Table 3.
Synthesis of studies included in the scoping review (n = 48), organized by developmental period and alphabetically within each developmental period.
| Reference | Study setting | Sample characteristics | Stress measure and timing of assessment | Cortisol measure and timing of assessment | Type of statistical analysis testing associations of stress and cortisol; covariates included in models (if applicable) | Summary of primary results |
|---|---|---|---|---|---|---|
|
| ||||||
| Studies including measures of childhood stress (n = 7) | ||||||
| Bublitz and Stroud (2012) | 135 pregnant individuals enrolled in a longitudinal study of the effects of maternal mood on fetal and infant development (Behavior and Mood in Mothers, Behavior in Infants [BAMBI]) | M age = 26 years (SD = 6 years); 42% Non Hispanic White, 23% Hispanic, 14% Non Hispanic Black, 12% multiracial, 5% Asian, 4% other; Mincome = $30–39k; 36%– 42% married (by child abuse status) |
Childhood stress Adverse Childhood Experiences Questionnaire 15-item version Retrospective report in mid-pregnancy (M=24 weeks, range = 20–26 weeks) |
Salivary cortisol Waking, 30 min after waking, and at bedtime over 3 consecutive days at 1–3 timepoints in the second and third trimester (M1 = 24 weeks, range = 20–26 weeks; M2 = 30 weeks, range = 27–32 weeks; M3 = 35 weeks, range = 33–38 weeks) Calculated cortisol awakening response and slope |
Hierarchical linear models adjusting for age, race, marital status, parity, gravida, smoking, yearly income, pre-pregnancy BMI, lifetime PTSD, physical illness, gestational diabetes, hypertension, and pre-eclampsia | (+) Individuals with child sexual abuse histories had significantly higher cortisol awakening response at 35 weeks compared to individuals with non-sexual child abuse and no abuse histories. (Ø) No group differences for cortisol slope. |
| Bublitz et al. (2014) | 185 pregnant individuals enrolled in a longitudinal study of the effects of maternal mood on fetal and infant development (Behavior and Mood in Mothers, Behavior in Infants [BAMBI]) | M age = 26.5 years (SD = 5.5 years); 43% Non-Hispanic White, 29% Hispanic, 16% Black, 4% Asian, 4% multiracial, 4% other; 47% reported yearly income less than $30,000; 36% married |
Childhood stress Adverse Childhood Experiences Questionnaire 15-item version Retrospective report at study enrollment Family functioning in pregnancy Family Assessment Device (evaluated as moderator) Assessed in the second trimester (~25 weeks) |
Salivary cortisol Waking, 30 min after waking, and bedtime over three days at 1–3 study visits in the second and third trimesters of pregnancy (M1 = 25 weeks, SD1 = 4 weeks; M2 = 29 weeks, SD2 = 1 week; M3 = 35 weeks, SD3 = 1 week) Calculated cortisol awakening response |
Hierarchical linear models adjusting for gestational age at each study visit and timing of waking that included interactive term between childhood stress and family functioning in pregnancy | (⊗) A more severe childhood sexual abuse history was associated with an increasing cortisol awakening response among individuals with poor family functioning but not among individuals with better family functioning (Ø) Other forms of childhood stress (physical abuse, neglect, domestic violence, total scores) were not associated with the cortisol awakening response; social support did not modify associations |
| Nyström-Hansen et al. (2019) | 44 pregnant individuals enrolled in a longitudinal cohort study of mothers with schizophrenia, bipolar disorder, depression, and controls in Denmark (WARM Study) | M age = 30.0 years (SD = 4.47); 97.7% White, 2.3% Asian; Modal educational attainment ‘upper secondary education or more’ (81.9%); 68.2% reported lifetime diagnosis of severe mental illness. 88.6% married or living with their partner |
Childhood stress Adverse Childhood Experiences Questionnaire (version not specified) Retrospective report in the second or third trimester |
Hair cortisol concentrations Hair samples collected in the second or third trimester (range = 18.7–38.9 weeks) and segmented to reflect prior four months of pregnancy |
Linear regression analyses adjusting for BMI | (−) Adverse childhood experiences were marginally inversely associated with hair cortisol concentrations |
| Schreier et al. (2015a) | 180 pregnant individuals enrolled in a prospective pregnancy cohort designed to examine the role of prenatal stress on stress responses and respiratory health in children (Programming of Intergenerational Stress Mechanisms [PRISM]) | M age = 31.01 years (SD = 5.41 years); 45.6% Hispanic, 35.5% White, 18.9% Black; Modal educational attainment ‘less than high school’ (25%) |
Childhood stress Childhood Trauma Questionnaire. Childhood abuse categorized as present if participants reported any item on emotional abuse, physical abuse, and sexual abuse subscale as occurring between sometimes and very often Retrospective report within two weeks of study enrollment (M=26.9 weeks, SD = 8.1 weeks) |
Hair cortisol concentrations Hair samples collected near the time of delivery and segmented to reflect all three trimesters (55.6%), the second and third trimesters (36.1%), or third trimester (8.3%) depending on length of hair sample |
Mixed-effects analyses of covariance models adjusting for maternal age, education, inhaled corticosteroid use, BMI, and PTSD symptoms Performed in the entire sample and then stratified by race/ethnicity |
(+) Individuals who experienced physical/sexual abuse during childhood had higher hair cortisol than women who did not experience childhood abuse. In analyses stratified by race/ethnicity, this association was only significant among Black women, not White or Hispanic women |
| Schury et al. (2017) | 94 pregnant individuals recruited in the maternity ward of the University Hospital Ulm, Germany | M age = 32.5 years (SD = 5.4 years); 88.3% of German origin; 58.1% completed higher school education; 76.6% married |
Childhood stress Childhood Trauma Questionnaire. Retrospective report within 6 days of giving birth |
Hair cortisol concentrations Hair samples collected within 6 days of giving birth and segmented to reflect the third trimester of pregnancy |
Ordinary least squares models. No covariates in model examining association of childhood trauma with hair cortisol | (Ø) Childhood maltreatment load was not significantly associated with third trimester hair cortisol |
| Thomas-Argyriou et al. (2021) | 248 pregnant individuals enrolled in a prospective pregnancy cohort (Alberta Pregnancy Outcomes and Nutrition [APrON]) | M age = 32.3 years (range = 22–43); 86.7% White, 4.4% Latin American, 3.6% Asian, 3.2% Chinese, 2.1% Other; modal household income ‘more than $100,000/year’ (58.9%); 99.2% married or in common law relationships |
