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Chovan S, Fiľakovská Bobáková D, Hubková B, Madarasová Gecková A, de Kroon MLA, Reijneveld SA. Mothers in stress: Hair cortisol of mothers living in marginalised Roma communities and the role of socioeconomic disadvantage. Psychoneuroendocrinology 2024; 167:107069. [PMID: 38795593 DOI: 10.1016/j.psyneuen.2024.107069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 04/26/2024] [Accepted: 05/03/2024] [Indexed: 05/28/2024]
Abstract
Roma living in marginalised communities are among the most disadvantaged groups in Slovakia. Socioeconomic disadvantage is associated with higher hair cortisol concentrations (HCC), including in parents. The aim of this study is therefore to assess differences in HCC, reflecting the levels of stress, between mothers living in MRCs and from the majority population, to assess the association of socioeconomic disadvantage with HCC, and whether disadvantage mediates the MRC/majority differences in HCC. Participants were mothers of children aged 15-18 months old living in MRCs (N=61) and from the Slovak majority population (N=90). During preventive paediatric visits, visits at community centres and home visits, hair samples and data by questionnaire were collected. HCC differed significantly between mothers living in MRCs and mothers from the majority population, with the mean HCC value being twice as high in mothers living in MRCs (22.98 (95% confidence interval, CI, 15.70-30.30) vs. 11.76 (8.34-15.20), p<0.05). HCC was significantly associated with education, household equipment and household overcrowding, but not with billing, socioeconomic stress and social support. The difference in HCC between mothers living in MRCs and mothers from the majority population was partially mediated by poor house equipment, such as no access to running water, no flushing toilet or no bathroom (the indirect effect of B=7.63 (95% CI: 2.12-13.92)). Practitioners and policymakers should be aware of high stress levels among mothers living in MRCs and aim at enhancing their living and housing conditions.
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Affiliation(s)
- Shoshana Chovan
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Trieda SNP 1, Kosice 040 11, Slovak Republic; Department of Health Psychology and Research Methodology, Medical Faculty, PJ Safarik University, Trieda SNP 1, Kosice 040 01, Slovak Republic.
| | - Daniela Fiľakovská Bobáková
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Trieda SNP 1, Kosice 040 11, Slovak Republic; Department of Health Psychology and Research Methodology, Medical Faculty, PJ Safarik University, Trieda SNP 1, Kosice 040 01, Slovak Republic; Olomouc University Social Health Institute, Palacky University in Olomouc, Univerzitni 22, Olomouc 771 11, Czech Republic
| | - Beáta Hubková
- Department of Biochemistry, Medical Faculty, PJ Safarik University, Trieda SNP 1, Kosice 040 11, Slovak Republic
| | - Andrea Madarasová Gecková
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Trieda SNP 1, Kosice 040 11, Slovak Republic; Department of Health Psychology and Research Methodology, Medical Faculty, PJ Safarik University, Trieda SNP 1, Kosice 040 01, Slovak Republic; Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University in Bratislava, Mlynske Luhy 4, Bratislava 821 05, Slovak Republic
| | - Marlou L A de Kroon
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, the Netherlands; Department of Environment and Health, Youth Health Care, University of Leuven, KU Leuven, Kapucijnenvoer 35, Leuven 3000, Belgium
| | - Sijmen A Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, the Netherlands
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Kang YS, Chien LC, Huang JP, Fan YT, Lin WY, Chakranon P, Au HK, Chen YY, Chao HJ, Kim P, Chen YH. Association between parental well-being and preschooler stress measured as hair cortisol concentration: A prospective cohort study. Stress Health 2024:e3462. [PMID: 39154192 DOI: 10.1002/smi.3462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/10/2024] [Accepted: 07/31/2024] [Indexed: 08/19/2024]
Abstract
Hair cortisol concentration (HCC) is a valuable biomarker for evaluating chronic stress in preschoolers. However, few studies have explored early life HCC and its associated factors. This prospective cohort study analysed the HCC in children aged 6-48 months and its associations with parental HCC as well as positive and negative parental mental health outcomes. We used data from the ongoing Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan (LEAPP-HIT) project, conducted in Taipei between 2020 and 2024. Hair samples were collected from both parents and children in 177 families (91 samples obtained during pregnancy and 86 during the postpartum period). The parents also completed self-reported questionnaires. Multiple linear regression was conducted to analyse the data. We observed a significant positive correlation between parents' and preschoolers' HCC. Furthermore, maternal depression (adjusted beta coefficient [aβ] = 0.09, 95% confidence interval [CI] = 0.02, 0.16) and perceived stress (aβ = 0.15, 95% CI = 0.02, 0.26) were positively associated with preschoolers' HCC. By contrast, higher maternal eudaimonia was associated with lower HCC in preschoolers (aβ = -0.11, 95% CI = -0.20, -0.01). For parents, maternal depression, anxiety, and perceived stress were independently associated with an increased HCC during the postnatal period, whereas maternal eudaimonia was negatively associated with HCC. Our results indicate that both mothers and fathers affect children's responses to stress. Assessment of cortisol stress hormone concentrations through hair samples can be a key means of detecting preschoolers' stress levels and enabling early intervention.
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Affiliation(s)
- Yun-Shiang Kang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ling-Chu Chien
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yen-Tzu Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Environmental Engineering, National Taiwan University, Taipei, Taiwan
| | - Wen-Yi Lin
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Pairote Chakranon
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Heng-Kien Au
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Yung Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Pilyoung Kim
- Department of Psychology, College of Arts, Humanities and Social Sciences, University of Denver, Denver, Colorado, USA
- Department of Psychology, Ewha Womans University, Seoul, South Korea
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
- Research Center of Health Equity, College of Public Health, Taipei Medical University, Taipei, Taiwan
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Letourneau N, McManus C, Novick J, Silverstone A. Impacts of Peer Support on Coping and Cortisol Levels for Women Affected by Domestic Violence and Coercive Control. Can J Nurs Res 2024:8445621241272723. [PMID: 39149993 DOI: 10.1177/08445621241272723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024] Open
Abstract
PURPOSE Gendered domestic violence and coercive control are prevalent public heath concerns in Canada with dire consequences for survivors. Peer support groups may address and reduce negative impacts of domestic violence and coercive control on women's stress, coping, safety, and alliances with social support network members, the focus of this study. METHODS A one-group, pre-test/post-test quasi-experimental study was undertaken to evaluate the effectiveness of Growth Circle, a 14-week peer support program offered at an agency serving women affected by domestic violence in a major western Canadian city. Through convenience sampling, women 18 years and older who experienced domestic violence were recruited and provided data on stress, coping, safety-related empowerment, and social support/alliances. Thirty-five participants provided all pre-test and post-test data, with a subsample of 14 providing repeated hair samples. Hair was employed to determine stress hormone (cortisol) levels. RESULTS A significant reduction in self-reported levels of perceived stress and stress hormone levels following completion of the Growth Circle program was revealed. Participants also reported a significant increase in safety-related empowerment, and supportive alliances with group members. CONCLUSIONS The Growth Circle peer support program was demonstrated to be effective. Further implementation and research into the Growth Circle program across Canada is recommended.
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Affiliation(s)
- Nicole Letourneau
- Professor, Faculty of Nursing and Cumming School of Medicine (Pediatrics, Psychiatry, Community Health Sciences), University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Carrie McManus
- Director of Innovation and Programs, Sagesse Domestic Violence Prevention Society, Calgary, Alberta, Canada
| | - Jason Novick
- Research Assistant, Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Andrea Silverstone
- Chief Executive Officer, Sagesse Domestic Violence Prevention Society, Calgary, Alberta, Canada
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Vesoulis ZA, Diggs S, Brackett C, Sullivan B. Racial and geographic disparities in neonatal brain care. Semin Perinatol 2024; 48:151925. [PMID: 38897830 DOI: 10.1016/j.semperi.2024.151925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
In this review, we explore race-based disparities in neonatology and their impact on brain injury and neurodevelopmental outcomes. We discuss the historical context of healthcare discrimination, focusing on the post-Civil War era and the segregation of healthcare facilities. We highlight the increasing disparity in infant mortality rates between Black and White infants, with premature birth being a major contributing factor, and emphasize the role of prenatal factors such as metabolic syndrome and toxic stress in affecting neonatal health. Furthermore, we examine the geographic and historical aspects of racial disparities, including the consequences of redlining and limited access to healthcare facilities or nutritious food options in Black communities. Finally, we delve into the higher incidence of brain injuries in Black neonates, as well as disparities in adverse neurodevelopmental outcome. This evidence underscores the need for comprehensive efforts to address systemic racism and provide equitable access to healthcare resources.
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Affiliation(s)
- Zachary A Vesoulis
- Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - Stephanie Diggs
- Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Cherise Brackett
- Department of Pediatrics, Division of Neonatology, University of Virginia, USA
| | - Brynne Sullivan
- Department of Pediatrics, Division of Neonatology, University of Virginia, USA
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Grinberg K, Yisaschar-Mekuzas Y. Assessing Mental Health Conditions in Women with Gestational Diabetes Compared to Healthy Pregnant Women. Healthcare (Basel) 2024; 12:1438. [PMID: 39057581 PMCID: PMC11276048 DOI: 10.3390/healthcare12141438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION Pregnant women with gestational diabetes mellitus (GDM) experience higher psychological stress levels than healthy pregnant women. The objectives of the current study were to examine (1) the differences in anxiety, depression, stress, and somatization levels between women diagnosed with GDM and healthy pregnant women, and (2) the differences in anxiety, depression, stress, and somatization levels among women with well-controlled blood sugar levels compared to those who are not well controlled. METHODS A quantitative cross-sectional study was conducted, involving 103 women who had been pregnant at least once, including 40 women diagnosed with GDM and 63 healthy pregnant women. An online questionnaire was distributed that included three parts: socio-demographic parameters, the DASS-21 questionnaire assessing anxiety, depression, and stress, and the Brief Symptom Inventory (BSI) questionnaire assessing somatization. RESULTS Differences in the anxiety (t = 14.470, <0.001), depression (t = 8.17, <0.001), stress (t = 16.354, <0.001), and somatization (t = 13.679, <0.001) levels between women diagnosed with GDM and healthy pregnant women were found. Women diagnosed with GDM reported higher levels of anxiety, depression, stress, and somatization compared to those without GDM. Additionally, women with better blood sugar control, as indicated by lower glycated hemoglobin (HbA1c) levels had lower anxiety (t (38) = -2.04, p < 0.05), depression (t(38) = -2.88, p < 0.01), stress (t(38) = -1.88, p < 0.05), and somatization (t(38) = -1.88, p < 0.05) levels compared to women with poorer blood sugar control. CONCLUSIONS Pregnant women diagnosed with GDM report higher levels of negative mental health conditions such as anxiety, depression, stress, and somatization compared to healthy pregnant women.
