scholarly journals Questionnaires and salivary cortisol to measure stress and depression in mid-pregnancy

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250459
Author(s):  
Richelle Vlenterie ◽  
Pauline M. Geuijen ◽  
Marleen M. H. J. van Gelder ◽  
Nel Roeleveld
Keyword(s):  
Depressive Symptoms ◽  
Pregnant Women ◽  
Salivary Cortisol ◽  
Infant Development ◽  
Depression Scale ◽  
Perinatal Outcomes ◽  
Measurement Scales ◽  
Potential Biomarker ◽  
Cortisol Levels ◽  
Distress Scale

The hypothalamic-pituitary-adrenal axis, with cortisol as its final metabolite, has been proposed as a potential underlying biological mechanism for associations between depression and stress symptoms during pregnancy and adverse perinatal outcomes. In this study, we explored associations between salivary cortisol as a potential biomarker for stress and depressive symptoms and several self-completed psychological measurement scales among pregnant women. In total, 652 pregnant women participating in the PRegnancy and Infant DEvelopment (PRIDE) Study completed the Edinburgh Depression Scale (EDS), Patient Health Questionnaire-2 (PHQ-2), Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R), and Tilburg Pregnancy Distress Scale (TPDS) and collected a single awakening salivary cortisol sample around gestational week 17. Odds ratios, Spearman’s correlation coefficients (ρs) and Cohen’s Kappa coefficients (κ) were calculated to examine the associations between the EDS, PHQ-2, PRAQ-R, TPDS, and maternal cortisol levels. The overall correlation coefficient between the score on the EDS and the salivary cortisol level was 0.01 (p = 0.89) with κ = -0.01 (95% confidence interval [CI] -0.08–0.06). We did not observe agreement between the PHQ-2 and cortisol levels either (κ = 0.06 (95% CI -0.02–0.14)). The results for the PRAQ-R and TPDS were similar with overall correlations with maternal cortisol levels of ρs = 0.01 (p = 0.81) and ρs = 0.06 (p = 0.35) and agreements of κ = 0.02 (95% CI -0.06–0.09) and κ = -0.02 (95% CI -0.11–0.07), respectively. Maternal awakening salivary cortisol levels and measures of maternal psychological distress, anxiety, depressive symptoms, and pregnancy-related anxiety, assessed by self-completed questionnaires, did not seem to be related in mid-pregnancy.

Salivary cortisol levels in children of low-income women with high depressive symptomatology

2008 ◽  
Vol 20 (2) ◽  
pp. 423-436 ◽  
Author(s):  
Lia C. H. Fernald ◽  
Heather M. Burke ◽  
Megan R. Gunnar
Keyword(s):  
Depressive Symptoms ◽  
Hierarchical Linear Modeling ◽  
Low Income ◽  
Salivary Cortisol ◽  
Arrival Time ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Cognitive Testing ◽  
Maternal Depressive Symptoms ◽  
Cortisol Levels

AbstractChildren (N = 324 boys, 315 girls) between the ages of 2.5 and 6 (mean age = 3.63) were identified in a house to house survey in low-income areas (income <20th percentile nationally) of urban Mexico. The Center for Epidemiologic Studies—Depression Scale was administered to mothers of all children. Salivary cortisol samples were taken in children as a measure of hypothalamic–pituitary–adrenocortical (HPA) system activity at time of arrival (baseline, Time 0), 25 min after arrival (Time 1), and 50 min after arrival (Time 2). Between Time 0 and Time 1, children were administered several cognitive tests. Results of hierarchical linear modeling analyses revealed that higher levels of maternal depressive symptoms were associated with lower baseline cortisol levels in their children (p < .05), while controlling for age, gender, and time since awakening. Higher levels of maternal depressive symptoms were associated with less of an increase in salivary cortisol to the arrival of the experimenters and subsequent cognitive testing (p < .05). All results were moderated by gender, with enhanced cortisol response in girls and no response in boys. These results suggest that among very low-income families, high maternal depressive symptoms are associated with hypoactivity of the HPA system in children, particularly boys.