Childhood stress Adverse Childhood Experiences Questionnaire 10-item version Retrospective report of during pregnancy |
Salivary cortisol Waking, 30 min after waking, 11 am, and 9 pm over two consecutive days in early pregnancy (M=15.1 weeks, SD = 3.5 weeks, range = 6–22 weeks) and late pregnancy (M=32.5 weeks, SD = 1.0 weeks, range = 27–37 weeks) Calculated cortisol awakening response, daytime slope, and total daytime cortisol output |
Multiple linear regression adjusting for gestational age at each prenatal assessment, socioeconomic status (composite of income, education, and ethnicity), child sex, and gestational age at birth | (+) Adverse childhood experiences were significantly associated with a greater cortisol awakening response in early pregnancy and in late pregnancy (Ø) Adverse childhood experiences were not associated with cortisol slope or total cortisol output at either timepoint |
| Thomas et al. (2018a) | 243 pregnant individuals enrolled in a prospective pregnancy cohort (Alberta Pregnancy Outcomes and Nutrition [APrON]) | M age = 31.3 years (range = 20–42); 82.8% White Caucasian, 4.2% Latin American, 3.8% Chinese, 3.8% Asian, 5.4% Other; modal household income ‘more than $100,000/year’ (57.8%); 98.7% married or in common law relationships |
Childhood stress Adverse Childhood Experiences Questionnaire 10-item version Retrospective report during pregnancy Social support in pregnancy Perception of partner support measured with Social Support Effectiveness Questionnaire (evaluated as moderator) Assessed at each pregnancy visit |
Salivary cortisol Waking, 30 min after waking, 11 am, and 9 pm over two consecutive days in early pregnancy (M=15.1 weeks, SD = 3.5 weeks, range = 6–22 weeks) and late pregnancy (M=32.5 weeks, SD = 1.0 weeks, range = 27–37 weeks) Calculated cortisol awakening response, daytime slope, and total daytime cortisol output |
Regression models adjusting for parity, gestational age, socioeconomic status (composite of income, education, and ethnicity), gestational age at birth, and child sex with an interactive term between childhood stress and social support in pregnancy | (+) Adverse childhood experiences associated with a greater cortisol awakening response in early but not late pregnancy (⊗) Adverse childhood experiences were associated with a steeper slope at low levels of social support (Ø) Adverse childhood experiences were not associated with total cortisol output; social support did not modify this association |
| Studies including measures of proximal preconception and pregnancy stress (n = 26) | ||||||
| Bolten et al. (2011) | 81 pregnant individuals recruited to a prospective longitudinal study on child development in Trier, Germany | M age = 31.4 years (SD = 5.3 years); 94.3% White; medium (43.4%) to high (14.5% income); 5.7% less than 8 years of schooling, 57.1% 10–12 years of schooling, 37.2% university degree |
Pregnancy stress Perceived Stress Scale 14-item version Assessed in mid and late pregnancy |
Salivary cortisol Waking, 30 min after waking, 45 min after waking, and 60 min after waking over two days in early to mid pregnancy (13–18 weeks) and in late pregnancy (35–37 weeks); Calculated cortisol awakening response |
Linear regression models adjusting for age, parity, pre-pregnancy BMI, gestational age at saliva sampling, number of cigarettes smoked, and infant sex | (Ø) Perceived stress was not significantly associated with the cortisol awakening response |
| Braig et al. (2016) | 932 pregnant individuals recruited to a birth cohort study (Ulm SPATZ Health Study) in Ulm, Germany during a hospital stay for delivery | 41.5% 30.1–35.0 years, 24.4% 35.1–40.0 years, 22.1% 25.1–30.0 years, 6.5% < 25 years, 5.5% > 40 years; 89.2% German nationality, 1.6% Turkish nationality, 9.2% Other; 58.6% > 11 years of education, 31.5% 10–11 years of education, 10.0% less than or equal to 9 years of education |
Pregnancy stress Trier Inventory of Chronic Stress to assess chronic stress in the prior 3 months Assessed after delivery (median=1.5 days, range = 0–3 days) |
Hair cortisol concentrations Hair samples collected after delivery (median=1.5 days, range = 0–3 days) that reflected hair cortisol concentrations the third trimester of pregnancy |
General linear regression models adjusting for number of people in the household, mode of delivery, season of delivery, smoking status, and BMI | (Ø) Levels of hair cortisol not associated with pregnancy stress |
| Cesta et al. (2018) | 485 individuals undergoing fertility treatment enrolled in a prospective longitudinal study in central Sweden (Uppsala-Stockholm Assisted Reproductive Techniques [UppStART]) | M age = 33.8 years. Most educated at the university level |
Pregnancy stress Perceived Stress Scale 10-item version; Fertility Problem Stress Scales Gestational timing of measurement not specified |
Salivary cortisol Waking and bedtime. Gestational age at time of collection not specified |
Pearson’s correlations | (Ø) Stress was not associated with morning or bedtime cortisol levels |
| Conradt, Shakiba et al. (2020) | 137 pregnant individuals recruited as a part of a longitudinal study on the intergenerational transmission of emotion dysregulation | M age = 29.0 years (SD = 5.2 years); 79.0% Caucasian, 27.2% Hispanic, 9.3% Asian, 6.2% more than one race, 3.1% Native American or Alaskan Native; 1.2% Hawaiian or Pacific Islander; 1.5% African American; 32.1% college graduates, 32.1% completed junior college or technical school; 76.8% married |
Pregnancy stress UCLA Life Stress Interview assessed episodic and chronic stress in the previous six months Gestational timing of assessment not specified |
Hair cortisol concentrations Hair samples collected in late pregnancy (M=33 weeks, range = 26–40 weeks) and segmented to reflect the previous six months of pregnancy |
Hierarchical linear regression models adjusting for BMI and education | (Ø) Episodic and chronic stress were not associated with hair cortisol concentrations |
| Duffy et al. (2018) | 52 pregnant individuals recruited to a cross-sectional, pilot study | 22 participants delivered preterm (M age = 27.7 years, SD = 7.1 years; 54.5% White, 27.3% Black or African American, 18.2% Other; 72.7% Not Hispanic or Latino; 63.6% completed high school or less; 45.5% married) 30 participants delivered at term (M age = 27.4 years, SD = 5.2 years; 66.7% White, 13.3% Black or African American, 16.7% Other, 3.3% Asian; 63.3% Not Hispanic or Latino; 36.7% completed high school or less; 60.0% married) |
Pregnancy stress Perceived Stress Scale 14-item version to assess perceived stress in the previous month Assessed at delivery |
