title: The association between perceived emotional support, maternal mood, salivary cortisol, salivary cortisone, and the ratio between the two compounds in response to acute stress in second trimester pregnant women.
abstract: OBJECTIVE
  Little is known about the effect of social support on the reactivity of the hypothalamic-pituitary-adrenal (HPA) axis during pregnancy. Moreover, when investigating the HPA axis most studies do not consider the activity of 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2), an enzyme within the salivary glands that inactivates cortisol to cortisone. This study explores the association between perceived emotional support and the maternal psychobiological stress response to a standardized naturalistic stressor by assessing maternal mood and the reactivity of salivary cortisol (SalF), salivary cortisone (SalE), and the SalE/(E+F) ratio as a marker of 11β-HSD2 activity.
  
  
  METHODS
  Repeated saliva samples and measures of maternal mood were obtained from 34 healthy second trimester pregnant women undergoing amniocentesis which served as a psychological stressor. The pregnant women additionally responded to a questionnaire of perceived emotional support and provided sociodemographic (e.g., maternal educational degree) and pregnancy-specific data (e.g., planned versus unplanned pregnancy).
  
  
  RESULTS
  Perceived emotional support neither showed a significant effect on mood nor on the SalF or SalE response to stress. However, a moderately strong positive association was found between perceived emotional support and SalE/(E+F) (r=.49). Additionally, the final regression analysis revealed a significant negative relationship between educational degree, planned/unplanned pregnancy and SalE/(E+F).
  
  
  CONCLUSIONS
  Findings suggest a higher metabolization of cortisol to cortisone in pregnant women with higher emotional support. In contrast, higher maternal education and unplanned pregnancy appear to be associated with decreased salivary 11β-HSD2 activity. The current study emphasizes the importance of taking the activity of 11β-HSD2 into account when examining SalF.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland. Electronic address: pearl.lamarca@psychologie.uzh.ch.
authors.forename: Pearl
authors.initials: P
authors.lastname: La Marca-Ghaemmaghami
authors.forename: Roberto
authors.initials: R
authors.lastname: La Marca
authors.forename: Sara M
authors.initials: SM
authors.lastname: Dainese
authors.forename: Marina
authors.initials: M
authors.lastname: Haller
authors.forename: Roland
authors.initials: R
authors.lastname: Zimmermann
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ehlert
mesh_terms: D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2 / Q000378:metabolism*; D000208:Acute Disease; D000328:Adult; D000339:Affect; D000649:Amniocentesis / Q000523:psychology*; D003348:Cortisone / Q000378:metabolism*; D004522:Educational Status; D004644:Emotions; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D009035:Mothers / Q000523:psychology; D010913:Pituitary-Adrenal System / Q000378:metabolism; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D049168:Pregnancy, Unplanned; D037841:Pregnant People / Q000523:psychology*; D012463:Saliva / Q000378:metabolism; D012938:Social Perception; D012944:Social Support; D013315:Stress, Psychological / Q000378:metabolism* / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D043209:11-beta-Hydroxysteroid Dehydrogenase Type 2; D003348:Cortisone; D006854:Hydrocortisone
keywords: HPA axis; Perceived emotional support; Prenatal stress; Salivary cortisol; Salivary cortisone; Stress response