title: Elevated maternal cortisol early in pregnancy predicts third trimester levels of placental corticotropin releasing hormone (CRH): priming the placental clock.
abstract: The purposes of this study were to determine the intervals when placental corticotrophic-releasing hormone (CRH) was most responsive to maternal cortisol. A sample of 203 women each were evaluated at 15, 19, 25 and 31 weeks gestation and followed to term. Placental CRH and maternal adrenocorticotropin hormone (ACTH), B-endorphin and cortisol were determined from plasma. CRH levels increased faster and were higher in women who delivered preterm compared with women who delivered at term (F3,603 = 5.73, p < .001). Simple effects indicated that CRH levels only at 31 weeks predicted preterm birth (F1,201 = 5.53, p = .02). Levels of cortisol were higher in women who delivered preterm at 15 weeks gestation (F1,201 = 4.45, p = .03) with a similar trend at 19 weeks gestation. Hierarchical regression suggested that the influence on birth outcome of maternal cortisol early in pregnancy was mediated by its influence on placental CRH at 31 weeks. Elevated cortisol at 15 weeks predicted the surge in placental CRH at 31 weeks (R = .49, d.f. = 1,199, Fchange = 61.78, p < .0001). Every unit of change in cortisol (microg/dl) at 15 weeks was associated with a 34 unit change of CRH (pg/ml) at 31 weeks. These findings suggested that early detection of stress signals by the placenta stimulated the subsequent release of CRH and resulted in increased risk for preterm delivery.
authors.affiliation: Women and Children's Health and Well-Being Project, Department of Psychiatry, University of California, Irvine, 333 City Drive West, Suite 1200, Orange, CA 92868, USA. casandma@uci.edu
authors.forename: Curt A
authors.initials: CA
authors.lastname: Sandman
authors.forename: Laura
authors.initials: L
authors.lastname: Glynn
authors.forename: Christine Dunkel
authors.initials: CD
authors.lastname: Schetter
authors.forename: Pathik
authors.initials: P
authors.lastname: Wadhwa
authors.forename: Thomas
authors.initials: T
authors.lastname: Garite
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Chicz-DeMet
authors.forename: Calvin
authors.initials: C
authors.lastname: Hobel
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D003346:Corticotropin-Releasing Hormone / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000378:metabolism*; D009035:Mothers; D010920:Placenta / Q000378:metabolism; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D047928:Premature Birth; D012044:Regression Analysis; D012306:Risk; D001615:beta-Endorphin / Q000097:blood
chemical_list: D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone