinol Metab"},{"key":"B37","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1210\/en.2016-1748","article-title":"Insulin and glucagon: partners for life","volume":"158","author":"Holst","year":"2017","journal-title":"Endocrinology"},{"key":"B38","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/BF02982543","article-title":"Cytokines: past, present, and future","volume":"74","author":"Oppenheim","year":"2001","journal-title":"Int J Hematol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"646596","DOI":"10.3389\/fimmu.2021.646596","article-title":"Editorial: innate immunity in normal and adverse pregnancy","volume":"12","author":"Burwick","year":"2021","journal-title":"Front Immunol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"402","DOI":"10.3390\/biology12030402","article-title":"Innate and adaptive immune systems in physiological and pathological pregnancy","volume":"12","author":"Weng","year":"2023","journal-title":"Biology (Basel)"},{"key":"B41","doi-asserted-by":"publisher","first-page":"e23146","DOI":"10.1002\/ajpa.23146","article-title":"Allostatic load and biological anthropology","volume":"162","author":"Edes","year":"2017","journal-title":"Am J Phys Anthropol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1177\/1099800412455688","article-title":"A systematic review of allostatic load, health, and health disparities","volume":"14","author":"Beckie","year":"2012","journal-title":"Biol Res Nurs"},{"key":"B43","doi-asserted-by":"publisher","first-page":"5","DOI":"10.2486\/indhealth.2014-0122","article-title":"Measuring allostatic load in the workforce: a systematic review","volume":"53","author":"Mauss","year":"2015","journal-title":"Ind Health"},{"key":"B44","doi-asserted-by":"publisher","first-page":"e0183297","DOI":"10.1371\/journal.pone.0183297","article-title":"Allostatic load as a predictor of all-cause and cause-specific mortality in the general population: evidence from the Scottish health survey","volume":"12","author":"Robertson","year":"2017","journal-title":"PLoS One"},{"key":"B45","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1002\/cplx.21743","article-title":"Allostatic load as a complex clinical construct: a case-based computational modeling approach","volume":"21","author":"Buckwalter","year":"2016","journal-title":"Complexity"},{"key":"B46","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1002\/cplx.21728","article-title":"Cases, clusters, densities: modeling the nonlinear dynamics of complex health trajectories","volume":"21","author":"Castellani","year":"2016","journal-title":"Complexity"},{"key":"B47","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1097\/PSY.0000000000000095","article-title":"Allostatic load and the assessment of cumulative biological risk in biobehavioral medicine: challenges and opportunities","volume":"76","author":"Gallo","year":"2014","journal-title":"Psychosom Med"},{"key":"B48","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1002\/nur.20084","article-title":"Allostatic load and health disparities: a theoretical orientation","volume":"28","author":"Carlson","year":"2005","journal-title":"Res Nurs Health"},{"key":"B49","doi-asserted-by":"publisher","first-page":"14158","DOI":"10.1073\/pnas.0606215103","article-title":"Combinations of biomarkers predictive of later life mortality","volume":"103","author":"Gruenewald","year":"2006","journal-title":"Proc Natl Acad Sci U S A"},{"key":"B50","doi-asserted-by":"publisher","first-page":"102621","DOI":"10.1016\/j.midw.2019.102621","article-title":"Exploring the validity of allostatic load in pregnant women","volume":"82","author":"Li","year":"2020","journal-title":"Midwifery"},{"key":"B51","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1007\/s40615-016-0246-8","article-title":"Variation in the calculation of allostatic load score: twenty-one examples from NHANES","volume":"4","author":"Duong","year":"2017","journal-title":"J Racial Ethn Health Disparities"},{"key":"B52","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1136\/jech-2018-211289","article-title":"Association between allostatic load and health behaviours: a latent class approach","volume":"73","author":"Forrester","year":"2019","journal-title":"J Epidemiol Community Health"},{"key":"B53","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1093\/jpepsy\/jst084","article-title":"An introduction to latent variable mixture modeling (part 1): overview and cross-sectional latent class and latent profile analyses","volume":"39","author":"Berlin","year":"2014","journal-title":"J Pediatr Psychol"},{"key":"B54","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1111\/cdep.12163","article-title":"Latent class analysis for developmental research","volume":"10","author":"Lanza","year":"2016","journal-title":"Child Dev Perspect"},{"key":"B55","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1007\/s11121-011-0201-1","article-title":"Latent class analysis: an alternative perspective on subgroup analysis in prevention