title: Preterm delivery as a predictor of diurnal cortisol profiles in adulthood: evidence from Cebu, Philippines.
abstract: OBJECTIVE
  Fetal exposure to elevated maternal cortisol can permanently modify hypothalamic-pituitary-adrenal (HPA) axis function, and thereby have long-term health impacts. Maternal cortisol steadily increases throughout normal pregnancy, but is abnormally high in preterm deliveries (<37 weeks). Prematurity remains a widespread public health problem, yet little is known about its potential long-term effects on adult HPA function. Here we test the hypothesis that diurnal cortisol profiles measured in young adulthood will vary based upon an individual's preterm status.
  
  
  METHODS
  Diurnal salivary cortisol profiles, a marker of HPA-axis function, were measured in 1,403 young adults (ages 21-23 years) participating in the Cebu Longitudinal Health and Nutrition Survey, located in Metropolitan Cebu City, Philippines.
  
  
  RESULTS
  Males who had been born preterm exhibited lower morning cortisol and non-significantly elevated evening cortisol, resulting in a more adverse, flatter rate of decline across the day. In contrast, there were no significant differences by preterm status in cortisol measured at any time of day in females.
  
  
  CONCLUSIONS
  These findings point to potential long-term effects of having been born preterm on adult HPA-axis function, and add to evidence from this and other populations for sex differences in the biological and health impacts of prenatal stress exposure.
authors.affiliation: Department of Anthropology, Northwestern University, Evanston, Illinois, 60208.
authors.forename: James
authors.initials: J
authors.lastname: Lee
authors.forename: Ruby
authors.initials: R
authors.lastname: Fried
authors.forename: Zaneta
authors.initials: Z
authors.lastname: Thayer
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Kuzawa
mesh_terms: D000328:Adult; D002940:Circadian Rhythm; D005260:Female; D015200:Fluoroimmunoassay; D006306:Health Surveys; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D010679:Philippines / Q000453:epidemiology; D047928:Premature Birth / Q000378:metabolism*; D015995:Prevalence; D012463:Saliva / Q000737:chemistry*; D012737:Sex Factors; D055815:Young Adult
chemical_list: D006854:Hydrocortisone