Chronic HPA activity in mothers with preterm delivery: A pilot nested case-control study
B Gelaye1, C Kirschbaum2, Q Y Zhong1
1Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States.
Journal of Neonatal-Perinatal Medicine
|November 21, 2019
Summary
Maternal hair cortisol concentration (HCC) was lower before and during early pregnancy in women who delivered preterm. This suggests chronic stress response dysregulation may increase preterm birth risk.
Area of Science:
- Endocrinology
- Reproductive Health
- Stress Physiology
Background:
- The role of chronic hypothalamic-pituitary-adrenal (HPA) axis activity in preterm birth (PTB) pathogenesis is unclear due to measurement limitations.
- Hair cortisol concentration (HCC) offers a reliable method for assessing long-term HPA axis activity.
Purpose of the Study:
- To investigate the association between maternal HCC and PTB.
- To explore the relationship between chronic HPA axis activity and the risk of preterm delivery.
Main Methods:
- A case-control study involving 137 pregnant women in Peru (40 PTB cases, 97 controls).
- Hair samples were collected to measure HCC using luminescence immunoassay.
- Statistical analyses included multivariable linear and logistic regressions to assess case-control differences.
Main Results:
- Combined pre-conception and first-trimester HCC was 13% lower in PTB cases versus controls (p=0.01).
- Lower HCC was observed in PTB cases for 3-6 months pre-conception, 0-3 months pre-conception, and the first trimester.
- A 1-unit increase in HCC was associated with a 55% reduced odds of PTB (aOR=0.45).
Conclusions:
- Women delivering preterm exhibit lower preconception and first-trimester HCC compared to term deliveries.
- Findings suggest chronic HPA axis dysregulation may be linked to an increased risk of PTB.
- HPA axis activation, part of the stress-response system, might be chronically altered in women at risk for PTB.
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