The effect of depression, anxiety and early life trauma on the cortisol awakening response during pregnancy: Preliminary results

Shea, Alison K.; Streiner, David L.; Fleming, Alison S.; Kamath, Markad V.; Broad, Kathleen; Steiner, Meir

doi:10.1016/j.psyneuen.2007.07.006

Cited by 99 publications

(92 citation statements)

References 49 publications

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“…Results are consistent with findings demonstrating reduced adrenocortical secretion in female survivors of sexual and physical abuse with and without major depressive disorder (Heim et al, 2001b), in pregnant females with a history of childhood abuse (Shea et al, 2007), in a sample of adult offspring of holocaust survivors (Yehuda et al, 2001), in PTSD patients (Rohleder et al, 2004; Wessa et al, 2006), and in adults with early loss experience (Meinslschmidt and Heim, 2005).…”

Section: Discussionsupporting

confidence: 88%

“…Participants of Mexican descent (n=59), aged 18 to 38, were recruited from the San Antonio metropolitan area, through advertisements in the community and local college campuses. During an initial visit to the laboratory, participants underwent an in-person screening interview and a battery of self-report assessments designed to identify and exclude factors known to potentially affect the HPA axis including: lifetime depression (Bhagwager et al, 2005; Shea et al, 2007), use of oral contraceptives in the past 60 days (Meulenberg and Hofman et al, 1990; Pruessner et al, 1997,1999), current pregnancy (Meulenberg and Hofman et al, 1990), menstrual cycle abnormalities in the past 60 days (Suh et al, 1988; Bao et al, 2003, 2004), strenuous aerobic exercise (more than 2 hours per day for 4 or more days per week in the past 60 days (Kanaley et al, 2001; Hansen et al, 2008; Kelly et al, 2008), reported medical conditions and previous head trauma, use of medications, severe obesity (defined as a body mass index of > 30.0 kg/m 2 ) and, alcohol or other drug use disorders (Wand and Dobs, 1991; Huizink et al, 2006; Hansen et al, 2008). In addition, participants were excluded from the study who reported abnormal sleeping patterns, including disrupted sleep for more than one night per week, in the past 60 days, as determined by a 60-day sleep diary (Lasikiewicz et al, 2008), shift work including night shifts for the past week, overtime work for more than 8 hours per week in the past 30 days (Lundberg and Hellstrom, 2002; Clow et al, 2004; for review, see Hanrahan et al, 2006).…”

Section: Methodsmentioning

confidence: 99%

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Acculturation, childhood trauma and the cortisol awakening response in Mexican–American adults

Mangold¹,

Wand²,

Javors³

et al. 2010

Hormones and Behavior

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Exposure to chronic and traumatic stress has been associated with the dysregulation of crucial stress response systems. Acculturation has been associated with unique forms of chronic psychosocial stress. The purpose of this study was to examine the effects of exposure to early traumatic stress and acculturation on dysregulation of the cortisol awakening response (CAR) in Mexican-American adults. Salivary cortisol samples were collected at awakening and 30, 45, and 60 minutes thereafter, on two consecutive weekdays from 59, healthy Mexican American adult males (26) and females (33), ages 18-38 years. Participants were assessed for level of acculturation and exposure to early trauma. Data were analyzed using a mixed effects regression model with repeated measures at four time points. Mixed effects regression results indicated a significant Early Trauma x Time interaction (p=.0029) and a significant Acculturation x Time interaction (p=.0015), after controlling for age and sex. Subsequent analyses of the interaction of Trauma x Acculturation x Time showed that more than minimal exposure to either risk factor was associated with attenuation of the awakening cortisol response (p=.0002). Higher levels of acculturation with greater Anglo-orientation were associated with attenuation of the CAR in Mexican-American adults. Both moderate and higher levels of exposure to early trauma were associated with an attenuated CAR. However, greater exposure to both risk factors was only incrementally worse than exposure to either one.

