*Infants born with PTSD, mothers preg during 911

mothers infants WTC

Yehuda et al, 2005

Transgenerational Effects of Posttraumatic Stress Disorder in Babies of Mothers Exposed to the World Trade Center Attacks during Pregnancy

Received: March 11, 2005
Accepted: April 14, 2005
Published Online: July 02, 2013


Mt. Sinai School of Medicine and Bronx Veterans Affairs Med Center

38 mothers directly exposed to the World Trade Center collapse during pregnancy, collected salivary cortisol samples from themselves and their 1-yr-old babies at awakening


Lower cortisol levels were observed in both mothers and babies of mothers who developed PTSD in response to 9/11 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


“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 [commonly accepted] biological risk for PTSD.”

If they controlled for exact location during 9/11 then these differences in the infants cannot be accounted for by exposure to pollution



Engel et al, 2005


Mt Sinai School of Medicine


Impact of extreme trauma on the birth outcomes of women highly exposed to the WTC

187 women who were pregnant and living or working within close proximity to the WTC on 9/11

52 women completed at least one psychological assessment prior to delivery

both posttraumatic stress symptomatology (PTSS) and moderate depression were associated with longer gestational durations, although only PTSS was associated with decrements in infant head circumference at birth


“The impact of stress resulting from extreme trauma may be different from that which results from ordinary life experiences, particularly with respect to cortisol production.”


“As prenatal PTSS was associated with decrements in head circumference, this may influence subsequent neurocognitive development.”



Lederman et al, 2004


Columbia U, NY


Assessed impact of gestational timing of the disaster and distance from the WTC in the 4 weeks after 9/11 on birth outcomes of 300 nonsmoking women who were pregnant at the time of event – recruited at delivery

……concern:  prenatal exposure to pollutants from WTC disaster on fetal growth and subsequent health and development of exposed children


“Term infants born to women who were pregnant on 11 September 201 and who were living within a 2-mile radius of the WTC during the month after the event showed significant decrements in term birth weight…and birth length…compared with infants born to the other pregnant women studied, after controlling for sociodemographic and biomedical risk factors.  The decrements remained significant with adjustment for gestational duration….Women in the first trimester of pregnancy at the time of the WTC event delivered infants with significantly shorter gestation…and a smaller head circumference…compared with women at later stages of pregnancy, regardless of the distance of their residence or work sites from the WTC.  The observed adverse effects suggest an impact of pollutants and/or stress related to the WTC disaster and have implications for the health and development of exposed children.”




Brand et al 2006




Examination of effect of in utero maternal stress as determined by PTSD symptom severity and maternal cortisol levels on behavioral outcomes in the infant


98 pregnant women directly exposed to WTC collapse “…provided salivary cortisol samples and completed PTSD symptom questionnaire and a behavior rating scale to measure infant temperament, including


distress to limitations, and response to novelty.


Mothers who developed PTSD in response to 9/11 had lower morning and evening salivary cortisol levels, [how do they know they didn’t have this before 9/11?  I guess it makes no difference any more…they have PTSD]compared to mothers who did not develop PTSD.


“Maternal morning cortisol levels were inversely related to their rating of infant distress [see the article that states parental assessment of children may reflect maternal PTSD rather than accurately reporting on the infant] and response to novelty (i.e., loud noises, new foods, unfamiliar people).


“Also, mothers who had PTSD rated their infants as having greater distress to novelty than did mothers without PTSD.”


Longitudinal studies are needed to determine how the association between maternal PTSD symptoms and cortisol levels and infant temperament reflect genetic and/or epigenetic mechanisms of intergenerational transmission.”





Yehuda et al 1998


Mt Sinai


Impact of Holocaust on the second generation – examined 100 adult offspring on prevalence of stress and exposure to trauma, current and lifetime posttraumatic stress disorder (PTSD), and other psychiatric diagnoses compared to 44 controls


“…although adult offspring of Holocaust survivors did not experience more traumatic events, they had a greater prevalence of current and lifetime PTSD and other psychiatric diagnoses than the demographically similar comparison subjects.  This was true in both community and clinical subjects.”


“The findings demonstrate an increased vulnerability to PTSD and other psychiatric disorders among offspring of Holocaust survivors, thus identifying adult offspring as a possible high-risk group within which to explore the individual differences that constitute risk factors for PTSD.”




Yehuda, Teicher et al 2007


Mt Sinai


“Lower cortisol levels in posttraumatic stress disorder (PTSD) may reflect a preexisting vulnerability associated with developing the disorder after trauma exposure. “


“Because offspring of trauma survivors with PTSD have a greater prevalence of PTSD after their own life events than offspring of trauma survivors without PTSD and offspring of nonexposed persons, examination of patterns of basal cortisol secretion in such offspring provides an opportunity to test this hypothesis.”


Raw hormonal data analyzed



Offspring with parental PTSD displayed lower mean cortisol levels, reflected by the circadian mesor and reduced cortisol amplitude, compared with offspring without parental PTSD and children of nonexposed parents.  This effect seemed to be specifically related to the presence of maternal PTSD.”


Low cortisol levels and other chronobiological alterations in offspring are associated with the risk factor of maternal PTSD, raising the possibility that these alterations are acquired via glucocorticoid programming either from in utero exposures or in response to maternal behaviors early in life.”


[what other chronobiological alterations?]




Yehuda, Blair, Labinsky & Bierer, 2007


Mt Sinai and Bronx VA


Cortisol negative feedback inhibition in adult offspring of Holocaust survivors with and without PTSD


Enhanced cortisol suppression in response to dexamethasone was associated primarily with parental PTSD status, with minimal contribution of subjects’ own trauma-related symptoms.”


Enhanced cortisol negative feedback inhibition may be associated with PTSD because it is related to the PTSD risk factor of parental PTSD.”


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