, Volume 233, Issue 7, pp 1299–1310 | Cite as

Blunted neuroactive steroid and HPA axis responses to stress are associated with reduced sleep quality and negative affect in pregnancy: a pilot study

  • Shannon K. Crowley
  • Todd K. O’Buckley
  • Crystal E. Schiller
  • Alison Stuebe
  • A. Leslie Morrow
  • Susan S. Girdler
Original Investigation



Anxiety during pregnancy has been linked to adverse maternal health outcomes, including postpartum depression (PPD). However, there has been limited study of biological mechanisms underlying behavioral predictors of PPD during pregnancy.


Considering the shared etiology of chronic stress amongst antenatal behavioral predictors, the primary goal of this pilot study was to examine associations among stress-related physiological factors (including GABA-ergic neurosteroids) and stress-related behavioral indices of anxiety during pregnancy.


Fourteen nulliparous women in their second trimester of a singleton pregnancy underwent speech and mental arithmetic stress, following a 2-week subjective and objective recording of sleep-wake behavior.


Lower cortisol, progesterone, and a combined measure of ALLO + pregnanolone throughout the entire stressor protocol (area under the curve, AUC) were associated with greater negative emotional responses to stress, and lower cortisol AUC was associated with worse sleep quality. Lower adrenocorticotropic hormone was associated with greater anxious and depressive symptoms. Stress produced paradoxical reductions in cortisol, progesterone, and a combined measure of allopregnanolone + pregnanolone, while tetrahydrodeoxycorticosterone levels were elevated.


These data suggest that cortisol, progesterone, and ALLO + pregnanolone levels in the second trimester of pregnancy are inversely related to negative emotional symptoms, and the negative impact of acute stress challenge appears to exert its effects by reducing these steroids to further promote negative emotional responses.


Pregnancy Anxiety Postpartum depression Cortisol Stress Sleep Neurosteroids Allopregnanolone (ALLO) 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Shannon K. Crowley
    • 1
  • Todd K. O’Buckley
    • 2
  • Crystal E. Schiller
    • 1
  • Alison Stuebe
    • 3
    • 4
  • A. Leslie Morrow
    • 1
    • 2
    • 5
  • Susan S. Girdler
    • 1
  1. 1.Department of PsychiatryCB#7175, UNC School of Medicine, Psychiatry Wing CChapel HillUSA
  2. 2.Bowles Center for Alcohol StudiesChapel HillUSA
  3. 3.Department of Obstetrics and GynecologyDivision of Maternal-Fetal MedicineChapel HillUSA
  4. 4.Department of Maternal and Child HealthGillings School of Global Public HealthChapel HillUSA
  5. 5.Department of PharmacologyUniversity of North Carolina at Chapel HillChapel HillUSA

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