Investigating the Associations between Prenatal Maternal Sleep, and Maternal and Fetal Hypothalamic-Pituitary-Adrenal (HPA) Axis Physiology

Abstract

The Developmental Originals of Health and Disease (DOHaD) and fetal programming hypotheses posit that developing organisms are especially susceptible to environmental signals at times of rapid maturation. These models highlight pregnancy as a sensitive period in which inputs from the environment can have long-lasting and robust effects on the health and development of the next generation. The purpose of this dissertation is to investigate prenatal maternal sleep as a process that may affect maternal and offspring health. Specifically, we focus on maternal and fetal hypothalamic-pituitaryadrenal (HPA) axis physiology since these systems have been commonly proposed as biological pathways linking prenatal experiences to offspring outcomes. The first study examines the associations among prenatal maternal hair cortisol, cortisol-cortisone ratio and perceived stress and prenatal maternal sleep across pregnancy. The second study investigates whether changes in prenatal maternal sleep predict neonatal hair cortisol levels. Results from the first study revealed that higher perceived stress, but not cortisol or cortisol-cortisone ratio, is associated with more sleep problems and shorter sleep duration across pregnancy. Further, results from the second study show that prenatal maternal sleep does not significantly predict neonatal hair cortisol levels. The findings from the two studies, as well as contributions to existing literature, strengths and limitations, and future directions, are discussed in detail.