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Affiliation(s)
- Keren Grinberg
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek Hefer 402500, Israel;
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Eckermann HA, Lugones M, Abdala D, Roge H, de Weerth C. Maternal early life and prenatal stress in relation to birth outcomes in Argentinian mothers. Dev Psychobiol 2024; 66:e22502. [PMID: 38807271 DOI: 10.1002/dev.22502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/15/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024]
Abstract
Environmental influences before and during pregnancy significantly impact offspring development. This study investigates open research questions regarding the associations between maternal early life stress (ELS), prenatal psychosocial stress, prenatal hair cortisol (HC), and birth outcomes in Argentinian women. Data on ELS, prenatal life events, HC (two samples representing first and second half of pregnancy), and birth outcomes were collected from middle-class Argentinian women (N = 69) upon delivery. Linear mixed models indicated that HC increased from the first half to the second half of pregnancy with considerable variability in the starting values and slopes between individuals. Mothers who experienced more ELS, were taller, or more educated, tended to show lower increases in HC. Older age was positively related to HC increases. Our data did not suggest an interaction between ELS and prenatal life events in relation to HC. We found that the change in HC was most likely negatively associated with birth weight. Our data are most compatible with either a weak or the absence of an association between ELS or prenatal life events and absolute values of HC. Mothers with stronger increases in hair cortisol tended to have newborns with slightly lower birth weight. Hence, ELS and birthweight may either have been related to changes in cortisol exposure during pregnancy or to factors that influence accumulation or retention of cortisol in hair.
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Affiliation(s)
- Henrik Andreas Eckermann
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Micaela Lugones
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Daniel Abdala
- Department of Neonatology, Hospital Español de Mendoza, Mendoza, Argentina
| | - Horacio Roge
- Department of Neonatology, Hospital Español de Mendoza, Mendoza, Argentina
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
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7
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Filakovska Bobakova D, Chovan S, Van Laer S. Perceived Stress of Mothers, Harsh Discipline, and Early Childhood Mental Health: Insights from a Cross-Sectional Study in Marginalized Roma Communities. Int J Public Health 2024; 69:1606721. [PMID: 38464908 PMCID: PMC10920110 DOI: 10.3389/ijph.2024.1606721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
Objectives: This study aims to compare the early childhood mental health of children from marginalized Roma communities (MRCs) in Slovakia with that of the majority and explore possible mediating pathways of mothers' perceived stress and harsh discipline practices. Methods: We used data from the first wave of the longitudinal RomaREACH study collected in 2021-2022. Two populations were included in the sample: 94 mother-child dyads from MRCs and 79 from the majority population (children aged 14-18 months). Data were analysed using linear regression, and mediation was tested using PROCESS Macro in SPSS. Results: Belonging to MRCs vs. the majority, perceived stress of mothers and harsh discipline were found to be associated with early mental health problems in children. Perceived stress of mothers partially mediates the relationship between belonging to MRCs vs. majority and harsh discipline and harsh discipline partially mediates the relationship between perceived stress of mothers and the mental health of children. Conclusion: Mothers from MRCs perceive more stress, which is associated with more frequent use of harsh discipline practices having a negative impact on the mental health of young children.
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Affiliation(s)
- Daniela Filakovska Bobakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia
| | - Shoshana Chovan
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovakia
| | - Stanislava Van Laer
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovakia
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Sosnowski DW, Rojo-Wissar DM, Peng G, Parade SH, Sharkey K, Hoyo C, Murphy SK, Hernandez RG, Johnson SB. Maternal Childhood Adversity and Infant Epigenetic Aging: Moderation by Restless Sleep During Pregnancy. Dev Psychobiol 2024; 66:e22464. [PMID: 38601952 PMCID: PMC11003750 DOI: 10.1002/dev.22464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/11/2024] [Indexed: 04/12/2024]
Abstract
Maternal exposure to childhood adversity is associated with detrimental health outcomes throughout the lifespan and may have implications for offspring. Evidence links maternal adverse childhood experiences (ACEs) to detrimental birth outcomes, yet the impact on the infant's epigenome is unclear. Moreover, maternal sleep habits during pregnancy may influence this association. Here, we explore whether restless sleep during pregnancy moderates the association between exposure to maternal childhood adversity and infant epigenetic age acceleration in 332 mother-infant dyads (56% female; 39% Black; 25% Hispanic). During the 2nd trimester, mothers self-reported childhood adversity and past-week restless sleep; DNA methylation from umbilical vein endothelial cells was used to estimate five epigenetic clocks. Multivariable linear regression was used to test study hypotheses. Despite no evidence of main effects, there was evidence of an interaction between maternal ACEs and restless sleep in predicting infant epigenetic age acceleration using the EPIC Gestational Age clock. Only infants whose mothers reported exposure to both ACEs and restless sleep demonstrated accelerated epigenetic aging. Results provide preliminary evidence that maternal childhood adversity and sleep may influence the infant epigenome.
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Affiliation(s)
- David W. Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Darlynn M. Rojo-Wissar
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital
| | - Gang Peng
- Department of Medical & Molecular Genetics, Indiana University School of Medicine
| | - Stephanie H. Parade
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital
| | - Katherine Sharkey
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
- Department of Medicine, The Warren Alpert Medical School of Brown University
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment North Carolina State University
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University School of Medicine
| | | | - Sara B. Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
- Department of Pediatrics, Johns Hopkins School of Medicine
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Howland MA. Recalibration of the stress response system over adult development: Is there a perinatal recalibration period? Dev Psychopathol 2023; 35:2315-2337. [PMID: 37641984 PMCID: PMC10901284 DOI: 10.1017/s0954579423000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
During early life-sensitive periods (i.e., fetal, infancy), the developing stress response system adaptively calibrates to match environmental conditions, whether harsh or supportive. Recent evidence suggests that puberty is another window when the stress system is open to recalibration if environmental conditions have shifted significantly. Whether additional periods of recalibration exist in adulthood remains to be established. The present paper draws parallels between childhood (re)calibration periods and the perinatal period to hypothesize that this phase may be an additional window of stress recalibration in adult life. Specifically, the perinatal period (defined here to include pregnancy, lactation, and early parenthood) is also a developmental switch point characterized by heightened neural plasticity and marked changes in stress system function. After discussing these similarities, lines of empirical evidence needed to substantiate the perinatal stress recalibration hypothesis are proposed, and existing research support is reviewed. Complexities and challenges related to delineating the boundaries of perinatal stress recalibration and empirically testing this hypothesis are discussed, as well as possibilities for future multidisciplinary research. In the theme of this special issue, perinatal stress recalibration may be a mechanism of multilevel, multisystem risk, and resilience, both intra-individually and intergenerationally, with implications for optimizing interventions.
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Affiliation(s)
- Mariann A Howland
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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10
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Ahabrach H, El Mlili N, Mafla-España MA, Cauli O. Hair cortisol concentration associates with insomnia and stress symptoms in breast cancer survivors. Int J Psychophysiol 2023; 191:49-56. [PMID: 37532197 DOI: 10.1016/j.ijpsycho.2023.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/04/2023]
Abstract
Stress, depressive symptoms and sleep quality are important and modifiable determinant of health and their association with hair cortisol concentrations (HCC) in breast cancer survivors has not been evaluated. We selected a random sample of 65 participants (mean age 57.9 years old, range 44-75 years) recruited from local patients' associations of breast cancer survivors. Each provided a hair sample at enrollment and basic clinical data and psychological evaluation regarding self-perceived stress (PSS-scale), depressive (GDS scale) and insomnia symptoms (Athens scale). We observed a direct and significant (p = 0.001) association between HCC and stress-levels. Depressive symptoms associated significantly (p < 0.01) with stress levels but not with HCC. There were also a significant and direct correlation between hair cortisol concentration and totals core of insomnia symptoms (p = 0.002), and the subdimension of sleep difficulty symptoms (p = 0.002), and with daytime sleepiness symptoms (p = 0.016). Further investigations into the association between stress and insomnia and changes in HCC in breast cancer survivors are warranted in order to validate this biomarker for diagnosis of psychological alterations and to tailor the effects of interventions aimed to reduced stress and improve sleep quality in these women.
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Affiliation(s)
- Hanan Ahabrach
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), 93000 Tetouan, Morocco; Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, 93000 Tetouan, Morocco
| | - Nisrin El Mlili
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), 93000 Tetouan, Morocco; Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, 93000 Tetouan, Morocco
| | - Mayra Alejandra Mafla-España
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain
| | - Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain; Chair of Healthy, Active and Participatory Aging, Valencia City Council, University of Valencia, 46010 Valencia, Spain.
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11
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Rinne GR, Hartstein J, Guardino CM, Dunkel Schetter C. Stress before conception and during pregnancy and maternal cortisol during pregnancy: A scoping review. Psychoneuroendocrinology 2023; 153:106115. [PMID: 37119659 PMCID: PMC10936734 DOI: 10.1016/j.psyneuen.2023.106115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/10/2023] [Accepted: 04/16/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Stress before conception and during pregnancy is associated with less favorable maternal and child health. Alterations in prenatal cortisol levels may serve as a central biological pathway linking stress to adverse maternal and child health. Research examining associations between maternal stress from childhood through pregnancy and prenatal cortisol has not been comprehensively reviewed. METHOD The current scoping review of 48 papers synthesizes studies reporting on associations between stress before conception and during pregnancy with maternal cortisol in pregnancy. Eligible studies measured childhood, the proximal preconception period, pregnancy, or lifetime stress based on stress exposures or appraisals and measured cortisol in saliva or hair during pregnancy. RESULTS Higher maternal childhood stress was associated with higher cortisol awakening responses and alterations in typical pregnancy-specific changes in diurnal cortisol patterns across studies. In contrast, most studies of preconception and prenatal stress reported null associations with cortisol and those reporting significant effects were inconsistent in direction. A few studies found that the associations between stress and cortisol during pregnancy varied as a function of several moderators including social support and environmental pollution. CONCLUSIONS Although many studies have evaluated effects of maternal stress on prenatal cortisol, this scoping review is the first to synthesize existing literature on this topic. The association between stress before conception and during pregnancy and prenatal cortisol may depend on the developmental timing of stress and several moderators. Maternal childhood stress was more consistently associated with prenatal cortisol than proximal preconception or pregnancy stress. We discuss methodological and analytic factors that may contribute to mixed findings.
