High maternal cortisol levels linked to unexpected birth problems

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A snippet of hair can reveal a pregnant woman’s stress levels and one day help warn of unexpected birth problems, a study suggests.

Washington State University researchers measured the stress hormone cortisol in hair samples from 53 women in their third trimester. Of that group, 13 women whose cortisol levels were elevated later experienced unexpected birth complications, such as premature birth or hemorrhage.

Although further research with larger cohorts is needed, this preliminary finding may eventually lead to a non-invasive way to identify individuals at risk for such complications. The researchers reported their findings in the journal Psychoneuroendocrinology.

Otherwise there was nothing about these women that would suggest any disease or anything complicating the pregnancy. This confirmed some hypotheses that stress levels, particularly in relation to cortisol levels, may be associated with adverse birth outcomes.”

Erica Crespi, a WSU developmental biologist and corresponding author of the study

As part of the study, participants answered survey questions about their levels of emotional distress during the third trimester of pregnancy and after their birth, in addition to measuring cortisol. Women who experienced unexpected birth complications had increased concentrations of cortisol in their hair, a measure that indicates circulating levels of the stress hormone in the body three months prior to collection. These women also reported feelings of stress, anxiety, and depression, but on average, only high cortisol levels during pregnancy showed a strong link with adverse birth outcomes.

Cortisol, a steroid hormone, increases in humans and many animals to help regulate the body’s response to stress, but prolonged high cortisol is linked to major health problems, including high blood pressure and diabetes. Throughout pregnancy, cortisol levels naturally rise two to four times and peak during the third trimester, but this study measured cortisol levels that were more pronounced among women who had unexpected birth complications.

“If this finding holds up, it could be a non-invasive way to get more insight into who might be at risk because that’s information we don’t get from surveys,” said co-author Sarah Waters, a WSU human development researcher. It wasn’t something we could find out just by asking people about their stress.”

Two months after giving birth, the group that experienced birth complications continued to show higher cortisol and answered surveys indicating persistent stress, anxiety and depression. At six months, their cortisol was higher, but they began to report lower emotional distress on the survey, which the authors noted could be a sign of recovery.

Finding ways to reduce stress around birth can help improve outcomes for both baby and mother, researchers say. They noted that adverse birth outcomes are increasing in the country. The United States notoriously has one of the highest maternal mortality rates among developed nations, with deaths disproportionately affecting black women and people of color.

More needs to be done to improve health care and support systems for pregnant people and new parents, Waters said. The study is also a reminder to pregnant and new mothers to prioritize their health.

“It’s very easy to sacrifice our own health and well-being to prioritize our children, especially when it seems that resources are scarce,” Waters said. “But our ability to show up as parents comes from the foundation of meeting our needs—as the saying goes, ‘You can’t pour from an empty cup.'”

The study involved an interdisciplinary research team at WSU. In addition to Crespi and Waters, co-authors include first author Jennifer Madigan, a Ph.D. Research Candidate in Stress Physiology; Maria Gertstein, a psychology professor; Jennifer Mattera, a psychology Ph.D. students; and Chris Connelly, an associate professor of kinesiology. This research received support from a WSU Grand Challenges grant as well as interdisciplinary grants from the WSU College of Arts and Sciences and the WSU Office of Research.


Journal Reference:

Madigan, J. A., etc. (2023). Perinatal hair cortisol concentrations are associated with psychological distress and unexpected birth complications. Psychoneuroendocrinology. doi.org/10.1016/j.psyneuen.2023.106921.

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