phd viva stressed

University of Strathclyde -->

Thank you for viewing this 1newwebsite site. Unfortunately you are using an out of date browser that we have yet to test on. Please upgrade your browser to improve your experience.

Strathclyde Business School

How to (and how not to) prepare for your phd viva.

Anyone doing a PhD will feel nerves kick in as they approach the date of the PhD viva. Here, Rohan Sachdev explains how he coped and gives some tips on how to get yourself ready for that all important event.

After having spent years writing my doctoral thesis, the moment of submission for examination was quite confusing for me. I felt a sense of relief but also a wave of panic for the PhD viva. I had written all I could and it was approved by my supervisors. But now I had to prepare to defend it in person in front of a panel that would decide the fate of my hard work. The only question that crippled me for the first couple of weeks was “Where do I start?”

The process of preparing for this once-in-a-lifetime experience can be intimidating. With so much information out there on the process, I wondered, “how much of it is relevant to me?” I spent countless nights reading about other researcher’s experiences and fixated on the bad experiences. Of course, I thought, this would happen to me.

Having gone through this emotional and intellectual roller coaster, I now know better; I now know where I went right and where I went wrong in my preparation. There is no one appropriate guide on how to prepare for a viva. There is no singular “right way” of preparing for it. It all depends on your thesis, your subject area, your university, and even the country you’re studying in.

In saying that, there are some pointers to consider. These are not hard lines that one must do, but things you may want to keep in mind while preparing.

Do: Read through all the guidance issued to you by your academic team

Remember, your supervisors and faculty in your department do this all the time, they may have been external examiners, internal examiners, chairs, and they have even gone through the same process you are going through. Ask them for advice. Check with them if a mock viva can be arranged for you about a week before the big day.

Don’t: Read through horror stories of badly gone vivas on the internet

The internet is a house of horrors when it comes to viva preparation. People are more likely to express and discuss their negative experiences. They may not even be relevant to you; their systems may be completely different where they studied. It may be good to know the potential outcomes, but not at the cost of scaring yourself.

Do: Systematically review your entire thesis end to end

After you’ve submitted, take some time off, go to that restaurant you’ve been eyeing, have some fun. Then print your thesis, sit down, and read it thoroughly without a pen in your hand. Know what is in your thesis without any additional notes. It is key to prepare well for your viva, but overpreparation may be counterproductive.

Don’t: Make extensive notes of your thesis

Making long notes will only stress you out. Once you’ve read your thesis thoroughly without a pen, take another week-long break and read it again - this time, with a pen. If you come across any typos, mark them. On the top of each page, write down one sentence about what’s on that page. Make a list of potential questions and consider how you could answer them. Avoid memorising pre-written answers. These steps will make it easier for your final revision the week before your viva.

Do: Ask for advice from your peers who have been through it before

Just as with your supervisors, fellow students from your department who have recently finished their PhD will have a good idea of the experience. Get an insight into what they went through. Ask for any tips and generic questions they were asked at the start of their viva. These will all be more relevant to you than anything you read online.

Don’t: Take advice from your non-academic friends and family

Sometimes, the advice you get from people around you who don’t completely understand the process of a PhD and/or what you’re doing can stress you out. Try and stick to talking about your in-depth preparation strategy to peers and friends who have a good idea of what the processes are.

Do: Lightly read blogs on viva preparation (NOT outcomes)

A lot of blogs and discussion threads out there are dedicated to viva preparation. Find these threads so you can interact with people and get hints from them. Try not to think about the outcome, you will only stress yourself out more. One of the keys is to relax and enjoy the experience.

Don’t: Google “how to fail your PhD in 1 minute”

If you’re as obsessive about the viva as I was, you may be tempted to gauge exactly what the examiners are thinking and end up googling things you shouldn’t. Coming across such posts, blogs and videos is the ultimate ‘don’t’ when it comes to preparation. Try to stay off these negative thoughts and focus on the other more important steps.

Do: Check out what your examiners have worked on

Having a good idea of the point of view your examiners come from is good to prepare for the types of questions you could get asked. Find their published papers and go over them. See what similarities you have to their style of writing and things they focus on for a hint on what to expect.

Don’t: Try to appease your examiners and change things to appeal to them

Having read their work, it is now too late to change your thesis to appease your examiners. Moreover, the point of doing your research is to express your point of view. Politely defend yourself in the viva, but don’t change things when you’re explaining them to make them happy. You are now on your path to becoming an independent researcher, after all!

In the end, the "dos and don’ts" are just for guidance, and represent the things that worked well for me. If there is anything different that works better for you, do that. This is your journey.

The three keys to eventual success are: Prepare, relax, and don’t obsess. You’ve done your best in writing the thesis, now it's time to show the examiners how well you can explain it. Remember, you’re inching towards the finish line. You’ve got this!

For more information on PhDs at Strathclyde, please click here and for more information on research degrees at Strathclyde Business School, click here

About Rohan Sachdev

Rohan Sachdev, a PhD Graduand in Economics at Strathclyde Business School, will graduate in November. He is now based in Belfast, working as a Research Economist at the Agri-Food and Biosciences Institute Northern Ireland. His PhD thesis is titled “The use of Multi-Sectoral Models in evaluating the Macroeconomic impacts of reduced Household Consumption of Sin Goods: The Case of Alcohol Consumption in Scotland”.

Stay in touch

    The Business School Blog     Latest Newsletter     Join us on Linkedin     Follow us on Twitter     Join us on Facebook     Visit our YouTube channel

Contact details

 Undergraduate admissions   +44 (0)141 548 4114   [email protected]  

 Postgraduate admissions   +44(0)141 553 6118 / 6119   [email protected]

Strathclyde Business School University of Strathclyde 199 Cathedral Street Glasgow G4 0QU

Triple accredited

The Savvy Scientist

Experiences of a London PhD student and beyond

PhD Burnout: Managing Energy, Stress, Anxiety & Your Mental Health

PhDs are renowned for being stressful and when you add a global pandemic into the mix it’s no surprise that many students are struggling with their mental health. Unfortunately this can often lead to PhD fatigue which may eventually lead to burnout.

In this post we’ll explore what academic burnout is and how it comes about, then discuss some tips I picked up for managing mental health during my own PhD.

Please note that I am by no means an expert in this area. I’ve worked in seven different labs before, during and after my PhD so I have a fair idea of research stress but even so, I don’t have all the answers.

If you’re feeling burnt out or depressed and finding the pressure too much, please reach out to friends and family or give the Samaritans a call to talk things through.

Note – This post, and its follow on about maintaining PhD motivation were inspired by a reader who asked for recommendations on dealing with PhD fatigue. I love hearing from all of you, so if you have any ideas for topics which you, or others, could find useful please do let me know either in the comments section below or by getting in contact . Or just pop me a message to say hi. 🙂

This post is part of my PhD mindset series, you can check out the full series below:

• PhD Burnout: Managing Energy, Stress, Anxiety & Your Mental Health (this part!)
• PhD Motivation: How to Stay Driven From Cover Letter to Completion
• How to Stop Procrastinating and Start Studying

What is PhD Burnout?

Whenever I’ve gone anywhere near social media relating to PhDs I see overwhelmed PhD students who are some combination of overwhelmed, de-energised or depressed.

Specifically I often see Americans talking about the importance of talking through their PhD difficulties with a therapist, which I find a little alarming. It’s great to seek help but even better to avoid the need in the first place.

Sadly, none of this is unusual. As this survey shows, depression is common for PhD students and of note: at higher levels than for working professionals.

All of these feelings can be connected to academic burnout.

The World Health Organisation classifies burnout as a syndrome with symptoms of:

– Feelings of energy depletion or exhaustion; – Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; – Reduced professional efficacy. Symptoms of burnout as classified by the WHO. Source .

This often leads to students falling completely out of love with the topic they decided to spend years of their life researching!

The pandemic has added extra pressures and constraints which can make it even more difficult to have a well balanced and positive PhD experience. Therefore it is more important than ever to take care of yourself, so that not only can you continue to make progress in your project but also ensure you stay healthy.

What are the Stages of Burnout?

Psychologists Herbert Freudenberger and Gail North developed a 12 stage model of burnout. The following graphic by The Present Psychologist does a great job at conveying each of these.

I don’t know about you, but I can personally identify with several of the stages and it’s scary to see how they can potentially lead down a path to complete mental and physical burnout. I also think it’s interesting that neglecting needs (stage 3) happens so early on. If you check in with yourself regularly you can hopefully halt your burnout journey at that point.

PhDs can be tough but burnout isn’t an inevitability. Here are a few suggestions for how you can look after your mental health and avoid academic burnout.

Overcoming PhD Burnout

Manage your energy levels, maintaining energy levels day to day.

• Eat well and eat regularly. Try to avoid nutritionless high sugar foods which can play havoc with your energy levels. Instead aim for low GI food . Maybe I’m just getting old but I really do recommend eating some fruit and veg. My favourite book of 2021, How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reduce Disease , is well worth a read. Not a fan of veggies? Either disguise them or at least eat some fruit such as apples and bananas. Sliced apple with some peanut butter is a delicious and nutritious low GI snack. Check out my series of posts on cooking nutritious meals on a budget.
• Get enough sleep. It doesn’t take PhD-level research to realise that you need to rest properly if you want to avoid becoming exhausted! How much sleep someone needs to feel well-rested varies person to person, so I won’t prescribe that you get a specific amount, but 6-9 hours is the range typically recommended. Personally, I take getting enough sleep very seriously and try to get a minimum of 8 hours.

A side note on caffeine consumption: Do PhD students need caffeine to survive?

In a word, no!

Although a culture of caffeine consumption goes hand in hand with intense work, PhD students certainly don’t need caffeine to survive. How do I know? I didn’t have any at all during my own PhD. In fact, I wrote a whole post about it .

By all means consume as much caffeine as you want, just know that it doesn’t have to be a prerequisite for successfully completing a PhD.

Maintaining energy throughout your whole PhD

• Pace yourself. As I mention later in the post I strongly recommend treating your PhD like a normal full-time job. This means only working 40 hours per week, Monday to Friday. Doing so could help realign your stress, anxiety and depression levels with comparatively less-depressed professional workers . There will of course be times when this isn’t possible and you’ll need to work longer hours to make a certain deadline. But working long hours should not be the norm. It’s good to try and balance the workload as best you can across the whole of your PhD. For instance, I often encourage people to start writing papers earlier than they think as these can later become chapters in your thesis. It’s things like this that can help you avoid excess stress in your final year.
• Take time off to recharge. All work and no play makes for an exhausted PhD student! Make the most of opportunities to get involved with extracurricular activities (often at a discount!). I wrote a whole post about making the most of opportunities during your PhD . PhD students should have time for a social life, again I’ve written about that . Also give yourself permission to take time-off day to day for self care, whether that’s to go for a walk in nature, meet friends or binge-watch a show on Netflix. Even within a single working day I often find I’m far more efficient when I break up my work into chunks and allow myself to take time off in-between. This is also a good way to avoid procrastination!

Reduce Stress and Anxiety

During your PhD there will inevitably be times of stress. Your experiments may not be going as planned, deadlines may be coming up fast or you may find yourself pushed too far outside of your comfort zone. But if you manage your response well you’ll hopefully be able to avoid PhD burnout. I’ll say it again: stress does not need to lead to burnout!

Everyone is unique in terms of what works for them so I’d recommend writing down a list of what you find helpful when you feel stressed, anxious or sad and then you can refer to it when you next experience that feeling.

I’ve created a mental health reminders print-out to refer to when times get tough. It’s available now in the resources library (subscribe for free to get the password!).

Below are a few general suggestions to avoid PhD burnout which work for me and you may find helpful.

• Exercise. When you’re feeling down it can be tough to motivate yourself to go and exercise but I always feel much better for it afterwards. When we exercise it helps our body to adapt at dealing with stress, so getting into a good habit can work wonders for both your mental and physical health. Why not see if your uni has any unusual sports or activities you could try? I tried scuba diving and surfing while at Imperial! But remember, exercise doesn’t need to be difficult. It could just involve going for a walk around the block at lunch or taking the stairs rather than the lift.
• Cook / Bake. I appreciate that for many people cooking can be anything but relaxing, so if you don’t enjoy the pressure of cooking an actual meal perhaps give baking a go. Personally I really enjoy putting a podcast on and making food. Pinterest and Youtube can be great visual places to find new recipes.
• Let your mind relax. Switching off is a skill and I’ve found meditation a great way to help clear my mind. It’s amazing how noticeably different I can feel afterwards, having not previously been aware of how many thoughts were buzzing around! Yoga can also be another good way to relax and be present in the moment. My partner and I have been working our way through 30 Days of Yoga with Adriene on Youtube and I’d recommend it as a good way to ease yourself in. As well as being great for your mind, yoga also ticks the box for exercise!
• Read a book. I’ve previously written about the benefits of reading fiction * and I still believe it’s one of the best ways to relax. Reading allows you to immerse yourself in a different world and it’s a great way to entertain yourself during a commute.

* Wondering how I got something published in Science ? Read my guide here .

Talk It Through

• Meet with your supervisor. Don’t suffer in silence, if you’re finding yourself struggling or burned out raise this with your supervisor and they should be able to work with you to find ways to reduce the pressure. This may involve you taking some time off, delegating some of your workload, suggesting an alternative course of action or signposting you to services your university offers.

