title: Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery.
abstract: OBJECTIVE
  Clinical and preclinical studies indicate that maternal stress during pregnancy may exert long-lasting adverse effects on offspring. This investigation sought to identify factors mediating the relationship between maternal and neonatal hypothalamic-pituitary-adrenal (HPA) axes in pregnant women with past or family psychiatric history.
  
  
  METHODS
  Two hundred and five pairs of maternal and umbilical cord blood samples from a clinical population were collected at delivery.
  
  
  METHODS
  Maternal and neonatal HPA axis activity measures were plasma adrenocorticotrophic hormone (ACTH), total cortisol, free cortisol and cortisol-binding globulin concentrations. The effects of maternal race, age, body mass index, psychiatric diagnosis (DSM-IV), birth weight, delivery method and estimated gestational age (EGA) at delivery on both maternal and neonatal HPA axis measures were also examined. Incorporating these independent predictors as covariates where necessary, we evaluated whether neonatal HPA axis activity measures could be predicted by the same maternal measure using linear regression.
  
  
  RESULTS
  Delivery method was associated with umbilical cord plasma ACTH and both total and free cord cortisol concentrations (T = 10·53-4·21; P < 0·0001-0·010). After accounting for method of delivery and EGA, we found that maternal plasma ACTH concentrations predicted 23·9% of the variance in foetal plasma ACTH concentrations (T = 6·76; P < 0·0001), and maternal free and total plasma cortisol concentrations predicted 39·8% and 32·3% of the variance in foetal plasma free and total cortisol concentrations (T = 5·37-6·90; P < 0·0001), respectively.
  
  
  CONCLUSIONS
  These data suggest that neonatal response is coupled with maternal HPA axis activity at delivery. Future investigations will scrutinize the potential long-term sequelae for the offspring.
authors.affiliation: Departments of Psychiatry & Behavioral SciencesPsychology, Emory University, Atlanta, GADepartment of Psychiatry & Behavioral Sciences, University of Miami, Miami, FLDepartments of PathologyHuman GeneticsGynecology & Obstetrics, Emory University, Atlanta, GA, USA.
authors.forename: Alicia K
authors.initials: AK
authors.lastname: Smith
authors.forename: D Jeffrey
authors.initials: DJ
authors.lastname: Newport
authors.forename: Morgan P
authors.initials: MP
authors.lastname: Ashe
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Brennan
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Laprairie
authors.forename: Martha
authors.initials: M
authors.lastname: Calamaras
authors.forename: Charles B
authors.initials: CB
authors.lastname: Nemeroff
authors.forename: James C
authors.initials: JC
authors.lastname: Ritchie
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Cubells
authors.forename: Zachary N
authors.initials: ZN
authors.lastname: Stowe
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D007231:Infant, Newborn; D001523:Mental Disorders / Q000378:metabolism*; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism*; D011379:Prognosis
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone