Placenta · 2026
Cortisol in early pregnancy: Impact on pregnancy outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
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Tomasis Damri Noam, Hagbi Bal Maayan, Sheiner Eyal, Shoham Iris, Salem Shimrit Yaniv, Yoles Israel, Israel-Tov Noa Dina, Baram Goldberg Ifat, Bergman Doron, Rosenbaum Ron, Haimov Ayal, Shoham-Vardi Ilana, Wainstock Tamar
Аннотация
BACKGROUND: Maternal cortisol may influence pregnancy outcomes, including preterm birth (PTB), though evidence remains inconsistent.
OBJECTIVE: To investigate the association between early pregnancy cortisol, perceived stress, and adverse pregnancy outcomes.
STUDY DESIGN: A prospective cohort study.
METHODS: Of 432 multigravida women categorized by prior PTB history (high-risk vs. low-risk), 202 were analyzed who were at 11-13 gestational weeks with standardized afternoon saliva collection (14:00-18:00). Saliva samples and stress questionnaires were collected. Pregnancy outcomes were compared between women with high and low salivary cortisol levels. Mean salivary cortisol levels were compared between high- and low-risk groups, as well as between women with and without selected pregnancy complications.
RESULTS: High-risk women had significantly higher mean cortisol (0.193 μg/dL vs. 0.144 μg/dL, p-value = 0.004). and 3.29-fold higher odds of elevated cortisol (aOR = 3.29, 95% CI: 1.55-6.96, p-value = 0.002). PTB rates were 21.4% in high-risk vs. 3.5%in low-risk women (p-value<0.001), high cortisol levels were not significantly predictive of current PTB in multivariable models (p-value = 0.099), despite high odds ratios (3.14). However, high cortisol levels were significantly associated with gestational hypertension (GHTN) (100% vs. 23.5%, p-value = 0.014) and fetal malformations (62.5% vs. 23.1%, p-value = 0.024). No association was found between perceived stress and cortisol levels.
CONCLUSIONS: Early pregnancy cortisol is significantly elevated in women with a history of PTB, reflecting HPA axis dysregulation. While not a reliable predictor for recurrent PTB at 11-13 gestational weeks, high cortisol is associated with GHTN and malformations, suggesting it may serve as a marker for specific adverse outcomes.
OBJECTIVE: To investigate the association between early pregnancy cortisol, perceived stress, and adverse pregnancy outcomes.
STUDY DESIGN: A prospective cohort study.
METHODS: Of 432 multigravida women categorized by prior PTB history (high-risk vs. low-risk), 202 were analyzed who were at 11-13 gestational weeks with standardized afternoon saliva collection (14:00-18:00). Saliva samples and stress questionnaires were collected. Pregnancy outcomes were compared between women with high and low salivary cortisol levels. Mean salivary cortisol levels were compared between high- and low-risk groups, as well as between women with and without selected pregnancy complications.
RESULTS: High-risk women had significantly higher mean cortisol (0.193 μg/dL vs. 0.144 μg/dL, p-value = 0.004). and 3.29-fold higher odds of elevated cortisol (aOR = 3.29, 95% CI: 1.55-6.96, p-value = 0.002). PTB rates were 21.4% in high-risk vs. 3.5%in low-risk women (p-value<0.001), high cortisol levels were not significantly predictive of current PTB in multivariable models (p-value = 0.099), despite high odds ratios (3.14). However, high cortisol levels were significantly associated with gestational hypertension (GHTN) (100% vs. 23.5%, p-value = 0.014) and fetal malformations (62.5% vs. 23.1%, p-value = 0.024). No association was found between perceived stress and cortisol levels.
CONCLUSIONS: Early pregnancy cortisol is significantly elevated in women with a history of PTB, reflecting HPA axis dysregulation. While not a reliable predictor for recurrent PTB at 11-13 gestational weeks, high cortisol is associated with GHTN and malformations, suggesting it may serve as a marker for specific adverse outcomes.