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Pregnant women’s cortisol is elevated with anxiety and depression — but only when comorbid

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Abstract

Elevated cortisol during pregnancy is associated with adverse birth outcomes and may alter fetal development and subsequent adult health. Numerous studies link elevated cortisol to depression and anxiety, but only a few have examined these relationships during pregnancy and in response to laboratory stressors. No studies have investigated the impact of comorbid anxiety and depression on cortisol during pregnancy. Salivary cortisol samples were collected twice before and once after a set of computer-based tasks (Stroop color-word matching task and either mental arithmetic or a controlled breathing task) from 180 pregnant women at approximately 36 weeks gestation. Based on psychiatric diagnoses, four groups of women were compared: 121 control, 16 depression, 34 anxiety, and 9 comorbid. Women also completed symptom and stress self-report scales. There was a significant main effect for maternal diagnosis on cortisol levels. Post hoc comparisons showed that comorbid subjects had higher salivary cortisol levels than controls, but subjects with only one diagnosis did not. Similar to cortisol, the comorbid subjects also had higher ratings on pregnancy-specific distress. Comorbidity during pregnancy, versus depression or an anxiety disorder alone, is uniquely associated with elevated cortisol and a negative evaluation of pregnancy. The potential impact of this combined psychiatric diagnosis on fetal development and future adult health needs further investigation.

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Acknowledgements

This research was supported by the March of Dimes, the National Alliance for Research on Schizophrenia and Depression, the Sackler Institute, a Career Development Award (MH01928) to Catherine Monk, and an NIMH postdoctoral training grant (T32 MH018264). We would like to thank the many women and children who participated in this research, as well as Felice Tager, Lauren Ellman, Elizabeth Werner and Sylvia Cabral for their contributions in the collection of these data.

Financial Disclosures

Drs. Evans, Myers, and Monks reported no biomedical financial interests or potential conflicts of interest.

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Authors and Affiliations

  1. Department of Psychiatry, Columbia University, New York, NY, USA

    Lynn M. Evans, Michael M. Myers & Catherine Monk

  2. Department of Pediatrics, Columbia University, New York, NY, USA

    Michael M. Myers

  3. Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA

    Catherine Monk

  4. Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, USA

    Lynn M. Evans, Michael M. Myers & Catherine Monk

  5. Behavioral Medicine Program, Columbia University Medical Center, 1150 St Nicholas Ave., Suite 1-121, New York, NY, 10032, USA

    Catherine Monk

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  1. Lynn M. Evans
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  2. Michael M. Myers
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  3. Catherine Monk
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Correspondence to Catherine Monk.

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Evans, L.M., Myers, M.M. & Monk, C. Pregnant women’s cortisol is elevated with anxiety and depression — but only when comorbid. Arch Womens Ment Health 11, 239–248 (2008). https://doi.org/10.1007/s00737-008-0019-4

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  • DOI: https://doi.org/10.1007/s00737-008-0019-4

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