Gestational and Postnatal Cortisol Profiles of Women With Posttraumatic Stress Disorder and the Dissociative Subtype.
Julia S Seng, Yang Li, James J Yang and 8 others
PMID 29175262WHAT IT FOUND
Pregnant women with the dissociative subtype of PTSD had significantly higher salivary cortisol levels than controls, particularly in early pregnancy.
At week 8, bedtime levels were ten times higher. This pattern was not seen in women with non-dissociative PTSD.
Key findings
01Women with PTSD and the dissociative subtype had significantly higher morning, afternoon, and bedtime cortisol levels than non-exposed controls before gestational week 34.
02In early pregnancy (week 8), cortisol levels in the dissociative PTSD group were two times higher in the morning, eight times higher in the afternoon, and ten times higher at bedtime compared to controls.
03Women with non-dissociative PTSD did not show significantly different cortisol levels compared to the other cohorts.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The longitudinal sample was smaller (111 women) and self-selected based on adherence to specimen collection, potentially introducing bias. Cortisol was measured in saliva, which has higher error variance than laboratory-collected specimens. The study used lifetime PTSD diagnosis and trait dissociation measures, which may not reflect current symptom load or state-dependent stress responses.
Declared interests
The study was supported by the National Institutes of Health (NIH R01 NR008767). No other conflicts of interest were declared.
The easy way to misread this
Do not assume all pregnant women with PTSD have elevated cortisol. The significant biological stress response was specific to the dissociative subtype (PTSD-D); women with non-dissociative PTSD did not differ from controls.