Gestational diabetes & diabetes in pregnancy
Serial Diurnal Salivary Cortisol Profiles in 667 Pregnant Women—Association With Cardiometabolic Complications
Authors' conclusion
The attenuation in CAR and diurnal slope support HPA axis hyporesponsivity during pregnancy. Less attenuation of both markers in women with a higher BMI may indicate reduced adaption of the HPA axis to pregnancy, presenting a mechanistic link to offspring health outcomes.
Study context
- Population
- Pregnant women in the InTraUterine sampling in early pregnancy (ITU) study; 7 salivary cortisol samples from awakening to bedtime up to 3 times during pregnancy (median gestational week 19.3, 25.7 and 38.1)9,356 samples
- Participants
- 667 women
- Outcome
- Changes in cortisol awakening response (CAR) and diurnal slope across gestation, and their associations with maternal BMI, hypertensive pregnancy disorders and GDM
- Follow-up
- Early to late pregnancy
Methodological detailslongitudinal, serial diurnal salivary cortisol sampling, linear mixed models
- Longitudinal
- Serial diurnal salivary cortisol sampling
- Linear mixed models
Main finding
As reported in the abstract
Cortisol awakening response (CAR) declined in proportion of women
60% to 67%
Diurnal slope attenuated from early to late pregnancy
b = 0.006
P = .001
Higher body mass index (BMI) associated with less decline in CAR
b = 0.031
P = .0004
Higher BMI associated with less attenuation in diurnal slope
b = −0.001
P = .006
Observational data: associations, not effects.
Original publication
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