Adiponectin and Glucocorticoids Modulate Risk for Preterm Birth: The Healthy Start Study

Area of Science:

• Reproductive biology
• Endocrinology
• Metabolic health

Background:

• Adiponectin, a uterine tocolytic, decreases with gestational age, potentially indicating maternal metabolic quiescence.
• Maternal stress is a risk factor for preterm birth, and adiponectin levels may respond to stress.

Purpose of the Study:

• To investigate the association between adiponectin and glucocorticoids in preterm birth.
• To model the predictive value of these biomarkers for preterm birth.
• To test the hypothesis that maternal adiponectin and cortisol are inversely related and associated with preterm birth.

Main Methods:

• A nested case-control study using biobanked maternal plasma from low-risk singleton pregnancies.
• Quantification of high molecular weight (HMW), low molecular weight (LMW), and total adiponectin.
• Measurement of cortisol, cortisone, and related steroid hormones using validated LC-MS/MS assay.
• Application of regression and machine learning for predictive modeling.

Main Results:

• Preterm births were associated with lower mean LMW adiponectin and higher mean cortisone levels at 15 weeks gestation.
• Lower cortisol/cortisone ratios and LMW adiponectin/cortisol ratios were observed in the preterm group.
• HMW adiponectin, cortisol/cortisone ratio, cortisone, maternal height, age, and BMI were strong predictors of preterm birth (AUC=0.8167).

Conclusions:

• Metabolic and stress biomarkers are associated with preterm birth in healthy pregnancies.
• A potential mechanistic link between maternal stress, metabolism, and pregnancy maintenance is identified.