Also remember that facing PhD-related challenges can be common. I wrote a whole post about mine in case you want to cheer yourself up! We can’t control everything we encounter, but we can control our response.

A free self-care checklist is also now available in the resources library , providing ideas to stay healthy and avoid PhD burnout.

Top Tips for Avoiding PhD Burnout

On top of everything we’ve covered in the sections above, here are a few overarching tips which I think could help you to avoid PhD burnout:

• Work sensible hours . You shouldn’t feel under pressure from your supervisor or anyone else to be pulling crazy hours on a regular basis. Even if you adore your project it isn’t healthy to be forfeiting other aspects of your life such as food, sleep and friends. As a starting point I suggest treating your PhD as a 9-5 job. About a year into my PhD I shared how many hours I was working .
• Reduce your use of social media. If you feel like social media could be having a negative impact on your mental health, why not try having a break from it?
• Do things outside of your PhD . Bonus points if this includes spending time outdoors, getting exercise or spending time with friends. Basically, make sure the PhD isn’t the only thing occupying both your mental and physical ife.
• Regularly check in on how you’re feeling. If you wait until you’re truly burnt out before seeking help, it is likely to take you a long time to recover and you may even feel that dropping out is your only option. While that can be a completely valid choice I would strongly suggest to check in with yourself on a regular basis and speak to someone early on (be that your supervisor, or a friend or family member) if you find yourself struggling.

I really hope that this post has been useful for you. Nothing is more important than your mental health and PhD burnout can really disrupt that. If you’ve got any comments or suggestions which you think other PhD scholars could find useful please feel free to share them in the comments section below.

You can subscribe for more content here:

Share this:

• Click to share on Facebook (Opens in new window)
• Click to share on LinkedIn (Opens in new window)
• Click to share on Twitter (Opens in new window)
• Click to share on Reddit (Opens in new window)

Related Posts

Minor Corrections: How To Make Them and Succeed With Your PhD Thesis

2nd June 2024 2nd June 2024

How to Master Data Management in Research

25th April 2024 27th April 2024

Thesis Title: Examples and Suggestions from a PhD Grad

23rd February 2024 21st July 2024

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Notify me of follow-up comments by email.

This site uses Akismet to reduce spam. Learn how your comment data is processed .

Privacy Overview

• Log in
• Site search

5 tips for passing your PhD viva

Every Doctoral researcher is expected to defend their thesis through an oral test known as a viva voce - so discover how to prepare for your PhD viva and ensure you make a good impression on the examiners

1. Understand what's expected of you

The PhD viva exam has traditionally always taken place in person, with the interview style discussion overseen by at least two (internal and external) examiners. Afterwards, you would be provided with a joint written report detailing any corrections that need to be made.

However, during the pandemic, the online PhD viva become more commonplace with this exam more likely to take place via Microsoft Teams, Skype or Zoom. Even now, a number of years later, many universities still allow for the viva to take place online, or a hybrid of online and in-person assessment.

The virtual experience still follows much the same format, but you'll be briefed in advance about the arrangements and any technical aspects to bear in mind. You can prepare for an online PhD viva by reading our video interview tips .

The chair of the viva is usually the internal examiner, although it can be an independent person. If you and the examiners agree, your PhD supervisor can also be present.

The examiners' main objective is to ascertain that you've written your own thesis, so if you have and are ready to talk through how you completed it, there's no need to panic. You may even enjoy the viva voce test.

In addition to assessing your thesis, the examiners are also there to assist you in deciding how and where this research might be published.

There are various results between a 'pass' and 'fail' but it's very rare to slip up at this point of a PhD. Most Doctorate awards will be made upon the condition that a number of minor corrections are made, with re-submission requests far less common.

While the pass rate is high, the viva exam itself can still be intellectually demanding. This is because you'll be debating issues that are conceptually complex, so preparation is crucial to your success.

At the end of it, whatever the outcome, be prepared to take on board any advice, as the examiners are there to help you improve your argument or the presentation of your thesis.

2. Know your thesis inside out

While this isn't a memory test - as you're fine bringing notes and a copy of your thesis with you - it's still important to gain a good understanding of what you've written and be knowledgeable about your field of study.

You'll need to think carefully about where this original piece of work would be placed in the context of the wider body of research carried out in this field. Questions will be asked about this, as well as whether the project could possibly be developed further through any future research.

As you'll be explaining parts of the document to the examiners (who'll also have a digital or physical copy), make sure the pagination is the same in your version as the one they're looking at to avoid any issues regarding everybody being on the same page.

If you get stuck at any point during the viva exam, you can use looking at the thesis as an excuse to re-focus and gather your thoughts.

3. Anticipate the PhD viva questions

The examiners will have prepared a series of questions for you to answer at the viva voce, but this is nothing to get too concerned about. The questions will all be based on your thesis - what it's about, what you did and what you found out - and why this matters, in relation to your field of study.

So when getting ready for the viva, consider the types of questions you're likely to be asked, including:

• What original contribution has your thesis made to this field of study?
• Explain the main research questions you were hoping to address.
• What are the strengths and weaknesses of your thesis?
• If you had to start the thesis again, what would you do differently?
• If funding was no object, describe how you'd follow on from this project.
• What are your plans for the future?

It can be helpful to practise your answers beforehand, ideally vocalising them by arranging a mock mini viva - although, as you aren't restricted in terms of referring to notes in the exam, you can leave room for spontaneity, and you don't need to learn it all off by heart.

If your viva is being held online, you can ensure any technical issues are identified before the day by having a run through with your supervisor or a friend.

While it may sound simple, stick to answering the questions posed. It's really easy to go off on a tangent and this can open up other lines of enquiry from the examiners - possibly in areas you hadn't expected to be quizzed about.

On the other hand, it's completely fine to bring personality to your reasoning and use stories as a means of describing the learning process you've gone through and the techniques mastered over the last three or four years that have brought you to this point.

4. Learn about your examiners' own work

The senior and well-respected academics who'll be reading your thesis will have their own ideas on conducting PhD standard research. Therefore, it's worth taking a look online at their academic and LinkedIn profiles to discover if there's any correlation with the research they've had published and your own work.

From this, you should be able to gain a better idea of their motivations, their possible views on your thesis and the kinds of questions they might wish to discuss after having read through it.

You should research up-to-date theories, read any recent papers on the subject and speak to others who've recently had their own viva exam. Think about how your work differentiates from the research carried out by others in your chosen field.

Prepare to provide any supporting evidence asked of you by the examiners - for example, they may request to see experimental data you mention once the exam is over.

It's also necessary to check the policies and practices in place at your university and be sure of what the roles of the examiners are and how the viva panel will be structured. In many cases, Doctoral students can choose the examiners conducting the PhD viva.

5. Plan towards the viva exam

From the moment you know the date of your viva voce, work backwards and plan the steps you'll need to take before the day itself. Allow enough time to assess and review your work so that as the day approaches, you can focus on the practicalities.

This encompasses everything from making sure you relax, eat and sleep well the day before to arranging transport so you get to the viva on time.

An online PhD viva will present its own challenges, so ensure your working space is presentable and you still make an effort in terms of what you'll be wearing.

It's always advisable to adhere to interview etiquette and go with something that's both smart and comfortable. By looking the part, this should get you in the right frame of mind to communicate in a professional manner.

In the build-up, avoid any situations that might make you feel stressed and instead try to adopt a positive attitude, one that results in a genuine eagerness to engage in a debate about the work you've been toiling over.

If you're travelling to the exam, be sure to check that you have everything you need, including the thesis, plus any notes or other materials that will help support your claims.

The Doctoral viva can last between one and four hours - usually two - so it's necessary to pace yourself to get off to the best possible start.

Remember, the examiners aren't trying to trip you up - they want you to pass and are primarily there to hear you talk about your project. So, after the polite introductions, they'll typically start with an icebreaker to put you at ease and help calm the nerves.

It's meant to be an open and honest conversation about your work, so feel free to politely disagree with the examiners, especially on areas you feel strongly about. Don't forget to use examples from your thesis to back up what you're saying, remembering to be clear and concise.

If you know your way around your thesis and can explain your thinking and way of working, this test shouldn't be a problem. And if you don't know the answer to a specific question - admit it, as it's better to concede your limitations in an area than ramble on and hope they don't notice you're struggling to come up with an explanation.

Remember that no research is perfect, so it's important to appreciate this during the discussion - but don't be too overcritical about your work either, as that's not your job.

Finally, as the PhD viva can quickly move from a series of friendly questions to those that are more in-depth, take some time to think before answering. Don't worry about any periods of silence from the examiners, as this certainly isn't an indication that you're doing badly.

Find out more

• Read about 5 challenges faced by PhD students .
• Explore possible careers at your PhD, what next?
• Consider getting an academic job .

How would you rate this page?

On a scale where 1 is dislike and 5 is like

• Dislike 1 unhappy-very
• Like 5 happy-very

Thank you for rating the page

How to structure your viva presentation (with examples)

Most PhD vivas and PhD defences start with a short presentation by the candidate. The structure of these presentations is very important! There are several factors and approaches to consider when developing your viva presentation structure.

Factors to consider when developing a viva presentation structure

Presenting a whole PhD in a short amount of time is very challenging. After all, a PhD is often the result of several years of work!

It is simply impossible to include everything in a viva presentation.

The structure of a viva presentation plays a crucial role in bringing across the key messages of your PhD.

Structuring your viva presentation traditionally

A very traditional viva presentation structure simply follows the structure of the PhD thesis.

The disadvantage of this traditional format is that it is very challenging to fit all the information in a – let’s say – 10-minute presentation.

Structuring your viva presentation around key findings

For instance, you can select your three main findings which you each connect to the existing literature, your unique research approach and your (new) empirical insights.

Furthermore, it might be tricky to find enough time during the presentation to discuss your theoretical framework and embed your discussion in the existing literature when addressing complex issues.

Structuring your viva presentation around key arguments

So, for example, your key argument 1 is your stance on an issue, combining your theoretical and empirical understanding of it. You use the existing theory to understand your empirical data, and your empirical data analysis to develop your theoretical understanding.

Structuring your viva presentation around case studies

Another common way to structure a viva presentation is around case studies or study contexts.

A viva presentation structure around case studies can be easy to follow for the audience, and shed light on the similarities and differences of cases.

Final thoughts on viva presentation structures

The key to a good viva presentation is to choose a structure which reflects the key points of your PhD thesis that you want to convey to the examiners.

The example viva presentation structures discussed here intend to showcase variety and possibilities and to provide inspiration.

Master Academia

Get new content delivered directly to your inbox, 18 common audience questions at academic conferences (+ how to react), 10 reasons to do a master's degree right after graduation, related articles, 13 great academic phrases to write your discussion (+ published examples), how to write a literature review introduction (+ examples), how to disagree with reviewers (with examples), the best coursera courses for phd researchers in 2023.

Viva Survivors

Daily viva help for PhDs

Subscribe via Email

Enter your email address to subscribe and receive new posts by email.

Email Address

Randomly…

Viva prep ebooks, recently….

• Eight Useful Reflection Starter Questions
• 3 Kinds Of Viva Prep
• The Viva Challenge
• What’s Important?
• Awesome Anticlimax
• Good Answers

Tags & Themes

Eight thoughts about viva stress.

• November 27, 2017

It’s normal to be a bit nervous about the viva. If you’re persistently feeling stressed as you approach the viva, you need to do something. Here are several ideas to help:

• Take a break. Step back from prep and do something you know helps you to relax.
• Reflect on how long you’ve been doing your PhD. You’ve not got this far by being lucky.
• Reflect on how short the viva is compared to how long you’ve been doing your PhD.
• When you can, gently read your thesis and focus on all of the good stuff to begin with.
• Visualise yourself crossing the stage at graduation. It’s not far away.
• Talk about it with someone you trust, someone who will listen before they offer advice.
• Write down exactly what is stressing for you about the viva. What can you do?
• Make a list of five things that help you to feel confident. Which of them can you do regularly between now and the viva?

Some people see stress as an endpoint. I try, not always successfully, to use it as a motivator: “I feel stressed. What do I need to do about that?”

Do you feel stressed about the viva? If so, what are you going to do about it?

Share this:

Tags: eight thoughts about viva stress finishing the phd questions viva anxiety viva day viva prep

You may also like...

The decision, big challenge, small step.

• Next Just Think
• Previous Commentary
• Pingbacks 1

[…] Eight Thoughts About Viva Stress – what to do if thinking about the viva becomes too much. […]

• PhD Viva Voces – A Complete Guide
• Doing a PhD
• A PhD viva involves defending your thesis in an oral examination with at least two examiners.
• The aim of a PhD viva is to confirm that the work is your own , that you have a deep understanding of your project and, overall, that you are a competent researcher .
• There are no standard durations, but they usually range from one to three hours, with most lasting approximately two hours .
• There are six outcomes of a PhD viva: (1) pass without corrections (2) pass subject to minor corrections, (3) pass subject to major corrections, (4) downgrade to MPhil with no amendments, (5) downgrade to MPhil subject to amendments, (6) immediate fail.
• Almost all students who sit their viva pass it, with the most common outcome being ‘(2) – pass subject to minor corrections’.

What Is a PhD Viva?

A viva voce , more commonly referred to as ‘viva’, is an oral examination conducted at the end of your PhD and is essentially the final hurdle on the path to a doctorate. It is the period in which a student’s knowledge and work are evaluated by independent examiners.

