Hair glucocorticoids during pregnancy in the context of trauma exposure and their predictive value for the development of childbirth-related posttraumatic stress disorder symptoms.


Journal

Psychoneuroendocrinology
ISSN: 1873-3360
Titre abrégé: Psychoneuroendocrinology
Pays: England
ID NLM: 7612148

Informations de publication

Date de publication:
02 2023
Historique:
received: 05 07 2022
revised: 07 10 2022
accepted: 09 11 2022
pubmed: 9 12 2022
medline: 7 2 2023
entrez: 8 12 2022
Statut: ppublish

Résumé

Childbirth-related posttraumatic stress disorder (CB-PTSD) is gaining attention as a mental disorder with negative sequela for mothers and their offspring. Maternal trauma history is a well-known vulnerability factor for CB-PTSD symptoms (CB-PTSS). Furthermore, alterations of the hypothalamus-pituitary-adrenal axis have been linked to both trauma exposure and PTSD development. Hence, we investigated whether trauma history was associated with long-term glucocorticoid (GC) levels during pregnancy and their predictive role for CB-PTSS. Further, we examined whether GCs act as a mediator in the relationship between trauma history and CB-PTSS and whether this was moderated by the subjective birth experience. 212 women participating in the prospective cohort study DREAM Trauma history predicted elevated hair cortisol and hair cortisone during the third trimester of pregnancy, however associations did not remain significant when Bonferroni correction due to multiple testing was applied. Trauma history also predicted higher CB-PTSS. Hair GC levels during pregnancy neither predicted CB-PTSS two months after birth nor mediated the relationship between trauma history and CB-PTSS. The subjective birth experience moderated the relationship of hair cortisol and cortisone with CB-PTSS. Our data suggest that a history of trauma contributes to a higher risk to develop CB-PTSS and elevated long-term GC levels during the third pregnancy trimester. Further, the predictive role of hair cortisol and cortisone levels for CB-PTSS may depend on subjective birth experience. This highlights the need to consider the latter in future investigations when examining the role of stress-related biomarkers in more severely affected samples.

Sections du résumé

BACKGROUND
Childbirth-related posttraumatic stress disorder (CB-PTSD) is gaining attention as a mental disorder with negative sequela for mothers and their offspring. Maternal trauma history is a well-known vulnerability factor for CB-PTSD symptoms (CB-PTSS). Furthermore, alterations of the hypothalamus-pituitary-adrenal axis have been linked to both trauma exposure and PTSD development. Hence, we investigated whether trauma history was associated with long-term glucocorticoid (GC) levels during pregnancy and their predictive role for CB-PTSS. Further, we examined whether GCs act as a mediator in the relationship between trauma history and CB-PTSS and whether this was moderated by the subjective birth experience.
METHODS
212 women participating in the prospective cohort study DREAM
FINDINGS
Trauma history predicted elevated hair cortisol and hair cortisone during the third trimester of pregnancy, however associations did not remain significant when Bonferroni correction due to multiple testing was applied. Trauma history also predicted higher CB-PTSS. Hair GC levels during pregnancy neither predicted CB-PTSS two months after birth nor mediated the relationship between trauma history and CB-PTSS. The subjective birth experience moderated the relationship of hair cortisol and cortisone with CB-PTSS.
CONCLUSION
Our data suggest that a history of trauma contributes to a higher risk to develop CB-PTSS and elevated long-term GC levels during the third pregnancy trimester. Further, the predictive role of hair cortisol and cortisone levels for CB-PTSS may depend on subjective birth experience. This highlights the need to consider the latter in future investigations when examining the role of stress-related biomarkers in more severely affected samples.

Identifiants

pubmed: 36481577
pii: S0306-4530(22)00314-6
doi: 10.1016/j.psyneuen.2022.105973
pii:
doi:

Substances chimiques

Cortisone V27W9254FZ
Glucocorticoids 0
Hydrocortisone WI4X0X7BPJ

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

105973

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest The authors report no conflict of interest.

Auteurs

S Steudte-Schmiedgen (S)

Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany. Electronic address: Susann.Schmiedgen@tu-dresden.de.

S Schälicke (S)

Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.

L Bergunde (L)

Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.

M Karl (M)

Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.

V Weise (V)

Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.

J Junge-Hoffmeister (J)

Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.

S Schumacher (S)

Clinical Psychology and Psychotherapy, Faculty of Health, Health and Medical University, Potsdam, Germany.

T von Soest (T)

PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway, and Norwegian Social Research, OsloMet - Oslo Metropolitan University, Oslo, Norway.

K Weidner (K)

Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.

C Kirschbaum (C)

Institute of Biological Psychology, Faculty of Psychology of the Technische Universität Dresden, Dresden, Germany.

S Garthus-Niegel (S)

Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany; Institute for Systems Medicine (ISM) and Faculty of Medicine, Medical School Hamburg MSH, Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway.

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