Perinatal Stress Research Articles

Maternal stress induced endoplasmic reticulum stress and impaired pancreatic islets’ insulin secretion via glucocorticoid receptor upregulation in adult male rat offspring

Exposure to perinatal (prenatal and/or postnatal) stress is considered as a risk factor for metabolic disorders in later life. Accordingly, this study aimed to investigate the perinatal stress effects on the pancreatic endoplasmic reticulum (ER) stress induction, insulin secretion impairment and WFS1 (wolframin ER transmembrane Glycoprotein, which is involved in ER homeostasis and insulin secretion) expression changes, in rat offspring. According to the dams’ period of exposure to variable stress, their male offspring were divided into, control (CTRL); pre-pregnancy, pregnancy, lactation stress (PPPLS); pre-pregnancy stress (PPS); pregnancy stress (PS); lactation stress (LS); pre-pregnancy, pregnancy stress (PPPS); pregnancy, lactation stress (PLS); pre-pregnancy, lactation stress (PPLS) groups. Offspring pancreases were removed for ER extraction and the assessment of ER stress biomarkers, WFS1 gene DNA methylation, and isolated islets’ insulin secretion. Glucose tolerance was also tested. In the stressed groups, maternal stress significantly increased plasma corticosterone levels. In PPS, PS, and PPPS groups, maternal stress increased Bip (Hsp70; heat shock protein family A member 4), Chop (Ddit3; DNA- damage inducible transcript3), and WFS1 protein levels in pancreatic extracted ER. Moreover, the islets’ insulin secretion and content along with glucose tolerance were impaired in these groups. In PPS, PS, LS and PPPS groups, the pancreatic glucocorticoid receptor (GR) expression increased. Maternal stress did not affect pancreatic WFS1 DNA methylation. Thus, maternal stress, during prenatal period, impaired the islets’ insulin secretion and glucose homeostasis in adult male offspring, possibly through the induction of ER stress and GR expression in the pancreas, in this regard the role of WFS1 protein alteration in pancreatic ER should also be considered.

Perinatal stress exposure induced oxidative stress, metabolism disorder, and reduced GLUT-2 in adult offspring of rats.

Growing evidence has demonstrated that adversity in early life, especially in the prenatal and postnatal period, may change the programming of numerous body systems and cause the incidence of various disorders in later life. Accordingly, this experimental animal study aimed to investigate the effect of stress exposure during perinatal (prenatal and/or postnatal) on the induction of oxidative stress in the pancreas and its effect on glucose metabolism in adult rat offspring. In this experimental study based on maternal exposure to variable stress throughout the perinatal period, the pups were divided into eight groups, as follows: control group (C); prepregnancy, pregnancy, lactation stress group (PPPLS); prepregnancy stress group (PPS); pregnancy stress group (PS); lactation stress group (LS); prepregnancy, pregnancy stress group (PPPS); pregnancy, lactation stress group (PLS); and prepregnancy, lactation stress group (PPLS). Following an overnight fast on postnatal day (PND) 64, plasma glucose, insulin, leptin levels, and lipid profiles were evaluated in the offspring groups. GLUT-2 protein levels, lipid peroxidation, antioxidant status, and number of beta-cells in the pancreatic islets of Langerhans as well as the weights of intra-abdominal fat and adrenal glands were assessed. Levels of plasma corticosterone were determined in the different groups of mothers and offspring. The levels of plasma corticosterone, insulin, and HOMA-B index increased, whereas glucose level and QUICKI index were reduced in the perinatal stress groups compared to C group (p < 0.001 to p < 0.05). Plasma triglyceride, LDL, and cholesterol level rose significantly, but HDL level decreased in the perinatal stress groups compared to C group (p < 0.001 to p < 0.05). Perinatal stress raised MDA concentrations and reduced the activities of antioxidant enzymes in plasma and pancreas compared to C group (p < 0.001 to p < 0.05). GLUT-2 protein levels and number of beta-cells in the stress groups declined compared to C group (p < 0.001 to p < 0.05). Intra-abdominal fat weight decreased in the PPS, PS, and LS groups compared to C group (p < 0.001 to p < 0.01), but adrenal gland weight remained unchanged. Our results showed that long-term exposure to elevated levels of corticosterone during critical development induces metabolic syndrome in adult male rats.

