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      Changes in the cortisol and oxytocin levels of first-time pregnant women during interaction with an infant: a randomized controlled trial

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          Abstract

          Background

          During pregnancy, physiological, psychological, and social changes affect pregnant women’s childcare anxiety and childrearing behavior. However, there are scarce reports on hormonal evaluation related to such anxiety and behavior. Herein, we evaluated changes in salivary cortisol (primary outcome) and oxytocin (secondary outcome) levels of first-time pregnant women when interacting with an infant and discussed the relation of these changes to the women’s stress level.

          Methods

          This was a two-arm randomized controlled trial. Participants were randomly assigned using a web-based randomization system. The experimental group involved interaction with an infant for 30 min. The control group involved watching a DVD movie of an infant for 30 min. Saliva samples were collected at preintervention and postintervention. Saliva samples were assayed, and all data were compared between and within the groups using independent t-test and paired t-test with a two-sided 5% significance level. This study was approved by the Research Ethics Committee of St. Luke’s International University.

          Results

          A total of 102 women were randomly assigned to the experimental (n = 51) and control (n = 51) groups. Finally, 38 women in the experimental group and 42 women in the control group were analyzed. The salivary cortisol level significantly decreased after the interventions in both groups (t = 4.57, p = 0.00; t = 5.01, p = 0.00). However, there were no significant differences in the salivary cortisol (t = 0.349, p = 0.73) and oxytocin (t = − 1.945, p = 0.58) levels between the two groups.

          Conclusions

          The salivary cortisol level of first-time pregnant women significantly decreased in the experimental and control groups postintervention, although no significant difference was found between the two groups. Such decrease indicates stress reduction and release among these women. The absence of a significant increase in salivary oxytocin level in both groups may be related to the limitations of an insufficient number of samples that could be analyzed owing to the small saliva volume in some samples and the lack of adequate tactile stimulation of the intervention protocol. These results and procedural limitations provide useful insights into approaching subsequent studies aiming at continuously optimizing detection procedures.

          Trial registration

          UMIN000028471 (Clinical Trials Registry of University Hospital Information Network. July 31, 2017- Retrospectively registered.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12884-021-03609-8.

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          Most cited references11

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          Lower CSF oxytocin concentrations in women with a history of childhood abuse.

          Early-life disruption of the parent-child relationship, for example, in the form of abuse, neglect or loss, dramatically increases risk for psychiatric, as well as certain medical, disorders in adulthood. The neuropeptide oxytocin (OT) plays a seminal role in mediating social affiliation, attachment, social support, maternal behavior and trust, as well as protection against stress and anxiety. We therefore examined central nervous system OT activity after early-life adversity in adult women. We measured OT concentrations in cerebrospinal fluid (CSF) collected from 22 medically healthy women, aged 18-45 years, categorized into those with none-mild versus those with moderate-severe exposure to various forms of childhood abuse or neglect. Exposure to maltreatment was associated with decreased CSF OT concentrations. A particularly strong effect was identified for emotional abuse. There were inverse associations between CSF OT concentrations and the number of exposure categories, the severity and duration of the abuse and current anxiety ratings. If replicated, the association of lower adult CSF OT levels with childhood trauma might indicate that alterations in central OT function may be involved in the adverse outcomes of childhood adversity.
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            Plasma oxytocin concentration during pregnancy is associated with development of postpartum depression.

            Postpartum depression (PPD) affects up to 19% of all women after parturition. The non-apeptide oxytocin (OXT) is involved in adjustment to pregnancy, maternal behavior, and bonding. Our aim was to examine the possible association between plasma OXT during pregnancy and the development of PPD symptoms. A total of 74 healthy, pregnant women were included in this prospective study. During the third trimester of pregnancy and within 2 weeks after parturition, PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Blood samples for plasma OXT assessment were collected in the third trimester. Following the literature, participants with postpartum EPDS scores of 10 or more were regarded as being at risk for PPD development (rPPD group). In a logistic regression analysis, plasma OXT was included as a potential predictor for being at risk for PPD. Results were controlled for prepartal EPDS score, sociodemographic and birth-outcome variables. Plasma OXT concentration in mid-pregnancy significantly predicted PPD symptoms at 2 weeks postpartum. Compared with the no-risk-for-PPD group, the rPPD group was characterized by lower plasma OXT concentrations. To our knowledge, this is the first study to show an association between prepartal plasma OXT concentration and postpartal symptoms of PPD in humans. Assuming a causal relationship, enhancing OXT release during pregnancy could serve as a potential target in prepartum PPD prevention, and help to minimize adverse effects of PPD on the mother-child relationship.
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              Oxytocin during pregnancy and early postpartum: individual patterns and maternal-fetal attachment.

              Oxytocin (OT), a nanopeptide hormone, plays a role in the emergence of maternal behavior, yet few studies examined OT in humans across pregnancy and the postpartum. We followed healthy women at three points: first trimester of pregnancy, third trimester, and first postpartum month. Plasma OT levels showed high individual stability. A third of the sample showed consistent OT levels, whereas others showed increasing or decreasing trends or peak in late pregnancy. The increase in OT from early to late pregnancy correlated with higher maternal-fetal bonding. These data may help set standards for OT levels and underscore links with maternal-infant attachment.
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                Author and article information

                Contributors
                15dn010@slcn.ac.jp
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                24 February 2021
                24 February 2021
                2021
                : 21
                : 162
                Affiliations
                [1 ]GRID grid.444320.5, ISNI 0000 0004 0371 2046, Japanese Red Cross Kyushu International College of Nursing, ; 1-1 Asty Munakata, Fukuoka, 811-4157 Japan
                [2 ]Shonan Kamakura University of Medical Science, 1195-3 Yamasaki, Kamakura-shi, 247-0066 Japan
                [3 ]GRID grid.174567.6, ISNI 0000 0000 8902 2273, Department of Neurobiology and Behavior, , Graduate School of Biomedical Science, Nagasaki University, ; 1-12-4 Sakamotomachi, Nagasaki, 852-8523 Japan
                [4 ]GRID grid.419588.9, ISNI 0000 0001 0318 6320, Graduate School of Nursing Science, , St. Luke’s International University, ; 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044 Japan
                Author information
                http://orcid.org/0000-0002-7013-4085
                Article
                3609
                10.1186/s12884-021-03609-8
                7903931
                a9d662f3-eb17-470a-9826-6f223cd3e7a3
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 25 September 2020
                : 31 January 2021
                Funding
                Funded by: Japan Society for the Promotion of Science (JP)
                Award ID: 19K19698
                Award ID: 16K15939
                Award Recipient :
                Funded by: Japan Society for the Promotion of Science
                Award ID: 17H01613
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Obstetrics & Gynecology
                pregnancy,primipara,infant,interaction,cortisol,oxytocin,single nucleotide polymorphism,randomized controlled trial (8/10)

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