and treatment","volume":"14","author":"Lanza","year":"2013","journal-title":"Prev Sci"},{"key":"B56","doi-asserted-by":"publisher","first-page":"2296","DOI":"10.1093\/humrep\/13.8.2296","article-title":"Stress and anxiety do not result in pregnancy wastage","volume":"13","author":"Milad","year":"1998","journal-title":"Hum Reprod"},{"key":"B57","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1177\/1753495x12473751","article-title":"Effects of prenatal stress on pregnancy and human development: mechanisms and pathways","volume":"6","author":"Coussons-Read","year":"2013","journal-title":"Obstet Med"},{"key":"B58","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/BF01857952","article-title":"Conceptualizations, measurement, and effects of prenatal maternal stress on birth outcomes","volume":"17","author":"Lobel","year":"1994","journal-title":"J Behav Med"},{"key":"B59","doi-asserted-by":"publisher","first-page":"e1297","DOI":"10.1016\/S2214-109X(18)30385-1","article-title":"Population-based rates, timing, and causes of maternal deaths, stillbirths, and neonatal deaths in south Asia and Sub-Saharan Africa: a multi-country prospective cohort study","volume":"6","year":"2018","journal-title":"Lancet Glob Health"},{"key":"B60","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1038\/npp.2015.247","article-title":"Intergenerational transmission of stress in humans","volume":"41","author":"Bowers","year":"2016","journal-title":"Neuropsychopharmacology"},{"key":"B61","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1146\/annurev-clinpsy-050718-095539","article-title":"Prenatal developmental origins of future psychopathology: mechanisms and pathways","volume":"15","author":"Monk","year":"2019","journal-title":"Annu Rev Clin Psychol"},{"key":"B62","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1007\/s10865-019-00068-7","article-title":"Conceptualization, measurement, and effects of pregnancy-specific stress: review of research using the original and revised prenatal distress questionnaire","volume":"43","author":"Ibrahim","year":"2020","journal-title":"J Behav Med"},{"key":"B63","doi-asserted-by":"publisher","first-page":"2393","DOI":"10.1007\/s10995-014-1479-y","article-title":"Perinatal distress in women in low- and middle-income countries: allostatic load as a framework to examine the effect of perinatal distress on preterm birth and infant health","volume":"18","author":"Premji","year":"2014","journal-title":"Matern Child Health J"},{"key":"B64","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/B978-0-12-397045-9.00164-6","article-title":"Pregnancy and prenatal stress","volume-title":"Encyclopedia of Mental Health [Internet]","author":"Lobel","year":"2016"},{"key":"B65","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jmwh.2008.08.001","article-title":"The interaction between chronic stress and pregnancy: preterm birth from A biobehavioral perspective","volume":"54","author":"Latendresse","year":"2009","journal-title":"J Midwifery Womens Health"},{"key":"B66","doi-asserted-by":"publisher","first-page":"4857065","DOI":"10.1155\/2018\/4857065","article-title":"Evaluating stress during pregnancy: do we have the right conceptions and the correct tools to assess it?","volume":"2018","author":"Gonz\u00e1lez-Ochoa","year":"2018","journal-title":"J Pregnancy"},{"key":"B67","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1111\/birt.12598","article-title":"\u201cHow am I going to make it through pregnancy?\u201d: a qualitative examination of prenatal maternal stress","volume":"49","author":"Mahaffey","year":"2022","journal-title":"Birth"},{"key":"B68","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1037\/a0013242","article-title":"Pregnancy-specific stress, prenatal health behaviors, and birth outcomes","volume":"27","author":"Lobel","year":"2008","journal-title":"Health Psychol"},{"key":"B69","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1097\/PSY.0b013e3180cac25d","article-title":"Maternal prenatal pregnancy-related anxiety and spontaneous preterm birth in Baltimore, Maryland","volume":"69","author":"Orr","year":"2007","journal-title":"Psychosom Med"},{"key":"B70","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1037\/0278-6133.27.1.43","article-title":"Pattern of perceived stress and anxiety in pregnancy predicts preterm birth","volume":"27","author":"Glynn","year":"2008","journal-title":"Health Psychol"},{"key":"B71","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1007\/s10995-018-2500-7","article-title":"Racial\/ethnic inequities in low birth weight and preterm birth: the role of multiple forms of stress","volume":"22","author":"Almeida","year":"2018","journal-title":"Matern Child Health J"},{"key":"B72","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1093\/abm\/kaaa008","article-title":"Maternal age patterns of preterm birth: exploring the moderating roles of chronic stress and race\/ethnicity","volume":"54","author":"Kim","year":"2020","journal-title":"Ann