A COMPARISON OF DOULA SUPPORT FOR IMPROVING BIRTH OUTCOMES AND EPIGENETIC AGING BIOMARKERS IN FIRST-TIME MOTHERS
- Authors
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Komal Mannan
Author
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Aqsa Shahbaz
Author
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- Keywords:
- Cesarean Section; DNA Methylation; Labor Support; Pregnancy; Primiparity; Randomized Controlled Trial; Stress, Psychological
- Abstract
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Background: Childbirth is a critical physiological and psychosocial event, particularly for first-time mothers, who are more vulnerable to stress and obstetric interventions. Continuous labor support through trained doulas has been associated with improved birth experiences and clinical outcomes, yet its potential biological effects on the newborn remain poorly understood. Emerging evidence suggests that perinatal stress may influence neonatal DNA methylation–based epigenetic aging, a biomarker linked to early-life health trajectories.
Objective: To evaluate the impact of doula support on obstetric complications and neonatal cord blood DNA methylation age among first-time mothers.
Methods: A randomized controlled trial was conducted in maternity facilities across South Punjab. A total of 160 primiparous women with singleton pregnancies were randomized to receive either continuous doula support during labor or standard obstetric care. Obstetric outcomes, including mode of delivery, labor duration, and analgesia use, were recorded. Neonatal outcomes and umbilical cord blood samples were collected at birth. DNA methylation age and epigenetic age acceleration were estimated from cord blood samples. Group comparisons were performed using independent-sample t-tests and chi-square tests, with multivariable regression analyses applied to adjust for relevant covariates.
Results: Women receiving doula support had lower rates of cesarean delivery, prolonged labor, and pharmacologic analgesia use compared with controls. Neonates in the doula group demonstrated higher mean birth weight, improved Apgar scores, and fewer intensive care admissions. Cord blood analysis revealed lower neonatal epigenetic age and reduced epigenetic age acceleration in the doula-supported group. The association between doula support and lower epigenetic age acceleration remained significant after adjustment for clinical factors.
Conclusion: Doula support during labor was associated with improved obstetric and neonatal outcomes and with favorable differences in neonatal epigenetic aging markers. These findings underscored the potential value of supportive, non-clinical interventions in enhancing both immediate birth outcomes and early biological indicators of health.
- Author Biographies
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- 2025-09-30
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This work is licensed under a Creative Commons Attribution 4.0 International License.
