Evidence map›Paper›PMID 37084672›Full record

ArticlePsychoneuroendocrinology2023

Pregnancy-specific anxiety and gestational length: The mediating role of diurnal cortisol indices.

Kharah M Ross, Harmeen Mander, Gabrielle Rinne, Michele Okun, Calvin Hobel, Mary Coussons-Read, Christine Dunkel Schetter

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychoneuroendocrinology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Kharah M RossPsychology Department, Athabasca University, Athabasca, AB, Canada; Psychology Department, University of Calgary, Calgary, AB, Canada. Electronic address: kharahr@athabascau.ca.
Harmeen ManderPsychology Department, University of Calgary, Calgary, AB, Canada. Electronic address: kharahr@athabascau.ca.
Gabrielle RinnePsychology Department, University of California - Los Angeles, Los Angeles, CA, United States.
Michele OkunPsychology Department, University of Colorado - Colorado Springs, Colorado Springs, CO, United States.
Calvin HobelCedars-Sinai Medical Centre, Los Angeles, CA, United States.
Mary Coussons-ReadPsychology Department, University of Colorado - Colorado Springs, Colorado Springs, CO, United States.
Christine Dunkel SchetterPsychology Department, University of California - Los Angeles, Los Angeles, CA, United States.
University of Calgary · CAUniversity of California, Los Angeles · USUniversity of Colorado Colorado Springs · USCedars-Sinai Medical Center · US

Funding

PREVENTION RESEARCH TRAINING:URBAN CHILDREN'S MENT HLTHT32MH015750 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CHRISTINE DUNKEL SCHETTER · 1985 to 2026
$6.2M
Mechanisms & Effects of Prenatal Maternal Affect on Pregnancy & Infant DevelopmentR01HD073491 · NICHD · UNIVERSITY OF COLORADO · PI COUSSONS-READ, MARY E, DUNKEL SCHETTER, CHRISTINE · 2013 to 2017
$3.1M
NICHD NIH HHS R01 HD073491NIMH NIH HHS T32 MH015750
6 · The paper itself

Abstract

backgroundPreterm birth or shorter gestation is a common adverse pregnancy outcome. Pregnancy-specific anxiety is robustly associated with risk for shorter gestation. Hypothalamic-pituitary-adrenal (HPA) dysregulation, indicated by diurnal cortisol index variability [slope, area-under-the-curve (AUC) or cortisol awakening response (CAR)], could mediate associations between pregnancy-specific anxiety and shorter gestation. The purpose of this study was to explore whether diurnal cortisol index variability mediates associations between pregnancy-specific anxiety and gestational length.

methodsA sample of 149 women from the Healthy Babies Before Birth study reported pregnancy-specific anxiety in early pregnancy. Saliva samples were taken at three times during pregnancy, for two days each, at wake, 30 min post wake, noon, and evening. Diurnal cortisol indices were calculated using standard approaches. Pregnancy cortisol index variability was calculated across pregnancy timepoints. Gestational length was derived from medical charts. Covariates were sociodemographics, parity and obstetric risk. Mediation models were tested using SPSS PROCESS.

resultsThere was a significant indirect effect of pregnancy-specific anxiety on gestational length via CAR variability, b(SE)= -0.102(0.057), .95CI [- 0.227,- 0.008]. Higher pregnancy-specific anxiety was associated with lower CAR variability, b(SE)= -0.019(0.008), p = .022, and lower CAR variability was associated with shorter gestation, b(SE)= 5.29(2.64), p = .047. Neither AUC or slope variability mediated associations between pregnancy-specific anxiety and gestational length.

conclusionLower CAR variability during pregnancy mediated the association between higher pregnancy-specific anxiety and shorter gestational length. Pregnancy-specific anxiety could dysregulate HPA axis activity, as indicated by lower CAR variability, demonstrating the importance of the HPA axis system in regulating pregnancy outcomes.

Indexed as

HydrocortisonePremature BirthAnxietyCircadian RhythmFemaleHumansHypothalamo-Hypophyseal SystemInfant, NewbornParturitionPituitary-Adrenal SystemPregnancySalivaHydrocortisoneCortisol variabilityDiurnal cortisol indicesGestational lengthPregnancyPregnancy-specific anxietyPreterm birth

Identifiers

PMID37084672
PMCPMC10952551
OpenAlexW4366133614

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.