1
|
Sobol M, Błachnio A, Plucińska E, Hryhorchuk I, Meisner M, Wdowiak A, Wdowiak N, Szczepaniak P, Jankowski KS. Associations of couples' balanced time perspective with maternal prenatal hair cortisol concentration and perceived stress. Psychoneuroendocrinology 2024; 168:107115. [PMID: 39002452 DOI: 10.1016/j.psyneuen.2024.107115] [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: 02/20/2024] [Revised: 06/22/2024] [Accepted: 06/27/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE The stress experienced by a woman during pregnancy not only has a negative impact on her well-being and physical health but also adversely affects the fetus. Stress is strongly linked with time perspective, defined as the tendency to focus on the past, present, or future. The study aimed to investigate how couples' balanced time perspective was related to maternal prenatal hair cortisol concentration and perceived stress in the first and third trimesters of pregnancy. METHOD The participants were pregnant women and their male partners (84 couples). Women completed online questionnaires: the Zimbardo Time Perspective Inventory (ZTPI), the Dark Future Scale (DFS), and the Perceived Stress Scale, while men completed online versions of the ZTPI and the DFS. These questionnaire measurements were conducted in the first and third trimesters. Maternal cortisol levels were measured in hair samples taken during gynecological visits, in the first and third trimesters. RESULTS The study revealed that the more unbalanced the partner's time perspective, the more unbalanced the pregnant woman's time perspective and, consequently, the higher the stress perceived by the pregnant woman. This effect was present in both the first (B = 1.06, SE =.36, p <.001, 95 % CI [.398, 1.826]) and the third trimesters (B =.98, SE =.36, p <.001, 95 % CI [.327, 1.774]). Moreover, the more unbalanced the partner's time perspective, the more unbalanced the woman's time perspective and, consequently, the lower the hair cortisol concentration in the first trimester (B = -.08, SE =.04, p <.05, 95 % CI [-.171, -.010]). Partner's unbalanced time perspective in the first trimester was also a predictor of stress perceived by the woman in the third trimester (t = 2.38, p <.05). CONCLUSIONS The results suggest the significance of the partner's time perspective for the pregnant woman's mental health. The partner's unbalanced, negative time perspective in the first trimester may increase the pregnant woman's stress in the third trimester. This effect can be even stronger than that of the woman's time perspective.
Collapse
Affiliation(s)
- Małgorzata Sobol
- Department of Psychology, University of Warsaw, ul. Stawki 5/7, Warsaw 00-183, Poland.
| | - Agata Błachnio
- John Paul II Catholic University of Lublin, al. Raclawickie 14, Lublin 20-950, Poland
| | | | - Inna Hryhorchuk
- Żywiec Hospital, ul. Pola Lisickich 80, Żywiec 34-300, Poland
| | - Michał Meisner
- Department of Psychology, University of Warsaw, ul. Stawki 5/7, Warsaw 00-183, Poland
| | - Artur Wdowiak
- Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland
| | - Natalia Wdowiak
- Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland
| | | | - Konrad S Jankowski
- Department of Psychology, University of Warsaw, ul. Stawki 5/7, Warsaw 00-183, Poland
| |
Collapse
|
2
|
Troller-Renfree SV, Sperber JF, Hart ER, Costanzo MA, Gennetian LA, Meyer JS, Fox NA, Noble KG. Associations between maternal stress and infant resting brain activity among families residing in poverty in the U.S. Biol Psychol 2023; 184:108683. [PMID: 37716521 PMCID: PMC10842437 DOI: 10.1016/j.biopsycho.2023.108683] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
Growing evidence suggests that maternal experiences of stress shape children's functional brain activity in the first years of life. Individuals living in poverty are more likely to experience stress from a variety of sources. However, it is unclear how stress is related to resting brain activity among children born into poverty. The present study examines whether infants born into households experiencing poverty show differences in brain activity associated with maternal reports of experiencing stress. The analytic sample comprised 247 mother-infant dyads who completed maternal questionnaires characterizing stress, and for whom recordings of infant resting brain activity were obtained at 1 year of age (M=12.93 months, SD=1.66; 50% female). Mothers (40% Black, non-Hispanic, 40% Hispanic, 12% White, non-Hispanic) who reported higher stress had infants who showed more resting brain activity in the lower end of the frequency spectrum (relative theta power) and less resting brain activity in the middle range of the frequency spectrum (relative alpha power). While statistically detectable at the whole-brain level, follow-up exploratory analyses revealed that these effects were most apparent in electrodes over frontal and parietal regions of the brain. These findings held after adjusting for a variety of potentially confounding variables. Altogether, the present study suggests that, among families experiencing low economic resources, maternal reports of stress are associated with differences in patterns of infant resting brain activity during the first year of life.