Hair cortisol concentrations Hair samples collected at delivery that reflected hair cortisol concentrations in the first trimester, second trimester, and third trimester |
Pearson’s correlations and independent samples t-tests | (Ø) No association of perceived stress with hair cortisol |
| Galbally et al. (2019) | 241 pregnant individuals recruited to a selected pregnancy cohort study (Mercy Pregnancy and Emotional Wellbeing Study [MPEWS]) in Australia | M age = 31.4 (SD = 4.7); 88.3% Oceania/European; 8.8% Asian, 2.1% Middle Eastern, 0.8% Aboriginal and Torres Strait Islander; 67.7% completed tertiary university degree; 66.2% married |
Pregnancy stress Pregnancy Risk Assessment Monitoring System to assess stressful life events. Assessed before 20 weeks of pregnancy and during the third trimester |
Hair cortisol concentrations Hair samples collected at delivery that reflected hair cortisol concentrations for each trimester of pregnancy |
Cross-lagged panels to examine the lagged and cross-sectional associations | (Ø) Stressful life events were not associated with hair cortisol concentrations |
| Harville et al. (2007) | 100 pregnant individuals enrolled in a cohort study examining stress and physical activity and preterm birth (Pregnancy, Infection, and Nutrition [PIN] Study). | 31% 31–35 years, 27% 26–30 years, 23% 20–25 years, 15% > 35 years, 4% < 20 years; 78% White, 17% Black, 5% Other; 37% completed more than college; 47% reported income > 400% of federal poverty level; 83% married |
Pregnancy stress Three questions about recent stressors and rated daily stress on a 4-point scale Assessed each evening of saliva collection |
Salivary cortisol Waking, 30 min after waking, 11 am, 5 pm, and 9 pm over three consecutive weekdays in either the early second trimester or late second trimester Calculated cortisol awakening response and total daytime cortisol output |
Pearson’s correlations, adjusting for gestational age and time of day | (Ø) No significant associations of recent or daily stressors with cortisol levels or daily patterns |
| Harville et al. (2009) | 1587 pregnant individuals enrolled in a cohort study examining stress and physical activity and preterm birth (Pregnancy, Infection, and Nutrition [PIN] Study) | 32% 25–29 years, 29% 30–35 years, 19% 20–24 years, 12% > 35 years, 8% < 20 years; 71% White, 20% Black, 9% Other; 27% completed college degree; 48% reported income > 400% of federal poverty level; 74% married |
Pregnancy stress Life Experiences Survey; Perceived Stress Scale Assessed in mid pregnancy (median=19 weeks, range = 18–20 weeks) and late pregnancy (median=27 and 28 weeks, range = 26–29 weeks) |
Salivary cortisol Saliva samples collected between 8 am and 10 am at clinic visits in mid pregnancy (median=17 weeks, range = 16–18 weeks) and late pregnancy (median=26 weeks, range = 25–28 weeks) |
Spearman correlations and hierarchical linear models adjusting for age, income as percent of the poverty line given reported household size, education, race, parity, marital status, smoking, pre-pregnancy BMI, pregnancy complications, and gestational age | (Ø) Neither stress measure was associated with cortisol |
| Hoffman et al. (2016) | 90 pregnant individuals recruited to a prospective cohort study | Term births (n = 79) M age = 28.2 years (SD =6.1 years); 38% non-Hispanic White, 37% Hispanic White, 11% Native American 8% African American, 6% Other; modal educational attainment high school diploma/GED (44%); 59% married Preterm births (n = 11) M age = 32.4 years (SD = 5.8 years); 36% non-Hispanic White, 36% African American, 18% Hispanic White, 9% Native American; modal educational attainment high school diploma/GED (72%); 36% married |
Pregnancy stress Perceived Stress Scale 14-item version Assessed at 16, 22, 28, 34, and 40 weeks gestation |
Hair cortisol concentrations Hair samples collected three times in pregnancy at 16–18 weeks, 28–30 weeks, and 38–42 weeks to that reflected the hair cortisol concentrations the past three months |
Regression models adjusting for race/ethnicity and tobacco use | (+) Perceived stress at 16 weeks gestation was associated with higher late second trimester hair cortisol (Ø) Perceived stress and hair cortisol concentrations at other timepoints |
| Kalra et al. (2007) | 25 pregnant individuals recruited to a prospective cross-sectional pilot study in Toronto, Canada | Age range 18–45 years. Other sociodemographic characteristics were not reported |
Pregnancy stress Perceived Stress Scale 10-item version Assessed in mid pregnancy (either end of the first or beginning of the second trimester) |
Hair cortisol concentrations Hair samples collected at the end of the first or beginning of the second trimester reflecting the previous 1–1.5 months of pregnancy |
Spearman’s rank order correlations | (+) Perceived stress was associated with significantly higher hair cortisol concentrations |
| King et al. (2022) | 90 pregnant individuals in a longitudinal observational study of prenatal stress and child development (Brain and Behavior Infant Experiences [BABIES] project) | M age = 32.7 years (SD = 4.9 years, range = 21.0–44.4 years); 58.9% White, 20.0% Asian/Asian American, 8.9% Other Race, 3.3% Black/African American; 8.9% Hispanic/Latinx Ethnicity; 34.4% reported income > $150,000 |
Pregnancy stress Crisis in Family Systems – Revised Assessed between 12 and 37 weeks gestation, 3–8 weeks postpartum, and 5–8 months postpartum |
Hair cortisol concentrations Hair samples collected at 12–37 weeks gestation, 3–8 weeks postpartum, and 5–8 months postpartum that reflected hair cortisol concentrations the past 5 months |
Linear mixed effects model adjusting for hair chemical exposure/heat treatment, average frequency of hair washing, age, and season when hair was collected | (+) Within-person fluctuations in stress were associated with variation in hair cortisol concentrations across pregnancy and postpartum such that when stress was higher relative to an individual’s average, hair cortisol concentrations were also higher (Ø) Between-person fluctuations in stress were not associated with variation in hair cortisol |
| Kramer et al. (2009) | 117 pregnant individuals enrolled in a larger multicenter prospective cohort study in the Montreal, Canada area | Sociodemographic characteristics of participants providing hair samples not reported. |
Proximal preconception and pregnancy stress Crowding; Daily Hassles Scale; Marital Strain Scale; Abuse Assessment Screen; job-related stress; Perceived Stress Scale 10-item version Assessed in the second trimester (range = 24–26 weeks) |
Hair cortisol concentrations Hair samples collected postpartum that reflected hair cortisol concentrations in the first trimester, second trimester, and third trimester Categorized as: (1) above versus at or below sample median; (2) by quartile |
Multiple logistic regression adjusting for age, parity, cohabitation status, birthplace, cigarette smoking, language spoken at home, maternal education, family income, maternal height, pre-pregnancy BMI, and medical/obstetric risk | (Ø) None of the stress measures were associated with hair cortisol |
| la Marca-Ghaemmaghami et al. (2021) | 51 pregnant individuals recruited to participate in a prospective longitudinal study in Zurich, Switzerland prior to 8 weeks gestation | M age = 30.0 years (range = 24.0–44.0); 56.9% completed university degree; 58.8% married, 98.0% cohabitating |
Pregnancy stress 12-item Chronic Stress Screening Scale of the Trier Inventory for the Assessment of Chronic Stress Assessed in the first trimester (median=6.0 weeks, range = 4.0–9.0 weeks) |
Salivary cortisol Waking, 30 min after waking, and 60 min after waking in the first trimester (78%) or second trimester (22%) Calculated cortisol awakening response |
Spearman’s correlations adjusting for level of employment (0–25%, 25–50%, 50–75%, 75–100%, >100%) | (Ø) Chronic stress was not associated with morning levels of cortisol or the cortisol awakening response |
| Lazarides et al. (2020) | 152 pregnant individuals were recruited for a prospective, longitudinal EMA-based study | M age = 27.8 years (SD = 5.5 years); 38.8% Non-Hispanic White, 38.1% Hispanic, 23.1% Other; 37.8% completed some college or associates degree; 36.6% income $50,000–100,000 |
Pregnancy stress Momentary stress assessed with Perceived Stress Scale EMA version; daily and monthly perceived stress assessed with the Perceived Stress 10-item version Assessed in early pregnancy (M=12.3 weeks, SD = 1.7 weeks), mid pregnancy (M= 19.3 weeks, SD = 1.3 weeks), and late pregnancy (M=28.7 weeks, SD = 1.3 weeks) |
Salivary cortisol Waking, 30 min after waking, 12 pm, 4 pm, and 8 pm over the course of four days in early pregnancy (M=12.3 weeks, SD = 1.7 weeks), mid pregnancy (M=19.3 weeks, SD = 1.3 weeks), and late pregnancy (M=28.7 weeks, SD = 1.3 weeks) |
Linear mixed models adjusting for time since waking, meal intake, weekend/weekday, pre-pregnancy BMI, and weeks gestation | (+) At the within-person level, momentary stress was positively associated with momentary cortisol. Cortisol output was greater on days when the subject reported higher day-level stress than their average stress level (Ø) No significant associations of stress with cortisol at the between-persons level |
| Musana et al. (2020) | 133 pregnant individuals enrolled in a cross-sectional cohort study in Kenya | M age = 25.0 years, SD = 5.0 years; 64% married |
Pregnancy stress Perceived Stress Scale 10-item Assessed in mid pregnancy (M=26 weeks, SD = 3 weeks) |
Hair cortisol concentrations Hair samples collected in mid pregnancy (M=26 weeks, SD = 3 weeks) that reflected the prior three months of pregnancy |
Hierarchical linear regression models adjusting for prenatal medical risk | (Ø) Perceived stress was not associated with hair cortisol |
| Obel et al. (2005) | 650 Danish-speaking pregnant individuals recruited to a study of stressful life events in pregnancy and risk of preterm birth and intra-uterine growth restriction | 44.5% 25–29 years, 36.2% > 29 years, 12.2% 20–24 years |
Pregnancy stress Life Events Inventory; pregnancy-related stress. Dichotomized into individuals who experienced more than one life event, felt severely stressed by more than one life event, and women who experienced any pregnancy complications. Assessed in early pregnancy (median=14 weeks) and late pregnancy (median=30 weeks) |
Salivary cortisol Morning and evening saliva samples in early pregnancy (median=14 weeks) and late pregnancy (median=30 weeks) |
Independent samples t-tests and multiple linear regression, adjusting for gestational age, sample time, and smoking | (+) Individuals who either were very stressed by more than one life event in late pregnancy had significantly higher evening cortisol in late pregnancy. (+) Individuals who were worried about pregnancy in early pregnancy had significantly higher evening cortisol in early pregnancy. (Ø) Individuals who experienced more than one life event in pregnancy did not differ in evening cortisol levels. (Ø) Pregnancy stress measures were not associated with morning cortisol levels. |
| Pluess et al. (2012) | 60 pregnant individuals enrolled in a prospective longitudinal study on child development in Trier, Germany | M age = 30.4 years (SD = 4.8 years, range = 16–39); 38.3% completed less then high school; 47.5% monthly household income 1500–3000 Euro; 91.7% living with partner |
Proximal preconception and pregnancy stress Life Experiences Survey measured life events in the previous 12 months Assessed at 10–20 weeks gestation |
Salivary cortisol Waking, 30 min after waking, 45 min after waking, and 60 min after waking on two different days during 35th and 36th week of gestation Calculated total morning cortisol output |
Multiple linear regression adjusting for planned pregnancy and neuroticism | (Ø) Negative life events did not predict morning cortisol levels |
| Scharlau et al. (2018) | 62 pregnant individuals enrolled in a larger longitudinal birth cohort study conducted in Leipzig, Germany (LIFE CHILD BIRTH cohort; Leipzig Research Center for Civilization Diseases Child Study) | 37% 25–29 years, 27% 30–34 years, 21% < 25 years, 15% 35–30 years; 92% German nationality, 8% Other; 48% high socioeconomic status, 41% middle socioeconomic status, 11% low socioeconomic status |
Pregnancy stress Patient Health Questionnaire – Stress subscale to assess stress in the prior 4 weeks Assessed in the stress subscale in the second (24–26 weeks) and third trimester (34–36 weeks) |
Hair cortisol concentrations Hair samples collected in the second (24–26 weeks) and third trimester (34–36 weeks) that reflected hair cortisol concentrations the past month |
Multiple linear regression models adjusting for BMI, offspring sex, hair washing, and location of hair sample | (Ø) Neither stress or changes in stress were associated with hair cortisol or changes in hair cortisol |
| Schreier et al. (2015b) | 732 pregnant individuals enrolled in a pregnancy cohort study in Mexico City | M age = 27.4 years (SD = 5.6 years); 29.4% completed high school or junior college |
Proximal preconception and pregnancy stress Crisis in Family Systems Questionnaire (past 6 months) Gestational timing of assessment not specified Environmental pollution in pregnancy Mercury exposure based on toenail clippings (evaluated as moderator) Measured during the second or third trimester |