scholarly journals Adverse childhood experiences, daytime salivary cortisol, and depressive symptoms in early adulthood: a longitudinal genetically informed twin study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eleonora Iob ◽  
Jessie R. Baldwin ◽  
Robert Plomin ◽  
Andrew Steptoe
Keyword(s):  
Depressive Symptoms ◽  
Hpa Axis ◽  
Salivary Cortisol ◽  
Adverse Childhood Experiences ◽  
Emotional Abuse ◽  
Early Adulthood ◽  
Cumulative Exposure ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Cortisol Levels

AbstractDysregulated hypothalamic–pituitary–adrenal (HPA)-axis function might underlie the relationship between adverse childhood experiences (ACEs) and depression. However, limited research has examined the possible mediating role of the HPA-axis among young people using longitudinal data. Moreover, it remains unclear whether genetic influences could contribute to these associations. Participants were 290 children from the Twins Early Development Study. ACEs were assessed from age 3–11 years. We calculated a cumulative risk score and also derived different ACEs clusters using factor analysis and latent class analysis. HPA-axis activity was indexed by daytime salivary cortisol at age 11. Depressive symptoms were ascertained at age 21. Genetic liability to altered cortisol levels and elevated depressive symptoms was measured using a twin-based method. We performed causal mediation analysis with mixed-effects regression models. The results showed that ACEs cumulative exposure (b = −0.20, p = 0.03), bullying (b = −0.61, p = 0.01), and emotional abuse (b = −0.84, p = 0.02) were associated with lower cortisol levels at age 11. Among participants exposed to multiple ACEs, lower cortisol was related to higher depressive symptoms at age 21 (b = −0.56, p = 0.05). Lower cortisol levels mediated around 10–20% of the total associations of ACEs cumulative exposure, bullying, and dysfunctional parenting/emotional abuse with higher depressive symptoms. Genetic factors contributed to these associations, but the mediation effects of cortisol in the associations of ACEs cumulative exposure (b = 0.16 [0.02–0.34]) and bullying (b = 0.18 [0.01–0.43]) remained when genetic confounding was accounted for. In conclusion, ACEs were linked to elevated depressive symptoms in early adulthood partly through lower cortisol levels in early adolescence, and these relationships were independent of genetic confounding.

scholarly journals Predictors of fear of childbirth and depressive symptoms among pregnant women: a cross-sectional survey in Pwani region, Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Agnes Fredrick Massae ◽  
Margareta Larsson ◽  
Sebalda Leshabari ◽  
Columba Mbekenga ◽  
Andrea Barnabas Pembe ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Pregnant Women ◽  
Male Partner ◽  
Depression Scale ◽  
Obstetric Complications ◽  
Fear Of Childbirth ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Pregnancy And Childbirth

Abstract Background Many women experience fear of childbirth (FoB) and depressive symptoms (DS) during pregnancy, but little is known about FoB among Tanzanian women. The current study aimed to assess the prevalence of FoB and DS among pregnant women and determine predictors of each and both, focusing on sociodemographic and obstetric predictors. Methods A cross-sectional study was conducted at six health facilities in two districts in Tanzania between 2018 and 2019. In total, 694 pregnant women with gestational age between 32 and 40 weeks and expecting vaginal delivery were consecutively recruited and assessed for FoB and DS. We collected data through interviews using 6 and 4-points Likert Scale of the Wijma Delivery Expectancy Questionnaire Version A and Edinburgh Postnatal Depression Scale, respectively. Women who scored ≥66 and ≥ 10 were categorised as having FoB and DS, respectively. We performed multivariable logistic regression to investigate the predictors of FoB and DS. Results The prevalence rates of FoB and DS among pregnant women were 15.1 and 17.7%, respectively. FoB and DS were more likely in women aged above 30 years [Adjusted Odds Ratio (AOR) 6.29, 95%CI 1.43–27.84] and in single mothers (AOR 2.57, 95%CI 1.14–5.78). Women with secondary education and above (AOR 0.22, 95%CI 0.05–0.99) and those who had given birth previously (AOR 0.27, 95% CI 0.09–0.87) were less likely to have FoB in combination with DS Women who had previous obstetric complications, and those who did not receive any social support from male partners in previous childbirth were more likely to have FoB and DS. FoB was strongly associated with DS (AOR 3.42, 95%CI 2.12–5.53). DS only was more common in women who had inadequate income (AOR 2.35, 95%CI 1.38–3.99) or had previously experienced a perineal tear (AOR 2.32, 95%CI 1.31–4.08). Conclusions Not having a formal education, having only primary education, being aged above 30 years, being single, being nulliparous, having experienced obstetric complications, and having a lack of social support from a male partner during previous pregnancy and childbirth were predictors of FoB and DS during pregnancy. FoB and DS were strongly associated with each other. It is vital to identify at-risk women early, to offer support during pregnancy and childbirth.

