Abstract
The Hypothalamic-Pituitary-Adrenal (HPA) axis has been proposed as a potential underlying biological mechanism linking prenatal depression with adverse offspring outcomes. However, it is unknown whether the reactivity of this system to stress is altered in pregnant women experiencing depression. The objective of this study was to investigate whether salivary cortisol response to a distressed infant film is enhanced in pregnant women with symptoms of depression compared with non-depressed controls. Salivary cortisol and subjective mood responses to the film were measured in 53 primiparous women, between 11 and 18 weeks gestation. Both groups showed similar increases in state anxiety in response to the film, but there was a significantly increased cortisol response in women experiencing symptoms of depression. Depression during pregnancy is associated with increased reactivity of the HPA axis. This is consistent with altered HPA axis functioning being a key mechanism by which prenatal mood disturbance can impact upon fetal development.
Highlights
Maternal depression during pregnancy is associated with increased risk of poor birth outcomes (Lobel 1994), infant behavioural, cognitive and emotional problems (O’Connor et al 2002; Talge et al 2007) and later diagnosis of psychiatric disease in adulthood (Van den Bergh et al 2007)
The aim of the current study was to investigate whether salivary cortisol response to a distressed infant film was increased in pregnant women currently experiencing symptoms of depression compared with non-depressed controls
Such evidence is consistent with the idea that depression during pregnancy is associated with increased reactivity of the HPA axis in response to stress
Summary
Maternal depression during pregnancy is associated with increased risk of poor birth outcomes (Lobel 1994), infant behavioural, cognitive and emotional problems (O’Connor et al 2002; Talge et al 2007) and later diagnosis of psychiatric disease in adulthood (Van den Bergh et al 2007). The underlying mechanisms by which prenatal depression may directly influence fetal development are not well understood. The Hypothalamic-Pituitary-Adrenal (HPA) axis of both the mother and child has been proposed as a potential underlying biological mechanism linking prenatal depressed mood with adverse offspring outcomes. Excessive levels of these hormones may have negative influences on fetal development, and there is evidence to suggest altered glucocorticoid exposure during gestation can permanently alter HPA function and lead to chronically elevated levels of glucocorticoid activity postnatally (Challis et al 2001). A theoretical model proposed to explain the association between maternal prenatal mood and infant outcomes suggests that maternal prenatal depression results in excessive levels of maternal cortisol, which leads to ‘programming’ of the offspring HPA axis during fetal development (Glover et al 2010)
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