Effect of Classical Music on Fetus: A Review

Even before birth, music may have a significant impact on your child's development. Music stimulates all aspects of a child's growth when they are exposed to it. And doing so at a young age may assist guarantee that your child grows up to be healthy. In several psychological conditions, music therapy is known to be effective, but not much research has been done to ascertain the effect of classical Indian music on psychiatric disorders. The ascendant is the antenatal musical practice. With reference to evidence-based study, the paper supports 5 primary objectives: music therapeutic modulation of pre- and perinatal stress, anxiety, and depression; mental and physical birth planning related to music, including cognitive change, emotional regulation, physical exercise, maintenance of relaxation and discomfort, and social inclusion; music-related bonding and self-efficacy; prenatal sound enhancement. Traditional therapeutic tools include Raga Chikitsa, Vedic chanting, Garbha Sanskara (Learning in the Womb), Time theory of ragas (combining ancient Ayurvedic notions) and Cakra activation (music and breathing approach using ragas). Outcomes in clinical are studied to see how they impact biological, physiological, psychological, chronobiological, as well as spiritual factors.

Educational Review: The Impact of Perinatal Oxidative Stress on the Developing Kidney.

Oxidative stress occurs when there is an imbalance between reactive oxygen species/reactive nitrogen species and antioxidant systems. The interplay between these complex processes is crucial for normal pregnancy and fetal development; however, when oxidative stress predominates, pregnancy related complications and adverse fetal programming such as preterm birth ensues. Understanding how oxidative stress negatively impacts outcomes for the maternal-fetal dyad has allowed for the exploration of antioxidant therapies to prevent and/or mitigate disease progression. In the developing kidney, the negative impact of oxidative stress has also been noted as it relates to the development of hypertension and kidney injury mostly in animal models. Clinical research addressing the implications of oxidative stress in the developing kidney is less developed than that of the neurodevelopmental and respiratory conditions of preterm infants and other vulnerable neonatal groups. Efforts to study the oxidative stress pathway along the continuum of the perinatal period using a team science approach can help to understand the multi-organ dysfunction that the maternal-fetal dyad sustains and guide the investigation of antioxidant therapies to ameliorate the global toxicity. This educational review will provide a comprehensive and multidisciplinary perspective on the impact of oxidative stress during the perinatal period in the development of maternal and fetal/neonatal complications, and implications on developmental programming of accelerated aging and cardiovascular and renal disease for a lifetime.

Hypercalcemia and Nephrocalcinosis in an Infant with Subcutaneous Fat Necrosis: A Rare but Potential Serious Clinical Condition

Background: Subcutaneous fat necrosis of the newborn (SCFN) is a panniculitis characterized by the presence of violaceous subcutaneous nodules and indurated plaques on the back, buttocks, proximal extremities, or cheeks. It is a self-limiting benign condition sometimes associated with hypercalcemia that can lead to serious complications such as seizures, failure to thrive and renal failure. It usually develops in full term neonates who experienced some perinatal stress. The literature shows that hypercalcemia is found in nearly 51% of infants, with 95% of the infants developing it within 60 days of onset of skin lesions.&#x0D; Clinical Description: In this case, we describe a full-term female infant presented to us with failure to thrive at 2 months of age with a postnatal history of meconium aspiration syndrome. On further evaluation, child was found to have hypercalcemia, anemia and bilateral nephrocalcinosis.&#x0D; Management &amp; Outcome: The clinical findings and lab investigations were consistent with subcutaneous fat necrosis with hypercalcemia as its main complication. Child was successfully treated with oral corticosteroids.&#x0D; Conclusion: Being a rare clinical condition, it is important to consider it as a differential diagnosis in infants with significant perinatal stress and hence this case report.

