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 ,Revised 14 May 2009 ,Accepted 29 June 2009.

References 

  1. Challis J, Sloboda D, Matthews S, et al. Fetal hypothalamic-pituitary adrenal (HPA) development and activation as a determinant of the timing of birth, and of postnatal disease. Endocr Res. 2000;26:489–504
  2. Petraglia F, Florio P, Nappi C, Genazzani AR. Peptide signaling in human placenta and membranes: autocrine, paracrine, and endocrine mechanisms. Endocr Rev. 1996;17:156–186
  3. Murphy VE, Smith R, Giles WB, Clifton VL. Endocrine regulation of human fetal growth: the role of the mother, placenta, and fetus. Endocr Rev. 2006;27:141–169
  4. Mastorakos G, Ilias I. Maternal and fetal hypothalamic-pituitary-adrenal axes during pregnancy and postpartum. Ann N Y Acad Sci. 2003;997:136–149
  5. Chan EC, Falconer J, Madsen G, et al. A corticotropin-releasing hormone type I receptor antagonist delays parturition in sheep. Endocrinology. 1998;139:3357–3360
  6. Morrison JL. Sheep models of intrauterine growth restriction: fetal adaptations and consequences. Clin Exp Pharmacol Physiol. 2008;35:730–743
  7. Sandman CA, Glynn L, Schetter CD, et al. Elevated maternal cortisol early in pregnancy predicts third trimester levels of placental corticotropin releasing hormone (CRH): priming the placental clock. Peptides. 2006;27:1457–1463
  8. Mazor M, Chaim W, Hershkowitz R, Levy J, Leiberman JR, Glezerman M. Association between preterm birth and increased maternal plasma cortisol concentrations. Obstet Gynecol. 1994;84:521–524
  9. Erickson K, Thorsen P, Chrousos G, et al. Preterm birth: associated neuroendocrine, medical, and behavioral risk factors. J Clin Endocrinol Metab. 2001;86:2544–2552
  10. Ruiz RJ, Fullerton J, Brown CE, Schoolfield J. Relationships of cortisol, perceived stress, genitourinary infections, and fetal fibronectin to gestational age at birth. Biol Res Nurs. 2001;3:39–48
  11. Van Cauter E, Turek FW. Endocrine and other biological rhythms. In:  DeGroot LJ editors. Endocrinology. Philadelphia: Saunders; 1995;p. 2487–2548
  12. de Weerth C, Buitelaar JK. Cortisol awakening response in pregnant women. Psychoneuroendocrinology. 2005;30:902–907
  13. Jones NM, Holzman CB, Zanella AJ, Leece CM, Rahbar MH. Assessing mid-trimester salivary cortisol levels across three consecutive days in pregnant women using an at-home collection protocol. Paediatr Perinat Epidemiol. 2006;20:425–437
  14. Kivlighan KT, Dipietro JA, Costigan KA, Laudenslager ML. Diurnal rhythm of cortisol during late pregnancy: associations with maternal psychological well-being and fetal growth. Psychoneuroendocrinology. 2008;33:1225–1235
  15. Kirschbaum C, Hellhammer DH. Salivary cortisol in psychoneuroendocrine research: recent developments and applications. Psychoneuroendocrinology. 1994;19:313–333
  16. Kudielka BM, Broderick JE, Kirschbaum C. Compliance with saliva sampling protocols: electronic monitoring reveals invalid cortisol daytime profiles in noncompliant subjects. Psychosom Med. 2003;65:313–319
  17. Wilhelm I, Born J, Kudielka BM, Schlotz W, Wust S. Is the cortisol awakening rise a response to awakening?. Psychoneuroendocrinology. 2007;32:358–366
  18. Nater UM, Maloney E, Boneva RS, et al. Attenuated morning salivary cortisol concentrations in a population-based study of persons with chronic fatigue syndrome and well controls. J Clin Endocrinol Metab. 2008;93:703–709
  19. Whitehead DL, Perkins-Porras L, Strike PC, Magid K, Steptoe A. Cortisol awakening response is elevated in acute coronary syndrome patients with type-D personality. J Psychosom Res. 2007;62:419–425
  20. Pruessner JC, Hellhammer DH, Kirschbaum C. Burnout, perceived stress, and cortisol responses to awakening. Psychosom Med. 1999;61:197–204
  21. Wadhwa PD. Psychoneuroendocrine processes in human pregnancy influence fetal development and health. Psychoneuroendocrinology. 2005;30:724–743
  22. Slattery DA, Neumann ID. No stress please! (Mechanisms of stress hyporesponsiveness of the maternal brain). J Physiol. 2008;586:377–385
  23. O'Brien GD, Queenan JT, Campbell S. Assessment of gestational age in the second trimester by real-time ultrasound measurement of the femur length. Am J Obstet Gynecol. 1981;139:540–545
  24. Zhang X, Kramer MS. Variations in mortality and morbidity by gestational age among infants born at term. J Pediatr. 2008;Epub ahead of print
  25. Singer J, Willett J. Applied longitudinal data analysis: modeling change and event occurrence. New York: Oxford University Press; 2003;
  26. Raudenbush SW, Bryk AS. In: Hierarchical linear models: application and data analysis methods: advanced quantitative techniques in the social sciences. vol 1:Thousand Oaks, CA: Sage Publications; 2002;
  27. Raudenbush SW, Liu X. Effect of study duration, frequency of observation, and sample size on power in studies of group differences in polynomial change. Psychol Methods. 2001;6:387–401
  28. Adam EK. Transactions among adolescent trait and state emotion and diurnal and momentary cortisol activity in naturalistic settings. Psychoneuroendocrinology. 2006;31:664–679
  29. Glynn LM, Schetter CD, Hobel CJ, Sandman CA. Pattern of perceived stress and anxiety in pregnancy predicts preterm birth. Health Psychol. 2008;27:43–51
  30. Glynn LM, Wadhwa PD, Dunkel-Schetter C, Chicz-Demet A, Sandman CA. When stress happens matters: effects of earthquake timing on stress responsivity in pregnancy. Am J Obstet Gynecol. 2001;184:637–642
  31. Glynn LM, Schetter CD, Wadhwa PD, Sandman CA. Pregnancy affects appraisal of negative life events. J Psychosom Res. 2004;56:47–52
  32. Schulte HM, Weisner D, Allolio B. The corticotrophin releasing hormone test in late pregnancy: lack of adrenocorticotrophin and cortisol response. Clin Endocrinol (Oxf). 1990;33:99–106
  33. Sasaki A, Shinkawa O, Yoshinaga K. Placental corticotropin-releasing hormone may be a stimulator of maternal pituitary adrenocorticotropic hormone secretion in humans. J Clin Invest. 1989;84:1997–2001
  34. Glynn LM, Schetter CD, Chicz-DeMet A, Hobel CJ, Sandman CA. Ethnic differences in adrenocorticotropic hormone, cortisol and corticotropin-releasing hormone during pregnancy. Peptides. 2007;28:1155–1161

 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