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

We hypothesized second trimester serum cortisol would be higher in spontaneous preterm births compared to provider-initiated (previously termed 'medically indicated') preterm births. We used a nested case-control design with a sample of 993 women with live births. Cortisol was measured fro...

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Bibliographic Details
Published in:Journal of perinatology 2018-08, Vol.38 (8), p.973-981
Main Authors: Bandoli, Gretchen, Jelliffe-Pawlowski, Laura L, Feuer, Sky K, Liang, Liang, Oltman, Scott P, Paynter, Randi, Ross, Kharah M, Schetter, Christine Dunkel, Ryckman, Kelli K, Chambers, Christina D
Format: Article
Language:English
Subjects:
Biological markers
Biomarkers
Birth
Delivery (Childbirth)
Gestational age
Glucocorticoids
Health aspects
Health risk assessment
Hormones
Hydrocortisone
Membranes
Pregnancy
Pregnant women
Premature birth
Premature infants
Premature labor
Regression analysis
Statistical analysis
Statistical methods
Steroids (Organic compounds)
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Summary:We hypothesized second trimester serum cortisol would be higher in spontaneous preterm births compared to provider-initiated (previously termed 'medically indicated') preterm births. We used a nested case-control design with a sample of 993 women with live births. Cortisol was measured from serum samples collected as part of routine prenatal screening. We tested whether mean-adjusted cortisol fold-change differed by gestational age at delivery or preterm birth subtype using multivariable linear regression. An inverse association between cortisol and gestational age category (trend p = 0.09) was observed. Among deliveries prior to 37 weeks, the mean-adjusted cortisol fold-change values were highest for preterm premature rupture of the membranes (1.10), followed by premature labor (1.03) and provider-initiated preterm birth (1.01), although they did not differ statistically. Cortisol continues to be of interest as a marker of future preterm birth. Augmentation with additional biomarkers should be explored.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-018-0128-5