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Cited by 151Maternal Mental Health During Pregnancy and PostpartumNeuroendocrine regulation and behaviorStress Responses and Cortisol

Oxytocin and HPA stress axis reactivity in postpartum women

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Cox, E.Q., Stuebe, A., Pearson, B., Grewen, K., Rubinow, D., Meltzer-Brody, S.·2015·Psychoneuroendocrinology
DOI 10.1016/j.psyneuen.2015.02.009PMC PMC4380745
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Abstract

Background Lactation is thought to buffer stress reactivity via oxytocin (OT). Dysregulation of the HPA axis has been reported in women with postpartum depression (PPD). The co-occurrence of PPD and lactation failure suggests that abnormalities in OT signaling may play a role in PPD. We hypothesized that abnormal OT signaling is implicated in dysregulated HPA axis reactivity among postpartum women with mood symptoms. In a prospective perinatal cohort, we tested associations between OT levels during breastfeeding and stress reactivity. Methods We recruited 52 pregnant women who intended to breastfeed, among whom 47 underwent a standardized stressor, the Trier Social Stress Test (TSST), at 8 weeks postpartum. 39 were breastfeeding at time of TSST. We assessed mood symptoms using validated instruments and defined as symptomatic women with EPDS ≥ 10 and/or Spielberger ≥ 34. Following IV placement for blood draws, women breastfed their infants and then underwent the TSST. Mothers' hormone responses were quantified. Results Among symptomatic breastfeeding women (N=11; asymptomatic N=28), we found lower OT levels during breastfeeding (p<0.05) and higher CORT levels (p<0.05) both during breastfeeding and the TSST, as compared to asymptomatic breastfeeding women. In a mixed effects model examining CORT reactivity by symptom group and OT AUC, we observed a paradoxical response in symptomatic breastfeeding women during the TSST (group × time × OT AUC p<0.05); higher OT AUC was associated with higher CORT. Conclusions In all breastfeeding women, the surge of OT during feeding appears to buffer subsequent stress-induced CORT secretion. However, in symptomatic breastfeeding women, we found a positive correlation between OT AUC and CORT, instead of the expected negative correlation, which we found among asymptomatic women.

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  • Surges in oxytocin during breastfeeding are known to dampen the effects of stress hormones.

    “Surges in oxytocin during breastfeeding are known to dampen the effects of stress hormones (Cox et al., 2015).”

    From The evolved nest, oxytocin functioning, and prosocial development (2023) · cites this paper as Cox et al., 2015

    The Abstract Conclusions say the oxytocin surge during breastfeeding appears to buffer subsequent stress-induced cortisol secretion. The claim states this more definitively as a known dampening of stress-hormone effects, whereas the paper measured cortisol secretion and reports an altered oxytocin–cortisol relationship in symptomatic women (Abstract Conclusions; 4. Conclusions). (LLM, conf=0.86)

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  • Breastfeeding has also been associated with maternal stress reduction and enhanced positive mood through oxytocinergic functioning.

    “Breastfeeding has also been associated with maternal stress reduction and enhanced positive mood through oxytocinergic functioning.”

    From The evolved nest, oxytocin functioning, and prosocial development (2023) · cites this paper as Cox et al., 2015

    The Results and discussion and Conclusions (page not provided) associate breastfeeding with lower cortisol and heart-rate responses to a stressor, and suggest oxytocin may help buffer that response. They do not show that breastfeeding enhances positive mood; they also report a different oxytocin–cortisol relationship in women with depression or anxiety symptoms. (LLM, conf=0.88)

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  • Several studies found that mothers who report more anxiety and depression also demonstrate lower levels of oxytocin when breastfeeding than asymptomatic breastfeeding mothers.

    “Several studies found that mothers who report more anxiety and depression also demonstrate lower levels of oxytocin when breastfeeding than asymptomatic breastfeeding mothers (Stuebe et al., 2013; Cox et al., 2015; Pawluski et al., 2017).”

    From The evolved nest, oxytocin functioning, and prosocial development (2023) · cites this paper as Cox et al., 2015

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Cited by

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Authors
Cox, E. Q., Stuebe, A., Pearson, B., Grewen, K., Rubinow, D., & Meltzer-Brody, S.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
Cox, E.Q.
ORCID
Venue
Psychoneuroendocrinology
Publisher
Elsevier BV
Published
2015-05
Volume
55
Pages
164-172
ISSN
0306-4530 (ISSN-L)
DOI
10.1016/j.psyneuen.2015.02.009
PMC
PMC4380745
OpenAlex
W2027341236
Cited by
151
References
7
Citations by year
2026: 12 · 2025: 10 · 2024: 9 · 2023: 12 · 2022: 21 · 2021: 23 · 2020: 15 · 2019: 14 · 2018: 8 · 2017: 13 · 2016: 9 · 2015: 5
FWCI
12.51
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychoneuroendocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR001111, UL1TR002489)
  • National Institute of Mental Health (T32 MH93315, K23MH085165, T32MH093315)
  • National Institute on Drug Abuse (P01DA022446)
  • National Center for Research Resources (UL1RR025747)
  • National Center for Advancing Translational Sciences
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD073220)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Social Psychology › Neuroendocrine regulation and behavior
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
oxytocin, hypothalamic-pituitary-adrenal axis, postpartum depression, lactation, breastfeeding, cortisol, stress reactivity, Trier Social Stress Test, mood symptoms, perinatal mental health
MeSH terms
Adult, Anxiety, Breast Feeding, Depression, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Lactation, Longitudinal Studies, Oxytocin, Pituitary-Adrenal System, Prospective Studies, Stress, Psychological, Cohort Studies, Case-Control Studies, Depression, Postpartum, Postpartum Period, Young Adult

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