The Mental Health Characteristics of Pregnant Women With Depressive Symptoms Identified by the Edinburgh Postnatal Depression Scale

2014 ◽  
Vol 75 (04) ◽  
pp. 393-398 ◽  
Author(s):  
Linda B. Lydsdottir ◽  
Louise M. Howard ◽  
Halldora Olafsdottir ◽  
Marga Thome ◽  
Petur Tyrfingsson ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Pregnant Women ◽  
Postnatal Depression ◽  
Edinburgh Postnatal Depression Scale ◽  
Depression Scale

scholarly journals The COVID-19 Pandemic and Mental Well-Being of Pregnant Women in Japan: Need for Economic and Social Policy Interventions

2020 ◽  
pp. 1-6 ◽  
Author(s):  
Midori Matsushima ◽  
Hanna Horiguchi
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Pregnant Women ◽  
Perceived Risk ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety And Depression ◽  
Cutoff Score ◽  
Economic Wealth ◽  
Mental Well Being

ABSTRACT Objective: This study explores the mental well-being of pregnant women in Japan during the coronavirus disease (COVID-19) pandemic. Methods: We collected 1777 responses from pregnant women through an online survey. Using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS), we calculated the percentage of pregnant women above the cutoff (≥ 13), and the factor scores of anhedonia, anxiety, and depression. Regression analyses were performed to identify factors and socioeconomic characteristics correlated with depressive symptoms. Results: The point prevalence of pregnant women with an EPDS score of ≥ 13 was 17%. The mean scores were 0.73, 3.68, and 1.82 for anhedonia, anxiety, and depression, respectively. The probability of becoming above the cutoff score positively correlated with the cancellation of planned informal support, higher perceived risk for infection of COVID-19, difficulties in household finances, and lack of social support. Moreover, being younger, less wealthy, unemployed, and without a partner showed a significantly higher possibility of having a score above the cutoff. Conclusions: The present study found a high percentage of pregnant women with depressive symptoms. Notably, COVID-19-related variables, including perceived risk for the infection, fear of decreasing economic wealth, and social support, were significantly associated with depressive symptoms.

scholarly journals Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038030
Author(s):  
Babette Bais ◽  
Astrid M Kamperman ◽  
Hilmar H Bijma ◽  
Witte JG Hoogendijk ◽  
Jan L Souman ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Pregnant Women ◽  
Rating Scale ◽  
Controlled Trial ◽  
Depression Scale ◽  
Bright Light ◽  
Light Therapy ◽  
Secondary Outcome ◽  
Bright Light Therapy ◽  
Double Blind

ObjectivesApproximately 11%–13% of pregnant women suffer from depression. Bright light therapy (BLT) is a promising treatment, combining direct availability, sufficient efficacy, low costs and high safety for both mother and child. Here, we examined the effects of BLT on depression during pregnancy.DesignRandomised, double-blind controlled trial.SettingPrimary and secondary care in The Netherlands, from November 2016 to March 2019.Participants67 pregnant women (12–32 weeks gestational age) with a DSM-5 diagnosis of depressive disorder (Diagnostic and Statistical Manual of Mental Disorders).InterventionsParticipants were randomly allocated to treatment with either BLT (9000 lux, 5000 K) or dim red light therapy (DRLT, 100 lux, 2700 K), which is considered placebo. For 6 weeks, both groups were treated daily at home for 30 min on awakening. Follow-up took place weekly during the intervention, after 6 weeks of therapy, 3 and 10 weeks after treatment and 2 months postpartum.Primary and secondary outcome measuresDepressive symptoms were measured primarily with the Structured Interview Guide for the Hamilton Depression Scale—Seasonal Affective Disorder. Secondary measures were the Hamilton Rating Scale for Depression and the Edinburgh Postnatal Depression Scale. Changes in rating scale scores of these questionnaires over time were analysed using generalised linear mixed models.ResultsMedian depression scores decreased by 40.6%–53.1% in the BLT group and by 50.9%–66.7% in the DRLT group. We found no statistically significant difference in symptom change scores between BLT and DRLT. Sensitivity and post-hoc analyses did not change our findings.ConclusionsDepressive symptoms of pregnant women with depression improved in both treatment arms. More research is necessary to determine whether these responses represent true treatment effects, non-specific treatment responses, placebo effects or a combination hereof.Trial registration numberNTR5476.