Behav Med"},{"key":"B73","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1093\/humrep\/dey261","article-title":"Allostatic load, a measure of chronic physiological stress, is associated with pregnancy outcomes, but not fertility, among women with unexplained infertility","volume":"33","author":"Barrett","year":"2018","journal-title":"Hum Reprod"},{"key":"B74","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1159\/000540579","article-title":"Allostatic load as a mediator and perceived chronic stress as a moderator in the association between maternal mental health and preterm birth: a prospective cohort study of pregnant women in Pakistan","volume":"58","author":"Premji","year":"2024","journal-title":"Psychopathology"},{"key":"B75","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.sleep.2016.09.001","article-title":"Allostatic load in early pregnancy is associated with poor sleep quality","volume":"33","author":"Hux","year":"2017","journal-title":"Sleep Med"},{"key":"B76","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1111\/1471-0528.17486","article-title":"Can allostatic load in pregnancy explain the association between race and subsequent cardiovascular disease risk: a cohort study","volume":"130","author":"Lueth","year":"2023","journal-title":"BJOG"},{"key":"B77","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3109\/10408369709038216","article-title":"Clinical biochemistry of pregnancy","volume":"34","author":"Lockitch","year":"1997","journal-title":"Crit Rev Clin Lab Sci"},{"key":"B78","doi-asserted-by":"publisher","first-page":"89","DOI":"10.5830\/CVJA-2016-021","article-title":"Physiological changes in pregnancy","volume":"27","author":"Soma-Pillay","year":"2016","journal-title":"Cardiovasc J Afr"},{"key":"B79","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/s12916-019-1399-1","article-title":"Trends of blood pressure and heart rate in normal pregnancies: a systematic review and meta-analysis","volume":"17","author":"Loerup","year":"2019","journal-title":"BMC Med"},{"key":"B80","doi-asserted-by":"publisher","first-page":"107","DOI":"10.2337\/diacare.9.2.107","article-title":"Longitudinal assessment of glycosylated blood protein concentrations in normal pregnancy and gestational diabetes","volume":"9","author":"Morris","year":"1986","journal-title":"Diabetes Care"},{"key":"B81","volume-title":"Maternal, Fetal, & Neonatal Physiology: A Clinical Perspective","author":"Blackburn","year":"2013"},{"key":"B82","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1111\/j.1552-6909.2007.00126.x","article-title":"Allostasis: a theoretical framework for understanding and evaluating perinatal health outcomes","volume":"36","author":"Shannon","year":"2007","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.1004073","article-title":"Prenatal allostatic load and preterm birth: a systematic review","volume":"13","author":"Premji","year":"2022","journal-title":"Front Psychol"},{"key":"B84","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s40615-020-00757-z","article-title":"Acknowledging and addressing allostatic load in pregnancy care","volume":"8","author":"Riggan","year":"2021","journal-title":"J Racial Ethn Health Disparities"},{"key":"B85","doi-asserted-by":"publisher","first-page":"2305680","DOI":"10.1080\/14767058.2024.2305680","article-title":"Allostatic load in early pregnancy and sleep-disordered breathing","volume":"37","author":"Lueth","year":"2024","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000006062","article-title":"Allostatic load mediates associations between race, ethnicity, and hypertensive disorders of pregnancy","volume":"4","author":"Ray","year":"2025","journal-title":"Obstet Gynecol"},{"key":"B87","doi-asserted-by":"publisher","first-page":"155658","DOI":"10.1016\/j.scitotenv.2022.155658","article-title":"Increased allostatic load associated with ambient air pollution acting as a stressor: cross-sectional evidence from the China multi-ethnic cohort study","volume":"831","author":"Xu","year":"2022","journal-title":"Sci Total Environ"},{"key":"B88","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.3390\/jcm8101625","article-title":"Preeclampsia: risk factors, diagnosis, management, and the cardiovascular impact on the offspring","volume":"8","author":"Fox","year":"2019","journal-title":"J Clin Med"},{"key":"B89","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1038\/s41598-025-85819-0","article-title":"Trends in global and regional incidence and prevalence of hypertensive disordersin pregnancy (1990\u20132021): an age-period-cohort analysis","volume":"15","author":"Sun","year":"2025","journal-title":"Sci Rep"},{"key":"B90","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1007\/s10995-016-2103-0","article-title":"Cumulative physiologic dysfunction and pregnancy: characterization and association with birth outcomes","volume":"21","author":"McKee","year":"2017","journal-title":"Matern Child Health