{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:25:19Z","timestamp":1785529519268,"version":"3.56.0"},"posted":{"date-parts":[[2026,7,24]]},"group-title":"Sexual and Reproductive Health","reference-count":106,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,24]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>Psychosocial distress is associated with adverse perinatal outcomes, yet its biological correlates remain incompletely understood. We evaluated associations of prenatal psychosocial distress with allopregnanolone (ALLO) and related steroids, and assessed race\/ethnicity as a potential effect modifier, using data from 237 participants from the Healthy Start Study. We selected participants based on high distress (Edinburgh Perinatal Depression Scale [EPDS] \u226513 or EPDS-3A \u22657; n = 57) or low distress (EPDS &lt;4 and EPDS-3A &lt;2; n = 180). We quantified ALLO, progesterone, pregnanolone, cortisol, and cortisone in maternal serum using HPLC-MS\/MS at two timepoints in pregnancy for each participant, (median \u223c17 and \u223c27 weeks\u2019 gestation; range: 10\u201334 weeks). We modeled the relationship between high vs. low prenatal distress with repeated measures of the steroid hormones using linear mixed-effects models. We found that ALLO was 20.6% lower (95% CI: \u201330.9%, \u20138.7%) in high-distress individuals after adjusting for maternal age, fetal sex, smoking and gestational age at blood draw, with no evidence of effect modification by race\/ethnicity. However, this association attenuated after additional adjustment for sociodemographic characteristics. Several ALLO-related ratios were lower with high distress, but only ALLO-to-progesterone remained significant across models. These findings suggest that associations between psychosocial distress and circulating ALLO concentrations during pregnancy are influenced by social and structural factors, with the exception of the ALLO-to-progesterone ratio, which may capture aspects of neurosteroid metabolism more closely linked to prenatal psychosocial distress.<\/jats:p>","DOI":"10.64898\/2026.07.22.26358684","type":"posted-content","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T23:35:16Z","timestamp":1784936116000},"source":"Crossref","is-referenced-by-count":1,"title":["Associations of Allopregnanolone and Related Steroid Hormones with Prenatal Psychosocial Distress in the Healthy Start Cohort"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9860-2939","authenticated-orcid":false,"given":"Gabriella","family":"Mayne","sequence":"first","affiliation":[{"name":"Department of Health & Behavioral Sciences, University of Colorado, Denver, CO, 80204 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Joseph","family":"Hurt","sequence":"additional","affiliation":[{"name":"Divisions of Maternal Fetal Medicine and Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Yeatman","sequence":"additional","affiliation":[{"name":"Department of Health & Behavioral Sciences, University of Colorado, Denver, CO, 80204 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jost","family":"Klawitter","sequence":"additional","affiliation":[{"name":"iC42 Clinical Research & Development, Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Tracer","sequence":"additional","affiliation":[{"name":"Department of Health & Behavioral Sciences, University of Colorado, Denver, CO, 80204 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Christians","sequence":"additional","affiliation":[{"name":"iC42 Clinical Research & Development, Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Dabelea","sequence":"additional","affiliation":[{"name":"Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center and the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA"},{"name":"Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Perng","sequence":"additional","affiliation":[{"name":"Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center and the Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026072709501928000_2026.07.22.26358684v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.09.002"},{"key":"2026072709501928000_2026.07.22.26358684v1.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000183597.31630.db"},{"key":"2026072709501928000_2026.07.22.26358684v1.3","doi-asserted-by":"crossref","first-page":"e0000034","DOI":"10.1371\/journal.pmen.0000034","article-title":"The global burden of perinatal depression: A call to action","volume":"1","year":"2024","journal-title":"PLOS Ment Heal"},{"key":"2026072709501928000_2026.07.22.26358684v1.4","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20769"},{"key":"2026072709501928000_2026.07.22.26358684v1.5","doi-asserted-by":"crossref","first-page":"e671","DOI":"10.3399\/bjgp12X656801","article-title":"Impact of socioeconomic deprivation on maternal perinatal mental illnesses presenting to UK general practice","volume":"62","year":"2012","journal-title":"Br J Gen Pr"},{"key":"2026072709501928000_2026.07.22.26358684v1.6","first-page":"138","article-title":"Perinatal Anxiety and Depression in Minority Women","volume":"45","year":"2020","journal-title":"MCN: Am J MaternChild Nurs"},{"key":"2026072709501928000_2026.07.22.26358684v1.7","doi-asserted-by":"crossref","first-page":"e203","DOI":"10.1016\/S2468-2667(22)00342-5","article-title":"The global burden of perinatal common mental health disorders and substance use among migrant women: a systematic review and meta-analysis","volume":"8","year":"2023","journal-title":"Lancet Public Heal"},{"key":"2026072709501928000_2026.07.22.26358684v1.8","doi-asserted-by":"crossref","unstructured":"Gimbel LA , Weingarten SJ , Smid MC , Hoffman MC . 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