Pregnancy anxiety and prenatal cortisol trajectories

Abstract

Pregnancy anxiety is a potent predictor of adverse birth and infant outcomes. The goal of the current study was to examine one potential mechanism whereby these effects may occur by testing associations between pregnancy anxiety and maternal salivary cortisol on 4 occasions during pregnancy in a sample of 448 women. Higher mean levels of pregnancy anxiety over the course of pregnancy predicted steeper increases in cortisol trajectories compared to lower pregnancy anxiety. Significant differences between cortisol trajectories emerged between 30 to 31 weeks of gestation. Results remained significant when adjusted for state anxiety and perceived stress. Neither changes in pregnancy anxiety over gestation, nor pregnancy anxiety specific to only a particular time in pregnancy predicted cortisol. These findings provide support for one way in which pregnancy anxiety may influence maternal physiology and contribute to a growing literature on the complex biological pathways linking pregnancy anxiety to birth and infant outcomes.

Maternal prenatal stress and infant birth weight and gestational age: A meta-analysis of prospective studies

“…Davis and Sandman (2010) recently suggested that this kind of stress is perhaps the best predictor of infant outcome. Moreover, at least three studies reveal that maternal reports of this measure correspond positively with cortisol blood levels in pregnant women, supporting the proposed biological processes thought to underlie the FPH (Kane, Dunkel-Schetter, Glynn, Hobel, & Sandman, 2014;Rini et al, 1999;Wadhwa, Sandman, Porto, Dunkel-Schetter, & Garite, 1993).…”

Associations between maternal prenatal cortisol concentrations and child outcomes: A systematic review

“…We cannot exclude the possibility that other markers of cortisol physiology may be more strongly linked to maternal psychological stress/anxiety and hence more relevant for fetal programming processes. For example, in a recent study of Kane et al (2014) the relation between the trajectory of changes in cortisol concentrations during pregnancy were examined in relation with pregnancy anxiety. These authors found that higher mean levels of pregnancy anxiety from mid to late pregnancy was related to steeper increases in cortisol secretion over pregnancy.…”

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

“…Antepartum anxiety is a risk factor for PPD: in our study sixty-two percent of AR-PPD subjects had an anxiety disorder. There is an emerging literature describing the effects of anxiety on cortisol during pregnancy (Kane et al 2014; King et al 2010; O'Connor et al 2014) and in the postpartum (Labad et al 2011; Lord et al 2011) but substantial methodological variation among studies makes it difficult to identify clear associations. The study sample size did not allow us to examine potential differences in cortisol reactivity among the clinical phenotypes.…”