title: Childhood sexual abuse is associated with cortisol awakening response over pregnancy: preliminary findings.
abstract: BACKGROUND
  Childhood sexual abuse (CSA) has been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in non-pregnant samples. However, it is not yet known whether CSA is associated with HPA dysregulation over pregnancy. In the present study we assessed whether maternal cortisol levels across pregnancy differed in women with CSA histories compared to women with histories of non-sexual child abuse (CA) and no abuse (NA).
  
  
  METHODS
  135 pregnant mothers (CSA=30, CA=58, NA=47) provided salivary cortisol samples at wakeup, wake +30 min, and bedtime for 3 consecutive days at 1-3 time points over second and third trimester. Cortisol awakening responses and slopes were computed.
  
  
  RESULTS
  Women with CSA histories displayed increasing cortisol awakening response over pregnancy compared to women with CA and NA histories. Group differences were not observed for slope.
  
  
  CONCLUSIONS
  This is the first study to show that cortisol awakening responses increase over pregnancy in women with CSA histories compared to women with CA and NA histories.
authors.affiliation: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Coro West, Suite 314, 1 Hoppin Street, Providence, RI 02903, USA. mhbublitz@lifespan.org
authors.forename: Margaret H
authors.initials: MH
authors.lastname: Bublitz
authors.forename: Laura R
authors.initials: LR
authors.lastname: Stroud
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse; D002648:Child; D002650:Child Abuse, Sexual; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D010913:Pituitary-Adrenal System / Q000502:physiology; D011247:Pregnancy; D012463:Saliva / Q000737:chemistry; D014851:Wakefulness / Q000502:physiology*
chemical_list: D006854:Hydrocortisone