The effects of pregnancy on post traumatic symptoms and fear physiology in traumatized African American women

修改项目摘要/摘要部分 反复创伤暴露的累积率在城市、低社会经济地位的非洲裔美国人（AA）社区更高。这种累积的创伤暴露与抑郁和创伤后症状（PTS）增加以及恐惧反应失调有关。虽然与男性相比，遭受创伤的女性更容易患抑郁症和焦虑症，但增加对创伤引起的情感改变的脆弱性的因素仍不清楚。对于孕妇来说尤其如此，尽管有证据表明PTS在怀孕期间发生了变化，但她们在创伤研究中受到的关注最少。然而，妊娠对PTS影响的具体性质一直不明确。由于怀孕的AA妇女经历不成比例的累积创伤暴露率和PTS，了解如何激素波动在怀孕期间的创伤AA妇女影响PTS和恐惧心理生理学是至关重要的母亲的福祉之前和之后交付。 鉴于我们从高创伤风险人群中招募AA孕妇，拟议的纵向研究能够很好地解决这一知识差距。本研究将结合联合收割机的临床访谈和恐惧生理学方法，研究妊娠各期和产后1个月内雌激素、孕激素和皮质醇的变化如何影响PTS和恐惧抑制缺陷。此外，由于研究暗示产前压力暴露与胎儿皮质醇暴露增加和不良出生结果的风险增加有关，（即出生体重低）和成年后的不良身心健康结果，我们将通过评估胎盘DNA甲基化和胎儿暴露于糖皮质激素通过脐带。

Modified Project Summary/Abstract 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.