Trauma Exposure: Consequences to Maternal and Offspring Stress Systems

Abstract

Trauma exposure is a common experience for childbearing-age women: among women over age 18 in the USA, one in three has experienced intimate partner violence, and more than 40% has experienced sexual violence during their lifetime (Breiding et al. 2014; Tjaden and Thoennes, 2000). In this chapter, we discuss associations between traumatic experiences and physiological stress system functioning among adults, with particular emphasis on the experiences of mothers and their young children. We focus on abnormalities of two interdependent physiological systems that orchestrate the stress response: the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Dysfunction in these systems has been implicated in the development of multiple physical and psychological problems (Shonkoff et al. 2009). Importantly, stress system alterations may help explain the negative outcomes observed among children of trauma-exposed women or the intergenerational transmission of trauma. First, stress system dysfunction is likely to permeate functioning across a range of functional domains, including parenting (Leerkes et al. 2015), shaping children’s development. Second, dysregulation of stress responses can directly affect fetal development during gestation, when maternal and fetal biology are intrinsically connected, leading to increased risk for physical and psychological disease (Talge et al. 2007). Stress response alterations may be fruitful targets of interventions that seek to address the needs of trauma-exposed mothers and promote better outcomes for their offspring.