title: Cortisol response to the Trier Social Stress Test in pregnant women at risk for postpartum depression.
abstract: Antepartum depression and anxiety are risk factors for postpartum depression (PPD). Postpartum abnormalities in hypothalamic-pituitary-adrenal (HPA) reactivity are associated with PPD. It is not known if antepartum HPA abnormalities exist in women at risk for PPD (AR-PPD). We measured salivary cortisol response to the Trier Social Stress Test (TSST) in 44 (24 AR-PPD, 20 healthy comparison) pregnant women. Depression and anxiety were measured using the Edinburgh Postnatal Depression Scale (EPDS) and Spielberger State-Trait Anxiety Inventory-State (STAI-S). We analyzed longitudinal changes in cortisol using generalized estimating equation methods to control for the correlation within subjects at the six TSST time points. Group differences in area under the curve (AUC) were examined. A majority (70.8 %) of the AR-PPD had prior depression. EPDS total score was higher in AR-PPD vs. comparison women (mean EPDS = 9.8 ± 4.9 vs. mean EPDS = 2.4 ± 2.0 respectively, p < 0.001). Mean STAI-S total score was higher in AR-PPD vs. comparison women at all TSST time points and over time (z = 2.71, df = 1, p = 0.007). There was no significant difference in cortisol concentration over time between groups. We observed no detectable difference in cortisol response to psychosocial stress induced by the TSST despite clinically significant between-group differences in current/past depression and current symptomatology.
authors.affiliation: Center for Psychopharmacologic Research and Treatment, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, 01605, USA. Kristina.Deligiannidis@umassmemorial.org.|Women's Mental Health Program, Departments of Psychiatry and Obstetrics and Gynecology, University of Massachusetts Medical School, UMass Memorial Medical Center, 55 Lake Avenue, North, Worcester, MA, 01605, USA. Kristina.Deligiannidis@umassmemorial.org.
authors.forename: Kristina M
authors.identifier: 0000-0001-7439-2236
authors.initials: KM
authors.lastname: Deligiannidis
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA.
authors.forename: Aimee R
authors.initials: AR
authors.lastname: Kroll-Desrosiers
authors.affiliation: Center for Psychopharmacologic Research and Treatment, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, 01605, USA.
authors.forename: Abby
authors.initials: A
authors.lastname: Svenson
authors.affiliation: Center for Psychopharmacologic Research and Treatment, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, 01605, USA.|National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709-2233, USA.
authors.forename: Nina
authors.initials: N
authors.lastname: Jaitly
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Barton
authors.affiliation: National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709-2233, USA.|Reproductive Endocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, 02114-2696, USA.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Hall
authors.affiliation: Center for Psychopharmacologic Research and Treatment, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, 01605, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Rothschild
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D011247:Pregnancy; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: Anxiety; Cortisol; Depression; Postpartum