Collapse
Affiliation(s)
| | | | - Emma R Hart
- Teachers College, Columbia University, New York, NY, USA
| | | | | | | | | | | |
Collapse
|
3
|
Galbally M, Watson SJ, van IJzendoorn MH, Tharner A, Luijk M, de Kloet ER, van Rossum EFC, Lewis AJ. Prenatal predictors of childhood anxiety disorders: An exploratory study of the role of attachment organization. Dev Psychopathol 2023; 35:1296-1307. [PMID: 34911592 DOI: 10.1017/s0954579421001206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Childhood anxiety disorders (CAD) are a common childhood mental disorder and understanding early developmental pathways is key to prevention and early intervention. What is not understood is whether early life stress predictors of CAD might be both mediated by infant cortisol reactivity and moderated by infant attachment status. To address this question, this exploratory study draws on 190 women recruited in early pregnancy and followed together with their children until 4 years of age. Early life stress is operationalized as maternal depression measured using the Structured Clinical Interview for the DSM, Childhood Trauma Questionnaire, Parenting Stress Index, and antenatal maternal hair cortisol concentrations. Infant cortisol reactivity was measured at 12 months together with the Strange Situation Procedure and CAD assessed at 4 years of age using the Preschool Age Psychiatric Assessment. There was no direct association between attachment classification and CAD. Furthermore, infant cortisol reactivity neither mediated nor attachment moderated the association of early life stress predictors and CAD. However, only for infants with organized attachment classifications, higher maternal antenatal depression, and hair cortisol were associated with a higher risk of CAD.
Collapse
Affiliation(s)
- Megan Galbally
- Psychology, Murdoch University, Murdoch, Australia
- School of Medicine, University of Notre Dame, Australia
- King Edward Memorial Hospital, Subiaco, Perth, WA, Australia
| | - Stuart J Watson
- Psychology, Murdoch University, Murdoch, Australia
- School of Medicine, University of Notre Dame, Australia
| | - Marinus H van IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, UCL, UK
| | - Anne Tharner
- Department of Educational and Family Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje Luijk
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - E Ron de Kloet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Galbally M, Watson SJ, van Rossum EFC, Chen W, de Kloet ER, Lewis AJ. The perinatal origins of childhood anxiety disorders and the role of early-life maternal predictors. Psychol Med 2022; 52:506-514. [PMID: 32597740 DOI: 10.1017/s0033291720002147] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The development of childhood anxiety disorders (CADs) is likely to depend on pathways that can be programmed by early-life risk factors. We test the hypothesis that early-life maternal factors can predict this programming effect on CAD. METHODS Data were obtained from 198 women and children from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy, postpartum and until 4 years of age. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV), together with antenatal hair cortisol concentrations, maternal childhood trauma and parenting stress at 6 months postpartum. CAD was assessed with the Preschool Age Psychiatric Assessment and the Child Behaviour Checklist. RESULTS Antenatal depression, a history of maternal childhood trauma and lower gestational age at birth were each associated with anxiety disorders at 4 years of age in their children. A multivariate binary logistic model with these early predictors explained approximately 9% of variance in CAD outcome at 4 years of age; however, only maternal trauma and gestational age were significant predictors in the model. The effect of early parenting stress on CAD was found to vary by the concentration of maternal antenatal hair cortisol, whereby postpartum parenting stress was associated with CAD only when there were higher maternal antenatal cortisol levels. CONCLUSIONS This study suggests the importance of maternal factors pre-conception, pregnancy and in the postnatal period, which predict CADs and this is consistent with a developmental programming hypothesis for CAD.