In order to assess the student and their work around their research question, a viva sets out to determine:

• you understand the ideas and theories that you have put forward,
• you can answer questions about elements of your work that the examiners have questions about,
• you understand the broader research in your field and how your work contributes to this,
• you are aware of the limitations of your work and understand how it can be developed further,
• your work makes an original contribution, is your own and has not been plagiarised.

Note: A viva is a compulsory procedure for all PhD students, with the only exception being when a PhD is obtained through publication as opposed to the conventional route of study.

Who Will Attend a Viva?

In the UK, at least two examiners must take part in all vivas. Although you could have more than two examiners, most will not in an attempt to facilitate a smoother questioning process.

One of the two examiners will be internal, i.e. from your university, and the other will be external, i.e. from another university. Regardless, both will be knowledgeable in your research field and have read your thesis beforehand.

In addition to your two examiners, two other people may be present. The first is a chairperson. This is an individual who will be responsible for monitoring the interview and for ensuring proper conduct is followed at all times. The need for an external chairperson will vary between universities, as one of the examiners can also take on this role. The second is your supervisor, whose attendance is decided upon by you in agreement with your examiners. If your supervisor attends, they are prohibited from asking questions or from influencing the outcome of the viva.

To avoid any misunderstandings, we have summarised the above in a table:

Note: In some countries, such as in the United States, a viva is known as a ‘PhD defense’ and is performed publicly in front of a panel or board of examiners and an open audience. In these situations, the student presents their work in the form of a lecture and then faces questions from the examiners and audience which almost acts as a critical appraisal.

How Long Does a Viva Last?

Since all universities have different guidelines , and since all PhDs are unique, there are no standard durations. Typically, however, the duration ranges from one to three hours, with most lasting approximately two hours.

Your examiners will also influence the duration of your viva as some will favour a lengthy discussion, while others may not. Usually, your university will consult your examiners in advance and notify you of the likely duration closer to the day of your viva.

What Happens During a Viva?

Regardless of the subject area, all PhD vivas follow the same examination process format as below.

Introductions

You will introduce yourselves to each other, with the internal examiner normally introducing the external examiner. If an external chairperson is present, they too are introduced; otherwise, this role will be assumed by one of the examiners.

Procedure Explained

After the introductions, the appointed chair will explain the viva process. Although it should already be known to everyone, it will be repeated to ensure the viva remains on track during the forthcoming discussion.

Warm-Up Questions

The examiners will then begin the questioning process. This usually starts with a few simple opening questions, such as asking you to summarise your PhD thesis and what motivated you to carry out the research project.

In-Depth Questions

The viva questions will then naturally increase in difficulty as the examiners go further into the details of your thesis. These may include questions such as “What was the most critical decision you made when determining your research methodology ?”, “Do your findings agree with the current published work?” and “How do your findings impact existing theories or literature? ”. In addition to asking open-ended questions, they will also ask specific questions about the methodology, results and analysis on which your thesis is based.

Closing the Viva

Once the examiners are satisfied that they have thoroughly evaluated your knowledge and thesis, they will invite you to ask any questions you may have, and then bring the oral examination to a close.

What Happens After the Viva?

Once your viva has officially ended, your examiners will ask you to leave the room so that they can discuss your performance. Once a mutual agreement has been reached, which can take anywhere from 10 minutes to an hour, you will be invited back inside and informed of your outcome.

PhD Viva Outcomes

There are six possible outcomes to a viva:

• Immediate award of degree: A rare recommendation – congratulations, you are one of the few people who completely satisfied your examiners the first time around. You do not have to do anything further at this point.
• Minor amendments required: The most common recommendation – you obtain a pass on the condition that you make a number of minor amendments to your thesis, such as clarifying certain points and correcting grammatical errors. The time you have to make these changes depends on the number of them, but is usually one to six months.
• Major amendments required: A somewhat uncommon recommendation – you are requested to make major amendments to your thesis, ranging from further research to collecting more data or rewriting entire sections. Again, the time you have to complete this will depend on the number of changes required, but will usually be six months to one year. You will be awarded your degree once your amended thesis has been reviewed and accepted.
• Immediate award of MPhil: An uncommon recommendation – your examiners believe your thesis does not meet the standard for a doctoral degree but meets the standard for an MPhil (Master of Philosophy), a lower Master’s degree.
• Amendments required for MPhil: A rare recommendation – your examiners believe your thesis does not meet the standard for a doctoral degree, but with several amendments will meet the standard for an MPhil.
• Immediate fail: A very rare recommendation – you are given an immediate fail without the ability to resubmit and without entitlement to an MPhil.

Finding a PhD has never been this easy – search for a PhD by keyword, location or academic area of interest.

What Is the Pass Rate for Vivas?

Based on an  analysis of 26,076 PhD students  who took their viva exam between 2006 and 2017, the PhD viva pass rate in the UK is 96%; of those who passed, about 80% were required to make minor amendments to their thesis. The reason for this high pass rate is that supervisors will only put their students forward for a viva once they confidently believe they are ready for it. As a result, most candidates who sit a viva are already well-versed in their PhD topic before they even start preparing for the exam.

How Do I Arrange a Viva?

Your viva will be arranged either by the examiners or by the chairperson. The viva will be arranged at least one to two months after you have submitted your thesis and will arrange a viva date and venue that is suitable for all participants.

Can I Choose My Examiners?

At most universities, you and your supervisor will choose the internal and external examiners yourselves. This is because the examiners must have extensive knowledge of the thesis topic in order to be able to examine you and, as the author of the thesis in question, who else could better determine who they might be than you and your supervisor. The internal examiner is usually quite easy to find given they will be from your institution, but the external examiner may end up being your second or third preference depending on availability.

Can I Take Notes Into a Viva?

A viva is about testing your competence, not your memory. As such, you are allowed to take notes and other supporting material in with you. However, keep in mind that your examiners will not be overly impressed if you constantly have to refer to your notes to answer each question. Because of this, many students prefer to take an annotated copy of their thesis, with important points already highlighted and key chapters marked with post-it notes.

In addition to an annotated copy of a thesis, some students also take:

• a list of questions they would like to ask the examiners,
• notes that were created during their preparation,
• a list of minor corrections they have already identified from their viva prep work.

How Do I Prepare for a PhD Viva?

There are several ways to prepare for a PhD viva, one of the most effective being a mock viva voce examination . This allows you to familiarise yourself with the type of viva questions you will be asked and identify any weak areas you need to improve. They also give you the opportunity to practise without the pressure, giving you more time to think about your answers which will help to make sure that you know your thesis inside out. However, a mock viva exam is just one of many methods available to you – some of the other viva preparation methods can be found on our “ How to Prepare for a PhD Viva ” page.

Browse PhDs Now

Join thousands of students.

Join thousands of other students and stay up to date with the latest PhD programmes, funding opportunities and advice.

• Skip to primary navigation
• Skip to main content
• Skip to primary sidebar
• Skip to secondary sidebar
• Skip to footer

career-advice.jobs.ac.uk

Your PhD Viva and How to Prepare

At the end of the long road of your PhD research, lies the viva examination . Just as every PhD is different, then every viva is different. But there are some things that all PhD candidates can do ahead of time to prepare academically, mentally and physically for the viva examination. Handing in your thesis at the first submission as it gets passed to the examiners feels like a huge weight has been lifted. However, it can be some weeks, even months between that hand in date and the viva. What this time gives you is distance and a chance to prepare.

Re-read your thesis

No matter the length of time between submission and the day of the viva, good preparation is key. In the first instance, as the viva date approaches giving yourself plenty of time, read your thesis, from cover to cover. This seems obvious, but that distance between submission and viva date allows you to step back from your research and allows you to read over it again with a more critical eye. In the midst of the final weeks of research and writing, ensuring all referencing is correct, all figures are identified, and getting copies printed and bound, PhD candidates are so close to their work that it is difficult to see the full picture of the thesis. Re-reading with some distance from submission will help to familiarise yourself with your work again, and to see it as a whole cohesive piece of research.

So what to keep in mind when you are re-reading? In addition to taking in the whole thesis, during the re-read go over your methodology again, in good detail. Make sure that you know your research design and the reasons for that methodology inside and out. A common viva question, regardless of discipline, will be centred on your methodological design. Why did you design it in the way that you did? What were the benefits of your methodology, and were there any problems along the way?

When you have read your thesis, have a think about and form succinct answers to these questions.

• What is your contribution to your field? Why is your study important?
• What was the inspiration for the study and what is it about? It can be a useful exercise to write a one page summary of each chapter.
• What did you do – be able to explain your methodology and how you went about doing it.
• What did you find, what were your outcomes?

Think about and prepare answers to these questions, write them down and importantly, practice saying them out loud. This is a preparation point that everyone should do. In much the same way that you might practice giving a speech or a conference paper, practice – with these questions as a guideline – talking about your thesis out loud. This will help you to avoid getting tongue-tied, and you will be able to answer your examiners’ questions smoothly. You can take these notes into the viva with you.

Know about developments in your field

Another thing to be up to date on is other developments in your field that occurred during the process of your own PhD research. And crucially, where would you position yourself and your work in your field? This is essential to the viva examination, as knowing your position in your particular academic field shows that you understand the past and current academic frameworks and contexts around your own thesis subject. It is also helpful to think about where your research will take you next. Does your thesis open doors for more research ? Development into a publication ?

Practicalities

Make sure that you know in advance where the viva will take place, where the building is and what room number. Have your journey planned, taking into account public transport access, parking or avoiding busy rush hours. Nothing will add to pre-viva stress than being late. Get a good nights sleep the night before, and make sure that you eat before you begin your viva.

What to take with you

Take a bottle of water in with you. It is also useful to take in with you a notebook and pen. Write down the questions as your examiners ask you, or make notes as you discuss your work. This way you can refer to what they have asked and what is being discussed with confidence.

It is perfectly acceptable to ask for clarification on anything that your examiners ask you, and you can and should take time to think before you answer. Even write down your points before you start to answer. It is good practice to take a printed copy of your thesis into the viva with you. The examiners will have their copies, your own copy to refer to will be helpful. You can also prepare some questions that you might like to ask of your examiners.

Feel positive

The viva can seem incredibly daunting and makes all PhD candidates nervous. But your viva can actually be a hugely enjoyable and rewarding experience. Your examiners have been chosen as the ideal professionals in the field to read and feedback on your research. They want to see you do well, they are not there to make problems or to try and trip you up. Remember, your PhD examiners are on your side and they are interested in your work and they want to hear you talk about it.

Research your examiners

Take some time to do a little background research on your examiners. What are their interests, and what are they working on. A relaxed and fulfilling viva often becomes more of a mutual discussion between yourself and the examiners, rather than them only firing questions at you. Of course, there can be no guarantee what questions the examiners might ask you and what they might not. As long as you are very familiar with your own research, your methods, your outcomes and results, and your contribution to the knowledge of your field, the viva will go smoothly. You might even enjoy it.

Post PhD, Where Do I Go From Here?

What did you think of our article? - please rate

Share this article

Stella Gaynor

Dr Stella Gaynor is an Associate Lecturer at the University of Salford in the Broadcast Media Department, with eight years teaching experience in Higher Education. She completed her PhD thesis on the horror genre and the US television industry and is developing this into a monograph. She has written a chapter in the forthcoming edited collection Global TV Horror, an article for the Revenant journal, and regularly blogs for Critical Studies in Television. She is also a freelance copywriter.

Reader Interactions

You may also like:, leave a reply cancel reply.

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

Please enter an answer in digits: 18 − 7 =

This site uses Akismet to reduce spam. Learn how your comment data is processed .

Get the Reddit app

A subreddit dedicated to PhDs.

PhD viva in three and I am a mess

By continuing, you agree to our User Agreement and acknowledge that you understand the Privacy Policy .

Enter the 6-digit code from your authenticator app

You’ve set up two-factor authentication for this account.

Enter a 6-digit backup code

Create your username and password.

Reddit is anonymous, so your username is what you’ll go by here. Choose wisely—because once you get a name, you can’t change it.

Reset your password

Enter your email address or username and we’ll send you a link to reset your password

Check your inbox

An email with a link to reset your password was sent to the email address associated with your account

Choose a Reddit account to continue

Ehud Reiter's Blog

Ehud's thoughts and observations about natural language generation, “will i pass my phd viva”.

We had an interesting discussion at lunch last week, about the fact that many PhD students are very nervous about their viva (oral exam after submitting their thesis), despite the fact that its very rare to fail a viva.   That is, while only a small number of students have reason to worry, we see a lot of students who are very stressed and worried despite being very unlikely to fail.

So here is my thoughts on which students are likely to pass and which may have problems; hopefully this will reassure the majority of students who will not have problems!

Note that I am talking about students who actually submit a thesis.  Some students decide a PhD is not for them and drop out; I’m not talking about such people here.  Also I’m focusing on the UK system, other countries have different PhD processes, but I think similar factors apply.

Failing a Viva

In the 20 years I have been examining PhD students, I only once failed a student completely.   This happened when I was external examiner at another university (call it University A), it did not happen at Aberdeen!

Anyways, in this case, as with most failures I am familiar with, the problem was poor supervision.  The student had come to University A to work with Professor X.  However, Professor X then accepted a second appointment at University B, which was several thousand miles from University A.  In theory he was supposed to split his time between University A and University B, but in practice he spent almost all of his time at University B, and was rarely seen at University A.  Which meant that the student almost never saw his supervisor (this was many years ago, when video-conferencing was still an expensive rarity rather than an everyday occurrence).

