American Journal of Obstetrics & Gynecology
Volume 201, Issue 4 , Pages 398.e1-398.e8, October 2009

The maternal cortisol awakening response in human pregnancy is associated with the length of gestation

  • Claudia Buss, PhD

      Affiliations

    • Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine, Irvine, CA
    • ,
  • Sonja Entringer, PhD

      Affiliations

    • Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine, Irvine, CA
    • ,
  • Jonazary F. Reyes, BS

      Affiliations

    • Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine, Irvine, CA
    • ,
  • Aleksandra Chicz-DeMet, PhD

      Affiliations

    • Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine, Irvine, CA
    • ,
  • Curt A. Sandman, PhD

      Affiliations

    • Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine, Irvine, CA
    • ,
  • Feizal Waffarn, MD

      Affiliations

    • Department of Pediatrics, University of California, Irvine, School of Medicine, Irvine, CA
    • ,
  • Pathik D. Wadhwa, MD, PhD

      Affiliations

    • Department of Psychiatry and Human Behavior, University of California, Irvine, School of Medicine, Irvine, CA
    • Department of Obstetrics and Gynecology, University of California, Irvine, School of Medicine, Irvine, CA
    • Department of Pediatrics, University of California, Irvine, School of Medicine, Irvine, CA
    • Corresponding Author InformationReprints: Pathik D. Wadhwa, MD, PhD, Behavioral Perinatology Research Program, University of California, Irvine, School of Medicine, 3117 Gillespie Neuroscience Research Facility, Irvine, CA 92697

Received 20 February 2009; received in revised form 14 May 2009; accepted 29 June 2009. published online 31 August 2009.

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.

Key words: cortisol, gestational length, hypothalamic-pituitary-adrenal, pregnancy, stress responsiveness

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 Supported, in part, by US PHS (NIH) Grants HD-33506, HD-041696 and HD-047609 (P.D.W.).

 Cite this article as: Buss C, Entringer S, Reyes JF, et al. The maternal cortisol awakening response in human pregnancy is associated with the length of gestation. Am J Obstet Gynecol 2009;201:398.e1-8.

PII: S0002-9378(09)00734-0

doi:10.1016/j.ajog.2009.06.063

American Journal of Obstetrics & Gynecology
Volume 201, Issue 4 , Pages 398.e1-398.e8, October 2009

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