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Affiliation(s)
- Gabrielle R Rinne
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Jenna Hartstein
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Zak-Hunter L, Carr CP, Tate A, Brustad A, Mulhern K, Berge JM. Associations Between Adverse Childhood Experiences and Stressful Life Events and Health Outcomes in Pregnant and Breastfeeding Women from Diverse Racial and Ethnic Groups. J Womens Health (Larchmt) 2023; 32:702-714. [PMID: 37140441 PMCID: PMC10277999 DOI: 10.1089/jwh.2022.0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Background: This study sought to understand the characteristics of racially/ethnically diverse pregnant and breastfeeding women who have experienced adverse childhood experiences (ACEs) and stressful life events (SLEs) and the relationship among ACEs, SLEs, and health outcomes in this population. Materials and Methods: This was a secondary analysis of cross-sectional data from the Family Matters study. The participants in this study were families with children ages 5-9 (N = 1,307) recruited from Minneapolis-St. Paul primary care clinics representing six racial/ethnic backgrounds (White, Black, Native American, Hmong, Somali, Latino). Primary caregivers completed surveys about personal health, parenting styles, resilience, ACEs, and SLEs. Linear and logistic regression models were used to examine the associations between ACEs and SLEs with health outcomes of pregnant and breastfeeding women at the individual level. Results: A total of 123 racially/ethnically diverse women in this study reported being pregnant or currently breastfeeding. Eighty-eight (72%) reported a history of ACEs or SLEs. Those with both ACEs/SLEs reported more depression, economic strain, and a shorter duration of living in the United States. An increase in one reported ACE or SLE was positively associated with self-reported stress, number of reported medical conditions, substance use, self-efficacy, and permissive parenting (all β coefficients p < 0.05). SLEs independently demonstrated increased predictive probability of severe mental health distress (6.7 percentage points, confidence interval [95% CI: 0.02-0.11; p < 0.01]) and moderate or severe anxiety (7.5 percentage points [95% CI: 0.04-0.11; p < 0.001]). Conclusion: Exposure to ACEs and SLEs appear to have significant impacts on physical health, mental health, and substance use in pregnant racially/ethnically diverse women.
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Affiliation(s)
- Lisa Zak-Hunter
- Department of Family Medicine and Community Health, The University of Minnesota School of Medicine, St. Paul, Minnesota, USA
| | - Christopher P. Carr
- Department of Epidemiology and Biostatistics, College of Public Health, The University of Georgia, Athens, Georgia, USA
| | - Allan Tate
- Department of Epidemiology and Biostatistics, College of Public Health, The University of Georgia, Athens, Georgia, USA
| | - Abby Brustad
- Department of Family Medicine and Community Health, The University of Minnesota School of Medicine, St. Paul, Minnesota, USA
| | - Kaitlyn Mulhern
- Department of Family Medicine and Community Health, The University of Minnesota School of Medicine, St. Paul, Minnesota, USA
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, The University of Minnesota School of Medicine, St. Paul, Minnesota, USA
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13
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Kelsall NC, Sanchez SE, Rondon MB, Valeri L, Juvinao-Quintero D, Kirschbaum C, Koenen KC, Gelaye B. Association between trauma exposure and glucocorticosteroid concentration in hair during pregnancy. Psychoneuroendocrinology 2023; 151:106072. [PMID: 36893558 PMCID: PMC10095305 DOI: 10.1016/j.psyneuen.2023.106072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Traumatic events, including child abuse and intimate partner violence, are highly prevalent among women of child-bearing age. These traumatic experiences may impact maternal and offspring physical and mental health. A proposed mechanism for these effects is maternal hypothalamic-pituitary-adrenal (HPA) axis dysregulation which can be measured using hair corticosteroid levels. AIMS This study aims to examine the association of child abuse and intimate partner violence exposure with HPA axis functioning, as measured by hair corticosteroid levels in a cohort of pregnant women. METHODS We included data from 1822 pregnant women (mean gestational age 17 weeks) attending a prenatal clinic in Lima, Peru. We extracted cortisol and cortisone concentrations from hair samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Each participant provided 6-cm hair samples: 3 cm hair segment closest to the scalp reflecting HCC in early pregnancy (first three months), and 3-6 cm from the scalp reflecting HCC in pre-pregnancy (three months prior to conception). Multivariable linear regression procedures were used to assess the association between maternal trauma exposure and hair corticosteroid levels. RESULTS Overall, women who experienced child abuse on average had higher levels of cortisol (p < 0.01) and cortisone (p < 0.0001) after adjustment for age, race, adult access to basic foods and hair treatments. For the hair segment reflecting early pregnancy, presence of child abuse was associated with a 0.120 log unit increase in cortisol and a 0.260 log unit increase in cortisone (p < 0.001). For the hair segment reflecting pre-pregnancy, a history of child abuse was associated with a 0.100 log unit increase in cortisol and a 0.180 log unit increase in cortisone (p < 0.01). Results also suggested an impact of intimate partner violence on HPA regulation; however, associations were not statistically significant after controlling for child abuse. CONCLUSIONS These results underscore the long-lasting impacts of exposure to adversity and trauma during early life. Our study findings will have implications for research investigating HPA axis function and long-term effects of violence on corticosteroid regulation.
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Affiliation(s)
- Nora Clancy Kelsall
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Sixto E Sanchez
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Instituto de Investigación, Lima, Peru; Asociaciòn Civil Proyectos en Salud, Lima, Peru
| | | | - Linda Valeri
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | | | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; The Chester M. Pierce, M.D. Division of Global Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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14
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Penner F, Khoury JE, Bosquet Enlow M, Lyons-Ruth K. Threat versus deprivation in mother's childhood: Differential relations to hair cortisol and psychopathology in pregnancy. CHILD ABUSE & NEGLECT 2023; 139:106107. [PMID: 36870268 PMCID: PMC10101698 DOI: 10.1016/j.chiabu.2023.106107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The negative effects of childhood maltreatment can be intergenerational, and the prenatal period may play an important role in this intergenerational transmission. Maternal hypothalamic-pituitary-adrenal (HPA) axis dysfunction and maternal psychopathology represent two mechanisms through which the effects of childhood maltreatment are hypothesized to be transmitted across generations. OBJECTIVE This study first sought to extend prior research on pathways of intergenerational transmission by examining whether mothers' childhood experiences of abuse versus neglect differentially relate to maternal HPA activity and to maternal psychopathology during the prenatal period. Second, exploratory analyses examined the links between maternal variables and their State Protective Service involvement as a parent, as an indicator of maladaptive caregiving. METHODS During the third trimester of pregnancy, 51 women reported on experiences of childhood maltreatment, on State Protective Service involvement as an adult parent, and on current depressive and post-traumatic stress symptoms, and provided a hair sample for cortisol assay. RESULTS Regression analyses indicated that greater severity of abuse, but not neglect, in childhood was associated with higher maternal depressive symptoms (β = 0.488, p = .020). In contrast, greater severity of neglect, but not abuse, in mothers' childhood was associated with lower maternal hair cortisol concentration (β = -0.437, p = .031). Lower maternal hair cortisol concentration, but not maternal psychopathology or severity of childhood abuse or neglect, in turn, was associated with State Protective Service involvement (β = -0.785, p < .001). CONCLUSIONS Findings extend prior work by suggesting that childhood abuse and neglect may have different sequelae for mothers during pregnancy and that these sequelae may have different relations to parenting.
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Affiliation(s)
- Francesca Penner
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.
| | - Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Karlen Lyons-Ruth
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, Cambridge, MA, USA
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15
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Fedurek P, Lehmann J, Lacroix L, Aktipis A, Cronk L, Makambi EJ, Mabulla I, Berbesque JC. Status does not predict stress among Hadza hunter-gatherer men. Sci Rep 2023; 13:1327. [PMID: 36693868 PMCID: PMC9873806 DOI: 10.1038/s41598-023-28119-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
In recent years there has been much research regarding the extent to which social status is related to long-term indices of health. The majority of studies looking at the interplay between social status and health have been conducted in industrialized societies. However, it has been argued that most of human evolution took place in small, mobile and egalitarian hunter-gatherer groups where individuals exhibited very little variation in terms of material wealth or possessions. In this study, we looked at the extent to which two domains of social status, hunting reputation (being perceived as a good hunter) and popularity (being perceived as a friend), are related to physiological stress levels among Hadza men, hunter-gatherers living in Northern Tanzania. The results of our study show that neither hunting reputation nor popularity is associated with stress levels. Overall, our data suggest that, in at least some traditional small-scale societies exhibiting an egalitarian social model, such as the Hadza, the variation in social status measures based on both popularity and hunting reputation does not translate into one of the commonly used indices of wellbeing.
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Affiliation(s)
- Piotr Fedurek
- School of Human and Life Sciences, University of Roehampton, London, UK.
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland.
| | - Julia Lehmann
- School of Human and Life Sciences, University of Roehampton, London, UK
| | - Laurent Lacroix
- Health Sciences Research Centre, Roehampton University, London, UK
| | - Athena Aktipis
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Lee Cronk
- Department of Anthropology, Rutgers University, New Brunswick, NJ, USA
| | - E Jerryson Makambi
- Mount Meru Tour Guide and International Language School, Arusha, Tanzania
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16
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Mlili NE, Ahabrach H, Cauli O. Hair Cortisol Concentration as a Biomarker of Symptoms of Depression in the Perinatal Period. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:71-83. [PMID: 35297354 DOI: 10.2174/1871527321666220316122605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
Pregnancy is a sensitive period when women experience major hormonal and psychological changes. A high prevalence of the symptoms of depression and manifested major depression rates have been reported during this period, leading to negative outcomes both for mothers and the offspring. Despite its prevalence, the aetiology of depression is not yet fully understood. Nonetheless, alterations in cortisol levels have been proposed as a reliable biomarker to identify pregnant women at risk of perinatal depression. Hair cortisol has recently been extensively used in bio-psychological studies as a suitable non-invasive biomarker for several neuropsychiatric disorders. Various studies have published evidence regarding the relationship between cortisol fluctuations during the perinatal period, measured both in hair and in other substrates, and the onset of perinatal symptoms of depression. This current review provides an overview of cortisol level changes measured in women's hair during pregnancy or the postpartum period and its association with perinatal symptoms of depression. Further studies, including repetitive measurement of both hair cortisol and depression throughout the prenatal period, must be performed to clarify the relationship between cortisol levels and perinatal symptoms of depression.
