Cortisol Level and Perinatal Outcome in Pregnant Women With Posttraumatic Stress Disorder: A Pilot Study

Authors

  • Julia S. Seng CNM, PhD,

    Corresponding author
      Julia S. Seng, CNM, PhD, University of Michigan Institute for Research on Women and Gender, 6120 Lane Hall, 204 S. State Street, Ann Arbor, MI 48109–1290. E-mail: jseng@umich.edu
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    • Julia Seng, CNM, PhD, is Assistant Research Scientist at the Institute for Research on Women and Gender and in the School of Nursing and is Research Investigator in the Department of Obstetrics and Gynecology in the Medical School at the University of Michigan, Ann Arbor, Michigan.

  • Lisa Kane Low CNM, PhD,

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    • Lisa Kane Low, CNM, MS, PhD, FACNM, is Assistant Research Scientist in the School of Nursing and Lecturer III in the Program in Women's Studies, and lecturer and staff nurse-midwife in the Department of Obstetrics and Gynecology at the University of Michigan.

  • Dorit Ben-Ami MD,

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    • Dorit Ben-Ami, MD, is a resident physician in the Department of Psychiatry at the University of Michigan Medical School.

  • Israel Liberzon MD

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    • Israel Liberzon, MD, is affiliated with the Psychiatry Service of the Ann Arbor Veterans Administration Medical Center, Associate Professor of Psychiatry in the Neuroscience Graduate Program, and codirector of the Trauma, Stress, and Anxiety Research Group in the Department of Psychiatry at the University of Michigan Medical School.


Julia S. Seng, CNM, PhD, University of Michigan Institute for Research on Women and Gender, 6120 Lane Hall, 204 S. State Street, Ann Arbor, MI 48109–1290. E-mail: jseng@umich.edu

Abstract

Posttraumatic stress disorder (PTSD) affects 12% of women in the United States and could affect childbearing via behavioral and neuroendocrine mechanisms. This pilot study collected preliminary data about the extent to which the low cortisol profile found in patients with PTSD also occurs in the hormonal context of pregnancy, as well as the association between PTSD and less optimal processes and outcomes of pregnancy. Standardized psychiatric diagnostic telephone interviews, salivary cortisol assays, and medical records review were evaluated in a community sample of 25 women pregnant with their first child. Higher PTSD symptom counts correlated with worse overall perinatal outcomes summarized by an Optimality Index Score (n = 22; r = —.725; P < .001). The women whose symptoms met diagnostic criteria for PTSD or partial PTSD had lower peak basal salivary cortisol concentrations (n = 14; mean = .4584 versus .8123; P = .010). Further research on the effects of PTSD on pregnancy processes and outcomes is warranted. Differences in cortisol levels were consistent with the pattern seen in nonpregnant women with PTSD. This finding suggests that salivary cortisol would be a useful biological measure to include in perinatal research on PTSD and childbearing.

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