Associations between psychological distress and hair cortisol during pregnancy and the early postpartum: A meta-analysis

Khoury, Jennifer E.; Giles, Lauren; Kaur, Hargun; Johnson, Dylan; González, Andrea; Atkinson, Leslie

doi:10.1016/j.psyneuen.2022.105969

Cited by 23 publications

(12 citation statements)

References 103 publications

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“…Because hair growth is relatively stable over time [49,50], hair cortisol concentration (HCC) and hair cortisone concentration (HCNC) indicate the respective hormone secretion over a specific timespan [51], such as pregnancy. Hence, HCC and HCNC have become promising biomarkers of psychological distress in both, pregnant and non-pregnant individuals [52,53] and respective correlations with PTB have been shown in previous studies [28,[54][55][56][57][58][59][60].…”

Section: Introductionmentioning

confidence: 83%

The Association Between Pre-Pregnancy and First-Trimester Hair Cortisol and Preterm Birth: A Causal Inference Model

Chen,

Künzel,

Sanchez

et al. 2024

Preprint

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Background Adverse life events and chronic psychological distress before and during pregnancy have frequently been associated with preterm birth (PTB) but the biological underpinnings remain unclear. We investigated the association between corticosteroid levels in pre-pregnancy and first-trimester hair and the risk of PTB. Methods We followed 1,808 pregnant women from a prospective pre-birth cohort study in Lima, Perú. Hair samples were taken at the end of the first pregnancy trimester. The two most proximal 3cm segments to the scalp (representing pre-pregnancy and first-trimester) were analyzed to obtain hair cortisol and cortisone concentrations (HCC and HCNC). PTB was defined as birth < 37 completed gestational weeks. We constructed four generalized propensity scores for pre-pregnancy and first-trimester HCC and HCNC to create corresponding inverse probability weights before fitting marginal structural models for estimating the effect of HCC and HCNC on PTB risk. Results Pre-pregnancy Log HCC was not independently associated with PTB risk (RR = 0.97; 95%CI: 0.79, 1.19). In contrast, one SD increase from the mean first-trimester Log HCC was independently associated with a 37% (95%CI: 1.11, 1.69) increased risk of PTB. Although imprecise, pre-pregnancy Log HCNC was negatively associated with PTB risk (RR = 0.84; 95%CI: 0.58, 1.20), whereas the association between first-trimester Log HCNC and PTB risk was positive (RR = 1.20; 95%CI: 0.87, 1.65). Conclusions Our findings show that chronic corticosteroid levels in early pregnancy are causally linked to PTB risk in pregnant Peruvian women. This finding contributes to understanding the biological underpinnings of PTB better to enhance PTB prevention.

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Section: Introductionmentioning

confidence: 83%

The Association Between Pre-Pregnancy and First-Trimester Hair Cortisol and Preterm Birth: A Causal Inference Model

Chen,

Künzel,

Sanchez

et al. 2024

Preprint

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“…Second, maternal distress during pregnancy and the early postpartum is associated with altered stress biology for both the mother and child. More specifically, elevated perinatal distress is linked to changes in the functioning of the mother's and infant's hypothalamic‐pituitary‐adrenal (HPA) axis, the primary stress response system, resulting in alterations in the production of the stress hormone cortisol (Entringer et al., 2015; Khoury et al., 2023; Romero‐Gonzalez et al., 2018; Seth et al., 2016). It is possible that perinatal distress plays a role in the development of the child's stress response system, which predisposes the child to experience more behavior problems.…”

Section: Discussionmentioning

confidence: 99%

“…Further, this research shows that prenatal distress may be indirectly linked to child outcomes through postpartum distress. However, prior research is limited by only assessing postpartum distress at a single time point, often early in infancy, which is potentially problematic given that levels of postpartum distress have been shown to change over the course of the pandemic (Khoury et al., 2023). Thus, it remains unclear whether the longitudinal associations between pregnancy distress, postpartum distress and child outcomes (1) differ depending on the timing of postpartum distress assessment, (2) persist beyond the first few months of life (into toddlerhood), and (3) whether there are unique effects on different domains of socioemotional development (e.g., competence, problems, internalizing vs. externalizing problem behaviors).…”