Collapse
Affiliation(s)
- Megan Galbally
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
- School of Medicine, University of Notre Dame, Fremantle, Australia
- King Edward Memorial Hospital, Subiaco, Australia
| | - Stuart J Watson
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wai Chen
- School of Medicine, University of Notre Dame, Fremantle, Australia
- Graduate School of Education, University of Western Australia, Crawley, Australia
| | - Edo Ronald de Kloet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrew J Lewis
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
| |
Collapse
|
6
|
Galbally M, Watson SJ, Lappas M, de Kloet ER, van Rossum E, Wyrwoll C, Mark P, Lewis AJ. Fetal programming pathway from maternal mental health to infant cortisol functioning: The role of placental 11β-HSD2 mRNA expression. Psychoneuroendocrinology 2021; 127:105197. [PMID: 33743501 DOI: 10.1016/j.psyneuen.2021.105197] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 02/06/2023]
Abstract
Placental 11β-HSD2 has been a focus of research for understanding potential fetal programming associated with maternal emotional disorders. This study examined the pathway from antenatal mental health via placental 11β-HSD2 mRNA to cortisol regulation in the infant offspring. This study reports on data obtained from 236 participants in the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). At term, placental tissue was collected within 30 min of birth from 52 participants meeting current criteria for a depressive disorder, and 184 control participants. Depressive disorders were diagnosed using the SCID-IV. In addition, antidepressant use, depressive and anxiety symptoms were measured in early and late pregnancy. Placental 11β-HSD2 mRNA expression was measured using qRT-PCR. Infant salivary cortisol samples were taken at 12 months of age. Women on antidepressant medication and with higher trait anxiety had higher placental 11β-HSD2 expression compared to women not taking medication. Furthermore, the offspring of women taking an antidepressant and who also had a current depressive disorder and high trait anxiety had high cortisol reactivity at 12 months of age and this was mediated through 11β-HSD2 mRNA expression. In contrast, offspring of women not taking antidepressant medication with depressive disorder and high anxiety there was low cortisol reactivity observed. Our findings suggest that the relationship between maternal antenatal depression and anxiety and infant cortisol reactivity is mediated through placental 11β-HSD2 mRNA expression. Furthermore, the direction differed for women taking antidepressants, where infant cortisol reactivity was high whereas when compared to those with unmedicated depression and anxiety, where infant cortisol reactivity was low.
Collapse
Affiliation(s)
- Megan Galbally
- Psychology, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia; King Edward Memorial Hospital, Subiaco, Australia.
| | - Stuart J Watson
- Psychology, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia
| | - Martha Lappas
- Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - E Ron de Kloet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Elisabeth van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Caitlin Wyrwoll
- School of Human Sciences, The University of Western Australia, Australia
| | - Peter Mark
- School of Human Sciences, The University of Western Australia, Australia
| | | |
Collapse
|
7
|
Vuppaladhadiam L, Lager J, Fiehn O, Weiss S, Chesney M, Hasdemir B, Bhargava A. Human Placenta Buffers the Fetus from Adverse Effects of Perceived Maternal Stress. Cells 2021; 10:cells10020379. [PMID: 33673157 PMCID: PMC7918582 DOI: 10.3390/cells10020379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/25/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022] Open
Abstract
