title: Childhood abuse is associated with increased hair cortisol levels among urban pregnant women.
abstract: BACKGROUND
  Hypothalamic-pituitary-adrenal (HPA) axis activity is known to be altered following events such as childhood abuse. However, despite potential adverse consequences for the offspring of women who have experienced abuse, very little is known about altered HPA axis activity during pregnancy.
  
  
  METHODS
  During pregnancy, 180 women from diverse racial/ethnic backgrounds reported on their exposure to emotional, physical and/or sexual abuse before the age of 11, and general post-traumatic stress symptoms (ie, not limited to childhood years or abuse experiences). Around delivery, they provided hair samples for the assessment of cortisol levels during pregnancy. Hair cortisol was assessed for each pregnancy trimester. The effect of childhood abuse on hair cortisol was assessed using mixed-effects analyses of covariance models allowing for within-subject correlated observations, and were first performed in the entire sample and subsequently stratified by race/ethnicity.
  
  
  RESULTS
  Controlling for post-traumatic stress symptoms, hair cortisol levels varied by history of child abuse, F(2,166)=3.66, p=0.028. Childhood physical and/or sexual abuse was associated with greater hair cortisol levels, t(166)=2.65, p=0.009, compared with no history of abuse. Because childhood rates of abuse and hair cortisol levels varied by race/ethnicity, analyses were stratified by race/ethnicity. The associations between history of abuse and cortisol levels were only significant among black women, F(2,23)=5.37, p=0.012.
  
  
  CONCLUSIONS
  Childhood abuse, especially physical and/or sexual abuse, is associated with differences in cortisol production during pregnancy, particularly among black women. Future research should investigate how these differences impact physical and mental health outcomes among offspring of affected women.
authors.affiliation: Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Hannah M C
authors.initials: HM
authors.lastname: Schreier
authors.affiliation: Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Michelle Bosquet
authors.initials: MB
authors.lastname: Enlow
authors.affiliation: Department of Psychology, Southern Methodist University, Dallas, Texas, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ritz
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Gennings
authors.affiliation: Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Rosalind J
authors.initials: RJ
authors.lastname: Wright
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D001741:Black or African American / Q000706:statistics & numerical data; D005260:Female; D006197:Hair / Q000737:chemistry*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000378:metabolism; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology / Q000378:metabolism* / Q000523:psychology; D044465:White People
chemical_list: D006854:Hydrocortisone
keywords: ENDOCRINOLOGY; ETHNICITY; Lifecourse / Childhood Circumstances; PREGNANCY