Maternal Psychological Distress and Cortsiol

Abstract Background: Previous studies have reported associations between prenatal maternal distress and negative health outcomes for the unborn. There are gaps within this body of knowledge and inconsistencies in the research which make the relevant relationships unclear. If changes in maternal cortisol cause alterations in fetal development, it is important to gain an adequate understanding of how, and if, maternal psychological distress predicts maternal cortisol levels. This study is an integrative literature review that looks at the research investigating a connection between maternal psychological distress and maternal cortisol levels during pregnancy. Lazarus and Folkman’s (1984) Transactional Model of Stress and Coping will be used as a conceptual framework to guide the development of interventions that can decrease the impact of stressors on maternal psychosocial wellbeing and improve maternal resilience to stress. Objective: To examine the existing literature that investigates a relationship between maternal psychological distress and maternal cortisol levels. Method: An integrative literature review was performed, and a chart matrix was created to compare and contrast the results from existing research studies on this topic. Results: The link between prenatal maternal stress and cortisol was present but weak. Changes in the cortisol awakening response (CAR), or non-typical CARs, were found in depressed individuals and individuals comorbid for depression and anxiety. The degree of change in CAR during gestation was associated with length of gestation. Positive life events predicted significantly lower cortisol while negative life events proved unrelated to cortisol. Trait anxiety, or neuroticism, were found to be significantly correlated with self-reported distress and with elevated cortisol. Discussion: A focus on the development of coping skills through maternity support groups may be the most productive intervention for limiting the negative impacts of maternal psychological distress on a fetus. Additionally, future research should focus on changes in CAR when looking at the effects of stress on maternal cortisol secretion. WorldCat.org, MEDLINE, PsycARTICLES, and Academic Search Complete were searched using keywords anxiety, cortisol, depression, perceived maternal stress, and pregnancy