Psychophysiology and posttraumatic stress disorder symptom profile in pregnant African-American women with trauma exposure
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While female sex is a robust risk factor for posttraumatic stress disorder (PTSD), pregnant women are an understudied population in regards to PTSD symptom expression profiles. Because circulating hormones during pregnancy affect emotionality, we assessed whether pregnant women would have increased expression of the intermediate phenotypes of hyperarousal and fear-potentiated startle (FPS) compared to non-pregnant women. We examined PTSD symptom profiles in pregnant (n = 207) and non-pregnant women (n = 370). In a second study, FPS responses were assessed in 15 pregnant and 24 non-pregnant women. All participants were recruited from the obstetrics and gynecology clinic at a public hospital serving a primarily African-American, low socioeconomic status, inner-city population. Our results indicate that overall PTSD symptoms were not different between the groups of women. However, pregnant women reported being more hypervigilant (p = 0.036) than non-pregnant women. In addition, pregnant women showed increased FPS to a safety signal compared to non-pregnant women (p = 0.024). FPS to a safety signal in pregnant women was significantly correlated with PTSD hyperarousal symptoms (r = 0.731, p < 0.001). Furthermore, discrimination between danger and safety signals was present in non-pregnant women (p = 0.008), but not in pregnant women (p = 0.895). Together, these data suggest that pregnant women show clinical and psychophysiological hyperarousal compared to non-pregnant women, and support screening for PTSD and assessment of PTSD risk in pregnant women.
KeywordsPTSD Pregnancy Women Psychophysiology Hyperarousal Startle
The current study was supported by MH096764, MH071537 (KJR), MH100122, MH092576 (TJ), the Emory and Grady Memorial Hospital General Clinical Research Center, NIH National Centers for Research Resources (M01RR00039), NARSAD (TJ), The Burroughs Welcome Fund (KJR), Emory Medical Care Foundation (TJ), and the Howard Hughes Medical Institute (KJR). The study was supported in part by PHS Grant (UL1 RR025008, KL2 RR025009 or TL1 RR025010) from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources. The contents of this manuscript do not reflect the views of the Department of Veterans Affairs or the United States Government. This study would not have been possible without the research expertise and technical assistance of Allen Graham, Angelo Brown, and all the staff, volunteers, and participants of the Grady Trauma Project.
Conflicts of interest
All authors have no conflicts of interests.
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