Cumulative stress and maternal prenatal corticotropin-releasing hormone in an urban U.S. cohort.

BACKGROUND: To date, there have been conflicting reports of the association of psychosocial stressors with prenatal corticotropin-releasing hormone (CRH) levels. METHODS: We examined whether racial discrimination, community violence, interpersonal violence (IPV), negative life events, considered independently, and as a composite measure of cumulative stress, were associated with prenatal CRH levels in the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project, a multiethnic pre-birth cohort in urban Boston. Blood was collected between 20 and 37 weeks gestation (Mean=28.1, SD=4.6 weeks gestation). During pregnancy, women were administered the Conflict Tactics Scale survey to assess IPV, the Crisis in Family Systems-Revised survey to assess negative life events, the My Exposure to Violence survey to assess community violence, and the Experiences of Discrimination survey. A cumulative stress measure was derived from these instruments to characterize exposure to high levels of multiple stressors. RESULTS: None of the individual stressors or cumulative stress was associated with CRH in combined analyses including Whites (n=20), Blacks (n=46), and Hispanics (n=110). In separate analyses of Blacks and Hispanics, racial discrimination, community violence, and cumulative stress were associated with CRH in Blacks, but were not associated with CRH in Hispanics. CONCLUSIONS: Though these results require replication, they suggest that the effects of stress on prenatal CRH levels may be mediated by factors that differ between racial/ethnic groups. Further studies in larger samples are warranted to clarify whether associations of chronic stressors and prenatal CRH levels differ by race/ethnicity and to better understand underlying mechanisms.

Association of maternal prenatal depressive symptoms with child cognition at age 3 years.

We examined the association of prenatal depressive symptoms at mid-pregnancy with child cognition at age 3 years in Project Viva, a pre-birth cohort study of 1030 mother-child pairs in eastern Massachusetts. We measured maternal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS), a self-report measure validated for use during pregnancy. Measures of child cognition included the Peabody Picture Vocabulary Test (PPVT) and the Wide Range Achievement of Visual Motor Abilities (WRAVMA). At mid-pregnancy, 81 mothers (7.9%) scored 13 or above on the EPDS, indicating probable depression. In the unadjusted model, children born to mothers with prenatal depressive symptoms had PPVT scores that were 3.8 points lower [95% confidence interval (CI) -7.1, -0.5]. With adjustment for sociodemographic variables, the association substantially attenuated [adjusted regression coefficient b for PPVT score = -0.7 (95% CI -3.6, 2.3)]. In both unadjusted and multivariable models, prenatal depressive symptoms were not associated with WRAVMA scores [adjusted b for total WRAVMA score = -0.5 (95% CI -3.0, 2.1)]. We found no evidence to suggest that maternal prenatal depression is independently associated with early child cognition.