Understanding links between maternal perinatal posttraumatic stress symptoms and infant socioemotional and physical health.

Maternal posttraumatic stress symptoms (PTSS) are associated with adverse consequences for older children, but very few studies have examined links between perinatal maternal PTSS and infant outcomes. Trauma exposure and psychopathology, including PTSS, is often heightened for women during pregnancy through 1 year postpartum. Therefore, the perinatal period may be a critical time for understanding the risk maternal PTSS and other mental health factors pose to the socioemotional and physical health of infants. The present study explored the relation between maternal PTSS and infant socioemotional and physical health problems in a sample of racially and ethnically diverse mother-infant dyads (N = 295) assessed prenatally and at 12 months postpartum. This study also examined whether there are: (1) moderating effects of maternal depressive symptoms and parenting stress on these associations and (2) indirect effects of PTSS on infant outcomes through observed maternal sensitivity. Results indicated that postpartum depressive symptoms and parenting stress, rather than PTSS, were associated with greater infant socioemotional health problems. However, prenatal PTSS were associated with greater infant physical health problems when mothers also reported clinically significant levels of postpartum depressive symptoms. Maternal sensitivity was not associated with maternal PTSS, depressive symptoms, or parenting stress, nor was it related to infant socioemotional and physical health; thus, maternal sensitivity was not tested as an intermediary mechanism linking maternal mental health with infant outcomes. Implications for promoting maternal mental health in the perinatal period to bolster socioemotional and physical health of infants are discussed.

Association among postpartum posttraumatic stress disorder, family coping, neurodevelopment, and language development in high-risk infants: a retrospective study.

BackgroundA high-risk infant (HRI) is a child whose fetal, neonatal, and infant development is impacted by adverse factors that may cause cognitive, sensory, behavioral, or language defects. The complex situation in the treatment process is a continuous challenge and stressor for parents. If parents fail to take appropriate coping styles, it will have an adverse impact on the health of parents and the growth and development of children. The purpose of this study was to explore the impact of clinical characteristics, postpartum posttraumatic stress disorder (PTSD), and family coping on the neurodevelopment and language development of HRIs as a reference for targeted intervention.MethodsThis study retrospectively recruited 211 children who were hospitalized in the neonatal intensive care unit (NICU) of Suzhou Kowloon Hospital from January 2018 to December 2021. HRI and their mother were interviewed by telephone with general information questionnaire, Perinatal Post-traumatic Stress Disorder Questionnaire, medical coping modes questionnaire, Bayley Scales of Infant Development the Early Language Milestone Scale to investigate HRI and their mothers; Logistic regression was used to analyze the relationship between HRI mothers’ emotions and family coping with neurodevelopment and language development.ResultsThe neurodevelopmental scores of HRIs differed according to gestational week of delivery, birth weight, and disease diagnosis. The language development scores of HRIs differed according to gestational week of delivery, birth weight, disease diagnosis, and maternal education. Multiple stepwise regression analysis showed that the neurodevelopmental scores were affected by gestational week of delivery, postpartum PTSD score, and family coping. Logistic regression analysis showed that the language development scores were affected by maternal education and neurodevelopmental level. The correlation analysis showed that the postpartum PTSD scores were negatively correlated with family coping, neurodevelopment, and language development, and that family coping was positively correlated with the neurodevelopment and language development scores (P<0.05).ConclusionsThe neurodevelopment and language development of HRIs were affected by the gestational week of delivery, maternal education, the child’s birth weight, and disease diagnosis. NICU wards can promote the healthy development of HRIs by providing mothers with targeted health education concerning the child’s condition, postpartum PTSD, and family coping strategies.

