Epstein CM, et al. - In order to examine how early life adversity (ELA) influence the hypothalamic-pituitary-adrenal (HPA) cortisol response to adulthood adversity and depressive symptoms in pregnant women, researchers examined the differential patterns of cortisol in correlation to ELA, adulthood adversity, and depressive symptoms. In addition, they examined how ELA influences the relationship of adulthood adversity or depressive symptoms to cortisol. In this descriptive, cross-sectional study, 58 pregnant women (mean = 26.5 weeks gestation) completed the Stress and Adversity Inventory and Edinburgh Depression Scale and collected salivary cortisol five times per day for 3 days to assess cortisol awakening response, diurnal cortisol slope, and cortisol area under the curve. The analysis revealed a significant correlation of early adversity and depressive symptoms with the HPA axis during pregnancy, with early adversity also moderating effects of depressive symptoms and adulthood adversity on cortisol regulation. These findings support the significance of early adversity as a factor in identifying unique HPA phenotypes and risk for HPA axis dysregulation in pregnancy.