Salivary cortisol Waking, 45 min after waking, 10 h after waking, and at bedtime over two days in the second trimester (M=19.5 weeks, SD = 3.0 weeks) Calculated cortisol awakening response, slope, and total cortisol output |
Multiple linear regression models to evaluate main and interactive effects adjusting for age, highest level of education, BMI, and gestational age | (⊗) Individuals above the median for mercury exposure (higher environmental pollution) and stress had a blunted morning cortisol response compared to women exposed to high stress but lower mercury levels (lower environmental pollution) |
| Simon et al. (2016) | 30 participants enrolled in a supplementary pilot study to a longitudinal pregnancy cohort study (Stress in Pregnancy Study) designed to clarify the relationship between maternal stress and pregnancy outcomes | 12 African American women (M age = 30.8 years, SD = 4.8 years; 75% completed college education; 83% household income >$30,000) 18 Caucasian women (M age = 29.9 years, SD = 6.6 years; 66.7% completed college education; 61.1% household income >$30,000) |
Proximal preconception and pregnancy stress The Home Hardship Scales; the Stressful Life Events Scale; the USDA Food Security Scale; Krieger Perceived Discrimination Scale; Misra Stress Scale; Perceived Stress Scale Assessed in the third trimester |
Salivary cortisol Waking, 30 min after waking, and bedtime over two days in the third trimester Calculated cortisol awakening response |
Multivariate linear regression models adjusting for age, parity, income, and BMI | (−) Higher perceived stress was associated with a lower cortisol awakening response (Ø) Other measures of stress with cortisol levels and cortisol awakening response |
| Smew et al. (2018) | 92 pregnant individuals enrolled in a larger prospective longitudinal birth cohort study (Born into Life) in Stockholm, Sweden | M age = 32.5 years (SD = 3.7 years); 88.5% completed university level education |
Pregnancy stress Perceived Stress Scale 10-item version Assessed at 26–28 weeks gestation |
Salivary cortisol Evening before a lab visit and the morning of the lab visit at 26–28 weeks gestation. Calculated decline from morning to evening |
Pearson’s correlations | Higher perceived stress was associated with: (−) lower morning cortisol levels (−) a smaller cortisol decline from morning to evening (Ø) Perceived stress with evening cortisol levels |
| Suglia et al. (2010) | 200 pregnant individuals enrolled in a prospective pregnancy cohort study (Asthma Coalition on Community, Environment, and Social Stress) | M age = 26.7 years (SD = 5.9 years); 66% Hispanic, 34% Black; 41.5% completed less than high school |
Proximal preconception and pregnancy stress Cumulative stress calculated based on recent (past year) interpersonal violence, discrimination, negative life events, and exposure to violence. Participants were given a score of 1 if they were in the upper quartile for each measure. Summed to create a cumulative stress score Assessed in the second or third trimester |
Salivary cortisol Waking, 30–90 min after waking, 3–6.5 h after waking, 7.5–11.5 h after waking, and 11.5 h after waking over three days in mid pregnancy (~25 weeks) Calculated cortisol awakening response, slope, and total cortisol output |
Linear mixed models adjusting for age, education, smoking, pre-pregnancy BMI, and gestational age at saliva sampling | Higher cumulative stress was associated with: (−) lower morning cortisol levels* (+) a flatter diurnal slope* *Among Black participants, but not among Hispanic participants |
| Urizar et al. (2004) | 41 pregnant individuals at an outpatient prenatal clinic recruited to receive a pilot stress reduction intervention | M age = 26.0 years (SD = 4.6 years); 81% Spanish-speaking Latina; 68% earned annual income less than $20,000; 71% married or living with a partner |
Pregnancy stress Participants reported on stress on a 100-point analog scale (0: not at all stressed, 100: extremely stressed) Assessed on four days of a ten-day study period. Participants reported on stress 2 days before stress reduction intervention (day 1, day 2; baseline) and on 2 days after the stress reduction intervention (day 9, day 10). Stress reduction intervention occurred in late pregnancy (M=27 weeks, SD = 8.0) |
Salivary cortisol 45 min after waking up and at 8 pm on four days of a ten-day study period Participants collected samples 2 days before stress reduction intervention (day 1, day 2) and on 2 days after the stress reduction intervention (day 9, day 10) |
Pearson’s correlations adjusting for gestational age | (Ø) Pregnancy stress was not significantly associated with morning or evening cortisol levels |
| Urizar et al. (2019) | 100 pregnant individuals enrolled in a randomized controlled trial of a prenatal cognitive behavioral stress management intervention | M age = 27 years, SD = 6.26, range = 18–40 years; 71% Latina, 18% African American, 4% Asian American, 4% Non-Hispanic White, 3% Mixed Ethnicity; 71% completed high school or less; 76% annual family combined income < $20,000. 51% single |
Pregnancy stress Perceived Stress Scale 14-item version Assessed prior to the intervention (M=10.0 weeks, SD = 4.3 weeks, range = 2–17 weeks) |
Salivary cortisol Waking, 30 min after waking, 45 min after waking, 60 min after waking, 12 pm, 4 pm, and 8 pm over one day in early pregnancy, the second trimester, and third trimester Calculated cortisol awakening response, slope, and total cortisol output |
Pearson’s correlations, adjusting for ethnicity and pregnancy anxiety | (+) Higher perceived stress associated with a greater cortisol awakening response during the third trimester of pregnancy (Ø) Perceived stress was not associated with the cortisol awakening response at other gestational timepoints or other measures of diurnal cortisol |
| Valladares et al. (2009) | 147 pregnant individuals in a larger ongoing demographic surveillance study conducted in an urban area of Nicaragua | Age range 14–40 years (33% adolescents); 71% “low socio-economic conditions” |
Pregnancy stress Violence during pregnancy and perceived stress at in home interviews with trained field workers Assessed between 18 and 29 weeks gestation |
Salivary cortisol Morning (7–8 am) and afternoon (2–3 pm) on one day at 18–39 weeks gestation |
Structural equation modeling using unstandardized residuals of cortisol after adjustment for gestational age at saliva sampling | (+) Higher perceived stress was associated with an increase in the standardized residuals of afternoon cortisol levels (+) Violence during pregnancy was associated with higher afternoon cortisol levels (Ø) Perceived stress and violence during pregnancy were not associated with morning cortisol levels |
