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The relationship between labor pain management, cortisol level and risk of postpartum depression development: a prospective nonrandomized observational monocentric trial


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1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013. doi: 10.1176/appi.books. 9780890425596Search in Google Scholar

2. Riazanova OV, Aleksandrovich YS, Gorkovaia IA, Korgozha MA, Koshkina YV, Ioskovich A. The impact of anesthesia during delivery on the frequency of postpartum depression of puerperas [Article in Russian]. Annals of Anesthesiology and Reanimatology 2017; 14(1): 29-35Search in Google Scholar

3. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 2005; 106: 1071-1083. doi: 10.1097/01.AOG.0000183597.31630.dbSearch in Google Scholar

4. Wisner KL, Moses-Kolko EL, Sit DKY. Postpartum depression: a disorder in search of a definition. Arch Womens Ment Health 2010; 13: 37-40. doi: 10.1007/s00737-009-0119-9Search in Google Scholar

5. Corwin EJ, Pajer K, Paul S, Lowe N, Weber M, McCarthy DO. Bidirectional psychoneuroimmune interactions in the early postpartum period influence risk of postpartum depression. Brain Behav Immun 2015; 49: 86-93. doi: 10.1016/j.bbi.2015.04.012Search in Google Scholar

6. Corwin EJ, Brownstead J, Barton N, Heckard S, Morin K. The impact of fatigue on the development of postpartum depression. J Obstet Gynecol Neonatal Nurs 2005; 34: 577-586. doi: 10.1177/0884217505279997Search in Google Scholar

7. Beck CT. Postpartum depression: it isn’t just the blues. Am J Nurs 2006; 106: 40-5010.1097/00000446-200605000-0002016639243Search in Google Scholar

8. Hay DF, Pawlby S, Waters CS, Sharp D. Antepartum and postpartum exposure to maternal depression: different effects on different adolescent outcomes. J Child Psychol Psychiatry 2008; 49: 1079-1088. doi: 10.1111/j.1469-7610.2008.01959.xSearch in Google Scholar

9. Field T. Postpartum depression effects on early interactions, parenting, and safety practices: A review. Infant Behav Dev 2010; 33: 1-6. doi: 10.1016/j.infbeh.2009.10.005Search in Google Scholar

10. Thompson KS, Fox JE. Post-partum depression: a comprehensive approach to evaluation and treatment. Ment Health Fam Med 2010; 7: 249-257Search in Google Scholar

11. Markhus MW, Skotheim S, Graff IE, Frřyland L, Braarud HC, Stormark KM, et al. Low omega-3 index in pregnancy is a possible biological risk factor for postpartum depression. PLoS One 2013; 8: e67617. doi: 10.1371/journal.pone.0067617Search in Google Scholar

12. Jaeschke R, Siwek M, Dudek D. Poporodowe zaburzenia nastroju - update 2012. Neuropsychiatria i Neuropsychologia. 2012; 7: 113-121Search in Google Scholar

13. O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Ann Rev Clin Psychol 2013; 9: 379-407. doi: 10.1146/annurev-clinpsy-050212-185612Search in Google Scholar

14. Maliszewska K, Świątkowska-Freund M, Bidzan M, Preis K. Relationship, social support, and personality as psychosocial determinants of the risk for postpartum blues. Ginekol Pol 2016; 87: 442-447. doi: 10.5603/GP.2016.0023Search in Google Scholar

15. Kumar R, Robson KM. A prospective study of emotional disorders in childbearing women. Br J Psychiatry 1984; 144: 35-47. doi: 10.1192/bjp.144.1.35Search in Google Scholar

16. Brugha TS, Sharp HM, Cooper SA, Weisender C, Britto D, Shinkwin R, et al. Social support and the development of postnatal depressive symptoms, a prospective cohort survey. Psychol Med 1998; 28: 63-7910.1017/S0033291797005655Search in Google Scholar

17. Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, et al. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord 2008; 108: 147-157. doi: 10.1016/j.jad.2007.10.014Search in Google Scholar

18. Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry 2008; 65: 805-815. doi: 10.1001/archpsyc.65.7.805Search in Google Scholar

19. Skalkidou A, Hellgren C, Comasco E, Sylvén S, Sundstrom PI. Biological aspects of postpartum depression. Womens health (Lond) 2012; 8: 659-672. doi: 10.2217/whe.12.55Search in Google Scholar

20. Iliadis SI, Comasco E, Sylvén S, Hellgren C, Sundström Poromaa I, Skalkidou A. Đrenatal and postpartum evening salivary cortisol levels in association with peripartum depressive symptoms. PLoS One 2015; 10: e0135471. doi: 10.137/journal.pone.0135471Search in Google Scholar

21. Magiakou MA, Mastorakos G, Rabin D, Dubbert B, Gold PW, Chrousos GP. Hypothalamic corticotropin-releasing hormone suppression during the postpartum period: implications for the increase in psychiatric manifestations at this time. J Clin Endocrinol Metab 1996; 81: 1912-1917. doi: 10.1210/jcem. 81.5.8626857Search in Google Scholar

22. Glynn LM, Davis EP, Sandman CA. New insights into the role of perinatal HPA-axis dysregulation in postpartum depression. Neuropeptides 2013; 47: 363-370. doi: 10.1016/j.npep.2013.10.007Search in Google Scholar

23. Sasaki A, Liotta AS, Luckey MM, Margioris AN, Suda T, Krieger DT. Immunoreactive corticotropin-releasing factor is present in human maternal plasma during the third trimester of pregnancy. J Clin Endocrinol Metab 1984; 59: 812-814. doi: 10.1210/jcem-59-4-812Search in Google Scholar

24. Allolio B, Hoffmann J, Linton EA, Winkelmann W, Kusche M, Schulte HM. Diurnal salivary cortisol patterns during pregnancy and after delivery: relationship to plasma corticotrophinreleasing- hormone. Clinical endocrinology 1990; 33: 279-28910.1111/j.1365-2265.1990.tb00492.x2225483Open DOISearch in Google Scholar

25. Harris B, Lovett L, Newcombe RG, Read GF, Walker R, Riad- Fahmy D. Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II. BMJ 1994; 308: 949-953. doi: 10.1136/bmj.308.6934.949Search in Google Scholar

26. McLean M, Bisits A, Davies J, Woods R, Lowry P, Smith R. A placental clock controlling the length of human pregnancy. Nat Med 1995; 1: 460-46310.1038/nm0595-4607585095Search in Google Scholar

27. Jung C, Ho JT, Torpy DJ, Rogers A, Doogue M, Lewis JG, et al. A longitudinal study of plasma and urinary cortisol in pregnancy and postpartum. J Clin Endocrinol Metab 2011; 96: 1533-1540. doi: 10.1210/jc.2010-2395Search in Google Scholar

28. Sandman C, Davis EP, Buss C, Glynn LM. Prenatal programming of human neurological function. Int J Pept 2011; 2011: 837596. doi: 10.1155/2011/837596Search in Google Scholar

29. Shelton MM, Schminkey DL, Groer MW. Relationships among prenatal depression, plasma cortisol, and inflammatory cytokines. Biol Res Nurs 2015; 17: 295-302. doi: 10.1177/1099800414543821Search in Google Scholar

30. Chrousos GP, Torpy DJ, Gold PW. Interactions between the hypothalamic-pituitary-adrenal axis and the female reproductive system: clinical implications. Ann Intern Med 1998; 129: 229-240. doi: 10.7326/0003-4819-129-3-199808010-00012Search in Google Scholar

31. Kalantaridou SN, Makrigiannakis A, Zoumakis E, Chrousos GP. Stress and the female reproductive system. J Reprod Immunol 2004; 62: 61-68. doi: 10.1016/j.jri.2003.09.004Search in Google Scholar

32. Thompson LA, Trevathan WR. Cortisol reactivity, maternal sensitivity, and learning in 3-month-old infants. Infant Behav Dev 2008; 31: 92-106. doi: 10.1016/j.infbeh.2007.07.00717716739Search in Google Scholar

33. Seth S, Lewis AJ, Galbally M. Đerinatal maternal depression and cortisol function in pregnancy and the postpartum period: a systematic literature review. BMC Pregnancy Childbirth 2016; 16: 124. doi: 10.1186/s12884-016-0915-ySearch in Google Scholar

34. Hochberg Z, Pacak K, Chrousos GP. Endocrine withdrawal syndromes. Endocr Rev 2003; 24: 523-538. doi: 10.1210/ er.2001-0014Search in Google Scholar

35. Halbreich U. The association between pregnancy processes, preterm delivery, low birth weight, and postpartum depressions - the need for interdisciplinary integration. Am J Obstet Gynecol 2005; 193: 1312-1322. doi: 10.1016/j.ajog.2005.02.103Search in Google Scholar

36. Kammerer M, Taylor A, Glover V. The HPA axis and perinatal depression: a hypothesis. Arch Womens Ment Health 2006; 9: 187-196. doi: 10.1007/s00737-006-0131-2Search in Google Scholar

37. Vitoratos N, Papatheodorou DC, Kalantaridou SN, Mastorakos G. “Reproductive” corticotrophin-releasing hormone. Ann N Y Acad Sci 2006; 1092: 310-318. doi: 10.1196/annals.1365.029Search in Google Scholar

38. Yim IS, Glynn LM, Dunkel-Schetter C, Hobel CJ, Chicz-DeMet A, Sandman CA. Risk of postpartum depressive symptoms with elevated corticotropin-releasing hormone in human pregnancy. Arch Gen Psychiatry 2009; 66: 162-169. doi: 10.1001/archgenpsychiatry.2008.533Search in Google Scholar

39. Penninx BW, Milaneschi Y, Lamers F, Vogelzangs N. Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profile. BMC Med 2013; 11: 129. doi: 10.1186/1741-7015-11-129Search in Google Scholar

40. Bhagwagar Z, Whale R, Cowen PJ. State and trait abnormalities in serotonin function in major depression. Br J Psychiatry 2002; 180: 24-28. doi: 10.1192/bjp.180.1.24Search in Google Scholar

41. Lancaster CA, Gold KJ, Flynn HA, Yoo H, Marcus SM, Davis MM. Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 2010; 202: 5-14. doi: 10.1016/j.ajog.2009.09.007Search in Google Scholar

42. Wei J, Sun G, Zhao L, Yang X, Liu X, Lin D, et al. Analysis of hair cortisol level in first-episodic and recurrent female patients with depression compared to healthy controls. J Affect Disord 2015; 175: 299-302. doi: 10.1016/j.jad.2015.01.023Search in Google Scholar

43. Watanabe R, Kakeda S, Watanabe K, Liu X, Katsuki A, Umeno- Nakano W, et al. Relationship between the hippocampal shape abnormality and serum cortisol levels in first-episode and drugnaďve major depressive disorder patients. Depress Anxiety 2017; 34: 401-409. doi: 10.1002/da.2260428129464Search in Google Scholar

44. Lommatzsch M, Hornych K, Zingler C, Schuff-Werner P, Höppner J, Virchow JC. Maternal serum concentrations of BDNF and depression in the perinatal period. Psychoneuroendocrinology 2006; 31: 388-394. doi: 10.1016/j.psyneuen.2005.09.00316289360Search in Google Scholar

45. Nierop A, Bratsikas A, Zimmermann R, Ehlert U. Are stressinduced cortisol changes during pregnancy associated with postpartum depressive symptoms? Psychosom Med 2006; 68: 931-937. doi: 10.1097/01.psy.0000244385.93141.3bSearch in Google Scholar

46. Taylor A, Glover V, Marks M, Kammerer M. Diurnal pattern of cortisol output in postnatal depression. Psychoneuroendocrinology 2009; 34: 1184-1188. doi: 10.1016/j.psyneuen.2009.03.00419406580Search in Google Scholar

47. Handley SL, Dunn TL, Waldron G, Baker JM. Tryptophan, cortisol and puerperal mood. Br J Psychiatry 1980; 136: 498-508. doi: 10.1192/bjp.136.5.498Search in Google Scholar

48. Ehlert U, Patalla U, Kirschbaum C, Piedmont E, Hellhammer DH. Postpartum blues: salivary cortisol and psychological factors. J Psychosom Res 1990; 34: 319-325. doi: 10.1016/ 0022-3999(90)90088-L2342000Search in Google Scholar