Depressive Symptoms and Diurnal Salivary Cortisol Patterns Among Female Caregivers of Stroke Survivors

2012 ◽  
Vol 14 (4) ◽  
pp. 396-404 ◽  
Author(s):  
Karen L. Saban ◽  
Herbert L. Mathews ◽  
Fred B. Bryant ◽  
Timothy E. O’Brien ◽  
Linda Witek Janusek
Keyword(s):  
Depressive Symptoms ◽  
Chronic Stress ◽  
Caregiver Burden ◽  
Perceived Stress ◽  
Salivary Cortisol ◽  
Allostatic Load ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Stroke Survivors ◽  
Increased Risk

Informal caregivers of stroke survivors experience elevated chronic stress and are at risk of developing depressive symptoms. The cumulative effects of chronic stress can increase allostatic load and dysregulate biological processes, thus increasing risk of stress-related disease. Stress-induced alterations in the pattern of cortisol secretion vary with respect to stressor onset, intensity, and chronicity. Little is known about the psychoendocrine response to stress in female caregivers of stroke survivors. The purpose of this study was to examine perceived stress, caregiver burden, and the association between caregiver depressive symptoms and diurnal cortisol in 45 females caring for a significant other who experienced a stroke within the past year. Women completed the Center for Epidemiologic Studies Depression Scale (CES-D) and collected saliva for cortisol upon awakening, 30 min postawakening, noon, and bedtime for 2 consecutive days. Results revealed that women had high levels of perceived stress and caregiver burden. In women with CES-D scores ≥ 16, salivary cortisol levels were significantly lower across the day relative to women with CES-D scores < 16. This difference persisted after adjusting for age, number of caregiving hours per week, perceived social support, and quality of sleep. Younger age was associated with more depressive symptoms as well as lower levels of cortisol at awakening and 30 min postawakening. Results demonstrate that the burden of caregiving increases risk of depressive symptoms and hypocortisolism across the day. Hypocortisolism may contribute to increased risk of depressive symptoms as a result of the loss of glucocorticoid attenuation of stress-induced inflammation.

scholarly journals Measurement Properties of the Centers for Epidemiological Studies Depression Scale (CES-D) in a Sample of African American and Non-Hispanic White Pregnant Women

2009 ◽  
Vol 17 (2) ◽  
pp. 91-104 ◽  
Author(s):  
Renée B. Canady ◽  
Manfred Stommel ◽  
Claudia Holzman
Keyword(s):  
Depressive Symptoms ◽  
Pregnant Women ◽  
Living Arrangements ◽  
White Women ◽  
Racial Bias ◽  
Factor Model ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Measurement Properties ◽  
Black And White

This study investigated the appropriateness of using the CES-D scale for comparing depressive symptoms among pregnant women of different races. Black and White women were matched on education, age, Medicaid status, and marital status–living arrangements. The matching procedure yielded a study sample of 375 in each ethnic group. Using a confirmatory factor analysis, the fit of several factor models for the CES-D was evaluated. One CES-D item, “everything was an effort,” showed a low item-total correlation (0.04 among blacks, 0.22 among whites) and was excluded from further analysis. After imposing the constraints of equal factor loadings and factor covariance across both groups, a two-factor model with 19 CES-D items provided a good fit. Only the loading for the “was happy” item displayed a small difference between the two groups. Furthermore, the correlations between the original 20-item and the unbiased 18-item scales were r = 0.994 for Whites and r = 0.992 for Blacks. The results suggest that the 20-item CES-D can be used to compare depressive symptoms in White and Black pregnant women without introducing significant ethnic–racial bias in the measurement of these symptoms.