| Voegtline et al. (2013) | 112 pregnant individuals recruited through advertisements posted in a local university and hospital | M age = 31.2 years (SD = 4.6 years); 80% Caucasian, 13% Black; 7% Asian; M education= 17.2 years (SD = 2.1 years); 91% married |
Pregnancy stress Pregnancy Experiences Scale to measure pregnancy hassles Assessed at 5 prenatal visits spanning 24 weeks to 38 weeks gestation |
Salivary cortisol Approximately 30 min after arrival to the laboratory between 2 pm and 4 pm in the afternoon at 5 prenatal visits spanning 24 weeks to 38 weeks gestation |
Partial correlations adjusting for time of day | (Ø) Stress was not associated with salivary cortisol levels |
| Studies including measures of both childhood stress and proximal preconception and pregnancy stress (n = 11) | ||||||
| Bowers et al. (2018) | 30 pregnant individuals recruited to a longitudinal cohort study on the association between maternal life-course distress and offspring development in a sample with high sociodemographic risk (Pregnancy and Infant Development [PRIDE] Study) | M age = 21.6 years (SD = 3.5 years); 46.7% White, 43.3% Black, 10.0% Other; 6.7% Hispanic; 100% single |
Childhood stress Adverse Childhood Experiences Questionnaire 10-item version Retrospective report in mid pregnancy Pregnancy stress Pregnancy Experiences Scale Brief version; Perceived Stress Scale Assessed in mid pregnancy (gestational weeks not specified) |
Hair cortisol concentrations Hair sample in mid pregnancy (gestational weeks not specified) reflecting the prior three months of pregnancy |
Linear regression models, adjusting for age and race | (−) Adverse childhood experiences were inversely associated with hair cortisol (⊗) Perceived stress associated with hair cortisol concentrations among individuals who experienced 2 or more adverse childhood experiences but not those who experienced fewer |
| Bublitz and Stroud (2013) | 41 pregnant individuals who were enrolled in a larger study of the effects of maternal mood on fetal and infant development (Behavior and Mood in Mothers, Behavior in Infants [BAMBI] Study) recruited to a pilot study on the links between daily stress and maternal cortisol | M age = 26 years (SD = 5 years); 63% Caucasian; 45% total household annual income < $30,000; 69% less than a college degree; 55% unmarried |
Childhood stress Adverse Childhood Experiences Questionnaire 15-item version Retrospective report during pregnancy Pregnancy stress Pregnancy Experiences Scale Assessed each day for three days after three study sessions at 20 weeks (SD = 1 week), 28 weeks (SD = 1 week), and 35 weeks (SD = 1 week) gestation |
Salivary cortisol Waking, 30 min after waking, and in the evening over three consecutive days after each study visit at 20 weeks (SD = 1 week), 28 weeks (SD = 1 week), and 35 weeks (SD = 1 week) gestation. Calculated cortisol awakening response |
Hierarchical linear models adjusting for time of cortisol sampling and gestational age | (⊗) Prior day stress was associated with increased cortisol 30 min after waking cortisol in women with childhood sexual abuse histories compared to women with no history of childhood abuse (Ø) Child abuse history did not moderate the association between pregnancy stress and waking, cortisol awakening response, or evening cortisol |
| Bublitz et al. (2016) | 17 pregnant individuals recruited from a larger study of maternal smoking and infant behavior (Behavior and Mood in Babies and Mothers II) and enrolled in a pilot study on the impact of everyday stressful experiences on gestational length | 6 participants reported a childhood maltreatment history and 11 participants reported no history of childhood maltreatment. M age = 25 years (SD = 3 years); 27% White, 19% Hispanic, 18% Black, 12% American Indian/Alaska Native, 24% Other; 41% annual income less than or equal to $19,999; 33% married |
Childhood stresss Adverse Childhood Experiences Questionnaire. Endorsing physical/sexual abuse qualified as having a maltreatment history Retrospective report during pregnancy Pregnancy stress Momentary stress level recorded via text message at semi-random intervals Assessed four times a day between 9 am and 6 pm for two days following a study session in mid pregnancy (M=27 weeks, SD = 2 weeks) and late pregnancy (M=34 weeks, SD = 1 week) 16 total stress assessments per participant |
Salivary cortisol 30 min following each measure of momentary stress (16 times/participant) |
Hierarchical linear models adjusting for parity | (⊗) As momentary stress increased, cortisol concentrations decreased for women with maltreatment history whereas for women without maltreatment histories, as momentary stress increased, cortisol concentrations increased |
| Epstein et al. (2020) | 58 pregnant individuals recruited to a cross-sectional study from an urban hospital-based obstetric clinic | M age = 27.9 years (SD = 5.3 years); 60% Caucasian, 22% Black or African American, 7% Asian, 10% Other; 9% Hispanic Ethnicity; 52% completed college; 48% household income < $40,000; 50% married |
Childhood and adulthood stress Cumulative exposure to stress over the life course with the Stress and Adversity Inventory categorized by timing (childhood vs. adulthood) Assessed in mid pregnancy (M=26.5 weeks, range = 20–28 weeks) |
Salivary cortisol Waking, 30 min after waking, before lunch, before dinner, and before bedtime over three consecutive days at an average of 26.5 weeks gestation Calculated cortisol awaking response, slope, and total cortisol output |
Multiple linear regression models to evaluate main effects and interactive effects of childhood stress and adulthood stress on cortisol levels adjusting for age and smoking | (+) More childhood stressors were associated with a greater cortisol awakening response. (⊗) More adulthood stressors were associated with a steeper cortisol slope and blunted cortisol awakening response only among individuals with high childhood stress. (Ø) Neither childhood nor adulthood stressors were associated with total cortisol output. (Ø) Interactive effect of childhood and adulthood stress on total cortisol output. |
| Jairaj et al. (2020) | 118 participants enrolled in a prospective longitudinal case-control study examining HPA axis output in pregnant women and postpartum in Dublin | Individuals with major depression in pregnancy (M age = 31.6 years, SD = 3.8 years; 95.7% Caucasian; 68.2% completed undergraduate education; 47.8% married); Individuals with a history of depression who were not depressed in pregnancy (M age = 32.4 years, SD = 5.2 years; 94.1% Caucasian; 51.5% completed undergraduate education; 69.7% married); Nondepressed control (M age = 33.9 years, SD = 4.7 years; 88.4% Caucasian; 55.8% completed undergraduate education; 7.9% single, 30.2% partnership, 62.8% married)a |