FEATURES OF EXPERIENCED STRESS IN THE PERINATAL PERIOD

This article describes the phenomenon of motherhood and its significance for modern society. An analysis of literary sources on the topic of psychological adaptation to motherhood is presented. The authors consider the importance and reasons for providing psychological assistance to women during pregnancy. The paper describes the problems of the psychology of motherhood as a scientific approach. The definition of perinatal psychology as an actual theoretical and applied direction is given. The concept of perinatal stress as a general syndrome is considered, as well as the problem of maternal stress as one of the particular manifestations of stress during pregnancy.

COVID-19 Vaccine Hesitancy during the Perinatal Period: Understanding Psychological and Cultural Factors to Improve Care and Address Racial/Ethnic Health Inequities.

COVID-19 Vaccine Hesitancy during the Perinatal Period: Understanding Psychological and Cultural Factors to Improve Care and Address Racial/Ethnic Health Inequities.

A Mindfulness Application for Reducing Prenatal Stress.

IntroductionUp to 40% of patients report depression or anxiety symptoms in pregnancy; feelings of increased stress are nearly universal. Antepartum stress is linked to adverse outcomes including preterm birth, low birthweight, postpartum depression, and maternal self harm. Unfortunately, limited treatment options exist, and patients are often hesitant to initiate medications prenatally. Thus, the development of efficacious nonpharmacologic interventions is crucial. This pilot study investigated the feasibility and impact of an application (app)‐based mindfulness practice, begun in the first trimester, on maternal stress and pregnancy outcomes.MethodsThe study enrolled patients prior to 15 weeks’ gestation and followed them prospectively through birth. Patients were provided with a free subscription to Expectful, a commercially available prenatal mindfulness app, and asked to complete daily meditations. Patients completed the Perceived Stress Scale (PSS) self‐assessment at 15 weeks and 28 weeks. PSS scores and pregnancy outcomes were compared with a historical control group of pregnant people who did not use the app.ResultsOf 68 patients approached, 59 consented to enrollment. Of these, 21 used the app, with an average use of 170 minutes (range, 1.3‐1315 min). The average PSS score was significantly lower in the app group at 28 weeks. Additionally, the change in PSS score for app users was greater compared with that of the historical control between enrollment and 28 weeks (−6.3 vs −0.95, P = .0008). Pregnancy outcomes were similar for app users and the historical control.DiscussionOur recruitment rate suggests pregnant patients are eager for a nonmedication intervention to decrease stress. However, adherence after enrollment was limited. For a subset of motivated patients, an app‐based mindfulness practice significantly reduced perceived stress between the second and third trimesters compared with non‐app users. Prenatal mindfulness apps represent an important low‐intervention, low‐cost, highly accessible tool for managing perinatal mood and stress.

Risk factors and predictive markers for early and late-onset neonatal bacteremic sepsis in preterm and term infants.

The early detection and prediction of bacteremic sepsis in preterm and term neonates remains a challenging task because of their nonspecific clinical presentations. We aimed to investigate the risk factors associated with bacteremia and find the cutoff values of predictive markers to achieve accurate diagnosis of neonatal bacteremic sepsis. Not-doing-well preterm and term neonates with suspected sepsis were retrospectively enrolled between January 2015 and December 2017 in Taipei Veterans General Hospital. Blood culture, hemogram, serum procalcitonin (PCT), and C-reactive protein (CRP) were drawn at the onset of clinical signs and symptoms. All cases were divided to either early-onset or late-onset groups according to postpartum age. Nonparametric statistic, logistic regression, and receiver operating characteristic analysis were performed to evaluate the risk factors and cutoff values for predicting bacteremia. A total of 169 suspected sepsis episodes were analyzed, 68.0% of which had cardiopulmonary dysfunction and 19.5% had perinatal stress. The early-onset group had 123 (72.8%) patients, 4 of which had bacteremia and 119 had nonbacteremia conditions. The late-onset group had 46 (27.2%) patients, 8 of which had bacteremia and 38 had nonbacteremia conditions. Gestational age, birth body weight, Apgar score at 5 minutes, serum PCT, CRP, and platelet (PLT) count in the early-onset group and white blood cell (WBC) count in the late-onset group were substantially different between the patients with bacteremia and nonbacteremia conditions. PCT greater than 27 µg/L (adjusted odd ratio [aOR], 21.6; 95% CI, 1.1-435.1) and thrombocytopenia less than 100 × 109/L (aOR, 38.6; 95% CI, 1.4-1030.3) were predictive markers for bacteremia in the early-onset group. Early- and late-onset neonatal sepsis had different risk factors and predictive markers of bacteremia. PCT and PLT count in the early-onset group and WBC count in the late-onset group were accurate diagnostic serum markers for neonatal bacteremic sepsis.

