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Decreased startle modulation during anticipation in the postpartum period in comparison to late pregnancy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
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2012 (English)In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102, Vol. 15, no 2, 87-94 p.Article in journal (Refereed) Published
Abstract [en]

Knowledge about healthy women's psychophysiological adaptations during the large neuroendocrine changes of pregnancy and childbirth is essential in order to understand why these events have the potential to disrupt mental health in vulnerable individuals. This study aimed to compare startle response modulation, an objective psychophysiological measure demonstrated to be influenced by anxiety and depression, longitudinally across late pregnancy and the postpartum period. The acoustic startle response modulation was assessed during anticipation of affective images and during image viewing in 31 healthy women during gestational weeks 36-39 and again at 4 to 6 weeks postpartum. No startle modulation by affective images was observed at either time point. Significant modulation during anticipation stimuli was found at pregnancy assessment but was reduced in the postpartum period. The women rated the unpleasant images more negative and more arousing and the pleasant images more positive at the postpartum assessment. Self-reported anxiety and depressive symptoms did not change between assessments. The observed postpartum decrease in modulation of startle by anticipation suggests a relatively deactivated defense system in the postpartum period.

Place, publisher, year, edition, pages
2012. Vol. 15, no 2, 87-94 p.
Keyword [en]
Acoustic startle response, Affective modulation, Anticipation, Postpartum, Pregnancy
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-175634DOI: 10.1007/s00737-012-0261-7ISI: 000304169100002OAI: oai:DiVA.org:uu-175634DiVA: diva2:532679
Available from: 2012-06-12 Created: 2012-06-11 Last updated: 2013-08-30Bibliographically approved
In thesis
1. Physiological Stress Reactivity in Late Pregnancy
Open this publication in new window or tab >>Physiological Stress Reactivity in Late Pregnancy
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

During pregnancy, the basal activity is increased in both of our major stress response systems: the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. At the same time, the reactivity towards stressors is reduced. These alterations sustain maternal and fetal homeostasis, and are involved in the regulation of gestational length. Although the feto-placental hormone synthesis produces the main endocrinological changes, also the central nervous system undergoes adaptation. Together, these profound adjustments have been suggested to make women’s mental health more vulnerable during pregnancy and postpartum period. The aim of this thesis was to examine factors connected to physiological stress responses during the late pregnancy in relation to pain, labour onset, emotional reactivity, and mental health.

The first study examined the pain and sympathetic response during cold stress, in relation to time to delivery. Women with fewer days to spontaneous delivery had lower sympathetic reactivity, while no pain measure was associated with time to delivery.

In the second study, acoustic startle response modulation was employed to study emotional reactivity during late gestation, and at four to six weeks postpartum. The startle response was measured by eye-blink electromyography, while the participants watched pleasant and unpleasant pictures, and positive and negative anticipation stimuli. A significant reduction in startle modulation by anticipation was found during the postpartum assessment. However, no startle modulation by pleasant, or unpleasant, pictures was detected at either time-point.

The serum level of allopregnanolone, a neurosteroid implied in pregnancy-induced hyporeactivity, was analysed in relation to self-reported symptoms of anxiety and depression. Although the participants reported low levels of depression, the women with the highest depression scores had significantly lower levels of serum allopregnanolone. There was no correlation between allopregnanolone and anxiety scores.

In the fourth study, the cortisol awakening response was compared between women with depression during pregnancy, women with depression prior to pregnancy, and women who had never suffered from depression. No group differences in cortisol awakening response during late pregnancy were found.

The results are in line with the previously described pregnancy-induced hyporesponsiveness, and add to the knowledge on maternal stress hyporeactivity, gestational length, and maternal mental health.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 70 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 887
acoustic startle response, allopregnanolone, antenatal, anxiety, cold pressor test, cortisol, cortisol awakening response, depression, electrodermal, estradiol, hypothalamic-pituitary-adrenal axis, postpartum, pregnancy, progesterone, skin conductance, stress, sympathetic nervous system
National Category
Physiology Neurosciences Obstetrics, Gynecology and Reproductive Medicine
Research subject
Medical Science
urn:nbn:se:uu:diva-197441 (URN)978-91-554-8636-5 (ISBN)
Public defence
2013-05-17, Sal X, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (English)
Available from: 2013-04-26 Created: 2013-03-25 Last updated: 2013-08-30Bibliographically approved

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Hellgren, CharlotteBannbers, ElinÅkerud, HelenaSundström-Poromaa, Inger
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