scholarly journals Associations of Tryptophan, Docosahexaenoic Acid (DHA), and Vitamin D With Sleep Quality and Depression During Pregnancy

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 766-766
Author(s):  
Amber Kautz ◽  
Ying Meng ◽  
Emily S Barrett ◽  
Jessica Brunner ◽  
Richard Miller ◽  
...  
Keyword(s):  
Vitamin D ◽  
Depressive Symptoms ◽  
Docosahexaenoic Acid ◽  
Sleep Quality ◽  
Pregnant Women ◽  
Maternal Mental Health ◽  
Smoking Status ◽  
Depression Scale ◽  
Poor Sleep ◽  
Increased Risk

Abstract Objectives During pregnancy women are at increased risk of poor sleep quality and depression. Serotonin and melatonin are compounds that are involved in regulation of sleep and mood. Several nutrients are involved in the synthesis of these compounds, including tryptophan, docosahexaenoic acid (DHA), and vitamin D. Studies exploring associations between these nutrients and sleep, as well as mood, have been largely limited to the general population, showing mixed results. The aim of this study was to assess the associations of dietary intake of these nutrients with sleep quality and depression in pregnant women. Methods Participants enrolled in the Understanding Pregnancy Signals and Infant Development (UPSIDE) Study (n = 253) were included in this analysis if they completed dietary, sleep and depression assessments during the 2nd trimester. Dietary and supplement intake were measured using 24-hour dietary recalls. The NCI method was used to estimate usual intake. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was conducted to estimate the associations between nutrients and sleep/depression, adjusting for age, race/ethnicity, parity, education, early pregnancy body mass index, smoking status, energy and macronutrient intake. Results The NCI adjusted mean intakes of tryptophan, DHA, and vitamin D were 1.02 ± 0.11 g/day, 0.13 ± 0.11g/day, and 19.74 ± 21.80 mcg/day, respectively. Mean PSQI score was 6.15 ± 3.39, where higher scores indicated worse sleep quality, and mean EPDS score was 5.84 ± 4.77, where higher scores indicated increased severity of depressive symptoms. Tryptophan intake was inversely associated with EPDS scores (b = −15.23, 95%CI: −26.75, −3.72). The associations between DHA, vitamin D, and depression were not significant. The selected nutrients were not associated with PSQI scores. Conclusions In this study, higher tryptophan intake was associated with lower depressive symptoms among pregnant women during the second trimester. Additional research on the relationship between tryptophan intake and maternal mental health during pregnancy is warranted. Funding Sources NIH, Mae Stone Goode Foundation, Wynne Family Foundation.

scholarly journals The relationship between stress and hair cortisol in healthy pregnant women

2007 ◽  
Vol 30 (2) ◽  
pp. 103 ◽  
Author(s):  
Sanjog Kalra ◽  
Adrienne Einarson ◽  
Tatyana Karaskov ◽  
Stan Van Uum ◽  
Gideon Koren
Keyword(s):  
Pregnant Women ◽  
Perceived Stress ◽  
Biological Marker ◽  
Hair Cortisol ◽  
Stress Scale ◽  
Potential Biomarker ◽  
Cortisol Levels ◽  
Gestational Stress ◽  
The Relationship

Purpose: Stress has been shown to cause a large range of adverse fetal effects. This pilot study is the first attempt to examine cortisol level in the hair of pregnant women and assess its potential as a biomarker of gestational stress. Patients and Methods: Twenty-five healthy pregnant women, in whom hair cortisol levels and the Perceived Stress Scale (PSS) were measured and correlated. Results: Maternal hair cortisol levels, ranging between 0.06 and 0.23 nmol/g of hair correlated positively and significantly with measures of perceived stress (ranging between 2-22); (Rs=0.47) (P < 0.05). Conclusions: Our findings corroborate recent primate studies with induced stress, and suggest that hair cortisol is a potential biomarker of chronic stress in pregnancy. This new long term biological marker may have important implications in research and clinical practice.

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