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Affiliation(s)
- Nisrin El Mlili
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Hanan Ahabrach
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia 46010, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, Valencia 46010, Spain
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17
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Khoury JE, Giles L, Kaur H, Johnson D, Gonzalez A, Atkinson L. Associations between psychological distress and hair cortisol during pregnancy and the early postpartum: A meta-analysis. Psychoneuroendocrinology 2023; 147:105969. [PMID: 36335755 DOI: 10.1016/j.psyneuen.2022.105969] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Pregnancy and the early postpartum signify a period of high stress. Perinatal stress can include psychological distress (PD), such as anxiety, depression, and stress, as well as neuroendocrine stress, indexed by activation of the hypothalamic-pituitary-adrenal (HPA) axis and the production of the hormone cortisol. Elevated PD and cortisol levels during the perinatal period can have long-term implications for the mother and child. Methodological advances have enabled the sampling of cortisol from hair, to provide a retrospective marker of HPA axis activity over several months. Despite knowing that maternal PD and HPA activity during the perinatal period independently impact health and development, research to date is unclear as to the association between maternal PD and hair cortisol. The present meta-analysis included 29 studies to assess the strength of the relation between maternal PD and hair cortisol levels during pregnancy and the early postpartum period. Several sample and methodological factors were assessed as moderators of this effect. Analyses were conducted using multilevel meta-analysis. Results of the multilevel meta-analysis indicated that the overall effect size between PD and HCC was small but not significant z = 0.039, 95% CI [- 0.001, 0.079]. Moderator analyses indicated that the strength of the association between PD and hair cortisol was moderated by pregnancy status (i.e., effects were stronger in pregnant compared to postpartum samples), timing of HCC and PD measurements (i.e., effects were larger when PD was measured before HCC) and geographic location (i.e., effects were larger in North American studies). The findings advance our understanding of the link between PD and HPA activity during the perinatal period, a time of critical impact to child development.
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS Canada.
| | - Lauren Giles
- Department of Psychology, Mount Saint Vincent University, Halifax, NS Canada
| | - Hargun Kaur
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Dylan Johnson
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON Canada
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18
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Gonzalez D, Maidana P, Ibar C, Jamardo J, Jacobsen D, Fritzler A, Fortuna F, Fernandez G, Lamas-Majek E, Mallea-Gil S, Ballarino C, Onetto C, Lopez M, Mesch V, Fabre B. Hair cortisol in polycystic ovary syndrome. Sci Rep 2022; 12:10309. [PMID: 35725989 PMCID: PMC9209522 DOI: 10.1038/s41598-022-14061-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
The aim of the study was to evaluate adrenal axis hyperactivation measuring hair cortisol levels, and its influence on the relationship among metabolic parameters, inflammation markers and androgens in adult women with PCOS. 44 women (18–34 years) with PCOS diagnosis and a control group of 49 healthy women (19–35 years) were included. In both gropus body mass index (BMI) was calculated and waist circumference (WC) was measured. Hair cortisol, total serum testosterone (TT), serum cortisol, 25 OH vitamin D (25OHD), insulin, high sensitivity C-reactive protein (hsCRP), triglycerides (TG), HDL cholesterol (HDL), glucose and leptin were measured. Bioavailable testosterone (bioT) was calculated. Hair cortisol concentration was higher and significantly different in PCOS patients compared to the control group (130 vs 63 pg/mg of hair, p < 0.001). Subsequently, patients with PCOS were divided into two groups according to hair cortisol levels: group 1 with normal hair cortisol concentration and group 2 with levels above the upper limit of the reference values (128 pg/mg of hair). In group 2, TT significantly correlated with 25OHD, hsCRP, TG/HDL index, BMI, WC, insulin and HOMA (p < 0.05); bioT correlated with hsCRP and leptin (p < 0.05). Finally, 25OHD was inversely correlated with leptin and with TG/HDL index (p < 0.05). High hair cortisol concentration in patients with PCOS confirmed hyperactivation of the HPA axis. The associations observed were only found in patients with PCOS with high hair cortisol levels (> 128 pg/mg of hair), showing a possible effect of HPA axis in these associations.
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Affiliation(s)
- D Gonzalez
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina
| | - P Maidana
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina
| | - C Ibar
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina
| | - J Jamardo
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina
| | - D Jacobsen
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina
| | - A Fritzler
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina
| | - F Fortuna
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina
| | - G Fernandez
- División Ginecología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, 2351 (1120), Córdoba, Buenos Aires, Argentina
| | - E Lamas-Majek
- División Ginecología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, 2351 (1120), Córdoba, Buenos Aires, Argentina
| | - S Mallea-Gil
- Servicio de Endocrinología, Hospital Militar Central, Luis María Campos, 726 (1426), Buenos Aires, Argentina
| | - C Ballarino
- Servicio de Endocrinología, Hospital Militar Central, Luis María Campos, 726 (1426), Buenos Aires, Argentina
| | - C Onetto
- División Ginecología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, 2351 (1120), Córdoba, Buenos Aires, Argentina
| | - M Lopez
- División Ginecología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, 2351 (1120), Córdoba, Buenos Aires, Argentina
| | - Viviana Mesch
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina.
| | - B Fabre
- Departamento de Bioquímica Clínica-Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, 956 (1113), Junín, Buenos Aires, Argentina
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19
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Buehler C, Girod SA, Leerkes EM, Bailes L, Shriver LH, Wideman L. Women's Social Well-Being During Pregnancy: Adverse Childhood Experiences and Recent Life Events. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:582-592. [PMID: 35814611 PMCID: PMC9258794 DOI: 10.1089/whr.2022.0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse experiences during childhood and recent stressful life events are each associated with women's reduced well-being and poorer health during pregnancy. Few studies, however, have focused upon pregnant women's social well-being, and inclusion of both independent variables in the same analysis is rare. This study focuses upon adverse experiences during childhood as well as recent life events in relationship to four aspects of social well-being: social support, couple aggression for partnered women, neighborhood safety, and food insecurity. MATERIALS AND METHODS A diverse community sample of 176 pregnant women completed questionnaires during their third trimester. A cross-sectional design was used that included retrospective reports of childhood experiences, as well as reports of recent life events and current well-being. RESULTS Adverse experiences during childhood were uniquely associated with couple aggression (β = 0.206, p = 0.026) and lower neighborhood safety (β = -0.185, p = 0.021). Recent stressful life events were uniquely associated with lower social support (β = -0.247, p = 0.001) and greater food insecurity (β = 0.494, p = 0.000). For social support and food insecurity, there was a significant indirect pathway from adverse childhood experiences through recent stressful life events. Adverse child experiences and recent stressful life events did not interact. CONCLUSIONS A life-course perspective that considers women's experiences across their life span is critical for use by both researchers and health practitioners. Adverse childhood experiences and recent stressful life events are important for understanding social features of pregnant women's daily lives.
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Affiliation(s)
- Cheryl Buehler
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Savannah A. Girod
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Esther M. Leerkes
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
- School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Lauren Bailes
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Lenka H. Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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20
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Ikram N, Frost A, LeMasters K, Hagaman A, Baranov V, Gallis J, Sikander S, Scherer E, Maselko J. Adverse childhood experiences and implications of perceived stress, anxiety and cortisol among women in Pakistan: a cross-sectional study. BMJ Open 2022; 12:e052280. [PMID: 35428618 PMCID: PMC9014037 DOI: 10.1136/bmjopen-2021-052280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 03/25/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) are linked to poor maternal mental health. The goal of this study is to examine the associations between ACEs and multiple manifestations of stress (including perceived stress, anxiety and cortisol) among mothers in rural Pakistan. DESIGN This study used a cross-sectional design. Mothers were originally recruited during their third trimester of pregnancy and followed until 36 months post partum. Cortisol was collected at 12 months post partum, and self-report data were collected at 36 months post partum. SETTING All participants reside in rural villages in Rawalpindi, Pakistan. The measures were administered at home visits by field interviewers. PARTICIPANTS Data were collected from 889 mothers. All mothers in the sample provided data on ACEs and perceived stress, 623 provided data on anxiety and 90 provided hair cortisol. PRIMARY AND SECONDARY OUTCOMES MEASURES ACEs were captured retrospectively using an adapted version of the ACE International Questionnaire, and represented as a continuous variable and subdomains (neglect, home violence, family psychological distress, community violence). Primary outcomes included perceived stress measured with the Cohen Perceived Stress Scale (PSS) and anxiety measured with the Generalised Anxiety Disorder-7 scale (GAD-7). Hair-derived cortisol was included as a secondary outcome. Generalised linear models with cluster-robust SEs were used to estimate associations between ACEs and the outcome variables. RESULTS All models featured positive associations between ACE items and PSS. The continuous total ACE score (B=0.4; 95% CI 0.0 to 0.8) was associated with higher anxiety symptoms on the GAD-7. Home violence (B=6.7; 95% CI 2.7 to 10.8) and community violence (B=7.5; 95% CI 1.4 to 13.6) were associated with increased hair cortisol production. CONCLUSIONS All four ACE domains were associated with elevated levels of perceived stress, anxiety and cortisol, with varying precision and strength of estimates, indicating that the type of ACE has a differential impact. This study informed our understanding of the differential impact of specific ACEs on perceived stress, anxiety and hypothalamic pituitary adrenal-axis functioning, providing implications for future clinical intervention and research development.