IDF21-0089 Perinatal stress induced ER stress and increased pancreatic isolated islets insulin secretion in young adult rats

Background: Impaired insulin secretion from the islets of Langerhans one of the major causes of metabolic diseases associated with glucose metabolism, which is caused by several factors, including stress. Growing evidence have demonstrated that, adversity in early life, especially in the perinatal period, may change the program of many body systems and cause the incidence of different disorders in later life.

Inflammatory blockade prevents injury to the developing pulmonary gas exchange surface in preterm primates.

Perinatal inflammatory stress is associated with early life morbidity and lifelong consequences for pulmonary health. Chorioamnionitis, an inflammatory condition affecting the placenta and fluid surrounding the developing fetus, affects 25 to 40% of preterm births. Severe chorioamnionitis with preterm birth is associated with significantly increased risk of pulmonary disease and secondary infections in childhood, suggesting that fetal inflammation may markedly alter the development of the lung. Here, we used intra-amniotic lipopolysaccharide (LPS) challenge to induce experimental chorioamnionitis in a prenatal rhesus macaque (Macaca mulatta) model that mirrors structural and temporal aspects of human lung development. Inflammatory injury directly disrupted the developing gas exchange surface of the primate lung, with extensive damage to alveolar structure, particularly the close association and coordinated differentiation of alveolar type 1 pneumocytes and specialized alveolar capillary endothelium. Single-cell RNA sequencing analysis defined a multicellular alveolar signaling niche driving alveologenesis that was extensively disrupted by perinatal inflammation, leading to a loss of gas exchange surface and alveolar simplification, with notable resemblance to chronic lung disease in newborns. Blockade of the inflammatory cytokines interleukin-1β and tumor necrosis factor-α ameliorated LPS-induced inflammatory lung injury by blunting stromal responses to inflammation and modulating innate immune activation in myeloid cells, restoring structural integrity and key signaling networks in the developing alveolus. These data provide new insight into the pathophysiology of developmental lung injury and suggest that modulating inflammation is a promising therapeutic approach to prevent fetal consequences of chorioamnionitis.

Depression, anxiety and stress in women with breech pregnancy compared to women with cephalic presentation—a cross-sectional study

PurposeThis study aims to evaluate the level of psychological distress for women with breech compared to cephalic presentation. We hypothesized, that women with breech presentation have higher levels of depression, stress and anxiety. Secondary objectives were to analyze potential demographic risk factors and comorbidity of psychological distress in breech pregnancy.MethodsThe breech study group was formed by 379 women with breech presentation. A sample of 128 women with cephalic presentation was recruited during routine clinical care. Depression, anxiety and stress symptoms were ascertained by means of the Depression–Anxiety–Stress-Score (DASS)-21 questionnaire. Categorial data was analyzed with Chi-square or exact test, continuous data with unpaired t test or Mann–Whitney U test. Demographic risk factors were identified using a binary logistic regression model.ResultsPrevalence of psychological distress among women with breech was not higher compared to those of other pregnant women. Symptomatic depression, anxiety and stress affected 5.8%, 14.5% and 11.9% of women with breech, respectively. Decreasing age was identified as a risk factor for anxiety (p = 0.006). Multiparity increased risk for depression (p = 0.001), for anxiety (p = 0.026) and for perinatal stress (p = 0.010). More than 80% of women with depressive symptoms had comorbidities of psychological distress.ConclusionsBreech presentation compared to cephalic presentation was not associated with higher levels of psychological distress. However, breech pregnancies are affected by symptoms of potential mental disorder. Multiparous women and younger women may need additional support and would benefit from a standardized screening tool for the assessment of perinatal psychological distress.Clinical trial registrationEthical approval (EA2/241/18) was granted by the Ethics Commission of the Charité University Hospital on the 23.01.2019 (ClinicalTrials.gov Identifier: NCT03827226).

