Impact of a prenatal cognitive-behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants
Section snippets
Participants and procedure
The objective of the Mothers and Babies: Mood and Health Project was to reduce the incidence of major depression in low-income, pregnant women receiving prenatal health services in a public sector hospital in California (Muñoz et al., 2007a, Urizar et al., 2004). Of the 110 pregnant women who participated in the original study, the current results focus on the 86 women and their infants (78%) for whom cortisol samples were collected from 2000 to 2003.
Women were eligible to join the study if
Participants
Of the 86 women who participated in cortisol collection for the Mothers and Babies: Mood and Health Project, 57 women (66%) were identified as being at high risk for depression during pregnancy and randomized to the CBSM intervention (n = 24) or the UC group (n = 33). In addition, 29 women were identified as being at low risk for depression during pregnancy and took part in the LRC group. A description of the study sample is shown in Table 1.
Overall, women in all three groups were similar on most
CBSM intervention effects on maternal cortisol
Despite the adverse effects of stress on maternal and infant health, few studies have examined the efficacy of stress management interventions on regulating cortisol and stress levels among mothers and their infants. Results from the current pilot study are one of the first, to our knowledge, to prospectively examine whether a prenatal cognitive behavioral stress management (CBSM) intervention would be effective in regulating salivary cortisol and self-reported stress levels among low-income
Implications
In summary, our results suggest that teaching low-income women CBSM strategies during pregnancy is effective in regulating maternal and infant cortisol levels up to 18 months postpartum, particularly among women with a past history of depression or among younger mothers. These results potentially have long-term implications for the health of mothers and their infants in helping to prevent the onset of stress-related health complications that have been associated with elevated cortisol levels
Role of the funding source
Funding for this study was provided by a grant from the Division of Research Resources at the National Institute of Health (5-MO1-RR00083) and a grant by the University of California Office of the President's Committee on Latino Research for the UCSF/San Francisco General Hospital Latino Mental Health Research Program (Ricardo F. Muñoz, PI). Additional support was provided by grants from the National Institute of Mental Health (MH 596056, Ricardo F. Muñoz, PI), the Research and Evaluation
Conflict of interest
The authors have read and consented to the authorship on this final version of the manuscript. There are no conflicts of interest in this study with any of the authors in any way.
Acknowledgements
Guido G. Urizar Jr. is in the Department of Psychology, California State University, Long Beach. Ricardo F. Muñoz is in the Department of Psychiatry, University of California, San Francisco.
This study was conducted in part in the GCRC at San Francisco General Hospital and supported by Grant 5-MO1-RR00083, Division of Research Resources, National Institutes of Health. The authors would like to acknowledge Bobbye Chang for conducting the cortisol assays. The preparation of this paper was
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2022, Comprehensive PsychoneuroendocrinologyCitation Excerpt :Most of these studies did not measure weight regain after the active weight loss period. Cognitive behavioral stress management (CBSM) had been shown to reduce perceived stress and several biological stress system markers in a variety of clinical settings, including HIV infection and malignancy [11–14]. CBSM is an adaptation of cognitive behavior therapy (CBT); a treatment originally developed for depression [15] with extra components of relaxation training.
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2021, International Journal of Nursing StudiesCitation Excerpt :Therefore, more tailored interventions are needed to help reduce socioeconomically disadvantaged parents’ high levels of anxiety. Only three studies measured salivary cortisol; surprisingly, the overall pooled effects were positive (g = 0.25), meaning that the interventions increased parents’ salivary cortisol (Urizar and Munoz, 2011; Urizar et al., 2019). One plausible explanation is that socioeconomically disadvantaged parents potentially grew up in a disadvantaged socioeconomic environment, thereby experiencing a persistent and high level of stress since childhood, which may lead to hypothalamic-pituitary-adrenal axis dysfunction or adrenal fatigue (de Kock et al., 2015).