Prospective associations between childhood stress characteristics and prenatal cortisol response to stress

Maternal hypothalamic-pituitary-adrenal axis functioning has important implications for maternal and offspring health, yet findings on cortisol responsivity to acute stress during pregnancy are mixed. Further, little is known about how childhood stress exposure relates to physiological stress regulation during this period, particularly among Black and White women. The present study leveraged multiple waves of prospectively gathered data from a large population-based sample to examine associations between degree of exposure to subsistence-, safety- and caregiving-related stress across childhood and cortisol responsivity during a later pregnancy. Participants (N = 338, 69.7% Black, 26.7% White) were enrolled in the longitudinal Pittsburgh Girls Study in middle childhood. Caregivers reported annually on exposure to a range of stressors when participants were 7-17 years of age. During a prenatal laboratory visit in which participants were between 22 and 31 years of age, participants completed the Trier Social Stress Test (TSST) and provided saliva samples for cortisol assay. Adjusting for covariates, the TSST did not produce a significant increase in cortisol levels over time, though 28.3% of participants were classified as responders. Greater exposure to subsistence-related stress (e.g., resource strain, housing instability) across childhood was associated with blunted cortisol levels during pregnancy. Findings suggest that childhood exposure to subsistence-related stress may have enduring effects on physiological stress regulation and underscore the potential value of targeted preventive interventions to promote intergenerational health. Results also highlight the relevance of public health initiatives aimed at reducing population-level differences in subsistence-related stress exposure.