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Affiliation(s)
- Naira Ikram
- Department of Program II, Duke University, Durham, North Carolina, USA
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Allison Frost
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Katherine LeMasters
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ashley Hagaman
- Department of Social and Behavioral Sciences, Yale University, New Haven, Connecticut, USA
| | - Victoria Baranov
- Department of Economics, University of Melbourne, Melbourne, Victoria, Australia
| | - John Gallis
- Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Siham Sikander
- Department of Public Health, Human Development Research Foundation, Islamabad, Pakistan
| | - Elissa Scherer
- RTI International, Research Triangle Park, North Carolina, USA
| | - Joanna Maselko
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
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21
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Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes. Obstet Gynecol 2021; 138:770-776. [PMID: 34619717 DOI: 10.1097/aog.0000000000004570] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/12/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the association between adverse childhood experiences and adverse pregnancy outcomes. METHODS This cohort study included individuals who enrolled in a perinatal collaborative mental health care program (COMPASS [the Collaborative Care Model for Perinatal Depression Support Services]) between 2017 and 2021. Participants completed psychosocial self-assessments, including an adverse childhood experiences screen. The primary exposure was adverse childhood experiences measured by the ACE (adverse childhood experience) score, which was evaluated as a dichotomized variable, with a high ACE score defined as greater than three. Secondary analyses used the ACE score as a continuous variable. Adverse pregnancy outcomes including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, and small-for-gestational-age (SGA) births were abstracted from the electronic health record. Bivariable and multivariable analyses were performed, including mediation analyses. RESULTS Of the 1,274 women with a completed adverse childhood experiences screen, 904 (71%) reported one or more adverse childhood experiences, and 290 (23%) reported a high ACE score (more than three adverse childhood experiences). Adverse childhood experience scores were not associated with gestational diabetes or SGA births. After controlling for potential confounders, individuals with high ACE score had 1.55-fold (95% CI 1.06-2.26) increased odds of having hypertensive disorders of pregnancy and 2.03-fold (95% CI 1.38-2.99) increased odds of preterm birth. Each point increase in ACE score was not associated with a statistically increased odds of hypertensive disorders of pregnancy (adjusted odds ratio [aOR] 1.07, 95% CI 0.99-1.15); however, each additional point on the adverse childhood experiences screen was associated with increased odds of preterm birth (aOR 1.13, 95% CI 1.05-1.22). Mediation analyses demonstrated tobacco use, chronic medical problems, and obesity each partially mediated the observed association between high ACE scores and hypertensive disorders of pregnancy. Having chronic medical comorbidities partially mediated the observed association between high ACE scores and preterm birth. CONCLUSION One in four individuals referred to a perinatal mental health program who were pregnant or postpartum had a high ACE score. Having a high ACE score was associated with an increased risk of hypertensive disorders of pregnancy and preterm birth. These results underscore how remote events may reverberate through the life course.
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Epstein CM, Houfek JF, Rice MJ, Weiss SJ. Integrative Review of Early Life Adversity and Cortisol Regulation in Pregnancy. J Obstet Gynecol Neonatal Nurs 2021; 50:242-255. [PMID: 33524324 DOI: 10.1016/j.jogn.2020.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To synthesize published findings on the relationship between early life adversity and hypothalamic-pituitary-adrenal axis cortisol parameters in pregnant women. DATA SOURCES We searched PubMed, CINAHL, and PsycINFO databases using variants and combinations of the keywords early life adversity, pregnancy, hypothalamic-pituitary-adrenal axis, and cortisol. STUDY SELECTION We selected articles that included pregnant participants, included measures of cortisol and early life adversity, were published in English in a peer-reviewed journal, and were of sufficient methodologic quality. Date of publication was unrestricted through May 2020. DATA EXTRACTION Twenty-five articles met the inclusion criteria and were evaluated for quality and risk of bias. Sources of cortisol included saliva, hair, plasma, and amniotic fluid. DATA SYNTHESIS We categorized findings according to four physiologically distinct cortisol output parameters: diurnal (daily pattern), phasic (in response to an acute stressor), tonic (baseline level), and pregnancy-related change. Preliminary evidence suggests that early adversity may be associated with elevated cortisol awakening response (diurnal) and blunted response to acute stressors (phasic), irrespective of other psychosocial symptoms or current stress. For women with high levels of current stress or psychological symptoms, early adversity was associated with higher baseline (tonic) cortisol levels. CONCLUSION Early life adversity in women is linked with alterations in cortisol regulation that are apparent during pregnancy. Researchers should examine how variations in each cortisol parameter differentially predict pregnancy health risk behaviors, maternal mental health, and neonatal health outcomes.
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Abstract
At least one in seven pregnant or recently postpartum women will experience a mental illness such as an anxiety disorder, depressive disorder, or substance use disorder. These mental illnesses have detrimental effects on the health of the mother, child, and family, but little is known about the hypothalamic and other neural correlates of maternal mental health concerns. The transition to parenthood alone is a time of remarkable neural plasticity, so it is perhaps not surprising that current research is showing that maternal mental illness has unique neural profiles. Furthermore, the neural systems affected by peripartum mental illness overlap and interact with the systems involved in maternal caregiving behaviors, and mother-infant interactions are, therefore, highly susceptible to disruption. This review discusses what we know about the unique neural changes occurring during peripartum mental illness and the role of the hypothalamus in these illnesses. With an improved understanding of the neural correlates of maternal mental health and disease, we will be better equipped to predict risk, develop effective treatments, and ultimately prevent suffering for millions of parents during this critical time in life.
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Affiliation(s)
- Jodi L Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR S 1085, Rennes, France.
| | - James E Swain
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Joseph S Lonstein
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI, United States
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Marceau K, Wang W, Robertson O, Shirtcliff EA. A systematic review of hair cortisol during pregnancy: Reference ranges and methodological considerations. Psychoneuroendocrinology 2020; 122:104904. [PMID: 33080521 PMCID: PMC8634732 DOI: 10.1016/j.psyneuen.2020.104904] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/24/2020] [Accepted: 10/02/2020] [Indexed: 12/17/2022]
Abstract
The present study systematically reviewed 56 articles that assessed hair cortisol concentrations during pregnancy collected from PubMed, Scopus, and Web of Science on 8/9/19 and updated on 6/29/20. Our goals were to establish reference ranges by trimester based on published studies. The majority of any given sample (e.g., 70 %, the range of -1SD to +1SD) is expected to fall between 0 and 34.15 pg/mg in trimester 1 and 2, and between 8.59 and 44 pg/mg in trimester 3, with very wide ranges (e.g., values of >250 pg/mg) and substantially higher values (e.g., averages of 200's-300's reaching as high as 768 pg/mg) coming out of one specific lab. Delineating a reference range for hair cortisol concentrations across pregnancy is challenging because of known factors like differences in values returned by different laboratories and assay types. We observed inconsistency in descriptions of the data and data preparation steps post-assay. Key findings include that only half of the studies examining all three trimesters showed a constant increase in mean levels (most retrospectively assessed via segmenting), with considerable variability in patterns of change. None of the studies reported individual patterns of change. Examining within-person changes are an important next step for the field. We conclude that researchers should more clearly report decisions around outliers, units, and specifics of data transformations in the future in order to improve our ability to compare findings across studies, to understand differences in HCC values reported, and potentially to understand differences in reported associations of HCC with other phenotypes in the literature.
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25
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Budnik-Przybylska D, Laskowski R, Pawlicka P, Anikiej-Wiczenbach P, Łada-Maśko A, Szumilewicz A, Makurat F, Przybylski J, Soya H, Kaźmierczak M. Do Physical Activity and Personality Matter for Hair Cortisol Concentration and Self-Reported Stress in Pregnancy? A Pilot Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218050. [PMID: 33139602 PMCID: PMC7663188 DOI: 10.3390/ijerph17218050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 01/01/2023]
Abstract
Background: Physical activity reduces psychosocial stress in pregnant women. Stress levels might be self-reported (psychosocial) or measured with biomarkers, one of which is hair cortisol concentration (HCC). Additionally, personality has been associated with stress and physical activity. Methods: The first aim of our study was to explore the differences in self-reported stress assessed by the Perceived Stress Scale (PSS) and in HCC with regard to physical activity level in pregnant (N = 29) and non-pregnant (N = 21) women. The second aim was to analyze the correlations among perceived stress, HCC, frequency of exercise and personality in the two groups separately. Results: There was a significant difference in frequency of exercise and self-reported stress between the two groups, with a lower level in pregnant women, but no differences in HCC and in personality were found. In the group of pregnant women, there was a significant negative correlation between HCC and frequency of exercise sessions, with the latter correlating positively with openness to experience. In the group of non-pregnant women, perceived stress negatively correlated with extraversion, agreeableness and emotional stability. HCC correlated negatively with conscientiousness. Conclusions: Our findings indicate the importance of physical activity programs dedicated to pregnant women for their life quality.
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Affiliation(s)
- Dagmara Budnik-Przybylska
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Radosław Laskowski
- Department of Physiology and Biochemistry, Faculty of Physical Culture, Gdansk University of Physical Education and Sport; 80-336 Gdańsk, Poland;
| | - Paulina Pawlicka
- Department of Cross-Cultural Psychology and Psychology of Gender, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Paulina Anikiej-Wiczenbach
- Psychological Counseling for Rare Genetic Diseases Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Ariadna Łada-Maśko
- Department of Developmental Psychology and Psychopathology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Anna Szumilewicz
- Department of Fitness, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-309 Gdańsk, Poland;
| | - Franciszek Makurat
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Jacek Przybylski
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Hideaki Soya
- Sports Neuroscience Division, Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, 305-8574 Tsukuba, Japan;
| | - Maria Kaźmierczak
- Department of Family Studies and Quality of Life, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland
- Correspondence:
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Comorbid Anxiety and Depression among Pregnant Pakistani Women: Higher Rates, Different Vulnerability Characteristics, and the Role of Perceived Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197295. [PMID: 33036215 PMCID: PMC7579342 DOI: 10.3390/ijerph17197295] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/27/2022]
Abstract
Anxiety and depression commonly co-occur during pregnancy and may increase risk of poor birth outcomes including preterm birth and low birth weight. Our understanding of rates, patterns, and predictors of comorbid anxiety and depression is hindered given the dearth of literature, particularly in low- and middle-income (LMI) countries. The aim of this study is (1) to explore the prevalence and patterns of comorbid antenatal anxiety and depressive symptoms in the mild-to-severe and moderate-to-severe categories among women in a LMI country like Pakistan and (2) to understand the risk factors for comorbid anxiety and depressive symptoms. Using a prospective cohort design, a diverse sample of 300 pregnant women from four centers of Aga Khan Hospital for Women and Children in Pakistan were enrolled in the study. Comorbid anxiety and depression during pregnancy were high and numerous factors predicted increased likelihood of comorbidity, including: (1) High level of perceived stress at any time point, (2) having 3 or more previous children, and (3) having one or more adverse childhood experiences. These risks were increased if the husband was employed in the private sector. Early identification and treatment of mental health comorbidities may contribute to decreased adverse birth outcomes in LMI countries.