Childhood stress Childhood Trauma Questionnaire Retrospective report at 20–30 weeks gestation Pregnancy stress Perceived Stress Scale Assessed at 20–30 weeks gestation. |
Salivary cortisol Waking, 30 min after waking, 45 min after waking, 12 h after waking, and 12.5 h after waking over one day between 20 and 30 weeks gestation (M=26 weeks) Calculated area under the curve with respect to ground and area under the curve with respect to increase |
Spearman rankorder correlation adjusting for depressive symptoms | (+) Childhood trauma associated with higher evening cortisol levels. (Ø) Childhood trauma was not associated with other measures of tonic cortisol or area under the curve measures. |
| King et al. (2008) | 214 pregnant individuals recruited from the community and selected for trauma exposure and lifetime PTSD diagnosis | M age = 32.7 years (range = 21.0–44.4); 53% White, 18% Asian American, 3% Black/African American, 2% Native Hawaiian/Pacific Islander, 8% Another race, 8% Hispanic/Latinx Ethnicity; modal annual income > $150,000 (31%) |
Childhood stress Life Stressor Checklist Proximal preconception and pregnancy stress Abuse Assessment Screen to assess past year intimate partner violence Gestational timing of assessment not specified. |
Salivary cortisol Evening prior to eating dinner (4–6 pm) Timing of assessment not specified |
Multivariate linear regression models adjusting for endocrine disorders, taking steroid or antidepressant medication, steroid hormones that vary by gestational age, smoker status | (Ø) Childhood abuse history and past year domestic violence were not significantly associated with evening cortisol levels |
| Orta et al. (2019) | 97 pregnant individuals drawn from a prospective cohort study consisting of individuals attending prenatal clinics in Lima, Peru recruited in early pregnancy (Pregnancy Outcomes, Maternal, and Infant Study [PrOMIS]) | M age = 26.5 years (SD = 5.8 years); 85.6% Mestizo ethnicity; 79.4% married or living with a partner |
Childhood stress Item assessing history of physical or sexual abuse prior to age 18 (yes/no) Retrospective report in first trimester Pregnancy stress Items assessing difficulty accessing basic goods (yes/no), unemployment (yes/no), educational attainment (12 years/>12 years), lifetime experiences of intimate partner violence (yes/no), and perceived stress with the Perceived Stress Scale 14-item version Assessed in the first trimester |
Hair cortisol concentrations Hair samples collected at delivery and segmented to reflect hair cortisol concentrations in the first trimester, second trimester, and third trimester |
Multivariate linear regression models adjusting for early pregnancy BMI, alcohol consumption, hair structure, hair treatment, and UV exposure Sensitivity analysis adjusted for gestational age |
(Ø) None of the stress measures were associated with hair cortisol |
| Shea et al. (2007) | 66 pregnant individuals enrolled in an ongoing clinical cohort study in Canada (Maternal Adversity, Vulnerability, and Neurodevelopment [MAVAN]) that included participants presenting symptoms of depression and control participants | 33 non-depressed control participants M age = 31.9 years (SD = 4.3 years); 100% married 14 depressed participants M age = 29.8 years (SD = 4.8 years); 93% married 19 depressed/anxious participants M age = 28.6 years (SD = 6.1 years); 100% married |
Childhood stress Childhood Trauma Questionnaire Retrospective report in mid pregnancy (M=20 weeks, range = 12–24 weeks) Proximal preconception and pregnancy stress Inventory for Recent Life Stressful Events (past 6 months) Assessed in mid pregnancy (M=20 weeks, range = 12–24 weeks) |
Salivary cortisol Waking, 30 min after waking, and 60 min after waking over two days in mid to late pregnancy (M=28.4 weeks, range = 25–33 weeks) Calculated cortisol awakening response |
Linear regression models adjusting for wake time and antidepressant use | (−) Childhood trauma was associated with lower cortisol levels at waking (Ø) Childhood trauma was not associated with the cortisol awakening response |
| Stephens et al. (2021) | 178 pregnant individuals enrolled in a larger prospective longitudinal study collecting measures of stress and health (Measurement of Maternal Stress [MOMS] Study) | M age = 30.1 years (SD = 5.1; range = 19.7–44.7); 80.9% White, 16.3% Black, 2.8% Other; Income 12.6% < $15,000; 26.4% $15,000–49,999; 37.9% $50,000–99,999, 23.0% ≥ $100,000; 83.7% married |
Childhood stress Childhood Trauma Questionnaire; childhood economic disadvantage Retrospective report in mid pregnancy (range = 12–21 weeks) Proximal preconception and pregnancy stress Stressful Life Events Schedule to assess life events in the past year; current economic disadvantage Assessed in mid pregnancy (range = 12–21 weeks) |
Salivary cortisol Waking, 30 min after waking, 12 pm, 4 pm, 8 pm, and at bedtime over four days in mid pregnancy (range = 12–21 weeks) Calculated cortisol awakening response and slope |
Hierarchical linear models adjusting for smoking status, relationship status, gestational age, maternal age, BMI, parity, and race/ethnicity that included interactive effect between childhood and proximal preconception/pregnancy stress | (+) Moderate/severe childhood maltreatment, specifically childhood sexual abuse, was associated with a greater cortisol awakening response Childhood economic disadvantage, not maltreatment, was associated with: (+) a flatter cortisol slope (−) less flattening of the cortisol slope across pregnancy (Ø) Interactive effect between childhood and proximal preconception/pregnancy stress |
| Swales et al. (2018) | 90 pregnant individuals recruited from a large university medical center where they had been admitted for risk of imminent preterm birth | M age = 30.0 years (SD = 6.4 years); 68.9% Hispanic, 21.1% Non-Hispanic White; modal income $0-$30,000 (37.8%); 76.7% cohabitating with a partner |
Childhood, adulthood, and pregnancy stress Lifetime life events with the Life Events Checklist Four sum scores were calculated based on the number of endorsed life events in each age group of childhood, adolescence, adulthood, and the current pregnancy Retrospective report in mid to late pregnancy (M=28.6 weeks, SD = 3.20 weeks) |
Hair cortisol concentrations Hair sample in mid to late pregnancy that reflected hair cortisol concentrations in the prior three months of pregnancy (M=28.6 weeks, SD = 3.20 weeks) |
