Cumulative stress and maternal prenatal corticotropin-releasing hormone in an urban U.S. cohort

Background: To date, there have been conflicting reports of the association of psychosocial stressors with prenatal corticotropin-releasing hormone (CRH) levels. Methods: We examined whether racial discrimination, community violence, interpersonal violence (IPV), negative life events, considered independently, and as a composite measure of cumulative stress, were associated with prenatal CRH levels in the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project, a multiethnic pre-birth cohort in urban Boston. Blood was collected between 20 and 37. weeks gestation (Mean. =. 28.1, SD. =. 4.6. weeks gestation). During pregnancy, women were administered the Conflict Tactics Scale survey to assess IPV, the Crisis in Family Systems-Revised survey to assess negative life events, the My Exposure to Violence survey to assess community violence, and the Experiences of Discrimination survey. A cumulative stress measure was derived from these instruments to characterize exposure to high levels of multiple stressors. Results: None of the individual stressors or cumulative stress was associated with CRH in combined analyses including Whites (. n=. 20), Blacks (. n=. 46), and Hispanics (. n=. 110). In separate analyses of Blacks and Hispanics, racial discrimination, community violence, and cumulative stress were associated with CRH in Blacks, but were not associated with CRH in Hispanics. Conclusions: Though these results require replication, they suggest that the effects of stress on prenatal CRH levels may be mediated by factors that differ between racial/ethnic groups. Further studies in larger samples are warranted to clarify whether associations of chronic stressors and prenatal CRH levels differ by race/ethnicity and to better understand underlying mechanisms.