Maternal stress during pregnancy is linked to several negative birth outcomes. The placenta, a unique pregnancy-specific organ, not only nourishes and protects the fetus but is also the major source of progesterone and estrogens. As the placenta becomes the primary source of maternal progesterone (P4) and estradiol between 6-9 weeks of gestation, and these hormones are critical for maintaining pregnancy, maternal stress may modulate levels of these steroids to impact birth outcomes. The objective was to test whether maternal perceived stress crosses the placental barrier to modulate fetal steroids, including cortisol, which is a downstream indicator of maternal hypothalamic-pituitary-adrenal (HPA) axis regulation and is associated with negative fetal outcomes. Nulliparous women, 18 years or older, with no known history of adrenal or endocrine illness were recruited during their third trimester of pregnancy at the University of California San Francisco (UCSF) Mission Bay hospital obstetrics clinics. Simultaneous measurement of 10 steroid metabolites in maternal (plasma and hair) and fetal (cord blood and placenta) samples was performed using tandem mass spectrometry along with assessment of the perceived stress score and sociodemographic status. While the maternal perceived stress score (PSS) and sociodemographic status were positively associated with each other and each with the body mass index (BMI) (r = 0.73, p = 0.0008; r = 0.48, p = 0.05; r = 0.59, p = 0.014, respectively), PSS did not correlate with maternal or fetal cortisol, cortisone levels, or fetal birth weight. Regardless of maternal PSS or BMI, fetal steroid levels remained stable and unaffected. Progesterone was the only steroid analyte quantifiable in maternal hair and correlated positively with PSS (r = 0.964, p = 0.003), whereas cord estradiol was negatively associated with PSS (r = -0.94, p = 0.017). In conclusion, hair progesterone might serve as a better marker of maternal stress than cortisol or cortisone and maternal PSS negatively impacts fetal estradiol levels. Findings have implications for improved biomarkers of stress and targets for future research to identify factors that buffer the fetus from adverse effects of maternal stress.
Collapse
Affiliation(s)
- Lahari Vuppaladhadiam
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA;
- Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA 94143, USA; (J.L.); (B.H.)
| | - Jeannette Lager
- Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA 94143, USA; (J.L.); (B.H.)
| | - Oliver Fiehn
- NIH West Coast Metabolomics Center, University of California Davis Genome Center, Davis, CA 95616, USA;
| | - Sandra Weiss
- Department of Community Health Systems, Stress and Depression Research Lab, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Margaret Chesney
- The Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Burcu Hasdemir
- Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA 94143, USA; (J.L.); (B.H.)
- NIH West Coast Metabolomics Center, University of California Davis Genome Center, Davis, CA 95616, USA;
| | - Aditi Bhargava
- Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA;
- Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA 94143, USA; (J.L.); (B.H.)
- NIH West Coast Metabolomics Center, University of California Davis Genome Center, Davis, CA 95616, USA;
- Correspondence: ; Tel.: +1-415-502-8453
| |
Collapse
|
8
|
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.
Collapse
|
9
|
Maimon L, Milo T, Moyal RS, Mayo A, Danon T, Bren A, Alon U. Timescales of Human Hair Cortisol Dynamics. iScience 2020; 23:101501. [PMID: 32911331 PMCID: PMC7490542 DOI: 10.1016/j.isci.2020.101501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/23/2020] [Accepted: 08/21/2020] [Indexed: 11/22/2022] Open
Abstract
Cortisol is a major human stress hormone, secreted within minutes of acute stress. Cortisol also has slower patterns of variation: a strong circadian rhythm and a seasonal rhythm. However, longitudinal cortisol dynamics in healthy individuals over timescales of months has rarely been studied. Here, we measured longitudinal cortisol in 55 healthy participants using 12 cm of hair, which provides a retrospective measurement over one year. Individuals showed (non-seasonal) fluctuations averaging about 22% around their baseline. Fourier analysis reveals dominant slow frequencies with periods of months to a year. These frequencies can be explained by a mathematical model of the hormonal cascade that controls cortisol, the HPA axis, when including the slow timescales of tissue turnover of the glands. Measuring these dynamics is important for understanding disorders in which cortisol secretion is impaired over months, such as mood disorders, and to test models of cortisol feedback control.
