Bibian van der Voorn

58 CHAPTER 4 TABLE 1. Characteristics of mother-infant pairs (n = 169) Neonatal Males 92 (54%) Gestational age wks 39.4 ± 1.7 Birth weight g 3,446.5 ± 585.8 percentile 53.9 ± 26.4 Hair cortisol pp pg/mg hair 156.3 (101.3 to 227.5) Hair cortisone pp pg/mg hair 80.8 (61.5 to 108.8) Maternal Primiparous 84 (50%) Age yr 33.8 ± 4.7 Ethnicity Caucasian, non-Dutch 16 (9%) non- Caucasian 59 (35%) Antidepressants SSRI 44 (26%) SNRI 7 (4 %) NaSSA 9 (5%) Combination* 5 (3%) HADS score pp HAS-score ≥ 8 29 (17%) HDS-score ≥ 8 19 (11%) Hair cortisol pp pg/mg hair 5.3 (3.6 to 10.6) Hair cortisone pp pg/mg hair 19.5 (14.5 to 32.7) Data are expressed as mean ± SD, median (interquartile range) or n (%). Abbreviations: pp = postpartum; HADS = Hospital Anxiety and Depression Scale; HAS = Hospital Anxiety Scale; HDS = Hospital Depression Scale. *These subjects were treated with a combination of SSRI with NaSSA ( n =4), or NaSSA with SNRI ( n =1) THE INFLUENCE OF MATERNAL STRESS ON NEONATAL HAIR GCS Prenatal HADS scores were known for the mothers who had consulted the POP clinic during pregnancy: n=45 during the first or second trimester, and n=57 during the third trimester. Neonatal hair cortisol levels were negatively associated with maternal anxiety and depression experienced pre- and/or postnatally ( Table 2 ). Neonatal hair cortisone levels showed similar, but weaker, associations. Correction for gender or birth weight percentiles did not change these associations. Correction for primiparity strengthened the associations with first or second trimester stress scores, but weakened the associations with third trimester and pp stress scores ( Table 2 ). When tested univariably, primiparity was positively associated with neonatal hair cortisol and cortisone levels (0.24 [0.16 to 0.32] p < 0.01, and 0.10 [0.04 to 0.17] p < 0.01, respectively). Consistently elevated stress scores both pre- and postnatally, had the greatest impact on neonatal hair GC levels, as compared to consistently low stress scores in the subgroup of mothers who were seen at the POP clinic during pregnancy ( Table 3 ).