Timing matters: long term effects of adversities from prenatal period up to adolescence on adolescents' cortisol stress response. The TRAILS study

Psychoneuroendocrinology. 2012 Sep;37(9):1439-47. doi: 10.1016/j.psyneuen.2012.01.013. Epub 2012 Feb 24.


Objective: Altered cortisol response is a vulnerability marker for a variety of stress-related diseases and psychiatric disorders. Childhood adversity has been shown to modify this response, but evidence is inconsistent. Effects may differ depending on the timing of exposure, or due to the interplay between pre/postnatal adversity and later adversities. The present study examined the influence of adversity during different timeframes (pre/postnatal, ages 0-5, 6-11, 12-13, 14-15 years), and the interaction between pre/postnatal and later adversity on adolescents' cortisol stress response.

Method: Four salivary cortisol samples were collected before and after a social stress test in 471 16-year-old adolescents from the longitudinal study TRAILS. Data on pre/postnatal exposure to adversities were obtained from Preventive Child Healthcare records and parental reports, subsequent adversities from parental and self-reports.

Results: Pre/postnatal adversity was associated with increased cortisol reactivity. Adversities during ages 0-5 were not associated with cortisol outcomes. Adversities during ages 6-11 were associated with a high cortisol level, especially in those exposed to pre/postnatal adversity, while adversities during ages 12-13 and 14-15 were associated with a low cortisol level.

Conclusions: Results highlight the importance to take the timing of stress exposure into account. In addition to programming effects, pre/postnatal adversity interacts with childhood adversity in producing deviant cortisol levels. Puberty may be marked by a transition in how adversities affect the HPA-axis, with cortisol hypersecretion before age 11 and hyposecretion after age 11.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hydrocortisone / analysis
  • Hydrocortisone / metabolism*
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Infant
  • Infant, Newborn
  • Life Change Events
  • Longitudinal Studies
  • Male
  • Pituitary-Adrenal System / physiopathology*
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Saliva / chemistry
  • Stress, Psychological / physiopathology*


  • Hydrocortisone