Maternal hair cortisol levels as a novel predictor of neonatal abstinence syndrome severity: A pilot feasibility study

Wachman, Elisha M.; Hunter, Richard G.; Shrestha, Hira; Lapp, Hannah E.; Meyer, Jerrold S.; Alvarez, Crystal; Tronick, Edward Z.

doi:10.1002/dev.21896

Cited by 7 publications

(6 citation statements)

References 40 publications

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“…[9][10][11] Hair cortisol has been successfully collected and measured from infants as young as 6 to 9 months of age; however, to our knowledge, it has not been measured in newborns at two time points over the first few months of life. 11 In our previous study that measured maternal HCCs in women with OUD shortly after birth, 12 we found a mean HCC of 131.8 pg/mg (standard deviation [SD] ¼ 124.7), higher than previously reported levels in new mothers without OUD (15.9 AE 19.5 pg/mg). 13 However, our previous study did not obtain HCC measurements from infants.…”

mentioning

confidence: 51%

Section: Methodsmentioning

confidence: 99%

“…Treatments include use of the Eat, Sleep, Console NOWS assessment tool and use of symptom-triggered pharmacological treatment dosing for infants who require pharmacological treatment. 12,14 Study participants were recruited between October 2020 and August 2021. Eligibility criteria for the opioid group were women 18 years or older with a diagnosis of OUD during the current pregnancy on prescribed buprenorphine (or buprenorphine-naloxone) or methadone as MOUD initiated prior to or during early pregnancy and maintained throughout the pregnancy, English-speaking, singleton pregnancy, and infants born at least 35 weeks' gestational age with no major medical conditions (e.g., metabolic disorder, significant respiratory compromise, or seizures).…”

Section: Participantsmentioning

confidence: 99%

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Hair Cortisol Concentrations in Opioid-Exposed versus Nonexposed Mother–Infant Dyads

Morrison,

Schiff,

Olson

et al. 2023

Am J Perinatol

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Objective To pilot measurement of hair cortisol concentration (HCC) in pregnant women with opioid use disorder and their infants over time and study the potential utility of hair cortisol as a biomarker of chronic stress in this population. Study Design In this pilot prospective cohort study of mother–infant dyads with and without prenatal opioid exposure, we obtained mother–infant HCCs at delivery and again within 1 to 3 months' postpartum. HCCs were compared between the opioid and control groups and between the two time points. Results There were no significant differences between opioid and control group maternal or infant HCCs at either time point. However, within the opioid-exposed group, there was a significant increase in infant HCCs across the two time points. Conclusion This pilot study describes our experience with the measurement of HCCs in opioid-exposed mother–infant dyads. Key Points

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confidence: 51%

Section: Methodsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

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Hair Cortisol Concentrations in Opioid-Exposed versus Nonexposed Mother–Infant Dyads

Morrison,

Schiff,

Olson

et al. 2023

Am J Perinatol

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“…Stress subjectively reported as well as indicated by elevated cortisol is another factor identified in the general OUD population that affects treatment adherence and outcomes negatively (Jaremko, Sterling, & Van Bockstaele, 2015). Relatedly, a recent study by Wachman and colleagues (2020) found that maternal cortisol levels predicted NAS among infants born to mothers with OUD, although this association was confounded by maternal opioid exposure and smoking. Greater treatment motivation or readiness to change improves treatment adherence and outcomes in the general OUD population and could also be advantageous in pregnant women with OUD.…”

Section: Discussionmentioning

confidence: 99%

Contributions of psychology to research, treatment, and care of pregnant women with opioid use disorder.

Preis

Inman

Lobel

2020

American Psychologist

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The number of women with opioid use disorder (OUD) in the United States has risen precipitously. Pregnant women with OUD are a particularly vulnerable subset of addicted women with unique characteristics and needs. Many of them are impoverished, have strenuous life circumstances, are affected by past and current trauma, and have high rates of psychiatric comorbidities. Their addiction can compromise their and their infant's health, particularly without sufficient treatment including prenatal care, medication-assisted treatment (MAT), and social and behavioral care. Furthermore, these women's needs are often undetected and untreated: They may not seek appropriate prenatal and addiction care, or if they do, may face barriers to comprehensive, evidence-based treatment. Theories, methods, tools, and existing knowledge from the field of psychology are needed to improve research, prevention, and treatment for pregnant women with OUD. Although a number of psychologists have made critical contributions to research on pregnant women with OUD, we demonstrate by a scoping review of scientific literature and by examining American Psychological Association (APA) Annual Convention proceedings that much research on this population has been communicated in areas and journals outside psychology and among audiences other than psychologists. We identify relevant theoretical frameworks and methods to facilitate psychological investigation as well as evidence-based intervention and care for this population. Our field is well positioned to examine, identify, and alleviate the needs of pregnant women with OUD to improve their health and the health of their children. Public Significance StatementThis article suggests that research and care for pregnant women with opioid use disorder can be improved by greater involvement of the field of psychology. We present psychological theories, methods, tools, and existing knowledge that can be used to improve research about pregnant women with opioid use disorder and we discuss treatment approaches in which psychologists' expertise is valuable to provide and evaluate evidence-based, woman-centered, trauma-informed, integrated care.

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“…In addition to ongoing life stress, early life adversity may negatively affect fetal and newborn health (Buss et al, 2017). A possible biomarker of prenatal chronic stress is maternal hair cortisol, which has been associated with prenatal stress and anxiety (Orta et al, 2019) as well as alterations in infants' neurobiological functioning (Wachman et al, 2019).…”

Section: Sustained Threatmentioning

confidence: 99%

Prenatal maternal transdiagnostic, RDoC-informed predictors of newborn neurobehavior: Differences by sex

et al. 2021

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We examined whether Research Domain Criteria (RDoC)-informed measures of prenatal stress predicted newborn neurobehavior and whether these effects differed by newborn sex. Multilevel, prenatal markers of prenatal stress were obtained from 162 pregnant women. Markers of the Negative Valence System included physiological functioning (respiratory sinus arrhythmia [RSA] and electrodermal [EDA] reactivity to a speech task, hair cortisol), self-reported stress (state anxiety, pregnancy-specific anxiety, daily stress, childhood trauma, economic hardship, and family resources), and interviewer-rated stress (episodic stress, chronic stress). Markers of the Arousal/Regulatory System included physiological functioning (baseline RSA, RSA, and EDA responses to infant cries) and self-reported affect intensity, urgency, emotion regulation strategies, and dispositional mindfulness. Newborns’ arousal and attention were assessed via the Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale. Path analyses showed that high maternal episodic and daily stress, low economic hardship, few emotion regulation strategies, and high baseline RSA predicted female newborns’ low attention; maternal mindfulness predicted female newborns’ high arousal. As for male newborns, high episodic stress predicted low arousal, and high pregnancy-specific anxiety predicted high attention. Findings suggest that RDoC-informed markers of prenatal stress could aid detection of variance in newborn neurobehavioral outcomes within hours after birth. Implications for intergenerational transmission of risk for psychopathology are discussed.

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Maternal hair cortisol levels as a novel predictor of neonatal abstinence syndrome severity: A pilot feasibility study

Abstract: This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as

Cited by 7 publications

References 40 publications

Hair Cortisol Concentrations in Opioid-Exposed versus Nonexposed Mother–Infant Dyads

Hair Cortisol Concentrations in Opioid-Exposed versus Nonexposed Mother–Infant Dyads

Contributions of psychology to research, treatment, and care of pregnant women with opioid use disorder.

Prenatal maternal transdiagnostic, RDoC-informed predictors of newborn neurobehavior: Differences by sex

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