Collapse
Affiliation(s)
- Lior Maimon
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Tomer Milo
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Rina S. Moyal
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Avi Mayo
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Tamar Danon
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Anat Bren
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Uri Alon
- Department Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| |
Collapse
|
10
|
Galbally M, van Rossum EFC, Watson SJ, de Kloet ER, Lewis AJ. Trans-generational stress regulation: Mother-infant cortisol and maternal mental health across the perinatal period. Psychoneuroendocrinology 2019; 109:104374. [PMID: 31394490 DOI: 10.1016/j.psyneuen.2019.104374] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/28/2019] [Accepted: 06/30/2019] [Indexed: 01/11/2023]
Abstract
Understanding maternal mental health and cortisol regulation across pregnancy and the relationship to the development of the offspring's stress regulation is critical to a range of health outcomes. The aim of this study was to investigate infant and maternal cortisol in women with depression. Data were obtained from 241 pregnant women within the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a selected pregnancy cohort study. Depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) and repeat Edinburgh Postnatal Depression Scale (EPDS). Repeated measures of antidepressant use, stressful events, anxiety symptoms and maternal hair cortisol concentrations (HCC) and infant cortisol at 12 months postpartum in saliva and hair. Socio-emotional outcomes were measured at 12 months by maternal report on the Brief Infant and Toddler Socio-emotional Assessment (BITSEA). This study found that maternal depression was not associated with maternal HCC. Anxiety, stress and antidepressant use were not associated with maternal HCC. Independently, higher maternal 3rd trimester maternal depressive and anxiety symptoms were associated with lower infant cortisol response at 12 months of age. A higher number of postpartum stressful events was associated with lower infant cortisol response. Lower infant stress reactivity was associated with higher externalizing symptoms at 12 months of age. Future studies are required to understand implications for later mental health.
Collapse
Affiliation(s)
- Megan Galbally
- School of Psychology and Exercise Science, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia; King Edward Memorial Hospital, Australia.
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Stuart J Watson
- School of Psychology and Exercise Science, Murdoch University, Australia; School of Medicine, University of Notre Dame, Australia
| | - Edo Ronald de Kloet
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Andrew J Lewis
- School of Psychology and Exercise Science, Murdoch University, Australia
| |
Collapse
|
11
|
Abstract
OBJECTIVE The measurement of cortisol in hair became a popular and frequently used methodology in human stress research. This methodological approach, depending on the length of hair analyzed, allows to reflect cortisol secretion over prolong time periods in a retrospective fashion. There is a big variability in the experimental approaches to cortisol extraction used in individual laboratories. Moreover, there are many methodological details which are not described in most of the published papers, although they may be influential. The aim of the present study was to identify and optimize selected methodological steps of hair cortisol extraction. METHODS As the starting point served the methodology of Xiang et al. (2016). A hair pool was used to test the procedures. The main steps modified were pulverization, methanol extraction and centrifugation. RESULTS In the presented procedure, we decreased the speed and duration of the pulverization, we increased the volume of methanol and increased the time and speed of centrifugation. The results showed obtaining lower variability and higher cortisol concentrations than those we obtained by the methodology of Xiang et al. (2016), which was optimized. CONCLUSION The presented methodology is relatively simple and is likely to provide reliable results with low variability of cortisol concentrations measured in the same sample.
Collapse
|
12
|
Garay SM, Savory KA, Sumption LA, Penketh RJ, Jones IR, Janssen AB, John RM. Seasonal variation in salivary cortisol but not symptoms of depression and trait anxiety in pregnant women undergoing an elective caesarean section. Psychoneuroendocrinology 2019; 108:14-19. [PMID: 31181440 PMCID: PMC6854466 DOI: 10.1016/j.psyneuen.2019.05.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Seasonal changes in mood and behaviour are commonly reported in the general population but considerably less is known regarding seasonality and pregnancy. This study investigated the relationship between seasons and depression and anxiety symptoms, salivary cortisol concentrations, custom birthweight centiles (CBWC) and placenta weight for pregnant women living in South Wales. METHODS This study utilised data from the longitudinal Grown in Wales (GiW) cohort. Women were recruited at the presurgical elective caesarean section (ELCS) appointment, when they provided saliva samples and completed the Edinburgh Postnatal Depression Scale (EPDS) and trait subscale of the State-Trait Anxiety Inventory (STAI). Data on birthweight and placental weight was extracted from medical notes. Seasonal data was available for 316 participants. RESULTS No association was identified between seasons and EPDS (p = .178), STAI scores (p = .544), CBWC (p = .683) or placental weight (p = .857). Significance was identified between seasons and salivary cortisol concentration (p<.001), with highest levels in autumn and winter. Adjusted linear regression identified spring (B=-.05, p=.007, 95% CI -.09, -.01) and summer (B=-.06, p = .001, 95% CI -09, -.02) compared to autumn, and spring (B=-.05, p=.009, 95% CI -.09, -.01) and summer (B=-.06, p=.002, 95% CI -.10, -.02) compared to winter to be associated with decreased cortisol concentrations. CONCLUSION This study found no association between season and maternally-reported mental health symptoms, birthweight by CBWC or placental weight but did between season and term salivary cortisol. This finding will have implications for studies that do not account for seasonality when using salivary cortisol as a biomarker.
