Associations between maternal psychological distress and salivary cortisol during pregnancy: A mixed-models approach

M.I. van den Heuvel, M.A.L.M. van Assen, Vivette Glover, Stephan Claes, B.R.H van den Bergh

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: 

Maternal psychological distress during pregnancy is related to adverse child behavioral and emotional outcomes later in life, such as ADHD and anxiety/depression. The underlying mechanisms for this, however, are still largely unknown. The hypothalamic-pituitary-adrenal (HPA)-axis, with its most important effector hormone cortisol, has been proposed as a mechanism, but results have been inconsistent. The current study investigated the association between maternal psychological distress (i.e. anxiety and depressive symptoms) and maternal cortisol levels during pregnancy using a mixed models approach.

Method: 

During three pregnancy trimesters, mothers (N = 170) collected four salivary samples for two consecutive days. Mothers reported symptoms of anxiety and depression three times during pregnancy (at 13.3 ± 1.1, 20.2 ± 1.5, and 33.8 ± 1.5 weeks of pregnancy, respectively) using the anxiety subscale of the Symptom Checklist (SCL-90), the Spielberger State and Trait Anxiety Inventory (STAI), and the Edinburgh Postnatal Depression Scale (EPDS). Specific fears and worries during pregnancy were measured with the short version of the Pregnancy Related Anxiety Questionnaire (PRAQ-R).

Results: 

We found a significant effect of SCL-90 anxiety subscale on cortisol levels at awakening (p = .008), indicating that mothers with higher anxiety showed lower cortisol at awakening. Maternal psychological variables explained 10.5% of the variance at the person level in awakening cortisol level, but none in the overall diurnal cortisol model.

Conclusion: 

More research is necessary to unravel the underlying mechanisms of the association between maternal psychological distress and cortisol and the search for mechanisms other than the HPA-axis should be continued and extended.

Original languageEnglish
Pages (from-to)52-60
JournalPsychoneuroendocrinology
Volume96
DOIs
Publication statusPublished - 2018

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Mothers
Depression
Postpartum Depression
Checklist
Hormones
Equipment and Supplies

Keywords

  • 3RD TRIMESTER
  • ANXIETY
  • AWAKENING RESPONSE
  • CHILD OUTCOMES
  • DEPRESSION
  • Fetal Programming
  • GESTATION
  • HPA-axis
  • Maternal anxiety
  • Maternal cortisol
  • Maternal depression
  • Maternal psychological distress
  • PSYCHOSOCIAL STRESS
  • SYMPTOMS
  • TEMPERAMENT
  • WOMEN

Cite this

@article{eca1027ebb6e463aa7d949b9e5315768,
title = "Associations between maternal psychological distress and salivary cortisol during pregnancy: A mixed-models approach",
abstract = "Background: Maternal psychological distress during pregnancy is related to adverse child behavioral and emotional outcomes later in life, such as ADHD and anxiety/depression. The underlying mechanisms for this, however, are still largely unknown. The hypothalamic-pituitary-adrenal (HPA)-axis, with its most important effector hormone cortisol, has been proposed as a mechanism, but results have been inconsistent. The current study investigated the association between maternal psychological distress (i.e. anxiety and depressive symptoms) and maternal cortisol levels during pregnancy using a mixed models approach.Method: During three pregnancy trimesters, mothers (N = 170) collected four salivary samples for two consecutive days. Mothers reported symptoms of anxiety and depression three times during pregnancy (at 13.3 ± 1.1, 20.2 ± 1.5, and 33.8 ± 1.5 weeks of pregnancy, respectively) using the anxiety subscale of the Symptom Checklist (SCL-90), the Spielberger State and Trait Anxiety Inventory (STAI), and the Edinburgh Postnatal Depression Scale (EPDS). Specific fears and worries during pregnancy were measured with the short version of the Pregnancy Related Anxiety Questionnaire (PRAQ-R).Results: We found a significant effect of SCL-90 anxiety subscale on cortisol levels at awakening (p = .008), indicating that mothers with higher anxiety showed lower cortisol at awakening. Maternal psychological variables explained 10.5{\%} of the variance at the person level in awakening cortisol level, but none in the overall diurnal cortisol model.Conclusion: More research is necessary to unravel the underlying mechanisms of the association between maternal psychological distress and cortisol and the search for mechanisms other than the HPA-axis should be continued and extended.",
keywords = "3RD TRIMESTER, ANXIETY, AWAKENING RESPONSE, CHILD OUTCOMES, DEPRESSION, Fetal Programming, GESTATION, HPA-axis, Maternal anxiety, Maternal cortisol, Maternal depression, Maternal psychological distress, PSYCHOSOCIAL STRESS, SYMPTOMS, TEMPERAMENT, WOMEN",
author = "{van den Heuvel}, M.I. and {van Assen}, M.A.L.M. and Vivette Glover and Stephan Claes and {van den Bergh}, B.R.H",
note = "Copyright {\circledC} 2018. Published by Elsevier Ltd.",
year = "2018",
doi = "10.1016/j.psyneuen.2018.06.005",
language = "English",
volume = "96",
pages = "52--60",
journal = "Psychoneuroendocrinology",
issn = "0306-4530",
publisher = "PERGAMON-ELSEVIER SCIENCE LTD",

}

Associations between maternal psychological distress and salivary cortisol during pregnancy : A mixed-models approach. / van den Heuvel, M.I.; van Assen, M.A.L.M.; Glover, Vivette; Claes, Stephan; van den Bergh, B.R.H.