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Khoury JE, Bosquet Enlow M, Patwa MC, Lyons-Ruth K. Hair cortisol in pregnancy interacts with maternal depressive symptoms to predict maternal disrupted interaction with her infant at 4 months. Dev Psychobiol 2020; 62:768-782. [PMID: 32037544 PMCID: PMC7415595 DOI: 10.1002/dev.21950] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 11/01/2019] [Accepted: 01/02/2020] [Indexed: 12/12/2022]
Abstract
Disrupted maternal interaction in early infancy is associated with maladaptive child outcomes. Thus, identifying early risk factors for disrupted interaction is an important challenge. Research suggests that maternal depressive symptoms and maternal cortisol dysregulation are associated with disrupted maternal interaction, but both factors have rarely been considered together as independent or interactive predictors of disrupted interaction. In a sample of 51 women, hair cortisol concentrations (HCC) and depressive symptoms were assessed during pregnancy, and depressive symptoms were assessed again at 4-month postpartum. Maternal disrupted interaction was assessed during the Still-Face Paradigm at 4 months. Results indicated that HCC and depressive symptoms interacted to predict both maternal withdrawing and inappropriate/intrusive interaction. Withdrawing interaction was associated with high levels of HCC in pregnancy in the context of high depressive symptoms at 4 months; inappropriate/intrusive interaction was associated with high levels of HCC in the context of low depressive symptoms. Thus, high HCC potentiated both forms of disrupted interaction. Results raised questions about the meaning of very low reported depressive symptoms, and underscored the importance of chronic stress physiology and maternal depressed mood as risk factors for distinct forms of maternal disrupted interaction, both of which are deleterious for infant development.
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28
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Meyer JS, Novak MA. Assessment of prenatal stress-related cortisol exposure: focus on cortisol accumulation in hair and nails. Dev Psychobiol 2020; 63:409-436. [PMID: 32783213 DOI: 10.1002/dev.22021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/02/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022]
Abstract
Prenatal stress adversely affects offspring development. Although cortisol is hypothesized to be a key mediator of stress-induced developmental deficits, determining the amount of fetal cortisol exposure produced by maternal stress has proved challenging. Current approaches, such as measuring cortisol concentrations in maternal plasma, saliva, or urine, amniotic fluid, fetal plasma, or cord blood, all have significant limitations for assessing cumulative fetal cortisol exposure over time. A recently emerging approach is to measure cortisol concentrations in maternal hair and/or newborn hair or nail samples. Maternal hair cortisol potentially shows long-term production across each trimester of pregnancy, whereas neonatal hair or nail cortisol is thought to reflect mainly third trimester hormone accumulation. This review first describes fetal adrenocortical development, placental cortisol metabolism, and the various sources of fetal cortisol exposure across pregnancy. We then summarize the results obtained from "classical" methods of assessing prenatal cortisol exposure prior to the advent of hair and nail cortisol measurement. Lastly, we discuss the initial development and validation of the hair cortisol methodology, its subsequent application to studies of chronic stress, and recent findings regarding maternal and neonatal hair or nail cortisol concentrations in relation to prenatal stress and other variables of interest.
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Affiliation(s)
- Jerrold S Meyer
- Department of Psychological and Brain Sciences, Neuroscience and Behavior Program, University of Massachusetts, Amherst, MA, USA
| | - Melinda A Novak
- Department of Psychological and Brain Sciences, Neuroscience and Behavior Program, University of Massachusetts, Amherst, MA, USA
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29
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Brianda ME, Roskam I, Mikolajczak M. Hair cortisol concentration as a biomarker of parental burnout. Psychoneuroendocrinology 2020; 117:104681. [PMID: 32417622 DOI: 10.1016/j.psyneuen.2020.104681] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/11/2020] [Accepted: 04/06/2020] [Indexed: 12/15/2022]
Abstract
Parental Burnout (PB) is a chronic stress-related disorder experienced in the parental role. Recent studies have shown that PB is a serious condition with severe consequences for parents (e.g., suicidal ideations) and children (e.g., parental neglect and violence). However, PB's biological correlates have not yet been examined. Numerous studies suggest that hair cortisol concentration (HCC) is a valid biomarker of a variety of chronic stress conditions. HCC has been shown to be related to job burnout, but no studies have looked at the association between HCC and parental burnout. Given that the two forms of burnout are only weakly related, it is important to fill this gap. In this study, we compared HCC of parents suffering from PB (N = 119) to that of control parents (N = 59). We also examined the correlation between PB scores and HCC levels, controlling for job burnout symptoms. The results showed that HCC was 213 % higher in parents suffering from PB (mean level: 99.90 pg/mg) compared to controls (mean level: 46.83 pg/mg). Moreover, HCC was significantly related to PB (r = 0.27). These findings suggested that HCC can be considered as a biomarker of PB (though with caution, as 36.1 % of the parents in PB had HCC values equal to or below the mean of the control parents) and reinforce the view that HCC is a biomarker of chronic stress conditions. The HCC levels observed in parents suffering from PB point to the importance of this condition as well as its potential harmful consequences for their health.
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Affiliation(s)
- Maria Elena Brianda
- Psychological Sciences Research Institute, Department of Psychology, UCLouvain, 10 Place Cardinal Mercier, 1348 Louvain-la-Neuve, Belgium.
| | - Isabelle Roskam
- Psychological Sciences Research Institute, Department of Psychology, UCLouvain, 10 Place Cardinal Mercier, 1348 Louvain-la-Neuve, Belgium.
| | - Moïra Mikolajczak
- Psychological Sciences Research Institute, Department of Psychology, UCLouvain, 10 Place Cardinal Mercier, 1348 Louvain-la-Neuve, Belgium.
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Stephens JE, Kessler CL, Buss C, Miller GE, Grobman WA, Keenan-Devlin L, Borders AE, Adam EK. Early and current life adversity: Past and present influences on maternal diurnal cortisol rhythms during pregnancy. Dev Psychobiol 2020; 63:305-319. [PMID: 32572946 DOI: 10.1002/dev.22000] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 04/13/2020] [Accepted: 05/14/2020] [Indexed: 12/24/2022]
Abstract
Stress during pregnancy affects maternal health and well-being, as well as the health and well-being of the next generation, in part through the hypothalamic-pituitary-adrenal (HPA) axis. Although most studies have focused solely on proximal experiences (i.e., during the pregnancy) as sources of prenatal stress, there has been a recent surge in studies that examine maternal early life adversity as a source of stress system dysregulation during pregnancy. The current study of 178 pregnant women examined the association of economic and life stress experienced during two time periods (i.e., childhood and pregnancy) with maternal HPA axis activity during the third trimester of pregnancy. Findings indicated that a current annual income of less than $15,000 and greater childhood disadvantage were associated with a flatter diurnal cortisol slope. Childhood maltreatment, particularly sexual abuse, was associated with a higher cortisol awakening response (CAR), even when controlling for recent adversity. We found some evidence that past adversity moderates the relationship between current adversity and diurnal cortisol, specifically for economic adversity and waking cortisol. Overall, our findings indicate that early life stressors play an important and underappreciated role in shaping stress biology during pregnancy.
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Affiliation(s)
- Jacquelyn E Stephens
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | - Courtenay L Kessler
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | - Claudia Buss
- University of California Irvine, Irvine, CA, USA.,Charité University Medicine Berlin, Berlin, Germany
| | - Gregory E Miller
- Department of Psychology, Northwestern University, Evanston, IL, USA.,Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - William A Grobman
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Ann E Borders
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,NorthShore University HealthSystem, Evanston, IL, USA
| | - Emma K Adam
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA.,Institute for Policy Research, Northwestern University, Evanston, IL, USA
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31
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Association between maternal adverse childhood experiences and mental health problems in offspring: An intergenerational study. Dev Psychopathol 2020; 33:1041-1058. [DOI: 10.1017/s0954579420000334] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe aim of this study is to examine the association between maternal adverse childhood experiences (ACEs) and mental health problems in adolescent offspring. Data were obtained from the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016, and participants were 10,810 children in the fifth grade (3,144 pairs), eighth grade (3,497 pairs), and eleventh grade (4,169 pairs) living in Kochi Prefecture, Japan. Mothers of participating children were asked about their ACEs, childhood social economic status, current mental and physical health, current social economic status, positive parenting behaviors, child maltreatment, marital status, and child behavior problems using the Strength and Difficulty Questionnaire. Children reported their depressive symptoms using the Depression Self-Rating Scale. Children of mothers with a larger number of ACEs showed higher levels of behavior problems (p for trend <.001) and depressive symptoms (p for trend <.001), adjusting for potential confounders. In particular, maternal psychological distress mediated the association between maternal ACEs and child mental health. The adverse effects of maternal ACEs may have a direct intergenerational impact on behavior problems and depressive symptoms in adolescent offspring. Further studies to elucidate possible mediators are needed.
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Adverse Childhood Experiences and Changing Levels of Psychosocial Distress Scores Across Pregnancy in Kenyan Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103401. [PMID: 32414141 PMCID: PMC7277115 DOI: 10.3390/ijerph17103401] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/08/2020] [Accepted: 05/10/2020] [Indexed: 02/07/2023]
Abstract
Background: Adverse childhood experiences (ACEs) have been associated with deleterious effects on mental health in pregnancy. Methods: The ACE International Questionnaire (ACE-IQ) was used to measure neglect, abuse, and household dysfunction. Longitudinal mixed effect modelling was used to test the effect of ACEs on pregnancy-related anxiety, depressive symptoms, and perceived stress at two time points (12–19 and 22–29 weeks) during pregnancy. Results: A total of 215 women who were predominantly married (81%) and had attained tertiary education (96%) were enrolled. Total ACEs were significantly associated with depressive symptoms (r = 0.23, p < 0.05) and perceived stress (r = 0.18, p < 0.05). As depressive symptoms decreased, t (167) = −8.44, p < 0.001, perceived stress increased, t (167) = 4.60, p < 0.001, and pregnancy-related anxiety remained unchanged as pregnancy progressed. Contact sexual abuse (p < 0.01) and parental death or divorce (p = 0.01) were significantly associated with depression over time (p < 0.01). Total ACEs in this study were associated with depressive symptoms early but not late in pregnancy. Conclusions: Higher total ACEs were positively associated with depressive symptoms and perceived stress during pregnancy, suggesting that mental disorders may have an impact on pregnancy outcomes and ought to be addressed. Further validation of the Edinburgh Postnatal Depression Scale (EPDS) tool in local settings is required.
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Almanza-Sepulveda ML, Fleming AS, Jonas W. Mothering revisited: A role for cortisol? Horm Behav 2020; 121:104679. [PMID: 31927022 DOI: 10.1016/j.yhbeh.2020.104679] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 12/31/2019] [Accepted: 01/03/2020] [Indexed: 12/26/2022]
Abstract
This selective review first describes the involvement of the maternal hypothalamic-pituitary-adrenal (HPA) axis during pregnancy and the postpartum period, and the relation between peripartum HPA axis function and maternal behavior, stress reactivity and emotional dysregulation in human mothers. To provide experimental background to this correlational work, where helpful, animal studies are also described. It then explores the association between HPA axis function in mothers and their infants, under ongoing non-stressful conditions and during stressful challenges, the moderating role of mothers' sensitivity and behavior in the mother-child co-regulation and the effects of more traumatic risk factors on these relations. The overarching theme being explored is that the HPA axis - albeit a system designed to function during periods of high stress and challenge - also functions to promote adaptation to more normative processes, shown in the new mother who experiences both high cortisol and enhanced attraction and attention to and recognition of, their infants and their cues. Hence the same HPA system shows positive relations with behavior at some time points and inverse ones at others. However, the literature is not uniform and results vary widely depending on the number, timing, place, and type of samplings and assessments, and, of course, the population being studied and, in the present context, the state, the stage, and the stress levels of mother and infant.
