Women who experience depressive symptoms during pregnancy may experience an altered circadian rhythm cortisol, a hormone necessary for fetal development, which could influence the course of pregnancy. Cortisol naturally increases in pregnant women during pregnancy, but excessive levels of cortisol in early pregnancy can have a negative impact on fetal development, especially if this hormone increases for prolonged periods and especially when its levels are usually lower (p e.g., at night).
In pregnant women with depressive symptoms, the increase in total cortisol levels between the first and second trimesters of pregnancy is very pronounced. In particular, the increase in the second trimester may be related to a higher rate of preterm births and a lower percentile birth weight.
These are the main conclusions of a study conducted by Professor Lourdes Fañanás, of the Faculty of Biology and the Institute of Biomedicine of the University of Barcelona (IBUB), in collaboration with the Hospital Clinic de Barcelona BCNatal and the Hospital Sant Joan de Déu. Researchers from the Center for Biomedical Research in Mental Health Network (CIBERSAM) and the Center for Biomedical Research in Rare Diseases Network (CIBERER) also participated in the study.
The results of research were published in the journal Psychoneuroendocrinology.
Cortisol: the stress hormone
During pregnancy, pregnant women experience many physiological and psychological changes. During pregnancy, it is common for women to experience depressive symptoms that are usually not diagnosed during regular checkups. However, these symptoms could be linked to a deregulation of the circadian cortisol rhythm.
This depressive symptomatology can cause changes in the first and second trimesters of pregnancy. “Pregnant women fail to reduce cortisol levels enough at night, when they should be significantly lower,” says Águeda Castro, signed first author of the paper and member of the UB Department of Evolutionary Biology, Ecology and Environmental Sciences and researcher at the CIBERSAM Group.
“These conditions could affect the fetus, either by sensitizing its own stress response system – the hypothalamic-pituitary-adrenal (HHA) axis – or by direct toxicity on neurons,” he adds.
The study focused on a cohort of 112 women with their first pregnancy (aged 18 to 40). During pregnancy, the researchers analyzed the mothers' circadian cortisol rhythm, perception of stress and depressive symptoms every trimester.
“Our results show the importance of evaluating subclinical symptoms of depression, or situations of high psychosocial stress, in mothers throughout pregnancy and not just in the moments closest to giving birth,” says Professor Lourdes Fañanás (UB-IBUB- CIBERSAM), coordinator of the study. And she adds: “This is relevant even if there is no previous history of psychiatric illness or depression in the mothers.”
A further study indicates that a fragment of hair can reveal a pregnant person's stress level and could one day help warn of unexpected birth problems.
Researchers at Washington State University measured the stress hormone cortisol in hair samples from 53 women in the third trimester. Of that group, 13 women who had elevated cortisol levels later had unexpected birth complications, such as premature birth or hemorrhage.
While further research is needed on larger groups, this preliminary finding could eventually lead to a non-invasive way to identify people at risk of such complications. The researchers reported their findings in the journal Psychoneuroendocrinology.
“Otherwise there was nothing in these women to suggest disease or anything else complicating the pregnancy. This confirmed some hypotheses that stress levels, linked specifically to cortisol levels, might be associated with adverse birth outcomes,” said Erica Crespi, a WSU senior. developmental biologist and corresponding author of the study.
As part of the study, participants all answered survey questions about their levels of psychological distress as well as having their cortisol measured in the third trimester of pregnancy and after giving birth. Women who experienced unexpected birth complications had elevated concentrations of the hormone in their hair, a measure that indicates circulating levels of the stress hormone in the body during the three months before harvesting. These women also reported feelings of stress, anxiety and depression, but on average only elevated levels of the hormone during pregnancy showed a strong link to adverse birth outcomes.
Cortisol, a steroid hormone, increases in humans and many animals to help regulate the body's response to stress, but prolonged high cortisol levels are associated with serious health problems, including hypertension and diabetes. During pregnancy, cortisol levels naturally increase two- to fourfold and peak during the third trimester, but measurements in this study showed elevated cortisol levels even more pronounced among women who experienced unexpected birth complications.
“If this finding holds up, it could be a noninvasive way to get more information about who might be at risk because that's information we didn't get from the survey,” said co-author Sara Waters, a human development researcher at WSU. researcher. “This wasn't something we could find out by simply asking people what their stress was.”
