Transgenerational Effects of Posttraumatic Stress Disorder in Babies of Mothers Exposed to the World Trade Center Attacks during Pregnancy
Abstract
CONTEXT: Reduced cortisol levels have been linked with vulnerability to posttraumatic stress disorder (PTSD) and the risk factor of parental PTSD in adult offspring of Holocaust survivors. OBJECTIVE: The purpose of this study was to report on the relationship between maternal PTSD symptoms and salivary cortisol levels in infants of mothers directly exposed to the World Trade Center collapse on September 11, 2001 during pregnancy. DESIGN: Mothers (n = 38) collected salivary cortisol samples from themselves and their 1-yr-old babies at awakening and at bedtime. RESULTS: Lower cortisol levels were observed in both mothers (F = 5.15, df = 1, 34; P = 0.030) and babies of mothers (F = 8.0, df = 1, 29; P = 0.008) who developed PTSD in response to September 11 compared with mothers who did not develop PTSD and their babies. Lower cortisol levels were most apparent in babies born to mothers with PTSD exposed in their third trimesters. CONCLUSIONS: The data suggest that effects of maternal PTSD related to cortisol can be observed very early in the life of the offspring and underscore the relevance of in utero contributors to putative biological risk for PTSD.
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Women exposed to the World Trade Center collapse in 2001 and developed PTSD gave birth to offspring with lower birth weight and cortisol concentrations than offspring not exposed to maternal PTSD.
“Women who were directly exposed to the World Trade Center collapse in 2001 (either by being present or near the building while pregnant) and developed post-traumatic stress disorder (PTSD) gave birth to offspring that had lower birth weight and cortisol concentrations than offspring who were not exposed to maternal PTSD [101,102].”
From Stress and the HPA Axis: Balancing Homeostasis and Fertility. (2017) · cites this paper as [101]
The Results report significantly lower salivary cortisol in infants of mothers who developed PTSD (Results, passage 4). They also report no significant difference in infant birthweight between mothers with and without PTSD (Results, passage 2). The Discussion adds that reduced birthweight associated with September 11 exposure did not appear related to maternal PTSD (Discussion, passage 6). (LLM, conf=0.92)
Experimental — accuracy not yet measuredFollowing the September 11 attacks, infants born to mothers with PTSD who were directly exposed to the World Trade Center demonstrated lower baseline salivary cortisol levels, particularly with third-trimester exposure.
“Following the September 11 attacks, infants born to mothers with PTSD who were directly exposed to the World Trade Center demonstrated lower baseline salivary cortisol levels, particularly with third-trimester exposure (36).”
From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [36]
The gestational stage of the fetus is an important determinant of the impact of prenatal exposures on offspring, indicative of developmentally sensitive windows of fetal development.
“The gestational stage of the fetus is an important determinant of the impact of prenatal exposures on offspring, indicative of developmentally sensitive windows of fetal development 146,147 .”
From Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms (2018) · cites this paper as [146]
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- Authors
- Yehuda, R., Engel, S. M., Brand, S. R., Seckl, J., Marcus, S. M., & Berkowitz, G. S.
- Affiliations
- James J. Peters VA Medical Center (US)
- Western General Hospital (GB)
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Yehuda, Rachel
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-07
- Volume
- 90
- Issue
- 7
- Pages
- 4115-4118
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2124699909
- Cited by
- 711
- References
- 24
- Citations by year
- 2026: 5 · 2025: 26 · 2024: 20 · 2023: 25 · 2022: 32 · 2021: 38 · 2020: 83 · 2019: 41 · 2018: 36 · 2017: 38 · 2016: 32 · 2015: 37 · 2014: 36 · 2013: 42 · 2012: 26
- FWCI
- 37.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- New York Community Trust
- National Institute of Mental Health (5 R01 MH64675-03, R01MH064675)
- National Institute of Environmental Health Sciences (P42 ES07384, P42ES007384)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- post-traumatic stress disorder, maternal PTSD, transgenerational effects, salivary cortisol, infants, World Trade Center attacks, September 11 attacks, prenatal exposure, third trimester, biological risk
- MeSH terms
- Adult, Female, Humans, Hydrocortisone, Pregnancy, Pregnancy Complications, Stress Disorders, Post-Traumatic, Terrorism
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