Perinatal exposure to synergistic multiple stressors leads to cellular and behavioral deficits mimicking Schizophrenia-like pathology.

ABSTRACTProtein malnourishment and immune stress are potent perinatal stressors, encountered by children born under poor socioeconomic conditions. Thus, it is necessary to investigate how such stressors synergistically contribute towards developing neurological disorders in affected individuals. Pups from Wistar females, maintained on normal (high-protein, HP:20%) and low-protein (LP:8%) diets were used. Single and combined exposures of Poly I:C (viral mimetic: 5 mg/kg body weight) and Lipopolysaccharide (LPS; bacterial endotoxin: 0.3 mg/kg body weight) were injected to both HP and LP pups at postnatal days (PND) 3 and 9 respectively, creating eight groups: HP (control); HP+Poly I:C; HP+LPS; HP+Poly I:C+LPS; LP; LP+Poly I:C; LP+LPS; LP+Poly I:C+LPS (multi-hit). The effects of stressors on hippocampal cytoarchitecture and behavioral abilities were studied at PND 180. LP animals were found to be more vulnerable to immune stressors than HP animals and symptoms like neuronal damage, spine loss, downregulation of Egr 1 and Arc proteins, gliosis and behavioral deficits were maximum in the multi-hit group. Thus, from these findings it is outlined that cellular and behavioral changes that occur following multi-hit exposure may predispose individuals to developing Schizophrenia-like pathologies during adulthood.

193 Leptin as puberty abnormalities marker of adolescent girls, born at term low to gestational weight

Introduction: Puberty disorders may be associated with perinatal stress. One of the manifestations of which is the birth with a low fetal weight. The manifest function of puberty - menstrual (MF), appears in adolescents who have reached a certain body weight (at least 45-47 kg), it can be assumed that leptin is one of the markers for assessing the nature of puberty onset. Aim of the study: To determine the value of Leptin serum level (LSL) in adolescent girls with low birth weight (LBW) in puberty onset.

Abnormal Newborn Screen During a Pandemic.

Abnormal Newborn Screen During a Pandemic.

Impacts of a perinatal exposure to manganese coupled with maternal stress in rats: Learning, memory and attentional function in exposed offspring