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Acculturation, childhood trauma and the cortisol awakening response in Mexican–American adults

Mangold¹,

Wand²,

Javors³

et al. 2010

Hormones and Behavior

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“…Exogenous corticosteroids have been shown to decrease estriol levels, and, thus, the hyperactivity of the HPA axis in our depressed subjects could have influenced estriol levels. However, a recent study of the effect of depression on the cortisol awakening response during pregnancy did not find a significant difference between women who were depressed and normal controls (36). In addition, both groups of subjects in our study with a history of depression (on and off antidepressants) had a similar degree and duration of depression.…”

Section: Discussioncontrasting

confidence: 52%

Saliva Estriol Levels in Women with and Without Prenatal Antidepressant Treatment

Suri¹,

Hellemann²,

Cohen³

et al. 2008

Biological Psychiatry

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Objective-Prenatal antidepressant use has been associated with shorter pregnancy duration and an increased risk for preterm birth. This study measured saliva levels of estriol, a hormone which increases exponentially in the few weeks before spontaneous labor, in pregnant women with and without antidepressant treatment.Method-Saliva estriol levels were obtained across the day at three time points during pregnancy in 77 subjects with either a history of DSM-IV major depressive disorder (MDD) who were treated with antidepressants in pregnancy (Group 1), a history of DSM-IV major depressive disorder who were not treated or had limited exposure to antidepressants during pregnancy (Group 2), and a normal control group (Group 3).Results-Mean estriol levels in the second half of pregnancy were significantly higher for Group 1 (h/o MDD, on meds) than Group 2 (h/o MDD, off meds) or Group 3 (control).Conclusions-Prenatal antidepressant use was associated with significantly higher saliva estriol levels in the second half of pregnancy. Whether estriol reflects a causal mechanism by which women on antidepressants have shorter pregnancy duration remains to be further studied.

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“…However, consistent with the results of several other studies(Harville et al 2009; Hellgren et al 2013; Meinlschmidt et al 2010; Rothenberger et al 2011; Shea et al 2007; Voegtline et al 2013), we did not find an association between cortisol concentration and anxiety rating scores induced by the psychosocial stressor, the findings suggest that the psychological and the endocrine response to acute psychosocial stress may represent two separate aspects of the stress response in late gestation when both the HPA(Buss et al 2009; Entringer et al 2010) and psychological responses to stress are attenuated(Glynn et al 2001). …”

Section: Discussionsupporting

confidence: 91%

Cortisol response to the Trier Social Stress Test in pregnant women at risk for postpartum depression

Deligiannidis

Kroll‐Desrosiers

Svenson

et al. 2016

Arch Womens Ment Health

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Purpose Antepartum depression and anxiety are risk factors for postpartum depression (PPD). Postpartum abnormalities in hypothalamic-pituitary-adrenal (HPA) reactivity are associated with PPD. It is not known if antepartum HPA abnormalities exist in women at risk for PPD (AR-PPD). Methods We measured salivary cortisol response to the Trier Social Stress Test (TSST) in 44 (24 AR-PPD, 20 healthy comparison) pregnant women. Depression and anxiety was measured using the Edinburgh Postnatal Depression Scale (EPDS) and Spielberger State-Trait Anxiety Inventory-State (STAI-S). We analyzed longitudinal changes in cortisol using generalized estimating equation methods to control for the correlation within subjects at the six TSST time points. Group differences in area under the curve (AUC) were examined. Results A majority (70.8%) of the AR-PPD had prior depression. EPDS total score was higher in ARPPD vs. comparison women (mean EPDS=9.8±4.9 vs. mean EPDS=2.4±2.0 respectively; p<0.001). Mean STAI-S total score was higher in AR-PPD vs. comparison women at all TSST time points and over time (z=2.71, df=1, p=0.007). There was no significant difference in cortisol concentration over time between groups. Conclusion We observed no detectable difference in cortisol response to psychosocial stress induced by the TSST despite clinically significant between-group differences in current/past depression and current symptomatology.

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The effect of depression, anxiety and early life trauma on the cortisol awakening response during pregnancy: Preliminary results

Cited by 99 publications

References 49 publications

Acculturation, childhood trauma and the cortisol awakening response in Mexican–American adults

Acculturation, childhood trauma and the cortisol awakening response in Mexican–American adults

Saliva Estriol Levels in Women with and Without Prenatal Antidepressant Treatment

Cortisol response to the Trier Social Stress Test in pregnant women at risk for postpartum depression

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