Selective attention to fearful faces during pregnancy

There is some evidence that pregnancy may be associated with cognitive affective changes, including increased ability to encode emotional faces signaling threat and increased anxiety. Nevertheless, findings to date are inconsistent, and there are few data on correlations with endocrine and hormonal measures. The aim of this study was to investigate danger sensitivity, as measured by selective attention to fearful and angry faces during pregnancy, and to correlate findings with distress and anxiety levels, glucocorticoid (cortisol) and gonadal hormones (estrogen, progesterone and testosterone).

Selective attention to fearful, angry and happy faces was assessed in pregnant women (n=44) and non-pregnant controls (n=25) using a modified version of an emotional Stroop task. General distress was assessed using the K-10, and state and trait anxiety using the Spielberger State-Trait Inventory. Levels of cortisol, estrogen, progesterone and testosterone were determined at trimester 2 and 3. Analyses of variance, regression and correlational analyses were used to investigate associations between variables.

Pregnant women showed altered attentional responses to fearful faces, in comparison to controls. When analyzed according to different levels of distress (K-10>20 or K-10≤20), distressed pregnant women had significantly increased selective attention to fearful faces compared to distressed non-pregnant controls. Attention to fear was significantly associated with increased levels of estrogen and progesterone at trimester 2, and decreased levels of cortisol at trimester 3 of pregnancy.

Heightened sensitivity to danger cues during pregnancy is consistent with a perspective that emphasizes the importance of parental precaution and the adaptive significance of responding to potentially hazardous stimuli during this period. Such changes may be particularly apparent in distressed women, and may be mediated by changes in glucocorticoid and gonadal hormone systems during pregnancy.