Psychosocial stressors, sleep quality, and hair cortisol concentrations among pregnant women.

BACKGROUND: Psychosocial stress and sleep disturbances are common during pregnancy and can contribute to heightened hypothalamic-pituitary-adrenal (HPA) axis activity, potentially impacting maternal and fetal health. Hair cortisol concentrations (HCC) provide a measure of cumulative circulating cortisol over a period of months and serve as a marker of HPA-axis activity. Yet the interplay between psychosocial stress, sleep quality, and HCC during pregnancy remains unclear. METHODS: We conducted a secondary analysis of 141 pregnant women from the Brain and Early Experiences (BEE) Study. Two types of psychosocial stressors - financial strain and pregnancy-related anxiety - were assessed using the Economic Strain Questionnaire and the Pregnancy-Related Anxiety Questionnaire, respectively. Sleep quality was measured via the Pittsburgh Sleep Quality Index, and HCC was analyzed from 3 cm of hair collected toward the end of the second trimester. Multivariable linear regression tested associations between psychosocial stressors, sleep quality, and HCC, adjusting for key covariates. Mediation analyses assessed whether sleep quality mediated associations between psychosocial stressors and HCC. RESULTS: Financial strain was significantly associated with both poorer sleep quality (β=0.22, P = .02) and higher HCC (β=0.26, P = .006). Pregnancy-related anxiety was not linked to poorer sleep quality P = .23) or HCC (P = .17). Sleep quality did not mediate psychosocial stressors and HCC associations. CONCLUSION: Findings suggest that financial strain may contribute to poorer sleep quality during pregnancy. Financial strain may also contribute to higher cortisol levels, independent of its association with sleep quality. Understanding these associations is critical for identifying intervention targets to mitigate stress-related health risks during pregnancy.

Duke Scholars

Author Rong Jiang Head & Neck Surgical Oncology