Childhood sexual abuse is associated with cortisol awakening response over pregnancy: Preliminary findings

doi:10.1016/j.psyneuen.2012.01.009

Psychoneuroendocrinology

Volume 37, Issue 9, September 2012, Pages 1425-1430

https://doi.org/10.1016/j.psyneuen.2012.01.009 Get rights and content

Summary

Introduction

Childhood sexual abuse (CSA) has been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in non-pregnant samples. However, it is not yet known whether CSA is associated with HPA dysregulation over pregnancy. In the present study we assessed whether maternal cortisol levels across pregnancy differed in women with CSA histories compared to women with histories of non-sexual child abuse (CA) and no abuse (NA).

Methods

135 pregnant mothers (CSA = 30, CA = 58, NA = 47) provided salivary cortisol samples at wakeup, wake +30 min, and bedtime for 3 consecutive days at 1–3 time points over second and third trimester. Cortisol awakening responses and slopes were computed.

Results

Women with CSA histories displayed increasing cortisol awakening response over pregnancy compared to women with CA and NA histories. Group differences were not observed for slope.

Conclusions

This is the first study to show that cortisol awakening responses increase over pregnancy in women with CSA histories compared to women with CA and NA histories.

Section snippets

Participants

Participants were part of an ongoing study of the effects of maternal depression on fetal and infant development. Participants were recruited throughout pregnancy (8–38 weeks gestation). Seven hundred and ninety-three pregnant women volunteered to participate in the larger study, 359 met eligibility criteria, and 155 had enrolled at the time of the present analyses. Of these, 145 women completed both child abuse and maternal cortisol measures. We then excluded 10 women due to emerging

Data analysis

For each day of cortisol collection, cortisol awakening responses (CARs) were calculated by computing the difference in the morning samples, and slope was computed by calculating the difference between the morning and evening samples and dividing by the time interval between awakening and bedtime. CARs and slopes were then averaged across days for each study session. Morning saliva samples that were <20 or >40 min apart, and outliers ±4 standard deviations, were identified. Because neither

Results

30 participants reported CSA, 58 reported CA, and 47 participants reported NA. One-way analysis of variance (ANOVA) and chi-square tests were utilized to assess for significant group differences in demographic or psychosocial variables (see Table 1). Women with CSA histories showed significantly higher pre-pregnancy BMI (F(2, 133) = 6.01, p = .003) and greater anxiety symptoms (F(2, 133) = 3.37, p = .04) than CA and NA groups. Thus, BMI and anxiety symptoms were included as covariates. No other group

Discussion

In this ethnically diverse, low-income sample of primarily unplanned pregnancies, we found that women with child sexual abuse histories displayed increasing cortisol awakening response (CAR) across gestation compared to women with non-sexual child abuse histories or women who had never experienced abuse. Significant group differences were observed only at the end of the 3rd trimester. We did not observe group differences in slope over pregnancy, suggesting that women with sexual abuse histories

Role of the funding source

Funding for this study was provided by NIMH (MH079153). NIMH had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report, and in the decision to submit the paper for publication.

Conflict of interest

Neither Dr. Bublitz nor Dr. Stroud have any conflicts of interest to declare.

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Adverse childhood experiences (ACEs) of a woman can lead to dysregulated hypothalamus-pituitary-adrenal (HPA) axis during pregnancy, which can in turn adversely affect her offspring HPA axis function. Choline and docosahexaenoic acid (DHA) are dietary factors with the potential to favorably modify the stress response system. The current study aimed to investigate whether maternal choline intake and DHA status moderate the effects of maternal ACEs exposure on maternal and infant HPA axes function. Participants were a sub-sample of the prospective longitudinal Alberta Pregnancy Outcomes and Nutrition (APrON) study consisting of 340 mothers and 238 infants. We collected data on maternal ACEs, maternal choline intake (24-hour dietary recall) and serum phospholipid DHA concentrations (at each trimester). Women self-collected saliva samples on two consecutive days (at waking, +30 min, 1100 h, and 2100 h) in each trimester to calculate the cortisol awakening response (CAR) and total daytime cortisol. Infants’ salivary cortisol was measured before and after (20, and 40 min) exposure to a blood draw stressor 3 months postpartum. During pregnancy, choline intake moderated (reduced) the association between maternal ACEs and CAR (β = −0.003; 95% CI −0.006, −0.003), but not total daytime cortisol. DHA status did not moderate the association between ACEs and CAR or total daytime cortisol. Choline intake also moderated (reduced) the association between maternal CAR and infant cortisol during a stress task (β = −0.0001; 95% CI −0.0002, −0.00003). Maternal DHA status revealed no modifying effects on these associations. Our findings suggest that maternal choline intake, but not DHA status, can buffer the associations between ACEs and maternal HPA axis, as well as maternal and infant HPA axes function.

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View full text

Childhood sexual abuse is associated with cortisol awakening response over pregnancy: Preliminary findings

Summary

Introduction

Methods

Results

Conclusions

Section snippets

Participants

Data analysis

Results

Discussion

Role of the funding source

Conflict of interest

Biological Psychiatry

Sleep Medicine Review

Journal of the American Academy of Child and Adolescent Psychiatry

Progress in Brain Research

Psychoneuroendocrinology

Psychoneuroendocrinology

Journal of Psychosomatic Research

Journal of Psychosomatic Research

Schizophrenia Research

Psychoneuroendocrinology

Psychoneuroendocrinology

Biol Psychiatry

American Journal of Obstetrics and Gynecology Scandinavia

American Journal of Obstetrics and Gynecology

Clinics in Perinatology

Psychoneuroendocrinology

Psychoneuroendocrinology

Cortisol levels in pregnancy as a psychobiological predictor for birth weight

Archives of Women's Mental Health

Resetting the dynamic range of hypothalamic-pituitary-adrenal axis stress responses through pregnancy

Journal of Neuroendocrinology