Section: Introductionmentioning

confidence: 99%

A longitudinal study examining the associations between prenatal and postnatal maternal distress and toddler socioemotional developmental during the COVID‐19 pandemic

Khoury,

Atkinson,

Gonzalez

2024

Infancy

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Elevated psychological distress, experienced by pregnant women and parents, has been well‐documented during the COVID‐19 pandemic. Most research focuses on the first 6‐months postpartum, with single or limited repeated measures of perinatal distress. The present longitudinal study examined how perinatal distress, experienced over nearly 2 years of the COVID‐19 pandemic, impacted toddler socioemotional development. A sample of 304 participants participated during pregnancy, 6‐weeks, 6‐months, and 15‐months postpartum. Mothers reported their depressive, anxiety, and stress symptoms, at each timepoint. Mother‐reported toddler socioemotional functioning (using the Brief Infant–Toddler Social and Emotional Assessment) was measured at 15‐months. Results of structural equation mediation models indicated that (1) higher prenatal distress was associated with elevated postpartum distress, from 6‐weeks to 15‐months postpartum; (2) associations between prenatal distress and toddler socioemotional problems became nonsignificant after accounting for postpartum distress; and (3) higher prenatal distress was indirectly associated with greater socioemotional problems, and specifically elevated externalizing problems, through higher maternal distress at 6 weeks and 15 months postpartum. Findings suggest that the continued experience of distress during the postpartum period plays an important role in child socioemotional development during the COVID‐19 pandemic.

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“…Maternal and child hair cortisol was also sampled at 6 months, 15 months, 25 months and 35 months postpartum to capture parent and child biological stress in the postpartum period. Hair cortisol is a valid biomarker for chronic HPA activity,85–88 is a reliable index of stress during pregnancy,89–91 infancy and early childhood,88 92–94 and is linked to early risk and child psychosocial outcomes 40 95–97. Given the chronic nature of the COVID-19 pandemic, it is essential to use a biomarker that effectively measures long-term levels of cortisol.…”

Section: Methodsmentioning

confidence: 99%

Protocol for the COVID-19 Wellbeing and Stress Study: a longitudinal study of parent distress, biological stress and child biopsychosocial development during the pandemic and beyond

Khoury,

Atkinson,

Jack

et al. 2023

BMJ Open

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IntroductionThe COVID-19 pandemic has had a unique impact on the mental health and well-being of pregnant individuals and parents of young children. However, the impact of COVID-19-related stress during pregnancy on early child biopsychosocial development, remains unclear. The COVID-19 Wellbeing and Stress Study will: (1) investigate the impact of different forms of prenatal stress experienced during the pandemic (including objective hardship, perceived psychological distress and biological stress) on child stress biology, (2) examine the association between child stress biology and child developmental outcomes, (3) determine whether child stress biology acts as a mechanism linking prenatal stress to adverse child developmental outcomes and (4) assess whether gestational age at the onset of the COVID-19 pandemic or child sex, moderate these associations.Methods and analysesThe COVID-19 Wellbeing and Stress Study is a prospective longitudinal study, consisting of six time points, spanning from pregnancy to 3 years postpartum. The study began in June 2020, consisting of 304 pregnant people from Ontario, Canada. This multimethod study is composed of questionnaires, biological samples, behavioural observations and developmental assessmentsEthics and disseminationThis study was approved by the Hamilton Integrated Research Ethics Board (#11034) and the Mount Saint Vincent University Research Ethics Board (#2020-187, #2021-075, #2022-008). Findings will be disseminated through peer-reviewed presentations and publications, community presentations, and electronic forums (social media, newsletters and website postings).

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Associations between psychological distress and hair cortisol during pregnancy and the early postpartum: A meta-analysis

Cited by 23 publications

References 103 publications

The Association Between Pre-Pregnancy and First-Trimester Hair Cortisol and Preterm Birth: A Causal Inference Model

The Association Between Pre-Pregnancy and First-Trimester Hair Cortisol and Preterm Birth: A Causal Inference Model

A longitudinal study examining the associations between prenatal and postnatal maternal distress and toddler socioemotional developmental during the COVID‐19 pandemic

Protocol for the COVID-19 Wellbeing and Stress Study: a longitudinal study of parent distress, biological stress and child biopsychosocial development during the pandemic and beyond

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