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Affiliation(s)
- Mayra L Almanza-Sepulveda
- Department of Psychology, University of Toronto at Mississauga, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
| | - Alison S Fleming
- Department of Psychology, University of Toronto at Mississauga, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
| | - Wibke Jonas
- Department of Women's and Children's Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18a, 171 77 Stockholm, Sweden.
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Currie CL, Sanders JL, Swanepoel LM, Davies CM. Maternal adverse childhood experiences are associated with binge drinking during pregnancy in a dose-dependent pattern: Findings from the All Our Families cohort. CHILD ABUSE & NEGLECT 2020; 101:104348. [PMID: 31896532 DOI: 10.1016/j.chiabu.2019.104348] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 11/21/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Binge drinking (BD) is a serious risk factor for fetal alcohol spectrum disorders (FASD) and associated with more severe forms of the disorder. Thus, special attention to specific risk factors for BD adjacent to and during pregnancy is warranted. OBJECTIVES (1) To examine the role that maternal adverse childhood experiences (ACEs) may play in BD in the 12 months before pregnancy and during pregnancy in a sample of women with moderate to high socioeconomic status; and (2) to examine the sociodemographic correlates of BD before and during pregnancy within this sample. PARTICIPANTS AND SETTING This secondary analysis (N = 1663) was derived from the All Our Families prospective cohort study collected in Alberta, Canada between 2008-2011. METHODS Data were collected using three mailed surveys completed by women during and after pregnancy. An established scale examined maternal ACEs before 18 years. Adjusted logistic regression models tested associations between ACE score and BD before and during pregnancy. RESULTS Approximately 5 in 10 (48.3 %) and 1 in 10 (10.0 %) women reported ≥1 BD episode before and during pregnancy; respectively. In adjusted models, a woman's ACE score was associated with BD pre-pregnancy in a weak, nonmonotonic fashion; and during pregnancy in a moderate, dose-response fashion. Overall, ACEs resulted in two to three-fold increase in the odds of BD during pregnancy. CONCLUSIONS Maternal ACEs were common in this middle to upper-middle income, well-educated sample and impacted the next generation through BD in pregnancy. These findings combine with others to speak to the public health significance of maternal ACEs on alcohol-related behaviour among expectant mothers across the socioeconomic spectrum, and the need for targeted evidence-based interventions for this population.
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Affiliation(s)
- Cheryl L Currie
- Faculty of Health Sciences, University of Lethbridge, M3083 Markin Hall, 4401 University Drive, Lethbridge, Alberta, T1K 3M4, Canada.
| | - James L Sanders
- Faculty of Health Sciences, University of Lethbridge, M3083 Markin Hall, 4401 University Drive, Lethbridge, Alberta, T1K 3M4, Canada.
| | - Lisa-Marie Swanepoel
- Faculty of Health Sciences, University of Lethbridge, M3083 Markin Hall, 4401 University Drive, Lethbridge, Alberta, T1K 3M4, Canada.
| | - Colleen M Davies
- Department of Mathematical and Statistical Sciences, CAB 632, University of Alberta, Edmonton, Alberta, T6G 2G1, Canada.
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Does hair cortisol really reflect perceived stress? Findings from low-income mother-preschooler dyads. Psychoneuroendocrinology 2020; 111:104478. [PMID: 31704637 DOI: 10.1016/j.psyneuen.2019.104478] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/07/2019] [Accepted: 10/11/2019] [Indexed: 12/29/2022]
Abstract
Hair cortisol concentration (HCC) has emerged as an objective biological measure of stress in humans, but findings on the relationships between perceived stress and HCC and between mothers' HCC and children's HCC are inconsistent. To advance the understanding of HCC and its relationship with perceived stress, this study aimed to examine the relationships among mothers' HCC, perceived stress, distress, coping, and preschoolers' HCC in a low-income population. A correlational study was conducted with 35 Head Start mother-preschooler dyads. Mothers' mean HCC was 6.97 pg/mg, and preschoolers' mean HCC was 32.02 pg/mg. The receiver operating characteristic analysis identified an optimal HCC cutoff of 4.1 pg/mg based on the 10-item Perceived Stress Scale to divide mothers into low and high HCC groups. Mothers' perceived stress was negatively related to their HCC (ρ = -0.49, p = 0.005). While there were no statistically significant relationships between mothers' HCC and their perceived distress or coping in the low HCC group, mothers' HCC in the high HCC group was positively related to their perceived coping (ρ = 0.53, p = 0.036). Mothers' HCC was positively correlated with preschoolers' HCC (ρ = 0.39, p = 0.030). In the high HCC group, mothers' perceived stress and distress had very small correlations with preschoolers' HCC. In contrast, in the low HCC group, mothers' perceived stress and distress had very large correlations with preschoolers' HCC (ρ = 0.83, p < 0.001; ρ = 0.74, p = 0.001, respectively). The findings suggest mothers' coping ability plays a significant buffering role in modifying the influence of mothers' perceived stress on preschoolers' stress; however, considering the limited sample size, this conclusion warrants further investigation. This study provides an important foundation for studying HCC in low-income mothers and their preschoolers.
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Merced-Nieves FM, Aguiar A, Dzwilewski KLC, Musaad S, Korrick SA, Schantz SL. Association of prenatal maternal perceived stress with a sexually dimorphic measure of cognition in 4.5-month-old infants. Neurotoxicol Teratol 2020; 77:106850. [PMID: 31812786 PMCID: PMC6980724 DOI: 10.1016/j.ntt.2019.106850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/21/2019] [Accepted: 12/04/2019] [Indexed: 01/02/2023]
Abstract
Maternal prenatal stress can adversely impact subsequent child neurodevelopment, but little is known about its effect on cognitive development in infancy. This analysis of 107 infants from a prospective birth cohort assessed whether prenatal stress disrupts sexually dimorphic performance typically observed on a physical reasoning task. Maternal stress was assessed at 8-14 and 33-37 gestational weeks using the Perceived Stress Scale. Stress was defined as: low (scores below the median at both times), medium (scores above the median at one of the two times), and high (scores above the median at both times). At 4.5 months infants saw videos of two events: one impossible and the other possible. In the impossible event a box was placed against a wall without support underneath. In the possible event the box was placed against the wall, supported by the floor. Looking time at each event was recorded via infrared eye-tracking. Previous literature has shown that, at 4.5 months of age, girls typically look significantly longer at the impossible than at the possible event, suggesting that they expect the unsupported box to fall and are surprised when it does not. Boys tend to look equally at the two events suggesting that they do not share this expectation. This sex difference was replicated in the current study. General linear models stratified by sex and adjusted for household income, maternal education, mother's age at birth, infant's age at exam, and order of event presentation revealed that girls whose mothers reported high perceived stress during pregnancy had shorter looking time differences between the impossible and possible events than girls whose mothers reported low perceived stress (β = -7.1; 95% CI: -12.0, -2.2 s; p = 0.006). Similar to boys, girls in the highest stress category spent about the same amount of time looking at each event. For boys, there were no significant looking time differences by maternal stress level. This finding suggests prenatal stress is associated with a delay in the development of physical reasoning in girls.
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Affiliation(s)
- F M Merced-Nieves
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America.
| | - A Aguiar
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
| | - K L C Dzwilewski
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
| | - S Musaad
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States of America
| | - S A Korrick
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - S L Schantz
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States of America
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Mustonen P, Karlsson L, Kataja EL, Scheinin NM, Kortesluoma S, Coimbra B, Rodrigues AJ, Sousa N, Karlsson H. Maternal prenatal hair cortisol is associated with prenatal depressive symptom trajectories. Psychoneuroendocrinology 2019; 109:104383. [PMID: 31400561 DOI: 10.1016/j.psyneuen.2019.104383] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 11/15/2022]
Abstract
UNLABELLED Maternal prenatal cortisol levels have been inconsistently associated with self-reports of prenatal psychological distress (PD). Previous research has linked hair cortisol concentration (HCC) evaluating cumulatively the previous months with cross-sectional PD measures that usually cover the past week(s), which may lead to misleading conclusions on their relations. We aimed to investigate how maternal HCC relates to cumulative PD measures across pregnancy. METHODS Subjects (N = 595) were drawn from the FinnBrain Birth Cohort Study. Maternal HCC was measured from hair samples collected at gestational week (gwk) 24 (HCC1, n = 467) and at delivery (HCC2, n = 222). As HCC1 and HCC2 comprised mostly of different subjects, they were considered as independent populations. Maternal PD assessments at gwks 14, 24, and 34 were the Edinburgh Postnatal Depression Scale (EPDS), the anxiety subscale of the Symptom Checklist (SCL-90), the Pregnancy-Related Anxiety Questionnaire -Revised2 (PRAQ-R2), and a daily hassles scale. Cumulative PD comprised of the mean scores of two consecutive assessments (mean1 = gwks 14 and 24; mean2 = gwks 24 and 34). In addition, EPDS and SCL scores were modelled by using growth mixture modelling to identify symptom trajectory categories. Regression models were adjusted for age, body mass index, education and use of selective serotonin/serotonin-norepinephrine reuptake inhibitor medication. RESULTS In the adjusted regression model, higher HCC2 was related to the "consistently elevated" prenatal depressive symptoms trajectory in comparison to "consistently low" (β =.71, p =.021) and "low and increasing" (β =.82, p = .011) symptom trajectories. Additionally, the cumulative mean (mean 1) of daily hassles in relationships was associated with HCC1 (β = 0.25, p = .004). General or pregnancy-related anxiety symptoms were unrelated to HCC after adjustment for the covariates. CONCLUSIONS The assessment of cumulative or trajectory measures of PD can reveal important associations with maternal prenatal HCC, even though the associations are generally weak. Of the different dimensions of PD, prenatal trajectories of depressive symptoms were most consistently linked with end-pregnancy HCC levels.
