Maternal Stress During Pregnancy Is Associated with Decreased Cortisol and Cortisone Levels in Neonatal Hair

Background: Hair glucocorticoids (GCs) offer a retrospective view on chronic GC exposure. We assessed whether maternal pre- and postnatal stress was associated with neonatal and maternal hair GCs postpartum (pp). Methods: On the first day pp 172 mother-infant pairs donated hair, of whom 67 had consulted a centre of expertise for psychiatric disorders during pregnancy. Maternal stress was scored on the Hospital Anxiety and Depression Scale during the first/second (n = 46), third trimester (n = 57), and pp (n = 172). Hair cortisol and cortisone levels were determined by liquid chromatography-tandem mass spectrometry, and associations with maternal hospital anxiety subscale (HAS) and hospital depression subscale (HDS) scores, and antidepressant use were analyzed with linear regression. Results: Neonatal hair GCs were negatively associated with elevated HAS-scores during the first/second trimester, log 10 (β [95% CI]) cortisol –0.19 (–0.39 to 0.02) p = 0.07, cortisone –0.10 (–0.25 to 0.05) p = 0.17; third trimester, cortisol –0.17 (–0.33 to 0.00) p = 0.05, cortisone –0.17 (–0.28 to –0.05) p = 0.01; and pp, cortisol –0.14 (–0.25 to –0.02) p = 0.02, cortisone –0.07 (–0.16 to 0.02) p = 0.10. A similar pattern was observed for elevated HDS-scores. Maternal hair GCs were positively associated with elevated HAS-scores pp (cortisol 0.17 [0.01 to 0.32] p = 0.04, cortisone 0.18 [0.06 to 0.31] p = 0.01), but not prenatally or with elevated HDS-scores. Antidepressant use was associated with elevated maternal hair GCs (p ≤ 0.05), but not with neonatal hair GCs. Conclusion: Exposure to excessive pre- and perinatal maternal stress was associated with a decrease in neonatal hair GCs, while elevated stress-scores around birth were associated with increased maternal hair GCs and elevated stress-scores earlier in gestation were not associated with maternal hair GCs pp. Further studies are needed to test associations with infant neurodevelopment.

[1]  J. Joormann,et al.  Emotion regulation and biological stress responding: associations with worry, rumination, and reappraisal , 2018, Cognition & emotion.

[2]  R. Caparros-Gonzalez,et al.  Newborn infants’ hair cortisol levels reflect chronic maternal stress during pregnancy , 2018, PloS one.

[3]  B. van der Voorn,et al.  Interpretation of glucocorticoids in neonatal hair: a reflection of intrauterine glucocorticoid regulation? , 2017, Endocrine connections.

[4]  G. O’Keeffe,et al.  Maternal distress in late pregnancy alters obstetric outcomes and the expression of genes important for placental glucocorticoid signalling , 2017, Psychiatry Research.

[5]  C. Dennis,et al.  Prevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis , 2017, British Journal of Psychiatry.

[6]  R. Kahn,et al.  Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis , 2017, Psychoneuroendocrinology.

[7]  S. Short,et al.  Correspondence between hair cortisol concentrations and 30-day integrated daily salivary and weekly urinary cortisol measures , 2016, Psychoneuroendocrinology.

[8]  P. M. van de Ven,et al.  Serotonin and poor neonatal adaptation after antidepressant exposure in utero , 2016, Acta Neuropsychiatrica.

[9]  K. Dolman,et al.  Is poor neonatal adaptation after exposure to antidepressant medication related to fetal cortisol levels? An explorative study. , 2016, Early human development.

[10]  E. Tronick,et al.  Intra-individual stability and developmental change in hair cortisol among postpartum mothers and infants: Implications for understanding chronic stress. , 2016, Developmental psychobiology.

[11]  C. Coe,et al.  Hormone levels in neonatal hair reflect prior maternal stress exposure during pregnancy , 2016, Psychoneuroendocrinology.

[12]  S. Seth,et al.  Maternal Prenatal Mental Health and Placental 11β-HSD2 Gene Expression: Initial Findings from the Mercy Pregnancy and Emotional Wellbeing Study , 2015, International journal of molecular sciences.

[13]  H. Eriksen,et al.  Diurnal cortisol rhythm: Associated with anxiety and depression, or just an indication of lack of energy? , 2015, Psychiatry Research.

[14]  G. Noppe,et al.  LC‐MS/MS‐based method for long‐term steroid profiling in human scalp hair , 2015, Clinical endocrinology.

[15]  S. Suomi,et al.  Associations between Parity, Hair Hormone Profiles during Pregnancy and Lactation, and Infant Development in Rhesus Monkeys (Macaca mulatta) , 2015, PloS one.

[16]  I. Holme,et al.  A prospective cohort study of depression in pregnancy, prevalence and risk factors in a multi-ethnic population , 2015, BMC Pregnancy and Childbirth.

[17]  E. V. van Rossum,et al.  Validation and Reference Ranges of Hair Cortisol Measurement in Healthy Children , 2014, Hormone Research in Paediatrics.

