The maternal cortisol awakening response in human pregnancy is associated with the length of gestation.
OBJECTIVE
The purpose of this study was to examine the relationship between intraindividual changes in cortisol responsiveness over pregnancy and the length of human gestation.


METHODS
Pregnancy-related changes in the cortisol awakening response (CAR), which is a measure of hypothalamic-pituitary-adrenal axis responsiveness, were assessed prospectively in 101 pregnant women at 16.8 +/- 1.4 weeks' and 31.4 +/- 1.3 weeks' (+/-SD) gestation. Cortisol was measured in saliva that was collected immediately and +30, +45 and +60 minutes after awakening.


RESULTS
The CAR was significant in pregnancy and exhibited progressive attenuation over the course of gestation. A larger CAR in late pregnancy and reduced attenuation of the CAR from early to late gestation were associated significantly with shorter gestational length.


CONCLUSIONS
The findings are the first to suggest that the hormonal (cortisol) response to a naturally occurring challenge (awakening) and the degree of attenuation of this response over the course of gestation may represent a novel biomarker of increased vulnerability for earlier birth.
Buss
Claudia
C
Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine, Irvine, CA.
Entringer
Sonja
S
Reyes
Jonazary F
JF
Chicz-DeMet
Aleksandra
A
Sandman
Curt A
CA
Waffarn
Feizal
F
Wadhwa
Pathik D
PD
D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D010913:Pituitary-Adrenal System / Q000502:physiology; D011247:Pregnancy / Q000378:metabolism*; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological / Q000378:metabolism; D055815:Young Adult
D006854:Hydrocortisone