49. Okano T, Nomura J. Endocrine study of the maternity blues. Prog Neuropsychopharmacol Biol Psych 1992; 16: 921-932. doi: 10.1016/0278-5846(92)90110-ZSearch in Google Scholar

50. Pedersen CA, Stern RA, Pate J, Senger MA, Bowes WA, Mason GA. Thyroid and adrenal measures during late pregnancy and the puerperium in women who have been major depressed or who become dysphoric postpartum. J Affect Disord 1993; 29: 201-211. doi: 10.1016/0165-0327(93)90034-HSearch in Google Scholar

51. Taylor A, Littlewood J, Adams D, Doré C, Glover V. Serum cortisol levels are related to moods of elation and dysphoria in new mothers. Psychiatry Res 1994; 54: 241-247. doi: 10.1016/0165-1781(94)90018-37792328Search in Google Scholar

52. Harris B, Johns S, Fung H, Thomas R, Walker R, Read G, et al. The hormonal environment of postnatal depression. Br J Psychiatry 1989; 154: 660-667. doi: 10.1192/bjp.154.5.660Search in Google Scholar

53. Smith R, Cubis J, Brinsmead M, Lewin T, Singh B, Owens P, et al. Mood changes, obstetric experience and alterations in plasma cortisol, beta-endorphin and corticotrophin releasing hormone during pregnancy and the puerperium. J Psychosom Res 1990; 34: 53-69. doi: 10.1016/0022-3999(90)90008-R2138227Search in Google Scholar

54. O’Hara MW, Schlechte JA, Lewis DA, Varner MW. Controlled prospective study of postpartum mood disorders: psychological, environmental, and hormonal variables. J Abnorm Psychol 1991; 100: 63-73. doi: 10.1037/0021-843X.100.1.63Search in Google Scholar

55. Susman EJ, Schmeelk KH, Worrall BK, Granger DA, Ponirakis A, Chrousos GP. Corticotropin-releasing hormone and cortisol: longitudinal associations with depression and antisocial behavior in pregnant adolescents. J Am Acad Child Adolesc Psychiatry 1999; 38: 460-467. doi: 10.1097/00004583-199904000-00020Search in Google Scholar

56. Jolley SN, Elmore S, Barnard KE, Carr DB. Dysregulation of the hypothalamic-pituitary-adrenal axis in postpartum depression. Biol Res Nurs 2007; 8: 210-222. doi: 10.1177/109980040629459817172320Search in Google Scholar

57. Shea AK, Streiner DL, Fleming A, Kamath MV, Broad K, Steiner M. The effect of depression, anxiety and early life trauma on the cortisol awakening response during pregnancy: preliminary results. Psychoneuroendocrinology 2007; 32: 1013-1020. doi: 10.1016/j.psyneuen.2007.07.00617855000Search in Google Scholar

58. Salacz P, Csukly G, Haller J, Valent S. Association between subjective feelings of distress, plasma cortisol, anxiety, and depression in pregnant women. Eur J Obstet Gynecol Reprod Biol 2012; 165: 225-230. doi: 10.1016/j.ejogrb.2012.08.017Search in Google Scholar

59. Hellgren C, Akerud H, Skalkidou A, Sundstrom-Poromaa I. Cortisol awakening response in late pregnancy in women with previous or ongoing depression. Psychoneuroendocrinology. 2013; 38: 3150-3154. doi: 10.1016/j.psyneuen.2013.08.007Search in Google Scholar

60. Meliska CJ, Martínez LF, López AM, Sorenson DL, Nowakowski S, Kripke DF, et al. Antepartum depression severity is increased during seasonally longer nights: relationship to melatonin and cortisol timing and quantity. Chronobiol Int 2013; 30: 1160-1173. doi: 10.3109/07420528.2013.80865223998286Search in Google Scholar

61. Glynn L.M., Sandman C.A. Evaluation of the association between placental corticotrophin-releasing hormone and postpartum depressive symptoms. Psychosom Med 2014; 76: 355-362. doi: 10.1097/PSY.000000000000006624915294Search in Google Scholar

62. Parry BL, Sorenson DL, Meliska CJ, Basavaraj N, Zirpoli GG, Gamst A, et al. Hormonal basis of mood and postpartum disorders. Current Womens Health Rep 2003; 3: 230-235Search in Google Scholar

63. Groer MW, Morgan K. Immune, health and endocrine characteristics of depressed postpartum mothers. Psychoneuroendocrinology 2007; 32: 133-139. doi: 10.1016/j.psyneuen.2006.11.007Search in Google Scholar

64. Saleh el-S, El-Bahei W, Del El-Hadidy MA, Zayed A. Predictors of postpartum depression in a sample of Egyptian women. Neuropsychiatr Dis Treat 2013; 9: 15-24. doi: 10.2147/NDT.S37156Search in Google Scholar

65. Hiltunen P, Raudaskoski T, Ebeling H, Moilanen I. Does pain relief during delivery decrease the risk of postnatal depression? Acta Obstet Gynecol Scand 2004; 83: 257-261. doi: 10.1111/j.0001-6349.2004.0302.x14995921Search in Google Scholar

66. Ding T, Wang DX, Qu Y, Chen Q, Zhu SN. Epidural labor analgesia is associated with a decreased risk of postpartum depression: a prospective cohort study. Anesth Analg 2014: 119: 383-392. doi: 10.1213/ANE.0000000000000107Search in Google Scholar

67. Suhitharan T, Pham TP, Chen H, Assam PN, Sultana R, Han NL, et al. Investigating analgesic and psychological factors associated with risk of postpartum depression development: a case-control study. Neuropsychiatr Dis Treat 2016; 12: 1333-1339. doi: 10.2147/NDT.S105918Search in Google Scholar

68. Orbach-Zinger S, Landau R, Harousch AB, Ovad O, Caspi L, Kornilov E, et al. The Relationship Between Women’s Intention to Request a Labor Epidural Analgesia, Actually Delivering With Labor Epidural Analgesia, and Postpartum Depression at 6 Weeks: A Prospective Observational Study. Anesth. Analg 2018; 126: 1590-1597. doi: 10.1213/ANE.0000000000002501Search in Google Scholar

69. Yakhin KK, Mendelevich DM. Clinical questionnaire for detection and evaluation of neurotic conditions. In: Clinical and Medical Psychology: Practical Guide: Moskva: s.n.; 1998: p. 545-552Search in Google Scholar

70. Levine A, Zagoory-Sharon O, Feldman R, Lewis JG, Weller A. Measuring cortisol in human psychobiological studies. Physiol Behav 2007; 90: 43-53. doi: 10.1016/j.physbeh.2006.08.02517055006Search in Google Scholar

71. Bergant A, Nguyen T, Heim K, Ulmer H, Dapunt O. Deutschsprachige Fassung und Validierung der «Edinburgh postnatal depression scale». Dtsch Med Wochenschr 1998; 123: 35-40. doi: 10.1055/s-2007-1023895Search in Google Scholar

72. Myers ER, Aubuchon-Endsley N, Bastian LA, Gierisch JM, Kemper AR, Swamy GK, et al. Efficacy and Safety of Screening for Postpartum Depression. Comparative Effectiveness ReviewSearch in Google Scholar

106. (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-2007-10066-I.) AHRQ Publication No. 13-EHC064-EF. Rockville, MD: Agency for Healthcare Research and Quality; April 2013. www.effectivehealthcare.ahrq.gov/reports/final.cfm.Search in Google Scholar

73. Mazo GE, Wasserman LI, Shamanina MV. Choosing scales for postpartum depression assessment [Article in Russian]. Review of Psychiatry and Medical Psychology 2012; 2: 41-50.Search in Google Scholar

74. Melzack R, Katz J. Pain management in persons in pain. In: Wall PD, Melzack R, eds. Textbook of Pain. 4th edition. Edinburgh: Churchill Livingstone; 1999Search in Google Scholar

75. Boudou M, Teissčdre F, Walburg V, Chabrol H. Association between the intensity of childbirth pain and the intensity of postpartum blues. Encephale 2007; 33: 805-81010.1016/j.encep.2006.10.0021835785218357852Open DOISearch in Google Scholar