Two months after giving birth, the group who experienced birth complications continued to show elevated cortisol levels and provided survey responses indicating ongoing stress, anxiety, and depression. At six months, their cortisol remained elevated, but they began to report less psychological distress on the survey, which the authors say could be a sign of recovery.
Finding ways to reduce stress around birth could help improve outcomes for both newborns and mothers, researchers said. They point out that adverse birth outcomes are on the rise in the country. The United States also famously has one of the highest maternal mortality rates among developed countries, with deaths disproportionately affecting Black women and other people of color.
More needs to be done to improve health care and support systems for pregnant women and new parents, Waters said. This study is also a reminder to expectant and new mothers to prioritize their health.
“It is very easy to sacrifice our own health and well-being to prioritize those of our children, especially when it seems like resources are scarce,” Waters said. “But our ability to show up as parents also comes from having our needs met, like the saying, 'you can&#
39;t pour from an empty cup.'”
This study involved an interdisciplinary research team at WSU. In addition to Crespi and Waters, co-authors include first author Jennifer Madigan, a Ph.D. candidate researching stress physiology; Maria Gartstein, professor of psychology; Jennifer Mattera, PhD in psychology. student; and Chris Connelly, associate professor of kinesiology. This research received support from a WSU Grand Challenges Grant and interdisciplinary grants from the WSU College of Arts and Sciences and the WSU Office of Research.
Cortisol levels in late pregnancy can predict newborn sleep. The results show that infants with higher levels of cortisol in their hair samples took longer to fall asleep at 7 months of age. Neonatal hair cortisol is a measure of fetal cortisol in the last trimester of pregnancy.
“Although increases in cortisol during pregnancy are normal and important in preparing the fetus for birth, our findings suggest that higher cortisol levels during late pregnancy may predict that the baby will have difficulty falling asleep,” said co-author Melissa Nevarez-Brewster, PhD student. at the University of Denver. “We are excited to conduct future studies to better understand this link.”
The researchers collected cortisol in the hair of 70 newborns in the first days after birth; 57% of the newborns were girls. The parents then completed a sleep questionnaire when their baby was 7 months old. Co-variate analyzes for gestational age at birth and family income-needs ratios.
Tessa Benefield, co-lead author and research staff, noted that it will be important for future research to further study the potential long-term effects of fetal cortisol production on sleep health from infancy into toddlerhood.
“The findings indicate that there may be prenatal influences on sleep health early in life, indicating a need to better understand what factors may set the stage for better sleep health in childhood and beyond,” he said.
Another study claims that high levels of the stress hormone cortisol during the third trimester of pregnancy can improve speech and language skills in the first three years of a child's life. The findings help researchers further understand the role cortisol plays in the development of both the fetus and infant.
Language development during early childhood can indicate how well your baby's nervous system developed in the womb. Prenatal exposure to cortisol – a steroid hormone that helps the body respond to stress – directs the growth of the fetus and also influences its brain development. However, the effects of cortisol on early language development remain unknown.
In this study, researchers from Odense University Hospital analyzed data on the cortisol levels of 1,093 Danish women during the third trimester of pregnancy and on the speech and language skills of 1,093 Danish children aged 12 to 37 months, of 'Odense Child Cohort. They found that boys exposed to high levels of cortisol in the womb could say more words at ages 12-37 months, while girls were better at understanding more words at ages 12-21 months.
“To our knowledge, this is the first study to investigate the association between maternal cortisol levels and language development in children over time, also taking into account the sex of the offspring and the level of maternal education,” said Dr. .ssa Anja Fenger Dreyer, involved in the study.
He added: “We had access to a large study cohort, high-quality analysis methods, and relevant covariates, making our study an important contribution to the physiological understanding of prenatal cortisol exposure in fetal maturation and child development “.
The team will then assess whether babies exposed to high levels of cortisol in the womb are more likely to have higher intelligence quotient (IQ) scores. In addition to data on maternal cortisol levels and early language development, the Odense Child Cohort also has data on intelligence tests performed on seven-year-olds. “Early language development in children is known to predict cognitive functions later in life, such as attention, memory and learning, so we want to investigate whether prenatal cortisol exposure is also associated with children's IQ scores. children as young as 7,” said Dr. Fenger Dreyer.
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