In: Psychoneuroendocrinology, Vol. 96, 2018, p. 52-60.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Associations between maternal psychological distress and salivary cortisol during pregnancy

T2 - A mixed-models approach

AU - van den Heuvel, M.I.

AU - van Assen, M.A.L.M.

AU - Glover, Vivette

AU - Claes, Stephan

AU - van den Bergh, B.R.H

N1 - Copyright © 2018. Published by Elsevier Ltd.

PY - 2018

Y1 - 2018

N2 - Background: Maternal psychological distress during pregnancy is related to adverse child behavioral and emotional outcomes later in life, such as ADHD and anxiety/depression. The underlying mechanisms for this, however, are still largely unknown. The hypothalamic-pituitary-adrenal (HPA)-axis, with its most important effector hormone cortisol, has been proposed as a mechanism, but results have been inconsistent. The current study investigated the association between maternal psychological distress (i.e. anxiety and depressive symptoms) and maternal cortisol levels during pregnancy using a mixed models approach.Method: During three pregnancy trimesters, mothers (N = 170) collected four salivary samples for two consecutive days. Mothers reported symptoms of anxiety and depression three times during pregnancy (at 13.3 ± 1.1, 20.2 ± 1.5, and 33.8 ± 1.5 weeks of pregnancy, respectively) using the anxiety subscale of the Symptom Checklist (SCL-90), the Spielberger State and Trait Anxiety Inventory (STAI), and the Edinburgh Postnatal Depression Scale (EPDS). Specific fears and worries during pregnancy were measured with the short version of the Pregnancy Related Anxiety Questionnaire (PRAQ-R).Results: We found a significant effect of SCL-90 anxiety subscale on cortisol levels at awakening (p = .008), indicating that mothers with higher anxiety showed lower cortisol at awakening. Maternal psychological variables explained 10.5% of the variance at the person level in awakening cortisol level, but none in the overall diurnal cortisol model.Conclusion: More research is necessary to unravel the underlying mechanisms of the association between maternal psychological distress and cortisol and the search for mechanisms other than the HPA-axis should be continued and extended.

AB - Background: Maternal psychological distress during pregnancy is related to adverse child behavioral and emotional outcomes later in life, such as ADHD and anxiety/depression. The underlying mechanisms for this, however, are still largely unknown. The hypothalamic-pituitary-adrenal (HPA)-axis, with its most important effector hormone cortisol, has been proposed as a mechanism, but results have been inconsistent. The current study investigated the association between maternal psychological distress (i.e. anxiety and depressive symptoms) and maternal cortisol levels during pregnancy using a mixed models approach.Method: During three pregnancy trimesters, mothers (N = 170) collected four salivary samples for two consecutive days. Mothers reported symptoms of anxiety and depression three times during pregnancy (at 13.3 ± 1.1, 20.2 ± 1.5, and 33.8 ± 1.5 weeks of pregnancy, respectively) using the anxiety subscale of the Symptom Checklist (SCL-90), the Spielberger State and Trait Anxiety Inventory (STAI), and the Edinburgh Postnatal Depression Scale (EPDS). Specific fears and worries during pregnancy were measured with the short version of the Pregnancy Related Anxiety Questionnaire (PRAQ-R).Results: We found a significant effect of SCL-90 anxiety subscale on cortisol levels at awakening (p = .008), indicating that mothers with higher anxiety showed lower cortisol at awakening. Maternal psychological variables explained 10.5% of the variance at the person level in awakening cortisol level, but none in the overall diurnal cortisol model.Conclusion: More research is necessary to unravel the underlying mechanisms of the association between maternal psychological distress and cortisol and the search for mechanisms other than the HPA-axis should be continued and extended.

KW - 3RD TRIMESTER

KW - ANXIETY

KW - AWAKENING RESPONSE

KW - CHILD OUTCOMES

KW - DEPRESSION

KW - Fetal Programming

KW - GESTATION

KW - HPA-axis

KW - Maternal anxiety

KW - Maternal cortisol

KW - Maternal depression

KW - Maternal psychological distress

KW - PSYCHOSOCIAL STRESS

KW - SYMPTOMS

KW - TEMPERAMENT

KW - WOMEN

U2 - 10.1016/j.psyneuen.2018.06.005

DO - 10.1016/j.psyneuen.2018.06.005

M3 - Article

VL - 96

SP - 52

EP - 60

JO - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

SN - 0306-4530

ER -