Linear regression models testing main and interactive effects of traumatic events across development, adjusting for gestational age | (+) Traumatic life events in childhood and adulthood independently predicted higher hair cortisol concentrations. (⊗) Adult exposure to traumatic life events was more strongly positively associated with hair cortisol among individuals who experienced one or more traumatic events during childhood. (Ø) Traumatic events in adolescence and pregnancy did not predict hair cortisol. |
| Thomas et al. (2018b) | 356 pregnant individuals enrolled in a prospective pregnancy cohort (Alberta Pregnancy Outcomes and Nutrition [APrON]) | M age = 31.8 years (range = 21–43); 84.9% White Caucasian, 3.7% Latin American, 3.1% Chinese, 8.3% Other; modal household income ‘more than $100,000/year’ (57.8%); 88.5% married |
Childhood stress Adverse Childhood Experiences Questionnaire 10-item version Retrospective report during pregnancy Pregnancy stress Stressful Life Events Questionnaire Stressful life events assessed at each pregnancy visit |
Salivary cortisol Waking, 30 min after waking, midday, and bedtime over several days in the first trimester (M=11.4 weeks), second trimester (M=17.1 weeks), and third trimester (M=32.4 weeks) Calculated cortisol awakening response, daytime slope, and total daytime cortisol output |
Multilevel models adjusting for socioeconomic status, parity, and maternal age Secondary analyses (1) included stressful life events in pregnancy and maternal psychological distress in pregnancy as additional covariates and (2) examined the interaction between adverse childhood experiences and stressful life events in pregnancy | Adverse childhood experiences were associated with: (+) increased cortisol levels 30 min after waking (+) a flatter slope* (+) increased cortisol awakening response in early pregnancy (−) less flattening of the diurnal slope across pregnancy* (Ø) Interactive effect between childhood and pregnancy stress (Ø) Adverse childhood experiences were not associated with waking cortisol levels, the cortisol awakening response in late pregnancy, changes in the cortisol awakening response, total cortisol output, and changes in cortisol output |
| Studies including measures of lifetime stress (n = 4) | ||||||
| Bosquet Enlow et al. (2017) | 195 pregnant individuals enrolled in prospective pregnancy cohort designed to examine the role of prenatal stress on stress responses and respiratory health in children (Programming of Intergenerational Stress Mechanisms [PRISM]) | M age = 31.21 years (SD = 5.51 years); 34% White, 25% Black/Haitian, 34% Hispanic, 7% Other; 31% obtained high school diploma |
Lifetime stress 30-item Life Stressor Checklist-Revised Pregnancy stress Crisis in Family Systems-Revised survey Both assessed within two weeks of study enrollment (M study enrollment = 26.9 weeks, SD = 8.1 weeks) |
Hair cortisol concentrations Hair samples within one week of delivery that reflected hair cortisol concentrations in the third trimester |
Spearman correlation coefficients | (Ø) Lifetime stressful events were not associated with hair cortisol concentrations |
| Campbell et al. (2019) | 455 participants enrolled in a pregnancy cohort designed to examine effects of prenatal chemical and non-chemical exposures on childhood asthma risk (Asthma Coalition on Community, Environment and Social Stress [ACCESS] project) | M age = 27.5 years (SD = 5.8 years); 60% Hispanic, 28% Black, 9% White, 4% other or multiple races; 65.9% completed high school |
Lifetime stress Revised Conflict Tactics Scale short form. Any affirmative answer considered as having a history of trauma. Divided into development stage: childhood, adolescence, adulthood before pregnancy, pregnancy. Retrospectively reported during pregnancy. |
Salivary cortisol Waking, 45 min after waking, 4 h after waking, 10 weeks after waking, and at bedtime over three consecutive week days in late pregnancy (M=29.0 weeks, SD = 5.1 weeks). Calculated cortisol awakening response and diurnal slope |
Linear regression models adjusting for maternal age, race, education, pre-pregnancy BMI, and gestational age | (+) History of lifetime trauma associated with higher afternoon cortisol levels. No differences by developmental stage (Ø) History of lifetime trauma with other measures of tonic cortisol, cortisol awakening response, and diurnal slope |
| Ghosn et al. (2019) | 101 pregnant individuals enrolled in a prospective cohort study | Forty-two participants had a trauma history (M age = 31.9 years, SD = 5.2 years) and 59 did not have a trauma history (M age = 31.6 years, SD = 4.5 years) |
Lifetime stress The Trauma Questionnaire assessed history of 19 DSM Criterion A stressors Assessed at 38 weeks gestation. |
Salivary cortisol Between 10 am and 12 pm. Collected at 38 weeks gestation |
Quantile regression models tested differences in cortisol levels by trauma group adjusting for age and parity | (+) Individuals with a trauma history had higher morning levels compared to the non-trauma group |
| Schreier et al. (2016) | 180 pregnant individuals enrolled in prospective pregnancy cohort designed to examine the role of prenatal stress on stress responses and respiratory health in children (Programming of Intergenerational Stress Mechanisms [PRISM]) | M age = 31.03 years (SD = 5.41 years); 45.6% Hispanic, 35.6% White, 18.9% Black; 25% completed less than high school, 24.4% completed graduate education, 21.1% completed undergraduate, 18.9% completed some college, 10% completed high school |
Lifetime stress 30-item Life Stressor Checklist Calculated two scores: score of all endorsed lifetime stressful events and a score of lifetime traumatic events Assessed within 2 weeks of study enrollment (M=26.9 weeks, 8.1 weeks). |
Hair cortisol concentrations Hair samples collected after delivery segmented to reflect hair cortisol concentrations in all three trimesters (55.6%), in the second and third trimester (36.1%), and in the third trimester only (8.3%) |
Mixed effects models adjusting for inhaled corticosteroid use, pre-pregnancy BMI, PTSD and depressive symptoms, and race/ethnicity Secondary analyses stratified by race/ethnicity | (+) Lifetime traumatic events were associated with higher maternal hair cortisol. In stratified analyses, association was only significant in Black women but not White or Hispanic women (Ø) Lifetime stressful events were not associated with hair cortisol levels |
Note. Studies took place in the United States unless otherwise noted. Sociodemographic characteristics presented were based on author report in original manuscript and therefore vary across studies. 11 of the 48 reports included samples from prospective, longitudinal cohort studies (n = 3 APRON cohort; n = 3 PRISM cohort; n = 3 BAMBI cohort; n = 2 PiN cohort).
BMI = body mass index
a
Authors only report sociodemographic characteristics by subgroup; analyses conducted in full sample.