Maternal history of child sexual abuse moderates the association between daily stress and diurnal cortisol in pregnancy

• Main Authors: Margaret H. Bublitz, Laura R. Stroud
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2012-09-01
• Series: European Journal of Psychotraumatology
• Subjects: child sexual abuse; pregnancy; daily stress; cortisol

Introduction : Maternal hypothalamic–pituitary–adrenal (HPA)-axis functioning is a key mechanism linking stress in pregnancy to adverse neonatal outcomes. Past research has failed to consider whether a woman's history of child maltreatment impacts her stress biology in pregnancy. In this study we assessed whether association between daily stress and diurnal cortisol was moderated by maternal history of child sexual abuse (CSA). Methods : Participants were 30 pregnant women (M age=26, SD = 5) who completed a larger study of effects of maternal mood on fetal and infant development. At baseline, women completed a modified version of the Adverse Childhood Experiences Scale. Women were categorized into those who had a history of CSA, non-sexual child abuse (CA), or no child abuse (NA). Women reported the severity of daily stress for 3 days at 20 (SD = 2), 28 (SD = 1), and 35 (SD = 1) weeks gestation by completing a modified version of the Pregnancy Experiences Scale. Finally, women provided salivary cortisol samples at wake-up, +30 minutes after waking, and bedtime on each day of diary collection. Results : Twenty-three percentage of women in this pilot study reported CSA (N=7), 47% (N=14) reported CA, and 30% (N=9) reported NA. Hierarchical linear modeling (HLM) analyses were computed to assess whether prior day or same day stress predicted daily cortisol values (adjusting for gestational age at sampling and time of awakening). We found that maternal history of abuse moderated the association between prior daily stress and cortisol at awakening (p=0.07), and 30 minutes post awakening (p=0.006), but not bedtime (p=0.18). As stress the previous day increased, morning cortisol values in women with CSA history decreased, cortisol in NA women increased, and cortisol in CA women showed no change. Maternal history of child abuse did not moderate the association between daily stress and maternal cortisol on the same day (p's > 0.10). Conclusions : Results show a dynamic association between daily stressful experiences and diurnal cortisol in pregnancy and suggest that patterns of maternal cortisol following stress differ according to maternal abuse history. These findings have important implications for understanding links between maternal CSA history and adverse neonatal outcomes.