Section The cumulative rate of repeated trauma exposure is greater in African American (AA) communities of urban, low socioeconomic status. This cumulative trauma exposure is associated with increased depressive and posttraumatic symptoms (PTS), and dysregulated fear responses. While traumatized women are more at risk for depression and anxiety compared to men, the factors that increase vulnerability to hormone-induced alterations in affect remain unclear. This is especially true for pregnant women, who have received minimal focus in trauma research even though there is evidence that suggests that PTS are altered during pregnancy. However, the specific nature of the effect of pregnancy on PTS has been equivocal. Because pregnant AA women experience disproportionately higher rates of cumulative trauma exposure and PTS, understanding how hormonal fluctuations during pregnancy in traumatized AA women influence PTS and fear psychophysiology is critical for the mother?s wellbeing both before and after delivery. The proposed longitudinal study is well positioned to address this gap in knowledge given our recruitment of pregnant AA women from a high trauma risk population. The proposed research will combine clinical interviews and fear physiology methods to examine how changes in estrogen, progesterone, and cortisol during each trimester of pregnancy and 1-month postpartum period influence PTS and fear inhibition deficits. Furthermore, because studies implicate prenatal stress exposure with increased fetal cortisol exposure and increased risk for adverse birth outcomes (i.e. low birth weight) and negative physical and mental health outcomes in adulthood, we will determine how cumulative maternal trauma prior to pregnancy and PTS during pregnancy are transmitted to offspring to impact vulnerability to adverse outcomes by assessing placental DNA methylation and fetal exposure to glucocorticoids via the umbilical cord.
While approximately 70% of the general population will experience a single traumatic event in their lifetime, the cumulative rate of repeated trauma exposure is disproportionately greater in African American (AA) communities of urban, low socioeconomic status. While studies suggest that hormonal fluctuations may influence mood and anxiety disorders in women, pregnant women have received minimal focus in trauma research. The current study aims to address this gap in knowledge by characterizing the effects of biological changes over the course of pregnancy and in the postpartum period on anxiety and fear in traumatized AA women.
