Second trimester serum cortisol and preterm birth: an analysis by timing and subtype

Area of Science:

• Reproductive Endocrinology
• Maternal-Fetal Medicine
• Biomarker Discovery

Background:

• Preterm birth remains a leading cause of neonatal morbidity and mortality.
• Identifying reliable biomarkers for predicting preterm birth is crucial for timely intervention.
• Serum cortisol levels in the second trimester are being investigated as potential predictors.

Purpose of the Study:

• To investigate the association between second trimester serum cortisol levels and spontaneous versus provider-initiated preterm births.
• To determine if cortisol levels differ based on the subtype of preterm birth.
• To explore cortisol as a potential biomarker for predicting preterm birth.

Main Methods:

• Nested case-control study involving 993 women with live births.
• Serum cortisol levels measured from samples collected during routine prenatal screening.
• Multivariable linear regression used to analyze cortisol fold-change in relation to gestational age and preterm birth subtype.

Main Results:

• An inverse association was observed between serum cortisol and gestational age category (trend p=0.09).
• Among preterm births (<37 weeks), cortisol levels were highest for preterm premature rupture of membranes (1.10), followed by spontaneous preterm labor (1.03), and provider-initiated preterm birth (1.01).
• These differences in cortisol levels among preterm birth subtypes did not reach statistical significance.

Conclusions:

• Second trimester serum cortisol levels did not significantly differentiate between spontaneous and provider-initiated preterm births in this cohort.
• Cortisol warrants continued investigation as a potential biomarker for preterm birth risk.
• Future research should consider augmenting cortisol with additional biomarkers for improved prediction accuracy.