Universidad Peruana Cayetano Heredia

Chronic HPA activity in mothers with preterm delivery: A pilot nested case-control study

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dc.contributor.author Gelaye, B.
dc.contributor.author Kirschbaum, C.
dc.contributor.author Zhong, Q.Y.
dc.contributor.author Sanchez, S.E.
dc.contributor.author Rondon, M.B.
dc.contributor.author Koenen, K.C.
dc.contributor.author Williams, M.A.
dc.date.accessioned 2020-12-14T16:06:25Z
dc.date.available 2020-12-14T16:06:25Z
dc.date.issued 2020
dc.identifier.uri https://hdl.handle.net/20.500.12866/8715
dc.description.abstract BACKGROUND: Chronic hypothalamic-pituitary-adrenal (HPA) axis activity role in the pathogenesis of preterm birth (PTB) remains unclear due to inconsistent measures with limited ability to monitor long-term cortisol concentrations. We explored this relationship using the novel method of assessing cortisol in hair, which is a valid and reliable measure of chronic HPA axis activity. METHODS: 137 participants (40 PTB cases and 97 controls from a birth cohort of pregnant women in Peru) were interviewed and invited to provide a 9-cm hair sample from the posterior vertex position of the scalp (mean = 13 weeks gestation). Hair cortisol concentration (HCC) was determined using luminescence immunoassay and values were natural-log transformed. PTB cases were defined as women who delivered before 37 gestational weeks. Case-control differences were assessed using multivariable linear and logistic regressions. RESULTS: Overall, combined pre-conception and first-trimester HCC was 13% lower among cases as compared with controls (p-value = 0.01). Compared with controls, maternal HCC among PTB cases were 14% (p = 0.11), 10% (p = 0.22) and 14% (p = 0.08) lower for 3-6 months pre-conception, 0-3 months pre-conception, and first trimester, respectively. After adjusting for putative confounders, a 1-unit increase in HCC was associated with 55% reduced odds of PTB (aOR = 0.45; 95% CI: 0.17-1.17). For a 1-unit increase in HCC in the scalp-intermediate and scalp-distal segments (representing HCC concentrations in 0-3 months pre-conception and first trimester), the corresponding odds for PTB were 0.53 (95% CI: 0.19-1.48) and 0.39 (95% CI: 0.13-1.13), respectively. CONCLUSIONS: Women who deliver preterm, as compared with those who deliver at term, have lower preconception and first trimester HCC. Our findings suggest that HPA axis activation, integral to the adaptive stress-response system, may be chronically dysregulated in women at increased risk of PTB. en_US
dc.language.iso eng
dc.publisher IOS Press
dc.relation.ispartofseries Journal of Neonatal-Perinatal Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject HPA axis activity en_US
dc.subject hair cortisol en_US
dc.subject cortisol en_US
dc.subject HCC en_US
dc.subject preterm birth en_US
dc.subject stress en_US
dc.title Chronic HPA activity in mothers with preterm delivery: A pilot nested case-control study en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.3233/NPM-180139
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.03
dc.relation.issn 1934-5798


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