Exposure to childhood trauma among pregnant women is associated with increased placental CRH production over gestation

Abstract

Rationale : Exposure to traumatic events, particularly during sensitive periods in childhood, is known to have persisting effects on health and disease risk in adult life. A few studies that have examined the course and outcome of later pregnancies in women with early trauma history bring up the intriguing possibility of transgenerational transmission of the effect of maternal childhood trauma on her developing fetus. However, the mechanism(s) underlying this effect have yet to be clarified. In humans and other higher primates, a stress-related system that is particularly relevant for key gestational processes, fetal development, and birth outcomes is placental corticotropin-releasing hormone (pCRH). In this study, we address the hypothesis that history of early life trauma is associated with variation in the level and trajectory of pCRH production over the course of human gestation. Methods : A study population of sociodemographically and ethnically diverse women with singleton pregnancies (N=333) provided information about childhood abuse and neglect (Childhood Trauma Questionnaire, or CTQ). Placental CRH levels were assessed prospectively at 1–5 time points over gestation (T1: mean = 15.0 weeks, SD=.72 until T5: mean = 36.5 weeks, SD=.78). Because of the expected exponential increase of pCRH production over gestation, pCRH values were log-transformed and Generalized Estimating Equation modeling was employed. Results : One hundred thirty-seven women (41.1%) reported having experienced at least one type of trauma during childhood, and 75 (22.5%) reported exposure to multiple traumas. A higher childhood trauma score was significantly associated with higher pCRH levels over the entire period of gestation (Wald χ 2(1) = 4.68, p =.030, β=.005). With the exception of physical and sexual abuse, this relationship was observed for all trauma subscales. The effect was dose dependent, with a higher number of different types of traumas being related to higher concentrations of pCRH. Conclusion : To the best of our knowledge, this is the first report linking exposure to traumatic events in childhood with subsequent placental physiology, thus identifying a possible mechanism of transgenerational transmission. Given the importance of placental CRH in primate pregnancy, this finding also may have appreciable clinical significance.

Keywords

• childhood trauma
• placental CRH
• pregnancy
• maternal life course history