J"},{"key":"B91","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1007\/s10995-012-1083-y","article-title":"Allostatic load and birth outcomes among white and black women in New Orleans","volume":"17","author":"Wallace","year":"2013","journal-title":"Matern Child Health J"},{"key":"B92","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1111\/ppe.12091","article-title":"Preconception biomarkers of allostatic load and racial disparities in adverse birth outcomes: the Bogalusa heart study","volume":"27","author":"Wallace","year":"2013","journal-title":"Paediatr Perinat Epidemiol"},{"key":"B93","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.healthplace.2013.10.002","article-title":"Neighborhood poverty, allostatic load, and birth outcomes in African American and white women: findings from the Bogalusa heart study","volume":"24","author":"Wallace","year":"2013","journal-title":"Health Place"},{"key":"B94","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.annepidem.2013.03.006","article-title":"Allostatic load may not be associated with chronic stress in pregnant women, NHANES 1999\u20132006","volume":"23","author":"Morrison","year":"2013","journal-title":"Ann Epidemiol"},{"key":"B95","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1186\/1472-6963-11-286","article-title":"The world health organization multicountry survey on maternal and newborn health: study protocol","volume":"11","author":"Souza","year":"2011","journal-title":"BMC Health Serv Res"},{"key":"B96","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.socscimed.2017.09.025","article-title":"A systematic review of allostatic load in relation to socioeconomic position: poor fidelity and major inconsistencies in biomarkers employed","volume":"192","author":"Johnson","year":"2017","journal-title":"Soc Sci Med"},{"key":"B97","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1111\/j.1749-6632.2009.05341.x","article-title":"Socio-economic differentials in peripheral biology: cumulative allostatic load","volume":"1186","author":"Seeman","year":"2010","journal-title":"Ann N Y Acad Sci"},{"key":"B98","doi-asserted-by":"publisher","first-page":"153","DOI":"10.26502\/acbr.50170394","article-title":"Maternal allostatic load as a predictor of adverse pregnancy outcomes and offspring development in the F3 generation: evidence from a rat model of transgenerational and multigenerational stress","volume":"8","author":"Reynolds","year":"2024","journal-title":"Arch Clin Biomed Res"},{"key":"B99","doi-asserted-by":"publisher","first-page":"23996","DOI":"10.1073\/pnas.1905890116","article-title":"Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes","volume":"116","author":"Walsh","year":"2019","journal-title":"Proc Natl Acad Sci U S A"},{"key":"B100","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1111\/jcpp.12877","article-title":"Research review: intergenerational transmission of disadvantage: epigenetics and parents\u2019 childhoods as the first exposure","volume":"60","author":"Scorza","year":"2019","journal-title":"J Child Psychol Psychiatry"},{"key":"B101","doi-asserted-by":"publisher","first-page":"100229","DOI":"10.1016\/j.ajogmf.2020.100229","article-title":"Effects of psychological stress on adverse pregnancy outcomes and nonpharmacologic approaches for reduction: an expert review","volume":"2","author":"Traylor","year":"2020","journal-title":"Am J Obstet Gynecol MFM"},{"key":"B102","doi-asserted-by":"publisher","first-page":"104624","DOI":"10.1016\/j.neubiorev.2022.104624","article-title":"Prenatal psychological or metabolic stress increases the risk for psychiatric disorders: the \u201cfunnel effect\u201d model","volume":"136","author":"Musillo","year":"2022","journal-title":"Neurosci Biobehav Rev"},{"key":"B103","doi-asserted-by":"publisher","first-page":"107450","DOI":"10.1016\/j.psyneuen.2025.107450","article-title":"Maternal allostatic load in pregnancy is prospectively associated with child adiposity and metabolic function across infancy and early childhood","volume":"177","author":"Gyllenhammer","year":"2025","journal-title":"Psychoneuroendocrinology"},{"key":"B104","doi-asserted-by":"publisher","first-page":"17455057231184325","DOI":"10.1177\/17455057231184325","article-title":"Association between adverse childhood experiences and later-life allostatic load in UK biobank female participants","volume":"19","author":"Jakubowski","year":"2023","journal-title":"Womens Health (Lond)"}],"container-title":["Frontiers in Global Women's Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2025.1725275\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T06:34:38Z","timestamp":1767854078000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2025.1725275\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":104,"alternative-id":["10.3389\/fgwh.2025.1725275"],"URL":"https:\/\/doi.org\/10.3389\/fgwh.2025.1725275","relation":{},"ISSN":["2673-5059"],"issn-type":[{"value":"2673-5059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,8]]},"article-number":"1725275"}}