title: The morning and late-night salivary cortisol ranges for healthy women may be used in pregnancy.
abstract: OBJECTIVE
  The diagnosis of adrenal dysfunction in pregnancy and in women taking oral contraceptives remains a diagnostic challenge. Salivary cortisol seems to be a useful tool for the diagnosis of Cushing's syndrome and adrenal insufficiency. However, the changes in salivary cortisol concentration in healthy pregnancy are not clearly defined.
  
  
  METHODS
  The aim of our study was to compare diurnal changes in salivary cortisol in healthy pregnant women, healthy controls and women on oral contraceptives.
  
  
  METHODS
  The study groups consisted of (i) 41 healthy pregnant women, (ii) 42 healthy women and (iii) 12 healthy women on oral contraceptives.
  
  
  METHODS
  Serum and salivary cortisol in the morning and salivary late-night cortisol were measured with Roche ECLIA cortisol test (Elecsys 2010) in each trimester and postpartum.
  
  
  RESULTS
  Despite the elevation of morning serum cortisol in the second and third trimesters of pregnancy, the morning salivary values as well as late-night salivary cortisol throughout all trimesters were not significantly different from control values (P > 0·5). In the postpartum period, the morning and late-night salivary cortisol values were significantly lower than in late pregnancy. The morning and late-night salivary cortisol values in women on contraceptives were also not different from those in the healthy women group.
  
  
  CONCLUSIONS
  The results of our study suggest that reference values for salivary cortisol established for a healthy adult population can be used for pregnant women and women on oral contraceptives in the initial diagnostic testing for Cushing's syndrome and adrenal insufficiency.
authors.affiliation: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Ambroziak
authors.affiliation: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kondracka
authors.affiliation: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Bartoszewicz
authors.affiliation: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Krasnodębska-Kiljańska
authors.affiliation: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Bednarczuk
mesh_terms: D000309:Adrenal Insufficiency / Q000097:blood / Q000175:diagnosis; D000328:Adult; D003276:Contraceptives, Oral; D003480:Cushing Syndrome / Q000097:blood / Q000175:diagnosis; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry*
chemical_list: D003276:Contraceptives, Oral; D006854:Hydrocortisone