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Affiliation(s)
- Paula Mustonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Susanna Kortesluoma
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Institute of Biomedicine, University of Turku, Finland
| | - Bárbara Coimbra
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
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Doi S, Fujiwara T. Combined effect of adverse childhood experiences and young age on self-harm ideation among postpartum women in Japan. J Affect Disord 2019; 253:410-418. [PMID: 31103806 DOI: 10.1016/j.jad.2019.04.079] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/29/2019] [Accepted: 04/17/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Suicide among postpartum women is a new and emerging issue in developed countries. However, little is known about the combined effect of risk factors on self-harm ideation, although various risk factors have been found. The aim of this study is to examine the combined effect of maternal adverse childhood experiences and maternal age on self-harm ideation among postpartum women. METHODS The study comprised a cross-sectional study of 8074 mothers participating in a 3-month health checkup between September 2013 and August 2014 in City A, Prefecture A, Japan. Main outcome was self-harm ideation assessed using the Edinburgh Postnatal Depression Scale (EPDS), item 10. Possible risk factors were maternal adverse childhood experiences (ACEs), maternal characteristics, relationship with husband/partner (e.g., feelings when pregnancy was confirmed), household characteristics, child characteristics (e.g., age, sex, birth weight), and postpartum characteristics, and postpartum depression status other than self-harm ideation. RESULTS Postpartum women with 3 or more ACEs and younger age (<25 years old) were 10.3 times more likely than those with no ACEs and older age to have self-harm ideation (95%CI = 5.3-20.2). This combined effect was also found in first-time mothers (OR = 7.6, 95%CI = 3.2-17.9). LIMITATIONS Study limitations are excluding an item on sexual abuse which is one of the ACEs, recall bias and information bias. CONCLUSIONS Postpartum women with 3 or more ACEs and who were younger than 25 years old were at a high risk for self-harm ideation. Providing prevention strategies aimed at mothers with multiple risk factors, especially younger age and ACEs, is warranted.
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Affiliation(s)
- Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
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Kress V, Steudte-Schmiedgen S, Kopp M, Förster A, Altus C, Schier C, Wimberger P, Kirschbaum C, von Soest T, Weidner K, Junge-Hoffmeister J, Garthus-Niegel S. The Impact of Parental Role Distributions, Work Participation, and Stress Factors on Family Health-Related Outcomes: Study Protocol of the Prospective Multi-Method Cohort "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Front Psychol 2019; 10:1273. [PMID: 31263435 PMCID: PMC6584823 DOI: 10.3389/fpsyg.2019.01273] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/14/2019] [Indexed: 12/12/2022] Open
Abstract
The Dresden Study on Parenting, Work, and Mental Health (“DResdner Studie zu Elternschaft, Arbeit, und Mentaler Gesundheit”, DREAM) aims to prospectively investigate the relationship between parental work participation, role distribution, stress factors, and their effects on perinatal outcomes and long-term family mental and somatic health in a community sample targeting N = 4,000 individuals, i.e., 2,000 couples, expecting a child and residing in Dresden, Germany (interim sample of N = 1,410 participants, recruitment ongoing). Various questionnaires are completed at four measurement points from pregnancy to 2 years postpartum (prolongation into middle childhood planned). Applying a multi-method approach, long-term endocrinological data (analyses of hair cortisol concentrations and other endogenous hormones, “DREAMHAIR”) and qualitative interview data (regarding gender role attitudes and distribution of domestic work, child care, and paid employment; “DREAMTALK”) are obtained. In this study protocol, the theoretical background, methods, and preliminary results considering sociodemographic characteristics during pregnancy and birth-related factors at 8 weeks postpartum are presented. Additionally, there is a focus on our endocrinological sub-study DREAMHAIR. In this sub-study currently comprising N = 152 participants, i.e., 88 families (recruitment ongoing), we want to gain knowledge on the transgenerational processes of stress regulation and psychopathology in the whole family by analyzing hair cortisol concentrations in both parents and children during the course from pregnancy (or after birth regarding children) to at least 2 years postpartum. By comparing data of the community sample to a clinical sample of mothers with postpartum mental disorders, their children, and their partners during the period between admission and discharge from a mother-baby unit and post-treatment (“DREAMMBU”), the course of mothers' psychopathology, parent-infant interaction, and infant regulation disorders with special regard to long-term endocrine correlates will be examined. With previous studies neglecting the fathers or partners involved, a major advantage of DREAM is the use of a multi-method and multi-level approach by examining the whole family in a longitudinal design. Therefore, the DREAM study will contribute to a better understanding of the role of social, work, and stress factors for mental and somatic health and its long-term endocrine correlates in the natural course of becoming a family.
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Affiliation(s)
- Victoria Kress
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.,Institute of Biological Psychology, Faculty of Psychology of the Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Anke Förster
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Caroline Altus
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Caroline Schier
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Institute of Biological Psychology, Faculty of Psychology of the Technische Universität Dresden, Dresden, Germany
| | - Tilmann von Soest
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.,Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
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Hantsoo L, Jašarević E, Criniti S, McGeehan B, Tanes C, Sammel MD, Elovitz MA, Compher C, Wu G, Epperson CN. Childhood adversity impact on gut microbiota and inflammatory response to stress during pregnancy. Brain Behav Immun 2019; 75:240-250. [PMID: 30399404 PMCID: PMC6349044 DOI: 10.1016/j.bbi.2018.11.005] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/02/2018] [Accepted: 11/02/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs), such as abuse or chronic stress, program an exaggerated adult inflammatory response to stress. Emerging rodent research suggests that the gut microbiome may be a key mediator in the association between early life stress and dysregulated glucocorticoid-immune response. However, ACE impact on inflammatory response to stress, or on the gut microbiome, have not been studied in human pregnancy, when inflammation increases risk of poor outcomes. The aim of this study was to assess the relationships among ACE, the gut microbiome, and cytokine response to stress in pregnant women. METHODS Physically and psychiatrically healthy adult pregnant women completed the Adverse Childhood Experiences Questionnaire (ACE-Q) and gave a single stool sample between 20 and 26 weeks gestation. Stool DNA was isolated and 16S sequencing was performed. Three 24-hour food recalls were administered to assess dietary nutrient intake. A subset of women completed the Trier Social Stress Test (TSST) at 22-34 weeks gestation; plasma interleukin-6 (IL-6), interleukin-1β (IL-1β), high sensitivity C-reactive protein (hsCRP), tumor necrosis factor α (TNF-α), and cortisol were measured at four timepoints pre and post stressor, and area under the curve (AUC) was calculated. RESULTS Forty-eight women completed the ACE-Q and provided stool; 19 women completed the TSST. Women reporting 2 or more ACEs (high ACE) had greater differential abundance of gut Prevotella than low ACE participants (q = 5.7 × 10^-13). Abundance of several gut taxa were significantly associated with cortisol, IL-6, TNF-α and CRP AUCs regardless of ACE status. IL-6 response to stress was buffered among high ACE women with high intake of docosahexaenoic acid (DHA) (p = 0.03) and eicosapentaenoic acid (EPA) (p = 0.05). DISCUSSION Our findings suggest that multiple childhood adversities are associated with changes in gut microbiota composition during pregnancy, and such changes may contribute to altered inflammatory and glucocorticoid response to stress. While preliminary, this is the first study to demonstrate an association between gut microbiota and acute glucocorticoid-immune response to stress in a clinical sample. Finally, exploratory analyses suggested that high ACE women with high dietary intake of ω-3 polyunsaturated fatty acids (PUFAs) had a dampened inflammatory response to acute stress, suggesting potentially protective effects of ω-3s in this high-risk population. Given the adverse effects of inflammation on pregnancy and the developing fetus, mechanisms by which childhood adversity influence the gut-brain axis and potential protective factors such as diet should be further explored.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104, United States.
| | - Eldin Jašarević
- Department of Pharmacology, Center for Epigenetic Research in Child Health and Brain Development, University of Maryland School of Medicine, 670 W Baltimore St. HSF3, 9-173, Baltimore, MD 21201
| | - Stephanie Criniti
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104
| | - Brendan McGeehan
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104
| | - Ceylan Tanes
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, 19104
| | - Mary D. Sammel
- Department of Biostatistics, Epidemiology and Informatics, The University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, 605 Blockley Hall, Philadelphia, PA 19104
| | - Michal A. Elovitz
- Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, The University of Pennsylvania Perelman School of Medicine, 421 Curie Blvd., 1354 BRB II/III Philadelphia, PA 19104
| | - Charlene Compher
- Department of Biobehavioral Health Sciences, The University of Pennsylvania School of Nursing, 137 Claire Fagin Hall, Philadelphia, PA 19104
| | - Gary Wu
- Department of Gastroenterology, The University of Pennsylvania Perelman School of Medicine, 915 BRB II/III, 421 Curie Blvd, Philadelphia, PA 19104
| | - C. Neill Epperson
- Department of Psychiatry, The University of Pennsylvania Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104
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Olsen JM. Integrative Review of Pregnancy Health Risks and Outcomes Associated With Adverse Childhood Experiences. J Obstet Gynecol Neonatal Nurs 2018; 47:783-794. [PMID: 30308147 DOI: 10.1016/j.jogn.2018.09.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To identify pregnancy risk factors and outcomes associated with a woman's history of adverse childhood experiences (ACEs) and summarize what is known about routine screening for ACEs as part of prenatal care. DATA SOURCES The Academic Search Premier, Academic Search Complete, CINAHL, Health Source: Nursing Academic Edition, MEDLINE, PsychINFO, and PubMed databases were searched. The terms adverse childhood experiences or ACEs, trauma informed care, and childhood trauma were each paired individually with the terms pregnancy or pregnant or prenatal or antenatal or perinatal or maternal; obstetrics; and maternal-child health. STUDY SELECTION Database and reference list searches resulted in 1,626 articles with 230 retained for full review and 17 included in the final sample. Studies were included if results were reported specific to pregnancy and ACEs as operationally defined in the ACE Study. DATA EXTRACTION Studies were evaluated for methodologic quality using Joanna Briggs Institute appraisal tools. Data were extracted with the matrix method. Tabular synthesis was used to cluster and compare findings and identify themes. DATA SYNTHESIS Five categories of pregnancy health risks and outcomes related to ACEs were identified: physiologic risk, psychologic risk, social risk, behavioral risk, and negative pregnancy outcomes. Limited research was found on routine screening for ACEs as part of prenatal care, but findings indicated women's support for ACE screening during prenatal appointments. CONCLUSION Routine prenatal ACE screening may be accepted by women and may help identify significant pregnancy health risks. This could provide opportunities for interventions that improve pregnancy outcomes. More research is needed to determine the most effective and efficient methods to screen pregnant women for ACEs and intervene for those with high screening scores. To optimally advance science in this area, conceptual and operational clarity in ACE research is important. Nurses should be at the forefront of these research and practice translation efforts.
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