A randomized trial of prenatal cognitive behavioral stress management effects on obstetric health outcomes and infant cortisol levels

IF 3.4 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Psychoneuroendocrinology Pub Date : 2026-05-01 Epub Date: 2026-02-21 DOI:10.1016/j.psyneuen.2026.107807

Guido G. Urizar Jr. , Ilona S. Yim , Ruby Barragan , Jacob Nguyen , Gwendolyn Manning , Angela Dixon-Hamlett

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引用次数: 0

Abstract

Background

Altered cortisol patterns during pregnancy have been linked to heightened risk for obstetric health complications (e.g., low infant birthweight) and dysregulated infant cortisol levels after birth, particularly in chronically stressed, low-income and ethnic minority families. Considering the detrimental effects that dysregulated cortisol may have on maternal and infant health, prenatal interventions aimed at cortisol regulation in at-risk families are needed. In a previous study, we reported that low-income, ethnic minority pregnant women randomized to a prenatal cognitive behavioral stress management (CBSM) intervention showed improved pre- and postnatal stress and salivary cortisol patterns relative to a control group. The current study extends this work by investigating whether families who received this prenatal CBSM intervention, relative to a control group, experienced fewer obstetric health complications and more regulated infant post partum cortisol patterns, and if maternal cortisol patterns and psychosocial factors (stressful life events, resilience) influenced CBSM intervention effects.

Methods

One hundred pregnant women (76 % annual income < $20 K, <17 weeks of gestation) were randomized to an eight-week CBSM group intervention (n = 55) or a control group (n = 45). Salivary cortisol was collected at baseline (1st trimester), after the intervention (3rd trimester), and at three months post partum (mothers and infants). Obstetric health complications were assessed via a medical record review.

Results

Prenatal CBSM (compared to the control group) showed fewer obstetric health complications for mothers with elevated prenatal cortisol levels. Further, CBSM (compared to the control group) showed more regulated cortisol patterns (i.e., reducing total cortisol, steeper decline in diurnal cortisol) for infants of mothers who had high cortisol and stress levels, and for infants of African American mothers.

Conclusions

These results lend support to the effectiveness of prenatal CBSM in enhancing the health of low-income, ethnic minority mothers and their infants, and emphasize the need to investigate the prolonged impact of CBSM in community-based settings.

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产前认知行为压力管理对产科健康结局和婴儿皮质醇水平影响的随机试验

背景：怀孕期间皮质醇模式的改变与产科健康并发症（如婴儿出生体重过低）和出生后婴儿皮质醇水平失调的风险增加有关，特别是在长期压力、低收入和少数民族家庭中。考虑到皮质醇失调可能对母婴健康产生的有害影响，需要针对高危家庭的皮质醇调节进行产前干预。在之前的一项研究中，我们报道了随机分配到产前认知行为压力管理（CBSM）干预组的低收入少数民族孕妇，与对照组相比，产前和产后压力和唾液皮质醇模式有所改善。目前的研究通过调查接受产前CBSM干预的家庭是否比对照组经历更少的产科健康并发症和更受调节的婴儿产后皮质醇模式，以及母亲的皮质醇模式和社会心理因素（压力生活事件，恢复力）是否影响CBSM干预效果来扩展这项工作。方法：100名孕妇（76% %年收入< $20 K）。结果：产前CBSM（与对照组相比）显示产前皮质醇水平升高的母亲产科并发症较少。此外，对于皮质醇和压力水平较高的母亲所生的婴儿，以及非裔美国母亲所生的婴儿，CBSM（与对照组相比）显示出更受调节的皮质醇模式（即，总皮质醇减少，日皮质醇下降更陡）。结论：这些结果支持了产前CBSM对低收入、少数民族母亲及其婴儿健康的有效性，并强调了在社区环境下调查CBSM的长期影响的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychoneuroendocrinology 医学-精神病学

CiteScore

7.40

自引率

8.10%

发文量

268

审稿时长

66 days

期刊介绍： Psychoneuroendocrinology publishes papers dealing with the interrelated disciplines of psychology, neurobiology, endocrinology, immunology, neurology, and psychiatry, with an emphasis on multidisciplinary studies aiming at integrating these disciplines in terms of either basic research or clinical implications. One of the main goals is to understand how a variety of psychobiological factors interact in the expression of the stress response as it relates to the development and/or maintenance of neuropsychiatric illnesses.