What should have happened in this case is that University A should have appointed a replacement or second supervisor for the student, since Professor X was never around.  But they did not, so the student effectively did not have a supervisor.  And without guidance from a supervisor, he was unable to make progress towards a PhD.

Anyways, this is obviously an extreme case, where the student had effectively been abandoned by his supervisor, with no replacement supervisor.

Advice to students before a viva : If you have good relations with a supervisor who you see every week or two, and your  supervisor has agreed that your thesis is ready to be submitted, then it is very unlikely that you will fail the viva.

Major Corrections

At least in the UK, PhD students can be asked to make major corrections to their thesis (which could take another 6-12 months of work), and then resubmit it and have another viva.   This happens when the examiners think the work is not good enough for a PhD, but can be salvaged.

I have been involved in a few such cases over the years, and usually it is a result of either a weak supervisor or a weak student.   Some supervisors simply do not understand a field well enough to supervise a PhD student.  Its usually easy to identify such supervisors by checking their publication record (eg, via Google Scholar ).  If someone is regularly publishing papers in a field, then he is probably knowledgeable.  If his last relevant publication was ten years ago, then he may not be knowledgeable.   My advice to PhD students is that they should check the publication record of a potential supervisor, and look for alternative supervisors if the publication record is poor.  It will only take 10 minutes, and may save you a lot of grief.

The other cause of major corrections is weak students, that is students who for some reason (perhaps personal circumstances such as health issues) struggle to make good progress on their PhDs.   One indicator of a weak student is a lack of publications.   If you dont have *any* publications when you submit your thesis, this is definitely a warning sign!  On the other hand, if you have one or two papers accepted at good conferences or journals (especially if these are full papers on the normal track, not short papers or student-track papers), then you are not a weak student!

Advice to students before a viva : If your supervisor is regularly publishing academic papers, and you yourself have at least one full paper accepted at a good academic conference or journal, then it is unlikely that you will be asked to make major corrections.

Minor Corrections

Most students are asked to make minor corrections.   Ie, the thesis is basically fine, but the examiners want it to be tweaked a bit.   If you are asked to make minor corrections, then congratulations, you have passed!   In theory it is possible for a PhD thesis to be accepted as submitted, but in my years I have never seen this outcome; so minor corrections is as good as it gets!

Share this:

2 thoughts on “ “will i pass my phd viva” ”.

Lovely insights, but some Vivas can be used as battlegrounds by some agitated examiners to settle scores with the student’s supervisor.

• Pingback: Publication Requirements for PhD Students – Ehud Reiter's Blog

Leave a comment Cancel reply

• Already have a WordPress.com account? Log in now.
• Subscribe Subscribed
• Copy shortlink
• Report this content
• View post in Reader
• Manage subscriptions
• Collapse this bar

•  Twitter

What happened in my PhD viva – a tale of nerves

Published by michelle reeve on 27 february 2017.

So, the first post of Clutter. What shall I write about? Something cheery? That would be ideal. But I’d instead like to write about my PhD viva. ‘Viva’ is actually an antonym for ‘cheery’, in case you didn’t know (note: untrue, but feels like it should be true).

My PhD viva took place in January of this year (2017), so is still pretty fresh on my mind, no matter how hard I try to forget. A viva, just like the PhD itself, is a very unique and individual experience. Some people have a great time talking through their work, and some people don’t enjoy it quite as much. Guess which category I fit into?

There are several stages to a viva – not just the actual thing, but in the weeks and months before and after – handing in your thesis, preparing for your viva, the viva itself, and digesting everything afterwards. Let me take you through them in turn, and how they played out for me.

I was told that once you hand-in, you need to think about your viva. So I thought about it, a lot. But I had no idea how to actually prepare.

Ideally, setting up a mock viva would have been helpful, but that’s quite hard to fit in when you go straight into a full-time, non-academic job, like I did. I had to give a ’20 minute’ presentation (more on this later) to my examiners at the beginning of mine, so in preparing that I did at least have a proper look over all my work. I also read through my thesis cover to cover, and produced an ‘errata sheet’ of typos and incorrect grammar and minor mistakes to hand in to my examiners at the beginning of my viva. I thought it would demonstrate how thorough I was being, and give me something simple to work on when I started my corrections.

However producing this took a while longer than I thought, and though it was useful, in hindsight there was probably some more useful preparation I could be doing (though quite what I have no idea). I couldn’t do much more than this with my full-time job, and I needed to get a job straight away because, well, I have to pay my rent, so that was that.

Cue viva day. So nervous. More nervous than any job interview. This is the culmination of four years of my life – judgement day.

Get out laptop. Figure out how to use ridiculous university AV kit while examiners sit there. (I am more than capable of setting up my own laptop with AV kit but if you insist on using strange non-standard gear, the least you could do is send a technician to help during a frankly incredibly stressful situation. Rant over.)

Begin my ’20 minute’ presentation.

“Can I stop you there?”

I think You CAN, but I’d rather you didn’t.

What I say is “Yes, of course!” Big smile. Feel sick.

Then commences an agonisingly long round of questions, another slide of my presentation, and more questions. Repeat cycle. This goes on for an hour. After this, I am exhausted.

Now, I am not great at long meetings. During my PhD itself I requested with my supervisor that we limit meetings to an hour tops, and ideally 30 minutes. It’s just the way my brain works – at about half an hour I meet my maximum capacity for being able to digest new information and questions and produce coherent answers. For this reason I always have a notebook to write down things discussed in the meeting, so if need be I can refer to it and think about them later. Even during a casual chat about something work-related I have to do this or I forget things – Matt will vouch for after seeing all the scribbles written during our pub-based meetings.

So knowing that after this very intense 60+ minutes of standing up presenting and defending my work I would sit down and be questioned further was a bit difficult to deal with. The presentation was supposed to be a brief overview of my work, something to put me in a confident position from which to continue the rest of the viva, but in fact with the questioning it drained so much out of me that I think I performed quite poorly afterwards. In hindsight it was naive of me to think I wouldn’t get stopped for questions throughout my talk, but as this isn’t standard practice for a UK PhD viva I hadn’t really anticipated having to give a presentation at all.

In the end, my viva was just under 4 hours long. My examiners were reasonable, we had a good chat about things, some things I answered well and some things I didn’t. I was totally exhausted, and in hindsight probably not all that well prepared. I got sent out of the room while they discussed an outcome, and was waiting for an agonisingly long time. What can you do in that situation? I paced the freezing cold corridors and drank a lot of water. I eventually got called back in, discussed outcomes with my examiners. I didn’t fail – hurrah! But I have a reasonable amount of amendments – luckily mostly writing based, which is a lot easier to fit in around a full-time job and a life than collecting more or extensively reanalysing data. And I also have quite a while to do them in, which again is pretty handy.

I texted my mum, called a friend who’d also had a rough viva, had a little cry and then went home to drink whisky with my long-suffering boyfriend.

The next day I updated social media that I had indeed survived my viva and hadn’t fallen into a pit of despair, and got loads of lovely congratulatory messages from people calling me Doctor and promptly felt like a complete impostor (I have since learnt that this is also a normal reaction – a shitty, but seemingly normal one).

In the following couple of weeks I waited for my corrections; read my corrections; had a panic attack; got a migraine; and then calmed down.

And that’s about the stage I’ve got to now. It has been a fair few weeks since my viva, but I haven’t done much about my corrections just yet. I was given a reasonable time to do them in, so I am taking advantage of that and giving myself a little downtime. The PhD was a very stressful experience for me, and so was the viva – I think I deserve a few weeks away from it. Now, of course, is crunch time – that time off has given me (some) renewed enthusiasm for getting this thing done, and so that is what I shall be doing.

I’d like conclude by saying that although I didn’t especially enjoy my viva, this is certainly not the case for everyone. Your experience depends on many many things, and vary widely by examiner – remember that they may also be having a bad day and try not to take comments too personally. All badness aside, it is a very thorough way of making sure you and your work are worthy of a PhD. I know that my thesis will be infinitely better because of it.

Sign up to receive awesome cartoony content in your inbox, every month.

We don’t spam! Read our privacy policy for more info.

Check your inbox or spam folder to confirm your subscription.

Share this:

Naomi Boxall · 1 March 2017 at 21:39

Girl!! My first panic attack was in the middle of the night while procrastinating about the 7 typo/grammatical bloody amendments needed prior to leather binding.It took me 9 weeks, I think, to finally have them done. I sat up in bed at 4am one morning, feeling oh-so-peculiar, then realised what was causing the problem, picked up the laptop and sorted them. This article brought it allllll back. Thanks??!

You’ll forget it eventually. Ha ha ha ha ha ha ha ha ha. No. You won’t. But you’ll Ave everything else that follows it. NOTHING else is so awful.

michellereeve · 2 March 2017 at 20:11

Ahh, this sounds familiar! Sorry to bring back the bad memories…! I do agree, everything scary that has happened since my viva has been approached with an attitude of “well this can’t be as bad as my viva” – it has made me more confident, in a strange way. Thanks for sharing! 🙂

lewismackenzie · 11 July 2017 at 23:14

Vivas are scary things! During my viva day, my average heart rate was 130 bpm (thanks fitbit)! Even in the pub afterwards my heart-rate was just as high!

A couple of days later I was on the train with my laptop and hand-written thesis corrections in my rucksack. Half way through the train journey I released that if someone stole my rucksack from the luggage rack, then all trace of the hand-written corrections would be lost forever. This was incredibly anxiety inducing, and I kept glancing over my shoulder back to the luggage rack. Fortunately a couple of nice people took pity on me and let me swap seats so that I could see the luggage rack. I got home with the corrections and everything is fine. Now I use the 3 submitted copies of my thesis to prop up my laptop on my desk!

Michelle Reeve · 24 July 2017 at 13:03

Hmm I need to check my Fitbit data to compare!! Oh wow that sounds very stressful. I envisage using my final thesis copies for the same thing 😉

A long time coming | There's A Spider In The Bath! · 15 August 2017 at 13:35

[…] guess the biggest thing PhD-wise was my viva. I wrote about my viva there for my first post. I’m still not sure I’m over it. I know that my viva was not the […]

Leave a Reply Cancel reply

Related posts.

An update on continuing to feel like an imposter, but an imposter that’s trying

A year ago I wrote a post about feeling like an imposter because I no longer work in academia, but that the blog posts wouldn’t stop… That was the last blog post I wrote… It’s Read more…

Am I still a scientist? Imposter syndrome post-PhD

I like writing. I’ve missed writing since finishing my PhD, even though I didn’t really enjoy writing my thesis. Rather, I didn’t enjoy the style my thesis had to be written in – I kept Read more…

Freelancing doesn’t mean working for free

A few years ago, while I was still doing my PhD, I attended a science communication conference. One of the sessions was all about freelancing; though I wasn’t doing so at the time, I figured Read more…

Skip to content

Explore CUIMC

Diversity, equity, and inclusion.

At CUIMC, we are committed to continuous improvement in providing culturally inclusive medical education and clinical care.

Columbia Vagelos College of Physicians and Surgeons is dedicated to developing the next generation of leaders in medicine

Patient Care

• Find a Doctor

Search for a provider by specialty, expertise, location and insurance. Schedule an appointment online.

Read the latest news stories about CUIMC faculty, research, and events

CopeColumbia

Video resources.

In these video resources, Department of Psychiatry faculty provide helpful insight on how to manage stress and anxiety during difficult times. Check back frequently as more videos become available. 

CopeColumbia: The Power of Practicing Gratitude—Erin Engle, PsyD & Jared O'Garro-Moore, PhD

Copecolumbia_the_power_of_practicing_gratitude.

Why It's Important to Take Vacation—Erin Engle, PsyD

Why_its_important_to_take_vacation.

The Three Key Dimensions of Burnout —Erin Engle, PsyD

Dr._erin_engle-the_three_key_dimensions_of_burnout.

Managing Anxiety: "Catch it. Check it. Change it." — Rachel E. Ginsberg, PhD 

Managing_anxiety_catch_it._check_it._change_it._-_rachel_e._ginsberg_phd.

Nine Tips for Coping and Thriving During Difficult Times — Anna Allmann, PhD 

Nine_tips_for_coping_and_thriving_during_difficult_times_-_anna_allmann_phd.

Six Principles for Adapting to Stress — Jared K. O'Garro-Moore, PhD

Six_principles_for_adapting_to_stress_-_jared_k._ogarro-moore_phd.

Nueve consejos para afrontar y prosperar durante tiempos difíciles — Alexandra Canetti, MD

Nueve_consejos_para_afrontar_y_prosperar_durante_tiempos_dificiles_-_alexandra_canetti_md.

