Adverse Childhood Experiences: Associations with a Blunted Cortisol Stress Response During Pregnancy

• Published in: Maternal and child health journal 2023-08, Vol.27 (8), p.1293-1300
• Main Authors: Carbone, Jason T., Hicks, Laurel M., Brown, Suzanne, Saini, Ekjyot K., Dayton, Carolyn J.
• Format: Article
• Language: English
• Subjects: Adverse Childhood Experiences; Babies; Brief Report; Child; Child development; Childhood; Childrens health; Female; Gynecology; Hormones; Humans; Hydrocortisone; Infant; Infants; Maternal & child health; Maternal and Child Health; Medicine; Medicine & Public Health; Mental health; Mothers; Mothers - psychology; Parents & parenting; Pediatrics; Population Economics; Post traumatic stress disorder; Pregnancy; Pregnancy Trimester, Third; Premature birth; Public Health; Sociology; Stress response; Stress, Psychological
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-023-03651-2

Introduction Adverse Childhood Experiences (ACEs) are associated with a range of negative physical and mental health outcomes, yet there is limited research focused on the effect of ACEs on stress responses during pregnancy. Expectant mothers experience an increase in cortisol levels as pregnancy progresses, with this increase having important implications for fetal and early infant development. Little is known about the impact of ACEs on maternal cortisol levels. This study explored the relationship between maternal ACEs and cortisol response among expectant mothers nearing or in the third trimester of pregnancy. Methods 39 expectant mothers were exposed to a Baby Cry Protocol via an infant simulator, with salivary cortisol collected at five points in time (N = 181). Stepwise, multilevel model creation resulted in a random intercept and random slope model with an interaction term for total number of ACEs and week of pregnancy. Results The repeated measures data showed that cortisol levels decreased across collection times, from arrival at the lab, through the Baby Cry Protocol, to recovery. Predictive margins for the interaction term showed that while exposure to a greater number of ACEs was associated with higher cortisol levels early in the third trimester, the expected increase in cortisol late in pregnancy was blunted for expectant mothers who were exposed to a greater number of ACEs. Discussion These findings findings suggest the importance of ACEs screening and intervention efforts as part of prenatal care. Significance What is already known on this subject? Adverse childhood experiences (ACEs) can have long-term, negative impacts on an individual’s biological response to stress and are associated with negative health outcomes later in life. In addition, maternal cortisol plays an important role in child developmental outcomes. What this study adds? This study links the research on ACEs and maternal cortisol levels. It demonstrates the association between maternal ACEs and blunted cortisol levels in later pregnancy (near or during the third trimester).