The maternal cortisol awakening response in human pregnancy is associated with the length of gestation
The maternal cortisol awakening response in human pregnancy is associated with the length of gestation
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DOI：
10.1016/j.ajog.2009.06.063
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发表时间：
2009-10-01
影响因子：
9.8
通讯作者：
Wadhwa, Pathik D.
中科院分区：
文献类型：
--
作者：
Buss, Claudia;Entringer, Sonja;Wadhwa, Pathik D.
目的：本研究的目的是探讨怀孕期间皮质醇反应性的个体变化与人类妊娠时长之间的关系。 研究设计：对 101 名孕妇在 16.8 +/- 1.4 周和 31.4 周时前瞻性评估了与怀孕相关的皮质醇觉醒反应 (CAR) 变化，CAR 是下丘脑-垂体-肾上腺轴反应性的衡量标准。 +/- 1.3 周 (+/-SD) 妊娠。在醒来后立即以及+30、+45和+60分钟收集的唾液中测量皮质醇。结果：CAR在怀孕期间很显着，并且在妊娠过程中表现出逐渐减弱。妊娠晚期较大的 CAR 以及从妊娠早期到妊娠晚期 CAR 衰减的减少与较短的妊娠长度显着相关。结论：这些发现首次表明，荷尔蒙（皮质醇）对自然发生的挑战（觉醒）的反应以及这种反应在妊娠过程中的衰减程度可能代表了早产脆弱性增加的新生物标志物。
OBJECTIVE: The purpose of this study was to examine the relationship between intraindividual changes in cortisol responsiveness over pregnancy and the length of human gestation.STUDY DESIGN: Pregnancy-related changes in the cortisol awakening response (CAR), which is a measure of hypothalamic-pituitary-adrenal axis responsiveness, were assessed prospectively in 101 pregnant women at 16.8 +/- 1.4 weeks' and 31.4 +/- 1.3 weeks' (+/-SD) gestation. Cortisol was measured in saliva that was collected immediately and +30, +45 and +60 minutes after awakening.RESULTS: The CAR was significant in pregnancy and exhibited progressive attenuation over the course of gestation. A larger CAR in late pregnancy and reduced attenuation of the CAR from early to late gestation were associated significantly with shorter gestational length.CONCLUSION: The findings are the first to suggest that the hormonal (cortisol) response to a naturally occurring challenge (awakening) and the degree of attenuation of this response over the course of gestation may represent a novel biomarker of increased vulnerability for earlier birth.