Create Free Account or

• Acute Coronary Syndromes
• Anticoagulation Management
• Arrhythmias and Clinical EP
• Cardiac Surgery
• Cardio-Oncology
• Cardiovascular Care Team
• Congenital Heart Disease and Pediatric Cardiology
• COVID-19 Hub
• Diabetes and Cardiometabolic Disease
• Dyslipidemia
• Geriatric Cardiology
• Heart Failure and Cardiomyopathies
• Invasive Cardiovascular Angiography and Intervention
• Noninvasive Imaging
• Pericardial Disease
• Pulmonary Hypertension and Venous Thromboembolism
• Sports and Exercise Cardiology
• Stable Ischemic Heart Disease
• Valvular Heart Disease
• Vascular Medicine
• Clinical Updates & Discoveries
• Advocacy & Policy
• Perspectives & Analysis
• Meeting Coverage
• ACC Member Publications
• ACC Podcasts
• View All Cardiology Updates
• Earn Credit
• View the Education Catalog
• ACC Anywhere: The Cardiology Video Library
• CardioSource Plus for Institutions and Practices
• ECG Drill and Practice
• Heart Songs
• Nuclear Cardiology
• Online Courses
• Collaborative Maintenance Pathway (CMP)
• Understanding MOC
• Image and Slide Gallery
• Annual Scientific Session and Related Events
• Chapter Meetings
• Live Meetings
• Live Meetings - International
• Webinars - Live
• Webinars - OnDemand
• Certificates and Certifications
• ACC Accreditation Services
• ACC Quality Improvement for Institutions Program
• CardioSmart
• National Cardiovascular Data Registry (NCDR)
• Advocacy at the ACC
• Cardiology as a Career Path
• Cardiology Careers
• Cardiovascular Buyers Guide
• Clinical Solutions
• Clinician Well-Being Portal
• Diversity and Inclusion
• Infographics
• Innovation Program
• Mobile and Web Apps

Outcomes of Peri-Infarct Ischemia Detected by Stress CMR

Quick Takes

• Peri-infarct ischemia refers to regions of ischemia that are adjacent to regions of scar.
• Peri-infarct ischemia can be identified on stress CMR imaging.
• Peri-infarct ischemia is independently associated with increased rates of acute MI and CV death, even after adjustment for risk factors, systolic function, and amount of total ischemia and scar.

Study Questions:

What is the prognostic impact of peri-infarct ischemia on stress cardiovascular magnetic resonance (CMR) imaging?

This was a retrospective multicenter registry study within the multicenter SPINS (Stress CMR Perfusion Imaging in the United States) study. Peri-infarct ischemia was considered present if any segment adjacent to an infarcted segment was ischemia. Infarcted segments were defined based on late gadolinium enhancement imaging. The primary outcome was the composite of acute myocardial infarction (MI) and death from cardiovascular (CV) causes (CV death). Secondary endpoints included components of the primary outcome, hospitalization for unstable angina, hospitalization for heart failure, and coronary artery bypass surgery (>6 months after CMR). Cox regression was used to adjust for clinical risk factors, left ventricular systolic function, amount of ischemia, and infarct size.

A total of 3,915 participants were included and had follow-up information. Most patients had hypertension (66%) or dyslipidemia (57%). Nearly half of participants were female (45%) and the ages were typical of stress testing populations (mean 61 years). Ischemia was present in 19% of participants and peri-infarct ischemia was present in 9.8%. Peri-infarct ischemia was associated with a 1.72-fold increased risk of acute MI or CV death (p < 0.001), fully adjusted. Individuals with peri-infarct ischemia had a 6.5% per year rate of the primary composite endpoint compared to 0.9% for those without peri-infarct ischemia.

Conclusions:

The authors report that peri-infarct ischemia is a powerful predictor of adverse CV outcomes.

Perspective:

This is a well-done multicenter study demonstrating that peri-infarct ischemia is associated with worse prognosis, even after accounting for total amount of ischemia and scar with precise CMR measures. This adds to substantial literature from other modalities (including nuclear perfusion imaging) and smaller CMR studies evaluating this question. Potentially, the presence of scar and ischemia jointly is particularly high risk due to both atherosclerotic and arrhythmic mechanisms. This study does not directly address that question, but this will likely be explored in future studies.

Clinical Topics: Noninvasive Imaging, Magnetic Resonance Imaging

Keywords: Magnetic Resonance Imaging, Myocardial Ischemia

You must be logged in to save to your library.

Jacc journals on acc.org.

• JACC: Advances
• JACC: Basic to Translational Science
• JACC: CardioOncology
• JACC: Cardiovascular Imaging
• JACC: Cardiovascular Interventions
• JACC: Case Reports
• JACC: Clinical Electrophysiology
• JACC: Heart Failure
• Current Members
• Campaign for the Future
• Become a Member
• Renew Your Membership
• Member Benefits and Resources
• Member Sections
• ACC Member Directory
• ACC Innovation Program
• Our Strategic Direction
• Our History
• Our Bylaws and Code of Ethics
• Leadership and Governance
• Annual Report
• Industry Relations
• Support the ACC
• Jobs at the ACC
• Press Releases
• Social Media
• Book Our Conference Center

Clinical Topics

• Chronic Angina
• Congenital Heart Disease and     Pediatric Cardiology
• Diabetes and Cardiometabolic     Disease
• Hypertriglyceridemia
• Invasive Cardiovascular Angiography    and Intervention
• Pulmonary Hypertension and Venous     Thromboembolism

Latest in Cardiology

Education and meetings.

• Online Learning Catalog
• Products and Resources
• Annual Scientific Session

Tools and Practice Support

• Quality Improvement for Institutions
• Accreditation Services
• Practice Solutions

Heart House

• 2400 N St. NW
• Washington , DC 20037
• Contact Member Care
• Phone: 1-202-375-6000
• Toll Free: 1-800-253-4636
• Fax: 1-202-375-6842
• Media Center
• Advertising & Sponsorship Policy
• Clinical Content Disclaimer
• Editorial Board
• Privacy Policy
• Registered User Agreement
• Terms of Service
• Cookie Policy

© 2024 American College of Cardiology Foundation. All rights reserved.

I've Reached the Peak of PhD Stress: Waiting for my Result Post-Viva

As per the title, I'm waiting for my PhD result after receiving an R&R verdict a year ago. To summarise how I'm currently feeling, I think the words impatient, anxious and borderline insane aptly sum my mood up. As I'm sure everyone in this forum knows, embarking on a PhD is one hell of a journey. I've been looking back at my old posts from years ago where I was sat in the good old university library starting out on this turbulent journey. I've endured the stress of writing, re-writing and then re-writing some more. I've endured stress concerning the ineptness of both my supervisors. I've endured stress over my viva being a shambles. I've endured the stress of my university losing my viva report. I've endured the stress of a years worth of corrections to my thesis. I've endured the stress of editing, re-editing and resubmitting. But this stress of waiting for my (perhaps) final result....I CAN NO LONGER TAKE IT PEOPLE!! I resubmitted my thesis 9 weeks ago (November 2015). My supervisor expected a two week turn around...I think not. I got told that my result would probably be with me this week. Well, tomorrow's Friday and I've heard absolutely nothing. My result could be anything from a pass, to minor corrections, to a re-viva...even a downgrade to an MPhil. I've got a temporary lecturing contract coming to an end soon and I desperately need this PhD. I've worked so hard and dedicated five long years of my life to it. I'm terrified that after all this hard work...it still won't be mine. The possibility of actually receiving an email tomorrow saying "congratulations, we recommend to the board that you be awarded your doctorate"...I just don't see it happening. My journey just ain't been like that. So that's it. Just needed to rant. Is anyone else with me in the struggle?!

Fingers crossed you get positive news soon - I am familiar with your story from your posts and really hoping for good news for you!

Hey, I could have written your post a few years back :) My username was pineapple29/30 - September 2006, started PhD - submitted PhD- September 2010 - delay with viva vice date - viva date booked for 1st April 2011 - external examiner pulled out of viva examination two weeks before viva voce examination - major stress! - search for new external examiner - PhD viva voce- June 2011- r&r verdict - submission date of resubmitted thesis- August 2012. - Major stressful wait - 15th JANUARY 2013, finally received examiners verdict, awarded minor corrections - April 2013, minor corrections approved - July 2013, PhD graduation - July 2013 started postdoctoral research fellow post Eek, my nightmare PhD journey. I completely feel your pain, you're definitely not alone :). Hang in there :)

Oh no love you're not alone, as the great David Bowie put it. Argh, I get so angry for you, Anz, when I see this is still going on. Bloody heck. I can do nothing but wish you positive energy and urge you to take care of yourself. I guess just try and do all the right things - socialise, exercise, eat right - as that can only help. You have mental resilience and tenacity that few others have, you know. What doesn't kill you makes you stronger. I have everything crossed for you still. And DrPurplePineapple is living proof that this kind of protracted ending doesn't mean you can't go on to bigger and better things. You know my story - not as drawn out but shitty all the same. Personally I can say it made me even stronger and I learned a lot. I'd still prefer it hadn't happened but I learned to value my life more, the people in my life, and just started living more and not getting stressed about work. I opted out of the game and into a 9-5 where I am very happy but I keep my foot in the door as an independent scholar and that suits me. The rotten experience gave me a rebirth in a way. I hope there's some positives in your experience somewhere. Wishing you great news very soon. Take care :-) Edit: Anz, I just wanted to reiterate more forcefully that I am so angry that this is allowed to happen in the 21st century. It is just not on - who do these people think they are toying with someone's life in this way? The system needs changing to a more moderated form of examination. It's not right to continue putting such power in the hands of one person.

I felt exactly the same when I was waiting for the outcome of my major corrections - the journey had been so bumpy and crazy (six years!) that I was sure it couldn't possibly end well. I was 100% sure that there would be no congratulations email, that just wasn't my story. So I completely sympathise and agree that it's horrendous that they are taking so long to get back to you. That said, I DID get my congratulations email in the end and I believe the huge majority of people who actually resubmit after an R&R get their PhD; failure is far more likely where students give up after R&R and don't resubmit. So hang in there. It is much much more likely than not to be good news (at worst a few additional minor corrections) and the universe owes you that "congratulations, Dr" email. It will come.

Can't say how relieved I am to discover I am not alone. Submitted my thesis on 13th June and have not yet heard a dicky bird. I have been warned that it could take some time. Like anz07, I too have spent an additional year on my thesis rewriting post viva. The viva was truly one of the most awful experiences of my life thus far. I have worked bloody hard to address ALL the revisions the external examiner demanded (the internal examiner was happy with it as it stood) and now I am in limbo. Basically, I want to know if I am a Dr or not. I have tried distracting myself with all manner of things, but nothing seems to work. Best way to describe my current mind-set is - to use some key words - Bored. Twitchy. Stressed. Depressed. Anxious. Lethargic. Basically, I just don't know quite what to do with myself. HELP!!!!!!!!!

Post your reply

Postgraduate Forum

Masters Degrees

PhD Opportunities

Postgraduate Forum Copyright ©2024 All rights reserved

PostgraduateForum Is a trading name of FindAUniversity Ltd FindAUniversity Ltd, 77 Sidney St, Sheffield, S1 4RG, UK. Tel +44 (0) 114 268 4940 Fax: +44 (0) 114 268 5766

Welcome to the world's leading Postgraduate Forum

An active and supportive community.

Support and advice from your peers.

Your postgraduate questions answered.

Use your experience to help others.

Sign Up to Postgraduate Forum

Enter your email address below to get started with your forum account

Login to your account

Enter your username below to login to your account

Reset password

Please enter your username or email address to reset your password

An email has been sent to your email account along with instructions on how to reset your password. If you do not recieve your email, or have any futher problems accessing your account, then please contact our customer support.

or continue as guest

Postgrad Forum uses cookies to create a better experience for you

To ensure all features on our website work properly, your computer, tablet or mobile needs to accept cookies. Our cookies don’t store your personal information, but provide us with anonymous information about use of the website and help us recognise you so we can offer you services more relevant to you. For more information please read our privacy policy

THE BEST Elektrostal Art Museums

Art museums in elektrostal.

• Specialty Museums
• Art Museums
• History Museums
• 4.0 of 5 bubbles & up
• Good for Kids
• Good for Big Groups
• Adventurous
• Budget-friendly
• Good for a Rainy Day
• Hidden Gems
• Good for Couples
• Honeymoon spot
• Good for Adrenaline Seekers
• Things to do ranked using Tripadvisor data including reviews, ratings, number of page views, and user location.

1. Electrostal History and Art Museum

• Introduction
• Conclusions
• Article Information

Pearson correlation coefficients ( r ) and median absolute errors (MAEs) between child chronological age based on birth date and epigenetic age were estimated by the Horvath pan-tissue and skin and blood epigenetic clocks. The linear trendline and 95% CIs are plotted as a solid line with shaded area, and the identity line (y = x) is plotted as a dashed line. If chronological and epigenetic age are equivalent for a participant, their datapoint falls exactly on the identity line.

Mean EAA in years are given at different time points in childhood for children born to mothers working in different occupations during pregnancy. These results are not adjusted for hypothesized confounders. Deviations from an EAA of 0 years indicate either mean accelerated or decelerated epigenetic aging at the aggregate level.

Regression coefficients in years and 95% CIs (error bars) derived from linear mixed-effects models adjusted for sociodemographic covariates (maternal age at delivery, prepregnancy body mass index, baseline maternal educational level, baseline maternal marital status, parity, poverty status during pregnancy, smoking and alcohol consumption during pregnancy, and child sex) and prenatal organophosphate pesticide exposure (log 10 -transformed mean prenatal urinary dialkylphosphate concentrations and log 2 -transformed kilograms of organophosphate pesticides used within 1 km of the maternal residence during pregnancy). IEAA indicates intrinsic EAA.

eMethods. Supplemental Methods

eTable 1. Number of Participants Who Have EAA Data Available at 1, 2, or All 3 Timepoints (7, 9, and 14 Years)

eTable 2. Individual and Overlapping Sample Sizes at Three Timepoints (7, 9, and 14 Years)

eTable 3. Systematic Comparison of Three Available Methods for Calculating Epigenetic Clocks in CHAMACOS Children (Ages 7-14 Years, N = 290)

eTable 4. Sociodemographic Characteristics of Mother-Child Pairs Included in the Study by Prenatal Maternal Occupation (N = 290)

eTable 5. Comparison of Sociodemographic Characteristics Between Included and Excluded Mother-Child Pairs

eTable 6. Adjusted Associations Between Prenatal Maternal Occupation and Child Horvath EAA by Child Age Compared to Children Whose Mothers Did Not Work During Pregnancy (Ages 7-14 Years, N = 290)

eFigure 1. Performance of Six Epigenetic Clocks in CHAMACOS Children (Ages 7-14 Years, N = 290)

eFigure 2. Cross-sectional Correlations Between Chronological Age and Epigenetic Age Estimates in CHAMACOS Children

eFigure 3. Adjusted Associations Between Prenatal Maternal Occupation With Secondary Measures of Child EAA and DNmTLadjAge Compared to Children Whose Mothers Did Not Work During Pregnancy (Ages 7-14 Years, N = 290)

eReferences

Data Sharing Statement

• Sociodemographic and Lifestyle Factors and Epigenetic Aging in US Young Adults JAMA Network Open Original Investigation July 29, 2024 This cohort study investigates the association of sociodemographic and lifestyle factors with biological age as measured by epigenetic clocks among younger adults. Kathleen Mullan Harris, PhD; Brandt Levitt, PhD; Lauren Gaydosh, PhD; Chantel Martin, PhD; Jess M. Meyer, PhD; Aura Ankita Mishra, PhD; Audrey L. Kelly, PhD; Allison E. Aiello, PhD
• Telehealth Parenting Program and Epigenetic Biomarkers in Children With Developmental Delay JAMA Network Open Original Investigation July 29, 2024 This secondary analysis of a randomized clinical trial assesses the association of a telehealth parent-child interaction training program with biomarkers associated with aging and chronic inflammation among preschool-aged children with developmental delay. Sarah M. Merrill, PhD; Christina Hogan, MS; Anne K. Bozack, PhD; Andres Cardenas, PhD; Jonathan S. Comer, PhD; Daniel M. Bagner, PhD; April Highlander, PhD; Justin Parent, PhD
• Essential Nutrients, Added Sugar Intake, and Epigenetic Age in Black and White Women JAMA Network Open Original Investigation July 29, 2024 This cross-sectional study uses data from the NHLBI Growth and Health Study and its follow-up to examine the association of dietary patterns, such as intakes of essential nutrients and added sugar, and scores of nutrient indices with epigenetic age among Black and White women at midlife in the US. Dorothy T. Chiu, PhD; Elissa June Hamlat, PhD; Joshua Zhang, PhD; Elissa S. Epel, PhD; Barbara A. Laraia, PhD, MPH, RD
• Socioeconomic Status, Lifestyle, and DNA Methylation Age JAMA Network Open Original Investigation July 29, 2024 This cohort study explores whether the rate of biological aging estimated by an epigenetic clock is associated with social determinants of health in a racially and ethnically diverse population. Alika K. Maunakea, PhD; Krit Phankitnirundorn, PhD; Rafael Peres, PhD; Christian Dye, PhD; Ruben Juarez, PhD; Catherine Walsh, PhD; Connor Slavens, BSc; S. Lani Park, PhD; Lynne R. Wilkens, DrPH; Loïc Le Marchand, MD, PhD
• Epigenetic Age Acceleration and Disparities in Posttraumatic Stress in Women JAMA Network Open Original Investigation July 29, 2024 This cohort study examines the association of epigenetic age acceleration with probable posttraumatic stress disorder and symptom severity in US women exposed to disaster. Alicia K. Smith, PhD; Seyma Katrinli, PhD; Dawayland O. Cobb, MS; Evan G. Goff, BS; Michael Simmond, BS; Grace M. Christensen, PhD, MPH; Tyler Prusisz, BS; Sierra N. Garth, MPH; Meghan Brashear, MPH; Anke Hüls, PhD, MSc; Erika J. Wolf, PhD; Edward J. Trapido, ScD; Ariane L. Rung, PhD, MPH; Nicole R. Nugent, PhD; Edward S. Peters, DMD, SM, ScD
• Childhood Maltreatment and Longitudinal Epigenetic Aging JAMA Network Open Original Investigation July 29, 2024 This cohort study examines whether childhood exposure to physical and emotional abuse and neglect is associated with the rate of epigenetic aging. Olivia D. Chang, MSW; Helen C. S. Meier, PhD; Kathryn Maguire-Jack, PhD; Pamela Davis-Kean, PhD; Colter Mitchell, PhD
• Familial Loss of a Loved One and Biological Aging JAMA Network Open Original Investigation July 29, 2024 This cohort study evaluates associations between losing a loved one and accelerated biological aging. Allison E. Aiello, PhD, MS; Aura Ankita Mishra, PhD; Chantel L. Martin, PhD; Brandt Levitt, PhD; Lauren Gaydosh, PhD; Daniel W. Belsky, PhD; Robert A. Hummer, PhD; Debra J. Umberson, PhD; Kathleen Mullan Harris, PhD
• Obesity and Early-Onset Breast Cancer in Black and White Women JAMA Network Open Original Investigation July 29, 2024 This cohort study of patients with breast cancer examines whether a race-specific association exists between obesity and early-onset breast cancer or the diagnosis of specific molecular subtypes. Sarabjeet Kour Sudan, PhD; Amod Sharma, PhD; Kunwar Somesh Vikramdeo, PhD; Wade Davis, BS; Sachin K. Deshmukh, PhD; Teja Poosarla, MD; Nicolette P. Holliday, MD; Pranitha Prodduturvar, MD; Cindy Nelson, BS; Karan P. Singh, PhD; Ajay P. Singh, PhD; Seema Singh, PhD
• Psychosocial Disadvantage During Childhood and Midlife Health JAMA Network Open Original Investigation July 29, 2024 This cohort study examines independent and additive associations of low childhood socioeconomic status and perceived stress in childhood with insulin resistance and epigenetic aging among women followed up from 10 to 40 years of age. Ryan L. Brown, PhD; Katie E. Alegria, PhD; Elissa Hamlat, PhD; A. Janet Tomiyama, PhD; Barbara Laraia, PhD; Eileen M. Crimmins, PhD; Terrie E. Moffitt, PhD; Elissa S. Epel, PhD
• Epigenetic Aging and Racialized, Economic, and Environmental Injustice JAMA Network Open Original Investigation July 29, 2024 This cross-sectional study assesses whether socially structured adversity is associated with increased epigenetic accelerated aging among US-born Black non-Hispanic, Hispanic, and White non-Hispanic adults. Nancy Krieger, PhD; Christian Testa, BS; Jarvis T. Chen, ScD; Nykesha Johnson, MPH; Sarah Holmes Watkins, PhD; Matthew Suderman, PhD; Andrew J. Simpkin, PhD; Kate Tilling, BSc, MSc, PhD; Pamela D. Waterman, MPH; Brent A. Coull, PhD; Immaculata De Vivo, PhD; George Davey Smith, MA(Oxon), MD, BChir(Cantab), MSc(Lond); Ana V. Diez Roux, MD, PhD, MPH; Caroline Relton, PhD
• Advancing Health Disparities Science Through Social Epigenomics Research JAMA Network Open Special Communication July 29, 2024 This special communication introduces the studies included in this special issue as part of the National Institutes of Health National Institute on Minority Health and Health Disparities Social Epigenomics Program. Arielle S. Gillman, PhD, MPH; Eliseo J. Pérez-Stable, MD; Rina Das, PhD

See More About

Sign up for emails based on your interests, select your interests.

Customize your JAMA Network experience by selecting one or more topics from the list below.

• Academic Medicine
• Acid Base, Electrolytes, Fluids
• Allergy and Clinical Immunology
• American Indian or Alaska Natives
• Anesthesiology
• Anticoagulation
• Art and Images in Psychiatry
• Artificial Intelligence
• Assisted Reproduction
• Bleeding and Transfusion
• Caring for the Critically Ill Patient
• Challenges in Clinical Electrocardiography
• Climate and Health
• Climate Change
• Clinical Challenge
• Clinical Decision Support
• Clinical Implications of Basic Neuroscience
• Clinical Pharmacy and Pharmacology
• Complementary and Alternative Medicine
• Consensus Statements
• Coronavirus (COVID-19)
• Critical Care Medicine
• Cultural Competency
• Dental Medicine
• Dermatology
• Diabetes and Endocrinology
• Diagnostic Test Interpretation
• Drug Development
• Electronic Health Records
• Emergency Medicine
• End of Life, Hospice, Palliative Care
• Environmental Health
• Equity, Diversity, and Inclusion
• Facial Plastic Surgery
• Gastroenterology and Hepatology
• Genetics and Genomics
• Genomics and Precision Health
• Global Health
• Guide to Statistics and Methods
• Hair Disorders
• Health Care Delivery Models
• Health Care Economics, Insurance, Payment
• Health Care Quality
• Health Care Reform
• Health Care Safety
• Health Care Workforce
• Health Disparities
• Health Inequities
• Health Policy
• Health Systems Science
• History of Medicine
• Hypertension
• Images in Neurology
• Implementation Science
• Infectious Diseases
• Innovations in Health Care Delivery
• JAMA Infographic
• Law and Medicine
• Leading Change
• Less is More
• LGBTQIA Medicine
• Lifestyle Behaviors
• Medical Coding
• Medical Devices and Equipment
• Medical Education
• Medical Education and Training
• Medical Journals and Publishing
• Mobile Health and Telemedicine
• Narrative Medicine
• Neuroscience and Psychiatry
• Notable Notes
• Nutrition, Obesity, Exercise
• Obstetrics and Gynecology
• Occupational Health
• Ophthalmology
• Orthopedics
• Otolaryngology
• Pain Medicine
• Palliative Care
• Pathology and Laboratory Medicine
• Patient Care
• Patient Information
• Performance Improvement
• Performance Measures
• Perioperative Care and Consultation
• Pharmacoeconomics
• Pharmacoepidemiology
• Pharmacogenetics
• Pharmacy and Clinical Pharmacology
• Physical Medicine and Rehabilitation
• Physical Therapy
• Physician Leadership
• Population Health
• Primary Care
• Professional Well-being
• Professionalism
• Psychiatry and Behavioral Health
• Public Health
• Pulmonary Medicine
• Regulatory Agencies
• Reproductive Health
• Research, Methods, Statistics
• Resuscitation
• Rheumatology
• Risk Management
• Scientific Discovery and the Future of Medicine
• Shared Decision Making and Communication
• Sleep Medicine
• Sports Medicine
• Stem Cell Transplantation
• Substance Use and Addiction Medicine
• Surgical Innovation
• Surgical Pearls
• Teachable Moment
• Technology and Finance
• The Art of JAMA
• The Arts and Medicine
• The Rational Clinical Examination
• Tobacco and e-Cigarettes
• Translational Medicine
• Trauma and Injury
• Treatment Adherence
• Ultrasonography
• Users' Guide to the Medical Literature
• Vaccination
• Venous Thromboembolism
• Veterans Health
• Women's Health
• Workflow and Process
• Wound Care, Infection, Healing

Get the latest research based on your areas of interest.

Others also liked.

• Download PDF
• X Facebook More LinkedIn

Daredia S , Bozack AK , Riddell CA, et al. Prenatal Maternal Occupation and Child Epigenetic Age Acceleration in an Agricultural Region : NIMHD Social Epigenomics Program . JAMA Netw Open. 2024;7(7):e2421824. doi:10.1001/jamanetworkopen.2024.21824

Manage citations:

© 2024

• Permissions

Prenatal Maternal Occupation and Child Epigenetic Age Acceleration in an Agricultural Region : NIMHD Social Epigenomics Program

• 1 Division of Epidemiology, School of Public Health, University of California, Berkeley
• 2 Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California
• 3 Division of Biostatistics, School of Public Health, University of California, Berkeley
• 4 Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley
• 5 Division of Community Health Sciences, School of Public Health, University of California, Berkeley
• 6 Department of Public Health, University of California, Merced
• 7 Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley
• 8 Department of Pediatrics, School of Medicine, Stanford University, Stanford, California
• Original Investigation Sociodemographic and Lifestyle Factors and Epigenetic Aging in US Young Adults Kathleen Mullan Harris, PhD; Brandt Levitt, PhD; Lauren Gaydosh, PhD; Chantel Martin, PhD; Jess M. Meyer, PhD; Aura Ankita Mishra, PhD; Audrey L. Kelly, PhD; Allison E. Aiello, PhD JAMA Network Open
• Original Investigation Telehealth Parenting Program and Epigenetic Biomarkers in Children With Developmental Delay Sarah M. Merrill, PhD; Christina Hogan, MS; Anne K. Bozack, PhD; Andres Cardenas, PhD; Jonathan S. Comer, PhD; Daniel M. Bagner, PhD; April Highlander, PhD; Justin Parent, PhD JAMA Network Open
• Original Investigation Essential Nutrients, Added Sugar Intake, and Epigenetic Age in Black and White Women Dorothy T. Chiu, PhD; Elissa June Hamlat, PhD; Joshua Zhang, PhD; Elissa S. Epel, PhD; Barbara A. Laraia, PhD, MPH, RD JAMA Network Open
• Original Investigation Socioeconomic Status, Lifestyle, and DNA Methylation Age Alika K. Maunakea, PhD; Krit Phankitnirundorn, PhD; Rafael Peres, PhD; Christian Dye, PhD; Ruben Juarez, PhD; Catherine Walsh, PhD; Connor Slavens, BSc; S. Lani Park, PhD; Lynne R. Wilkens, DrPH; Loïc Le Marchand, MD, PhD JAMA Network Open
• Original Investigation Epigenetic Age Acceleration and Disparities in Posttraumatic Stress in Women Alicia K. Smith, PhD; Seyma Katrinli, PhD; Dawayland O. Cobb, MS; Evan G. Goff, BS; Michael Simmond, BS; Grace M. Christensen, PhD, MPH; Tyler Prusisz, BS; Sierra N. Garth, MPH; Meghan Brashear, MPH; Anke Hüls, PhD, MSc; Erika J. Wolf, PhD; Edward J. Trapido, ScD; Ariane L. Rung, PhD, MPH; Nicole R. Nugent, PhD; Edward S. Peters, DMD, SM, ScD JAMA Network Open
• Original Investigation Childhood Maltreatment and Longitudinal Epigenetic Aging Olivia D. Chang, MSW; Helen C. S. Meier, PhD; Kathryn Maguire-Jack, PhD; Pamela Davis-Kean, PhD; Colter Mitchell, PhD JAMA Network Open
• Original Investigation Familial Loss of a Loved One and Biological Aging Allison E. Aiello, PhD, MS; Aura Ankita Mishra, PhD; Chantel L. Martin, PhD; Brandt Levitt, PhD; Lauren Gaydosh, PhD; Daniel W. Belsky, PhD; Robert A. Hummer, PhD; Debra J. Umberson, PhD; Kathleen Mullan Harris, PhD JAMA Network Open
• Original Investigation Obesity and Early-Onset Breast Cancer in Black and White Women Sarabjeet Kour Sudan, PhD; Amod Sharma, PhD; Kunwar Somesh Vikramdeo, PhD; Wade Davis, BS; Sachin K. Deshmukh, PhD; Teja Poosarla, MD; Nicolette P. Holliday, MD; Pranitha Prodduturvar, MD; Cindy Nelson, BS; Karan P. Singh, PhD; Ajay P. Singh, PhD; Seema Singh, PhD JAMA Network Open
• Original Investigation Psychosocial Disadvantage During Childhood and Midlife Health Ryan L. Brown, PhD; Katie E. Alegria, PhD; Elissa Hamlat, PhD; A. Janet Tomiyama, PhD; Barbara Laraia, PhD; Eileen M. Crimmins, PhD; Terrie E. Moffitt, PhD; Elissa S. Epel, PhD JAMA Network Open
• Original Investigation Epigenetic Aging and Racialized, Economic, and Environmental Injustice Nancy Krieger, PhD; Christian Testa, BS; Jarvis T. Chen, ScD; Nykesha Johnson, MPH; Sarah Holmes Watkins, PhD; Matthew Suderman, PhD; Andrew J. Simpkin, PhD; Kate Tilling, BSc, MSc, PhD; Pamela D. Waterman, MPH; Brent A. Coull, PhD; Immaculata De Vivo, PhD; George Davey Smith, MA(Oxon), MD, BChir(Cantab), MSc(Lond); Ana V. Diez Roux, MD, PhD, MPH; Caroline Relton, PhD JAMA Network Open
• Special Communication Advancing Health Disparities Science Through Social Epigenomics Research Arielle S. Gillman, PhD, MPH; Eliseo J. Pérez-Stable, MD; Rina Das, PhD JAMA Network Open

Question   Is prenatal maternal occupation associated with child epigenetic aging in a farmworker population?

Findings   In this cohort study of 290 mother-child pairs, children whose mothers engaged in agricultural fieldwork during pregnancy had greater epigenetic age acceleration as measured by several DNA methylation–based biomarkers compared with those whose mothers did not work during pregnancy. These associations were independent of sociodemographic characteristics and prenatal pesticide exposure.

Meaning   These findings suggest that children of agricultural fieldworkers, a vastly understudied population, may experience increased rates of biological aging early in life and greater risk of age-related diseases later in life due to prenatal stressors.

Importance   Research on fetal epigenetic programming suggests that the intrauterine environment can have long-term effects on offspring disease susceptibility.

Objective   To examine the association between prenatal maternal occupation and child epigenetic age acceleration (EAA) among a farmworker community.

Design, Setting, and Participants   This cohort study included participants in the Center for the Health Assessment of Mothers and Children of Salinas, a prospective, Latino, prebirth cohort. Pregnant women were recruited from October 1, 1999, to October 1, 2000, from 6 community clinics in California’s Salinas Valley agricultural region. Participants were 18 years or older, English or Spanish speaking, Medicaid eligible, and at 20 weeks’ gestation or earlier at enrollment. Mother-child pairs who had blood DNA methylation measured at the ages of 7, 9, and 14 years were included. Data were analyzed from July 2021 to November 2023.

Exposures   Prenatal maternal occupation was ascertained through study interviews conducted during prenatal visits and shortly after delivery.

Main Outcomes and Measures   Child EAA at 7, 9, and 14 years of age was estimated using DNA methylation–based epigenetic age biomarkers. Three EAA measures were calculated: the Horvath EAA, skin and blood EAA, and intrinsic EAA. Linear mixed-effects models were used to estimate longitudinal associations of prenatal maternal occupation and child EAA, adjusting for confounders and prenatal organophosphate pesticide exposure.

Results   Analyses included 290 mother-child pairs (mean [SD] maternal age at delivery, 26.5 [5.2] years; 152 [52.4%] female infants); 254 mothers (87.6%) were born in Mexico, 33 (11.4%) in the US, and 3 (1.0%) in other countries; and 179 families (61.7%) were below the federal poverty line during pregnancy. Mothers reported engaging in several types of work during pregnancy, including agricultural fieldwork (90 [31.0%]), other agricultural work (40 [13.8%]), nonagricultural work (53 [18.3%]), or no work (107 [36.9%]). Children whose mothers worked in agricultural fields during pregnancy had a mean of 0.66 (95% CI, 0.17-1.15) years of greater Horvath EAA, 0.62 (95% CI, 0.31-0.94) years of greater skin and blood EAA, and 0.45 (95% CI, 0.07-0.83) years of greater intrinsic EAA compared with children whose mothers did not work during pregnancy.

Conclusions and Relevance   In this cohort study, prenatal maternal agricultural fieldwork was associated with accelerated childhood epigenetic aging independent of organophosphate pesticide exposure. Future research on which factors related to agricultural fieldwork accelerate aging in the next generation can inform targeted prevention programs and policies that protect children’s health.

Evidence suggests that exposures in utero can become biologically embedded via epigenetic mechanisms, affecting fetal development and disease onset later in life. 1 , 2 Genome-wide changes in DNA methylation (DNAm), a type of epigenetic modification, are strongly correlated with aging. 3 , 4 Gene-specific DNAm from multiple human tissue types has been leveraged to develop biomarkers of biological aging, known as epigenetic clocks. Epigenetic age acceleration (EAA), which is the difference between epigenetic age as estimated by these clocks and chronological age, is closely associated with morbidity and mortality in adults. 5 - 7 However, recent studies demonstrate that epigenetic aging processes begin as early as conception, 8 , 9 emphasizing the need to consider prenatal influences on aging.

Although some environmental and social exposures during pregnancy affect epigenetic age measured at birth, 8 - 17 data on whether the prenatal environment affects epigenetic aging throughout childhood are limited. Prenatal smoking, gestational diabetes, and exposure to phthalates have been associated with altered epigenetic aging in early to middle childhood. 9 , 18 - 20 However, only a small number of studies have examined prenatal exposures and prospective measurements of child EAA, 21 - 23 and even fewer have followed up youth into adolescence. 21 Moreover, no epigenetic studies have focused on maternal occupation during pregnancy, which is an important area to consider when assessing pregnancy-related stress and burden. Prenatal maternal stress alters DNAm signatures and downstream gene expression among newborns. 24 - 26 Longitudinal studies are needed to understand the persistence of these epigenetic modifications in childhood and beyond, 27 especially among low-income populations and mothers from underrepresented backgrounds, who are disproportionately exposed to occupational stressors during pregnancy that might affect their children. 28

To address these research gaps, we tested the association between prenatal maternal occupation and epigenetic aging among children in a Latino agricultural community. Pregnant farmworkers, especially those working in agricultural fields, are particularly vulnerable to occupational risk factors, including pesticide exposure, heat stress, and physical exertion. 29 , 30 Beyond workplace hazards, farmworker families also often experience food and housing insecurity, fears related to immigration status, cultural barriers, and inadequate access to medical and social services. 31 - 34 Given these stressors, we hypothesized that prenatal maternal agricultural work is associated with accelerated epigenetic aging in childhood.

This cohort study used data from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a longitudinal, prebirth cohort composed of primarily Mexican American children born in California’s agricultural Salinas Valley. Eligible pregnant women (≥18 years of age, English or Spanish speaking, ≤20 weeks’ gestation at enrollment, Medicaid eligible, and planning to deliver at the county hospital) were recruited between October 1, 1999, and October 1, 2000, from 6 community clinics, as described elsewhere. 35 , 36 Of 601 initial enrollees, 526 (87.5%) were followed up to the delivery of live, singleton newborns. The study continued to follow up mother-child pairs after delivery. A phlebotomist collected child blood samples via venipuncture at study visits conducted when the children were 7, 9, and 14 years old. We restricted these analyses to 290 mother-child pairs who reported prenatal maternal occupation, had available child chronological age data (estimated to the day of the study visit), and provided blood samples during at least 1 study visit: 7 (n = 182), 9 (n = 239), and 14 (n = 185) years of age. Details on the number of repeated measures per participant and overlapping participants between time points are presented in eTables 1 and 2 in Supplement 1 . The University of California, Berkeley Committee for the Protection of Human Subjects approved all study activities. Written informed consent was obtained from mothers. Child verbal assent was obtained from children aged 7 and 9 years; written assent was obtained from children aged 14 years. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline for cohort studies.

DNA methylation was measured from blood samples of children aged 9 years (Illumina Infinium HumanMethylation450 BeadChip; Illumina Inc) and from blood samples of children aged 7 and 14 years with the EPIC BeadChip (Illumina Inc), according to the manufacturer’s protocol. 37 , 38 DNA methylation profiling and quality control are described in the eMethods in Supplement 1 .

Epigenetic age measures from 6 clocks (Horvath pan-tissue, 39 skin and blood, 40 Hannum, 41 PhenoAge, 42 DNAmTL, 43 and GrimAge 44 ) were estimated from the DNAm data at each time point using 3 publicly available methods: (1) the methylCIPHER R package, 45 (2) the online Clock Foundation calculator, 39 and (3) a principal component–based estimation. 46 The performance of each clock and its estimation method was evaluated by Pearson correlation coefficients ( r ) and median absolute error (MAE) between epigenetic age and chronological age (eTable 3 in Supplement 1 ). The estimation method producing the highest Pearson r followed by the lowest MAE was systematically chosen for each clock for statistical analyses (eFigure 1 in Supplement 1 ). In primary analyses, epigenetic age from the Horvath pan-tissue clock (referred to here as the Horvath clock) and skin and blood clock were selected due to goodness of fit with chronological age in our sample ( r  ≥ 0.8, MAE ≤ 2 years), original training data including pediatric populations, and applicability throughout the human lifespan. 39 , 40 Secondary analyses were conducted using the other epigenetic aging biomarkers (Hannum, PhenoAge, DNAmTL, and GrimAge).

Epigenetic age acceleration was calculated for each clock as the residuals from a linear regression of epigenetic age on chronological age. We used Horvath EAA, skin and blood EAA, and intrinsic EAA (IEAA) as the primary outcomes. Intrinsic EAA is based on the Horvath clock but independent of changes in blood cell type composition and indicative of cell-intrinsic aging. 47 Details on how IEAA was calculated are available in the eMethods in Supplement 1 .

Trained bilingual staff members interviewed pregnant mothers at a median (IQR) of 13 (10-17) weeks’ and 26 (25-27) weeks’ gestation and 1 to 7 days after delivery. During each interview, mothers were asked if they were currently working and, if so, whether they had engaged in specific tasks (yes or no) at each of their jobs, if multiple. Each job was classified as agricultural fieldwork, other general agricultural work, or nonagricultural work. Agricultural fieldwork included harvesting, thinning, or weeding crops. Other agricultural work included applying and handling fertilizers, handling pesticides, operating equipment or tractors, serving as foreperson, or working in a packing shed, nursery, or greenhouse.

If mothers reported working in the fields during pregnancy and not participating in other agricultural tasks, their occupation was classified as agricultural fieldwork. Maternal occupation was categorized as other agricultural work if agricultural tasks other than fieldwork were reported during any study interview. Nonagricultural work was assigned if mothers reported working, but never in agricultural settings. Mothers were categorized as not having worked during their pregnancy if they reported not having a job during all 3 interviews. During interviews, working mothers also self-reported the physical difficulty of their jobs (not at all, not very, somewhat, or very strenuous) and the average hours per day spent standing on their feet and stooping or bending at work.