Collapse
Affiliation(s)
- Samantha M. Garay
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom
| | - Katrina A. Savory
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom
| | - Lorna A. Sumption
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom
| | - Richard J.A. Penketh
- Department of Obstetrics and Gynaecology, University Hospital Wales, Cardiff, Wales, CF144XW, United Kingdom
| | - Ian R. Jones
- National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, Wales, CF14 4XN, United Kingdom
| | - Anna B. Janssen
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom
| | - Rosalind M. John
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, United Kingdom,Corresponding author.
| |
Collapse
|
13
|
Robijn AL, Jensen ME, McLaughlin K, Gibson PG, Murphy VE. Inhaled corticosteroid use during pregnancy among women with asthma: A systematic review and meta-analysis. Clin Exp Allergy 2019; 49:1403-1417. [PMID: 31357230 DOI: 10.1111/cea.13474] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/16/2019] [Accepted: 08/24/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Studies demonstrate the prescription rate for inhaled corticosteroids (ICS) decreases in early pregnancy, possibly increasing exacerbation risk. This could be related to non-adherence to prescribed asthma medication or medication cessation by the patient or doctor. ICS use during pregnancy has not previously been summarized in a systematic review. OBJECTIVE The aim of this systematic review and meta-analysis was to evaluate the use of ICS during pregnancy among asthmatic women, specifically: (1) the prevalence of use, (2) changes of use during pregnancy compared with pre-pregnancy and (3) medication adherence among ICS users. METHODS We systematically searched literature in Embase, MEDLINE, CINAL and Cochrane, using terms related to asthma, pregnancy and medication use. All English articles reporting ICS among pregnant women with asthma were included. Prevalence, changes in ICS use during pregnancy and ICS adherence were pooled using STATA (version 15.0, StataCorp USA). RESULTS A total of 4237 references were retrieved in the initial search. Screening and review led to the inclusion of 52 articles for one or more aims (Aim 1: N = 45; Aim 2, N = 13; and Aim 3, N = 5). The pooled prevalence of ICS use during pregnancy was 41% (95%CI 36%-45%); 49% (95%CI 44%-55%) in Europe, 39% (95%CI 32%-47%) in Australia and 34% (95%CI 27%-41%) in North America. In eight prescription databases, ICS prescription rates lowered in the first trimester of pregnancy, compared with pre-pregnancy, increased in the second trimester and decreased in the third trimester. Five studies reported ICS adherence among pregnant women, using four measures of self-reported non-adherence. In two comparable studies, pooled ICS non-adherence was 40% (95%CI 36%-44%). CONCLUSIONS The prevalence of ICS use among pregnant women with asthma is 41% and varies widely between countries and continents, and prescription rates for ICS change throughout pregnancy. More studies are needed to investigate ICS adherence during pregnancy in women with asthma.
