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Second trimester serum cortisol and preterm birth: an analysis by timing and subtype

Journal of Perinatology volume 38, pages 973–981 (2018)Cite this article

Subjects

Abstract

Objective

We hypothesized second trimester serum cortisol would be higher in spontaneous preterm births compared to provider-initiated (previously termed ‘medically indicated’) preterm births.

Study design

We used a nested case-control design with a sample of 993 women with live births. Cortisol was measured from serum samples collected as part of routine prenatal screening. We tested whether mean-adjusted cortisol fold-change differed by gestational age at delivery or preterm birth subtype using multivariable linear regression.

Result

An inverse association between cortisol and gestational age category (trend p = 0.09) was observed. Among deliveries prior to 37 weeks, the mean-adjusted cortisol fold-change values were highest for preterm premature rupture of the membranes (1.10), followed by premature labor (1.03) and provider-initiated preterm birth (1.01), although they did not differ statistically.

Conclusion

Cortisol continues to be of interest as a marker of future preterm birth. Augmentation with additional biomarkers should be explored.

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Acknowledgements

This work was supported by NIH/NHLBI grants (RC2 HL101748, RO1 HD-57192, and R01 HD-52953), the Bill and Melinda Gates Millennium grants (OPP52256 and RSDP 5K12 HD-00849-23), March of Dimes grants (6-FY11-261 and FY10-180), and the California Preterm Birth Initiative at the UCSF Benioff Children’s Hospital funded by Marc and Lynne Benioff. Data from the California Prenatal Screening Program were obtained through the California Biobank Program (Screening Information System request no. 476). Data were obtained with an agreement that the California Department of Public Health is not responsible for the results or conclusions drawn by the authors of this publication.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of California San Diego, San Diego, CA, USA

    Gretchen Bandoli & Christina D Chambers

  2. California Preterm Birth Initiative, University of California San Francisco School of Medicine, San Francisco, CA, USA

    Laura L Jelliffe-Pawlowski, Sky K Feuer, Scott P Oltman & Randi Paynter

  3. Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA, USA

    Laura L Jelliffe-Pawlowski, Scott P Oltman & Randi Paynter

  4. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA

    Sky K Feuer

  5. Department of Genetics, Stanford University, Palo Alto, CA, USA

    Liang Liang

  6. Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA

    Kharah M Ross & Christine Dunkel Schetter

  7. Departments of Epidemiology and Pediatrics, University of Iowa, Iowa City, IA, USA

    Kelli K Ryckman

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  1. Gretchen Bandoli
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Correspondence to Gretchen Bandoli.

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Bandoli, G., Jelliffe-Pawlowski, L.L., Feuer, S.K. et al. Second trimester serum cortisol and preterm birth: an analysis by timing and subtype. J Perinatol 38, 973–981 (2018). https://doi.org/10.1038/s41372-018-0128-5

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