Cortisol Level and Perinatal Outcome in Pregnant Women With Posttraumatic Stress Disorder: A Pilot Study

Abstract

Posttraumatic stress disorder (PTSD) affects 12% of women in the United States and could affect childbearing via behavioral and neuroendocrine mechanisms. This pilot study collected preliminary data about the extent to which the low cortisol profile found in patients with PTSD also occurs in the hormonal context of pregnancy, as well as the association between PTSD and less optimal processes and outcomes of pregnancy. Standardized psychiatric diagnostic telephone interviews, salivary cortisol assays, and medical records review were evaluated in a community sample of 25 women pregnant with their first child. Higher PTSD symptom counts correlated with worse overall perinatal outcomes summarized by an Optimality Index Score (n = 22; r = -.725; P < .001). The women whose symptoms met diagnostic criteria for PTSD or partial PTSD had lower peak basal salivary cortisol concentrations (n = 14; mean = .4584 versus .8123; P = .010). Further research on the effects of PTSD on pregnancy processes and outcomes is warranted. Differences in cortisol levels were consistent with the pattern seen in nonpregnant women with PTSD. This finding suggests that salivary cortisol would be a useful biological measure to include in perinatal research on PTSD and childbearing.

Posttraumatic stress disorder, smoking, and cortisol in a community sample of pregnant women

“…(2011) find no differences in salivary cortisol concentrations based on pregnancy or non-pregnancy related distress, and Voegtline et al (2013) find that self-report of mental distress is not associated with significant variation in salivary cortisol among pregnant women. Data from our studies of pregnant women, including findings from this data set published elsewhere (Seng et al, under review) and previous preliminary work (Seng, Low, Ben-Ami, & Liberzon, 2005), have found flatter diurnal curves among women with PTSD (i.e., lower morning peak and higher late afternoon and bedtime levels). Obel et.…”

Effects of posttraumatic stress disorder on pregnancy outcomes

“…Finally, in a small prospective pilot study of 25 women, 10 with PTSD, researchers found that number of PTSD symptoms was significantly negatively correlated (r=−0.725) with the Optimality Index-US, a combined measure of 52 dichotomous antenatal and postnatal events (Seng et al 2005). Although the focus of this report was specifically preterm delivery, the study supports a higher general risk of birth complications among pregnant women with PTSD.…”

Evaluating PTSD on Reproductive Outcomes: Women Deployed in Iraq and Afghanistan

“…A pilot study with 25 subjects did determine that women who experienced PTSD had lower basal salivary cortisol levels but they did not examine pregnancy outcomes [8].…”