Collapse
Affiliation(s)
- Annelies L Robijn
- Priority Research Centre Grow Up Well, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Megan E Jensen
- Priority Research Centre Grow Up Well, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Karen McLaughlin
- Priority Research Centre Grow Up Well, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Peter G Gibson
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Vanessa E Murphy
- Priority Research Centre Grow Up Well, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| |
Collapse
|
14
|
Gillespie SL, Mitchell AM, Kowalsky JM, Christian LM. Maternal parity and perinatal cortisol adaptation: The role of pregnancy-specific distress and implications for postpartum mood. Psychoneuroendocrinology 2018; 97:86-93. [PMID: 30015009 PMCID: PMC6582962 DOI: 10.1016/j.psyneuen.2018.07.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Compared to women who have given birth before (i.e., multiparas), those giving birth for the first time (i.e., primiparas) show higher cortisol levels. Psychological factors may play a role; hypothalamic-pituitary-adrenal activation is a well-described stress response. Primiparity also predicts greater risk for postpartum depression, which may be related to greater correspondence between cortisol and mood following prenatal cortisol elevations. The current study examined associations among parity, perinatal cortisol adaptation, pregnancy-specific distress, and postpartum mood. METHODS This longitudinal study assayed serum cortisol levels among 137 women at early, mid-, and late pregnancy and postpartum. Pregnancy-specific distress and depressive symptoms were assessed. Maternal age, race, body mass index, sleep quality, depressive symptoms, and sampling time of day were statistically controlled. RESULTS Primiparous women showed higher cortisol levels than multiparous women during mid- (χ2 = 11.8, p < 0.01) and late pregnancy (χ2 = 18.9, p < 0.01) and higher distress across pregnancy (F1,126 = 22.1, p < 0.01). Mediation analyses demonstrated that the association between parity and prenatal cortisol (per area under the curve; AUC) was partially accounted for by distress (ab = 1.0, 95%CI [0.05, 2.9]). Prenatal cortisol (per AUC) did not predict postpartum depressive symptoms (b* = 0.03, p = 0.81), with no difference by parity (b* = 0.03, p = 0.91). At postpartum, a significant interaction between parity and cortisol (b* = 0.40, p = 0.03) revealed no significant association between cortisol and mood among multiparas (b* = -0.11, p = 0.28) but a trend toward a positive association among primiparas (b* = 0.24, p = 0.06). DISCUSSION Cortisol levels and pregnancy-specific distress are higher in primiparas versus multiparas, with pregnancy-specific distress partially mediating the association between parity and cortisol levels. Cortisol levels and mood display correspondence at postpartum in primiparous but not multiparous women. While observational studies must be interpreted with caution due to potential unmeasured confounders, these findings suggest that future studies examining mechanisms underlying perinatal and postpartum hypothalamic-pituitary-adrenal perturbations and designing interventions aimed at preventing related complications should carefully consider potential differences by parity.
Collapse
Affiliation(s)
- Shannon L. Gillespie
- College of Nursing, The Ohio State University, Columbus, OH, United States,Corresponding author at: College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, United States. (S.L. Gillespie), (L.M. Christian)
| | - Amanda M. Mitchell
- Department of Counseling and Human Development, University of Louisville, Louisville, KY, United State
| | | | - Lisa M. Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States,The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, United States,Corresponding author at: Institute for Behavioral Medicine Research, OSU Wexner Medical Center, 460 Medical Center Drive, Room 112, Columbus, OH 43210, United States
| |
Collapse
|
15
|
Smy L, Shaw K, Amstutz U, Staub M, Chaudhry S, Smith A, Carleton B, Koren G. Assessment of hair cortisol as a potential biomarker for possible adrenal suppression due to inhaled corticosteroid use in children with asthma: A retrospective observational study. Clin Biochem 2018; 56:26-32. [PMID: 29673814 DOI: 10.1016/j.clinbiochem.2018.