[The hormonal state of pregnancy: modification of cortisol and testosterone]

The pattern of cortisol and testosterone levels during the normal pregnancy was investigated by measuring these hormones in the same 19 healthy pregnant women at 11th to 19th, 24th to 29th and 34th to 39th week post amenorrhea. We noted the well-known increase in total plasma cortisol and testosterone, due to the elevated concentration of their transport protein, i.e., Corticosteroid Binding Globulin (CBG) and Testosterone Estradiol Binding Globulin (TeBG), consecutive to the increase in plasma oestrogens. Morning (8h) and evening salivary cortisol (20 h) values, which are a good reflect of free plasma cortisol, were found increased since the second trimester of pregnancy, with a conserved circadian cycle. 24 h urinary free cortisol was slightly increased since the first trimester, yet remaining within the normal range; in the late pregnancy it reached sometimes higher levels. "Vesperal" urinary cortisol measured on a collected urine sample between 20 h and 24 h was higher in pregnant women since the beginning of pregnancy as compared to that of non pregnant women. Levels of salivary free testosterone measured in a few patients appeared similar to that of non-pregnant controls. We also report the data obtained in two pregnant women with Cushing's syndrome due to an adrenocortical carcinoma which showed a strong elevation of urinary and salivary free cortisol while a pregnant woman with a luteoma had a lower level as compared to normal pregnant. Moreover these three patients had a marked increase in free salivary testosterone opposite to normal pregnant women.