title: Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids.
abstract: Psychological stress may affect up to 18% of all pregnant women, altering the function of both neuroendocrine and immune systems. Distress conditions may directly change the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol levels and associated changes in cellular immunity. Psychological events such as high stress levels, anxiety or depression may directly or indirectly affect pregnancy and may thus lead to pre-eclampsia (PE). Here, we suggest that distress conditions during pregnancy may lead the development of PE by enhancing in vivo cortisol levels. High cortisol levels are associated with hypertension and endothelial dysfunction, features often observed in patients with PE. Lymphocytes from patients with high cortisol levels may have a reduced sensitivity to the synthetic glucocorticoid dexamethasone (DEX). Stress-related steroid resistance may disrupt the HPA axis, leading to post-natal detrimental effects such as increased allostatic load, increased pro-inflammatory cytokine levels and even depression in the offspring.
authors.affiliation: Laboratory of Immunogenetics, Department of Genetics, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. privianna@gmail.com
authors.forename: Priscila
authors.initials: P
authors.lastname: Vianna
authors.forename: Moisés E
authors.initials: ME
authors.lastname: Bauer
authors.forename: Dinara
authors.initials: D
authors.lastname: Dornfeld
authors.forename: José Artur Bogo
authors.initials: JA
authors.lastname: Chies
mesh_terms: D003907:Dexamethasone / Q000494:pharmacology; D004351:Drug Resistance / Q000502:physiology; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008214:Lymphocytes / Q000187:drug effects*; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D013315:Stress, Psychological / Q000097:blood / Q000150:complications*
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone