Cortisol response to the Trier Social Stress Test in pregnant women at risk for postpartum depression

UMMS Affiliation

Department of Psychiatry; Department of Quantitative Health Sciences

Publication Date


Document Type



Female Urogenital Diseases and Pregnancy Complications | Mental Disorders | Obstetrics and Gynecology | Psychiatry | Translational Medical Research | Women's Health


Antepartum depression and anxiety are risk factors for postpartum depression (PPD). Postpartum abnormalities in hypothalamic-pituitary-adrenal (HPA) reactivity are associated with PPD. It is not known if antepartum HPA abnormalities exist in women at risk for PPD (AR-PPD). We measured salivary cortisol response to the Trier Social Stress Test (TSST) in 44 (24 AR-PPD, 20 healthy comparison) pregnant women. Depression and anxiety were measured using the Edinburgh Postnatal Depression Scale (EPDS) and Spielberger State-Trait Anxiety Inventory-State (STAI-S). We analyzed longitudinal changes in cortisol using generalized estimating equation methods to control for the correlation within subjects at the six TSST time points. Group differences in area under the curve (AUC) were examined. A majority (70.8 %) of the AR-PPD had prior depression. EPDS total score was higher in AR-PPD vs. comparison women (mean EPDS = 9.8 +/- 4.9 vs. mean EPDS = 2.4 +/- 2.0 respectively, p < 0.001). Mean STAI-S total score was higher in AR-PPD vs. comparison women at all TSST time points and over time (z = 2.71, df = 1, p = 0.007). There was no significant difference in cortisol concentration over time between groups. We observed no detectable difference in cortisol response to psychosocial stress induced by the TSST despite clinically significant between-group differences in current/past depression and current symptomatology.


UMCCTS funding

DOI of Published Version



Arch Womens Ment Health. 2016 Mar 7. Link to article on publisher's site

Journal/Book/Conference Title

Archives of women's mental health

Related Resources

Link to Article in PubMed

PubMed ID