The developmental effects of chemicals that co-occur in vulnerable populations with elevated psychological stress are of increasing concern to the public. To investigate these concerns, we developed a rodent model of co-occurring perinatal manipulations and conducted a series of cognitive assessments in male and female offspring. Manganese (Mn), a neurodevelopmental toxicant when exceeding physiological requirements, was delivered in the drinking water (0, 2, or 4 mg Mn/mL) of rats from gestational day (GD) 7 to postnatal day (PND) 22. A variable perinatal stress paradigm was applied to half of the animals from GD13 to PND9. Novel object recognition (NOR), Morris water maze (MWM), differential reinforcement of low-rates procedure (DRL) and cued and uncued choice reaction time (CRT) tests were used to assess cognitive functions in offspring. Mn (4 mg/mL) and stress impaired NOR in adolescent males but facilitated NOR performance in females. However, when stress and Mn were combined these effects were attenuated in both sexes. During training for the DRL, Mn (2 mg/mL) facilitated, while stress impaired, lever press learning in both sexes. Few effects related to the treatments were found on DRL or MWM. During cued CRT, Mn (2 and 4 mg/mL) and stress reduced accuracy in males, while stress and Mn (2 mg/mL) increased anticipatory responding and slowed decision time in both sexes. Stress combined with Mn (2 mg/mL) improved cued accuracy and decision time, and Mn attenuated the effect of stress on anticipatory responding in both sexes. Stress slowed female movement time but when combined with Mn (4 mg/mL) the effect of stress was attenuated. During uncued CRT, except for decision time (which replicated effects observed with the cued task), no other effects of Mn or its combination with stress occurred. Females remained negatively affected by stress in most uncued CRT performance measures, while stressed improved male uncued accuracy. Taken together these data do not support increased cognitive impairment produced by Mn when combined with stress. However, the effects of perinatal stress alone, on these cognitive functions may hinder the detection of effects due to chemical exposures and underscores the need to consider the psychological health and wellbeing of the mother and her environment in risk assessment for developmental neurotoxicity of chemicals.

Perinatal Stress in Immature Foals May Lead to Subclinical Adrenocortical Dysregulation in Adult Horses: Pilot Study

The persistent endocrinological effects of perinatal stress due to gestational immaturity in horses are unknown, although effects have been reported in other livestock species. This pilot study tested the hypothesis that persistent adrenocortical dysregulation is present in horses that were gestationally immature at birth by assessing the salivary cortisol response to exogenous ACTH.Case horses (n = 10) were recruited with histories of gestation length < 315 d or dysmaturity observable through neonatal signs. Positive controls (n = 7) and negative controls (n = 5) were recruited where possible from related horses at the same locations. Cases and positive controls received an intramuscular, low-dose (0.1 ug/kg) of synthetic ACTH (Tetracosactrin 250 mg/mL, Synacthen); negative controls received no ACTH. Saliva samples were collected from all horses at baseline T = 0 and at 30 min intervals post injection from T = 30 to T = 150. These were assayed for salivary cortisol concentration (SCC) using a commercially available ELISA kit (Salimetrics).All baseline values (T = 0) were within normal published ranges. Peak and AUC values (corrected for baseline) for case horses were significantly different (ANOVA P < .001) to positive controls, with either higher (H-cases) or lower (L-cases) SCC values, outside the 95% Confidence Interval of the reference population. There was no significant effect of breed, age, sex, test month, or location on results. The results suggest that gestational immaturity may lead to subclinical adrenocortical dysregulation, with affected horses presenting an elevated or blunted response to a low-dose ACTH stimulation, despite normal basal levels.

Maternal hair cortisol concentrations across pregnancy and the early postpartum period in a Puerto Rican sample.

Hair cortisol is a noninvasive, long-term biomarker of human stress. Strengths and weaknesses of this biomarker as a proxy measure of perinatal stress are not yet well understood. Hair cortisol data were collected from pregnant women in Puerto Rico to investigate maternal cortisol level variance across pregnancy. In 2017, we recruited 86 pregnant women planning to birth at a large urban hospital. We aimed to collect four hair samples from each participant, one in each trimester and one in the postpartum period. Median cortisol in the first trimester (n=82) was 5.7 picograms/milligram (pg/mg) (range: 1.0-62.4). In the second, third, and postpartum periods, the medians were 6.8pg/mg (1.0-69.5), (n=46), 20.1pg/mg (5.6-89.0), (n=30), and 14.1pg/mg (1.7-39.8), (n=9), respectively. These medians disguise a 10-fold and 50-fold variability for two participants. Our sample sizes declined sharply when Hurricane Maria caused major disruptions in services and participants' lives. Maternal hair cortisol concentrations were lower in the first and second trimester than the third trimester and early postpartum period. We also observed a wide range of variation in cortisol levels throughout pregnancy and in the postpartum period.