Covariates were selected a priori using a directed acyclic graph 48 and included maternal age at delivery, prepregnancy body mass index, maternal educational level (6th grade or less, 7th-12th grade, high school graduate or more), marital status (married, living as married, separated, divorced, or single), parity (nulliparous or multiparous), prenatal smoking and alcohol consumption (no or yes), poverty status during pregnancy (poverty line or below, between the poverty line and 200%, or higher than 200% of the poverty line as determined by US Census Bureau thresholds), and child sex.

From 1999 to 2000, the prenatal period for children in the CHAMACOS study, nearly a half-million pounds of organophosphate pesticides were applied in Salinas Valley. 49 In this study, we assessed prenatal organophosphate pesticide exposure using 2 methods. Dialkylphosphate metabolites, a proxy of exposure to organophosphate pesticides, were measured from maternal urine samples collected during the 2 prenatal study interviews, as described elsewhere. 50 Metabolite levels below the limit of detection were randomly imputed based on a log-normal probability distribution. 51 Urinary dialkylphosphate concentrations were averaged across both samples. Using California Pesticide Use Reporting data from 1999 to 2001, we also estimated kilograms of organophosphate pesticides applied within 1 km of each mother’s residence from estimated conception date to delivery, as described elsewhere. 52 , 53

We described participant characteristics with means (SDs) for continuous measurements and numbers (percentages) for categorical variables. Linear mixed-effects regression models were used to examine associations between prenatal maternal occupation and longitudinal measures of child Horvath EAA, skin and blood EAA, and IEAA. Models included random slopes and intercepts to account for within- and between-child variability in the outcome. Models were adjusted for child chronological age as recommended, 54 mother-child sociodemographic characteristics, and prenatal organophosphate pesticide exposure. We adjusted for both log 10 -transformed urinary dialkylphosphates and log 2 -transformed California Pesticide Use Reporting estimates because a previous study in our cohort showed that these were not highly correlated and provided complementary measures of organophosphate pesticide exposure. 53 The threshold for statistical significance was defined using 95% CIs.

As a sensitivity analysis, statistical interaction terms between child age and prenatal maternal occupation were added to the previously described models as recommended. 55 A likelihood ratio test was used to assess whether model fit was improved by including interaction terms. Additional sensitivity analyses adjusted for (1) maternal years in the US at child’s birth, (2) prenatal paternal occupation, (3) the number of farmworkers living in the household during pregnancy, and (4) replaced maternal occupation with physical exertion at mother’s work during pregnancy as the main exposure. Data were analyzed from July 2021 to November 2023. Analyses were performed using R, version 4.3.1 (R Foundation for Statistical Computing). 56

Among 290 mother-child pairs (mean [SD] maternal age at delivery, 26.5 [5.2] years; 152 female [52.4%] and 138 male [47.6%] infants) included in the analysis, 254 mothers (87.6%) were born in Mexico, 33 (11.4%) in the US, and 3 (1.0%) in other countries (specific countries not reported because of small sample size and possible identification of participants), and 282 (97.2%) self-identified as Mexican or Mexican American (race not reported for the other 2.8% to protect patient anonymity). A total of 179 mothers (61.7%) were living at or below the federal poverty line during pregnancy, with 279 (96.2%) living below 200% of the poverty line. Ninety mothers (31.0%) reported agricultural field work; 40 (13.8%), other agricultural work; 53 (18.3%), nonagricultural work; and 107 (36.9%), no work during pregnancy. The Table describes sociodemographic characteristics for our analytic sample overall and by each time point. eTable 4 in Supplement 1 describes characteristics for our sample by prenatal occupation category. eTable 5 in Supplement 1 shows a comparison of characteristics between included and excluded mother-child pairs. Mothers included in our analyses were slightly older and had lived in the US for a longer duration compared with those excluded.

Epigenetic aging measures from the Horvath and skin and blood epigenetic clocks were good estimates of child chronological age across 7, 9, and 14 years as measured by Pearson correlation coefficients (Horvath r  = 0.84 [MAE = 1.5 years]; skin and blood r  = 0.92 [MAE = 2.0 years]) ( Figure 1 ). Other clocks performed relatively well in accuracy but had weaker correlations with chronological age and higher MAEs (eFigure 1 in Supplement 1 ); therefore, Horvath, skin and blood, and IEAA were used in our primary analyses. Correlations between chronological age and epigenetic age estimates by each time point are presented in eFigure 2 in Supplement 1 .

Unadjusted mean child Horvath, skin and blood, and IEAA measures were consistently elevated (>0 years) at 7, 9, and 14 years of age among children whose mothers engaged in agricultural fieldwork during pregnancy ( Figure 2 ). In longitudinal adjusted models, children whose mothers were agricultural fieldworkers during pregnancy had a mean of 0.66 (95% CI, 0.17-1.15) years greater Horvath EAA, 0.62 (95% CI, 0.31-0.94) years greater skin and blood EAA, and 0.45 (95% CI, 0.07-0.83) years greater IEAA compared with children whose mothers did not work during pregnancy ( Figure 3 ). Associations between other agricultural work and nonagricultural work during pregnancy with child EAA were consistently close to the null ( Figure 3 ).

In secondary adjusted analyses, prenatal maternal agricultural fieldwork was also associated with greater mean child EAA from the Hannum (1.43 years; 95% CI, 0.34-2.52 years) and PhenoAge (0.74 years; 95% CI, 0.18-1.31 years) clocks and with a negative mean age–adjusted estimate of child DNAmTL (−0.05; 95% CI, −0.09 to −0.01), indicating shorter telomere length—a hallmark of increased biological aging (eFigure 3 in Supplement 1 ).

Estimates from models with statistical interaction terms provide evidence that the association of prenatal maternal agricultural fieldwork with child Horvath EAA may be greater with increasing child chronological age (eTable 6 in Supplement 1 ). Compared with children with mothers who did not work during pregnancy, children with mothers who engaged in agricultural fieldwork during pregnancy had a mean Horvath EAA that was 0.38 (95% CI, −0.16 to 0.92) years greater at 7 years of age, 0.70 (95% CI, 0.21-1.18) years greater at 9 years of age, and 1.49 (95% CI, 0.64-2.34) years greater at 14 years of age.

Prenatal maternal agricultural fieldwork remained associated with increased mean child EAA in models that additionally adjusted for (1) mothers’ years in the US as a proxy for social support and immigration-related stressors, (2) prenatal paternal occupation, or (3) the number of farmworkers living in the household during pregnancy. Mothers’ self-reported physical difficulty at work and mean hours per day standing at work were not associated with child EAA. A 1-hour increase in mothers’ mean hours per day stooping or bending at work was associated with increased mean child skin and blood EAA (0.10 years; 95% CI, 0.01-0.18 years) and IEAA (0.11 years; 95% CI, 0.01-0.20 years).

In this study, we tested prospective associations of maternal occupation during pregnancy with epigenetic aging across childhood in the CHAMACOS prebirth cohort. We found that prenatal maternal agricultural fieldwork was associated with accelerated child epigenetic aging independent of sociodemographic characteristics and prenatal organophosphate pesticide exposure. Our findings were consistent across multiple epigenetic clock biomarkers. Each clock was developed using DNAm at different CpG (cytosine-phosphate-guanine) sites, thus capturing different aspects of biological aging. Therefore, our results suggest that prenatal maternal agricultural fieldwork may impact several biological aging processes in children, including those independent of age-related changes in blood cell type composition as reflected by IEAA.

Theoretical frameworks, such as the DOHaD (Developmental Origins of Health and Disease), 57 , 58 posit that maternal stressors during pregnancy can cumulatively influence offspring’s health in later life. Mothers in our study population, an immigrant farmworker community, face a unique combination of adverse social and chemical exposures during pregnancy. Agricultural fieldworkers, in particular, are at the bottom of a labor hierarchy on farms that is largely defined by race, class, and citizenship. 59 Moreover, female agricultural fieldworkers are routinely exposed to sexual harassment in the fields. 60 Those who are pregnant are particularly vulnerable to harsh working conditions, such as irregular access to restrooms and drinking water, pesticide exposure, and prolonged, physically demanding work in high temperatures, 29 all of which have been independently linked to adverse pregnancy and birth outcomes. 61 - 64 Exposures to medium- and long-term heat 65 and organochlorine pesticides 66 have been associated with greater EAA in adults. Maternal psychosocial stress, including prenatal anxiety and perceived discrimination, have intergenerational consequences on child epigenetic aging. 22 , 67 Given these findings, we hypothesize that the accumulation of multiple stressors associated with prenatal maternal agricultural fieldwork, not any one stressor alone, accelerated child epigenetic aging in our cohort.

To our knowledge, this is the first study to assess the association of prenatal maternal occupation with child epigenetic aging. Numerous studies have shown that chemical, psychosocial, and ergonomic hazards in prenatal maternal work environments have downstream deleterious effects on birth outcomes and child health. 68 Our findings suggest that epigenetic pathways may be involved in these observed associations. Our study also considers a population that is typically underrepresented in research, especially in genomics. Diversifying cutting-edge research on biomarkers of aging will enable us to better understand how the social environment influences deviations in these biomarkers and develop health interventions for vulnerable populations. Moreover, our work provides support for workplace accommodations to ensure the safety of pregnant farmworkers, as well as expanded options for their paid leave during pregnancy.

Additional studies are needed to clarify the long-term health implications of altered aging processes in early life. Although the EAA of multiple clocks in adults is associated with morbidity and mortality, consequences of altered EAA in pediatric populations have not been characterized but provide immense opportunity for disease prevention. A handful of studies have linked EAA and maturation processes, showing that EAA is associated with higher weight for age, taller height for age, and earlier pubertal onset. 69 - 71 In turn, early pubertal timing is associated with later risk of adult obesity, type 2 diabetes, and cardiovascular disease. 72 More longitudinal research is needed to evaluate the persistence of epigenetic aging trajectories and whether accelerated epigenetic aging in childhood and adolescence impacts risk of chronic diseases.

Our study has some limitations. Maternal agricultural fieldwork may encompass a variety of exposures, including pesticides, heat, physical exertion, and socioeconomic adversity beyond the workplace, some of which may act as mechanisms on the causal path to epigenetic aging. We found robust associations after controlling for organophosphate pesticide exposure quantified by 2 different exposure assessment methods, as well as immigration-related stressors assessed using maternal years in the US. Although our sensitivity analysis showed positive associations with prenatal occupational bending and stooping and child EAA from some clocks, this measure did not capture physical exertion outside the workplace. Other potential prenatal (eg, mothers’ exposure to heat, harassment at work, and pesticide mixtures) and postnatal (eg, early-life socioeconomic status and pesticide exposure) mechanisms were also not captured in our study. Future research should focus on identifying mediating pathways to inform targeted preventive interventions and policies. In addition, although we adjusted for covariates that are proxies for maternal socioeconomic status and acculturation, there may be residual confounding in our study from unmeasured variables that may have influenced mothers’ choice of occupation (or lack thereof) during pregnancy. Finally, our study sample was largely composed of low-income, immigrant Latino families, which limits generalizability of our results to other populations. Nevertheless, we believe it is crucial to continue expanding social and environmental epigenomics research to more diverse study populations.

This longitudinal cohort study found that prenatal maternal agricultural fieldwork was associated with child EAA among a Latino prebirth cohort, independent of prenatal organophosphate pesticide exposure and sociodemographic characteristics. Understanding factors that accelerate early-life biological aging in vulnerable populations, such as farmworker communities, may help to identify targets for adult disease prevention and mitigate health disparities.

Accepted for Publication: March 5, 2024.

Published: July 29, 2024. doi:10.1001/jamanetworkopen.2024.21824

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Daredia S et al. JAMA Network Open .

Corresponding Author: Andres Cardenas, PhD, Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305 ( [email protected] ).

Author Contributions: Ms Daredia had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Deardorff and Cardenas contributed equally to this work and share senior authorship.

Concept and design: Daredia, Bradman, Eskenazi, Deardorff, Cardenas.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Daredia, Eskenazi, Cardenas.

Critical review of the manuscript for important intellectual content: Bozack, Riddell, Gunier, Harley, Bradman, Eskenazi, Holland, Deardorff, Cardenas.

Statistical analysis: Daredia, Riddell, Gunier.

Obtained funding: Bradman, Eskenazi, Holland, Deardorff, Cardenas.

Administrative, technical, or material support: Gunier, Bradman, Eskenazi, Holland, Deardorff, Cardenas.

Supervision: Gunier, Deardorff, Cardenas.

Conflict of Interest Disclosures: Dr Eskenazi reported receiving grants from the Environmental Protection Agency during the conduct of the study. No other disclosures were reported.

Funding/Support: This study was funded by grant R01MD016595 from the National Institute on Minority Health and Health Disparities (Drs Deardorff and Cardenas), grant R01DA035300 from the National Institute on Drug Abuse (Dr Deardorff), and grants R01ES026994 (Dr Eskenazi), P01ES009605 (Drs Bradman, Eskenazi, and Holland), R24ES028529 (Dr Eskenazi), and U24ES028529 (Dr Harley) from the National Institute of Environmental Health Sciences.

Role of the Funder/Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2 .

Additional Contributions: Katherine R. Kogut, MPH, MSC, and Stephen Rauch, MPH, Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, assisted with data collection and dataset preparation. They were compensated for their work. We gratefully acknowledge the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) participants and study staff.

• Register for email alerts with links to free full-text articles
• Access PDFs of free articles
• Manage your interests
• Save searches and receive search alerts