[18]  H. Gutierrez,et al.  Epigenetic regulation of the placental HSD11B2 barrier and its role as a critical regulator of fetal development , 2014, Epigenetics.

[19]  E. Davis,et al.  New insights into the role of perinatal HPA-axis dysregulation in postpartum depression , 2013, Neuropeptides.

[20]  Ian M. Bennett,et al.  Use of antidepressant medication in the United States during pregnancy, 2002-2010. , 2013, Psychiatric Services.

[21]  R. Reynolds,et al.  Changes in the Maternal Hypothalamic-Pituitary-Adrenal Axis in Pregnancy and Postpartum: Influences on Maternal and Fetal Outcomes , 2013, Neuroendocrinology.

[22]  K. Orth-Gomér,et al.  Anxiety as Predictor of the Cortisol Awakening Response in Patients with Coronary Heart Disease , 2013, International Journal of Behavioral Medicine.

[23]  S. Matthey,et al.  Comparison of four self-report measures and a generic mood question to screen for anxiety during pregnancy in English-speaking women. , 2013, Journal of affective disorders.

[24]  V. Glover,et al.  Maternal prenatal anxiety and downregulation of placental 11β-HSD2 , 2012, Psychoneuroendocrinology.

[25]  M. Laudenslager,et al.  Hair cortisol levels as a retrospective marker of hypothalamic–pituitary axis activity throughout pregnancy: Comparison to salivary cortisol , 2011, Physiology & Behavior.

[26]  C. Buss,et al.  Exposure to Prenatal Psychobiological Stress Exerts Programming Influences on the Mother and Her Fetus , 2011, Neuroendocrinology.

[27]  M. Vinberg,et al.  Salivary cortisol in depressed patients versus control persons: A systematic review and meta-analysis , 2010, Psychoneuroendocrinology.

[28]  Tessa J. Roseboom,et al.  Depression and anxiety: Associations with biological and perceived stress reactivity to a psychological stress protocol in a middle-aged population , 2010, Psychoneuroendocrinology.

[29]  G. Koren,et al.  Prenatal hair development: implications for drug exposure determination. , 2010, Forensic science international.

[30]  G. Parker,et al.  Depressive and anxiety disorders in the postpartum period: how prevalent are they and can we improve their detection? , 2010, Archives of Women's Mental Health.

[31]  F. Zitman,et al.  Salivary Cortisol Levels in Persons With and Without Different Anxiety Disorders , 2010, Psychosomatic medicine.

[32]  C. Norris,et al.  Gender as a determinant of responses to a self-screening questionnaire on anxiety and depression by patients with coronary artery disease. , 2009, Gender medicine.

[33]  C. Lau,et al.  Development of glucocorticoid receptor regulation in the rat forebrain: Implications for adverse effects of glucocorticoids in preterm infants , 2008, Brain Research Bulletin.

[34]  V. Glover,et al.  Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? , 2007, Journal of child psychology and psychiatry, and allied disciplines.

[35]  F. Pragst,et al.  State of the art in hair analysis for detection of drug and alcohol abuse. , 2006, Clinica chimica acta; international journal of clinical chemistry.

[36]  K. Watterberg.  Adrenocortical function and dysfunction in the fetus and neonate. , 2004, Seminars in neonatology : SN.

[37]  S. Furdon,et al.  Scalp hair characteristics in the newborn infant. , 2003, Advances in neonatal care : official journal of the National Association of Neonatal Nurses.

[38]  J. Dötsch,et al.  Course of placental 11beta-hydroxysteroid dehydrogenase type 2 and 15-hydroxyprostaglandin dehydrogenase mRNA expression during human gestation. , 2001, European journal of endocrinology.

[39]  H. Sasano,et al.  Localization of 11 beta-hydroxysteroid dehydrogenase type II in human epithelial tissues. , 1996, The Journal of clinical endocrinology and metabolism.

[40]  J. Foidart,et al.  Serum CBG, free and total cortisol and circadian patterns of adrenal function in normal pregnancy. , 1982, Journal of steroid biochemistry.

[41]  M. Laudenslager,et al.  Cortisol during human fetal life: Characterization of a method for processing small quantities of newborn hair from 26 to 42 weeks gestation , 2017, Developmental psychobiology.

[42]  Ashley M. St. John,et al.  Infant hair cortisol: associations with salivary cortisol and environmental context , 2017, Developmental psychobiology.

[43]  E. Kajantie,et al.  Placental 11β-Hydroxysteroid Dehydrogenase-2 and Fetal Cortisol/Cortisone Shuttle in Small Preterm Infants , 2003 .

[44]  C. Herrmann.  International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. , 1997, Journal of psychosomatic research.

[45]  V. Kis'ov.  [Corticosteroids and pregnancy]. , 1987, Akusherstvo i ginekologiia.

[46]  G. Huston.  The Hospital Anxiety and Depression Scale. , 1987, The Journal of rheumatology.