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/10/2018] [Accepted: 04/10/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Inhaled corticosteroids (ICS) are the recommended long-term control therapy for asthma in children. However, concern exists regarding potential adrenal suppression with chronic ICS use. Our pilot study reported that hair cortisol in children was 50% lower during ICS therapy than prior to therapy, suggestive of adrenal suppression. OBJECTIVE To evaluate hair cortisol concentration (HCC) as a potential biomarker for possible adrenal suppression from ICS use in children with asthma. METHODS A retrospective observational study was performed at asthma clinics in Vancouver, Winnipeg, and Toronto, Canada. Children (n = 586) were recruited from July 2012 to December 2014 inclusive of those without asthma, with asthma not using ICS, and with asthma using ICS. The most recent three-month HCC was measured by enzyme immunoassay and compared among the groups. Quantile regression analysis was performed to identify factors potentially affecting HCC. RESULTS The median HCC was not significantly different among the children: No ICS (n = 47, 6.7 ng/g, interquartile range (IQR) 3.7-9.8 ng/g), ICS Treated (n = 360, 6.5 ng/g, IQR 3.8-14.3 ng/g), and Controls (n = 53, 5.8 ng/g, IQR 4.6-16.7 ng/g). 5.6% of the children using ICS had hair cortisol <2.0 ng/g compared to none in the control groups (P < .05, comparing ICS Treated (20/360) to all Controls combined (0/100)) and only half had been exposed to systemic corticosteroids. Age, sex, BMI, and intranasal corticosteroid use were significantly associated with HCC. CONCLUSIONS Results suggest HCC may be a potential biomarker for adrenal suppression as a population of children using ICS with HCC < 2.0 ng/g was identified compared to none in the control groups. Further research is needed to determine if those children have or are at risk of adrenal suppression or insufficiency.
Collapse
Affiliation(s)
- Laura Smy
- Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada; Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Kaitlyn Shaw
- Child & Family Research Institute, Vancouver, BC, Canada; Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Ursula Amstutz
- Child & Family Research Institute, Vancouver, BC, Canada; Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; University Institute of Clinical Chemistry, Inselspital Bern University Hospital, University of Bern, Switzerland
| | - Michelle Staub
- Winnipeg Regional Health Authority, Pharmacy Department, Winnipeg, Manitoba, Canada
| | - Shahnaz Chaudhry
- Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anne Smith
- Child & Family Research Institute, Vancouver, BC, Canada; Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Bruce Carleton
- Child & Family Research Institute, Vancouver, BC, Canada; Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, BC, Canada.
| | - Gideon Koren
- Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada; Maccabi-Kahn Research Institute, Tel Aviv, Israel
| |
Collapse
|
16
|
Abstract
Preterm birth (PTB) occurs among 1:11U.S. white women and 1:7.5 African American women and is a significant driver of racial disparities in infant mortality. Maternal stress is the most common clinical phenotype underlying spontaneous PTB. Specific patterns of stress and biological mediators driving PTB remain unclear. We examined the effect of childhood stress on birth timing among African American women and evaluated maternal cortisol elevation as a biological mediator. A prospective observational design was employed, with a single study visit at 28-32 weeks gestation and medical record review. The Stress and Adversity Inventory was administered, which provides a comprehensive estimate of childhood stress, stress in adulthood, and five core characteristic subscales (interpersonal loss, physical danger, humiliation, entrapment, role disruption). Venipuncture was performed between 11:00am and 4:00pm and plasma cortisol quantified by ELISA. Analyses controlled for stress in adulthood. Among a final sample of 89, cumulative childhood stress predicted birth timing (p=0.01). The association was driven by stress related to interpersonal loss and physical danger, with support for maternal cortisol as a biological mediator (ab=0.02, 95% CI [0.001, 0.045]; ab=0.02, 95% CI [0.001, 0.043], respectively). Results were similar, overall, in sub-group analyses among spontaneously laboring women (n=53); however, role disruption arose as an additional predictor, as mediated by cortisol elevations (ab=0.03, 95% CI [0.005, 0.074]). Of note, cortisol was no longer supported as a mediator linking physical danger to birth timing after adjusting for sleep quality and hours awake prior to venipuncture (ab=0.02, 95% CI [-0.0001, 0.046]). We provide preliminary evidence that, independent of stress in adulthood, childhood stress of specific core characteristics may shape birth timing, with cortisol elevation as a biological mediator. Further investigation is warranted and may bolster the development of biologically-informed screening tools for the prediction and targeted prevention of stress-related PTB.
Collapse
|