Maternal health behavior during pregnancy mediates the relationship between maternal stress and newborn telomere length

Background Health behaviors play a key role in age-related disease risk and are influenced by psychosocial stress. The period of embryonic and fetal life represents among the most sensitive developmental windows at which the effects of maternal behaviors can impact the initial (newborn) setting of telomere length (TL), a marker of biological aging. In the present study, we aimed to investigate the aggregated effect of maternal diet, physical activity and sleep during pregnancy on newborn TL, as well as the mediating role of maternal health behaviors in the relationship between perceived stress and newborn TL. Methods Diet quality (Mediterranean Diet Score), physical activity (Measurement of Physical Activity and Sport Questionnaire) and sleep quality (Pittsburgh Sleep Quality Index) were assessed in healthy pregnant women enrolled in a longitudinal prospective cohort study and a Behavioral Health Score (BHS) was computed as the sum of their z-scores. Perceived stress was assessed using the Perceived Stress Scale (PSS). TL was measured in cord blood mononuclear cells (CBMCs) collected at birth in 113 newborns. Results A higher BHS during pregnancy was associated with longer CBMC newborn TL ( β = 0.24, 95% CI: 0.006 to 0.05, p = .01). The relationship between maternal perceived stress and newborn CBMC TL was mediated by the BHS ( b = -0.01, bootstrap 95% CI: -0.03 to -0.004). Conclusion Promoting maternal stress management and positive health behavior during pregnancy may have lasting benefits for offspring biological aging and health, potentially reducing the burden of age-related diseases across the lifespan.