76. Eisenach JC, Pan P, Smiley RM, Lavand’homme P, Landau R, Houle TT. Resolution of pain after childbirth. Anesthesiology 2013; 118: 143-151. doi: 10.1097/ALN.0b013e318278ccfdSearch in Google Scholar

77. Eisenach JC, Pan PH, Smiley R, Lavand’homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain 2008; 140: 87-94. doi: 10.1016/j.pain.2008.07.011Search in Google Scholar

78. Soet JE, Brack GA, Dilorio C. Prevalence and predictors of women’s experience of psychological trauma during childbirth. Birth 2003; 30: 36-46. doi: 10.1046/j.1523-536X.2003.00215.xSearch in Google Scholar

79. Vermelis JM, Wassen MM, Fiddelers AA, Nijhuis JG, Marcus MA. Prevalence and predictors of chronic pain after labor and delivery. Curr Opin Anaesthesiol 2010; 23: 295-299. doi: 10.1097/ACO.0b013e32833853e8Search in Google Scholar

80. Harris TO, Borsanyi S, Messari S, Stanford K, Cleary SE, Shiers HM, et al. Morning cortisol as a risk factor for subsequent major depressive disorder in adult women. Br J Psychiatry 2000; 177: 505-510. doi: 10.1192/bjp.177.6.505Search in Google Scholar

81. Adam EK, Doane LD, Zinbarg RE, Mineka S, Craske MG, Griffith JW. Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence. Psychoneuroendocrinology 2010; 35: 921-931. doi: 10.1016/j.psyneuen.2009Search in Google Scholar

82. Goodyer IM, Croudace T, Dudbridge F, Ban M, Herbert J. Polymorphisms in BDNF (Val66Met) and 5-HTTLPR, morning cortisol and subsequent depression in at-risk adolescents. Br J Psychiatry 2010; 197: 365-371. doi: 10.1192/bjp.bp.110.077750Search in Google Scholar

83. Vrshek-Schallhorn S, Doane LD, Mineka S, Zinbarg RE, Craske MG, Adam EK. The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history. Psychol Med 2013; 43: 483-493. doi: 10.1017/S0033291712001213Search in Google Scholar

84. Houshyar H, Galigniana MD, Pratt WB, Woods JH. Differential responsivity of the hypothalamic-pituitary-adrenal axis to glucocorticoid negative-feedback and corticotropin releasing hormone in rats undergoing morphine withdrawal: possible mechanisms involved in facilitated and attenuated stress responses. J Neuroendocrinol 2001; 13: 875-886. doi: 10.1046/j.1365-2826.2001.00714.x11679056Search in Google Scholar

85. Workman JL, Barha CK, Galea LAM. Endocrine substrates of cognitive and affective changes during pregnancy and postpartum. Behav Neurosci 2012; 126: 54-72. doi: 10.1037/a0025538Search in Google Scholar

86. Shimizu A, Nishiumi H, Okumura Y, Watanabe K. Depressive symptoms and changes in physiological and social factors 1 week to 4 months postpartum in Japan. J Affect Disord 2015; 179: 175-182. doi: 10.1016/j.jad.2015.03.036Search in Google Scholar

87. Buss C, Entringer S, Reyes JF, Chicz-DeMet A, Sandman CA, Waffarn F, et al. The maternal cortisol awakening response in human pregnancy is associated with the length of gestation. Am J Obstet Gynecol 2009; 201: 398.e1-398.e8. doi: 10.1016/ j.ajog.2009.06.063Search in Google Scholar

88. Hompes T, Vrieze E, Fieuws S, Simons A, Jaspers L, Van Bussel J, et al. The influence of maternal cortisol and emotional state during pregnancy on fetal intrauterine growth. Pediatr Res 2012; 72: 305-315. doi: 10.1038/pr.2012.70Search in Google Scholar

89. Pluess M, Bolten M, Pirke KM, Hellhammer D. Maternal trait anxiety, emotional distress, and salivary cortisol in pregnancy. Biol Psychol 2010; 83: 169-175. doi: 10.1016/j.biopsycho.2009.12.005.Search in Google Scholar

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