Sikkema J M, Robles de Medina P G, Schaad R R, Mulder E J, Bruinse H W, Buitelaar J K, Visser G H, Franx A
Department of Obstetrics, University Medical Center, KE4.134.2, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands.
J Psychosom Res. 2001 Jan;50(1):45-9. doi: 10.1016/s0022-3999(00)00208-7.
To compare salivary cortisol levels and maternal anxiety (general and pregnancy-specific) in the early and late second trimester of pregnancy between women who developed preeclampsia (PE) and women who remained normotensive.
Nested case-referent study. In a prospectively studied cohort of 250 pregnant women, nine women developed PE in late pregnancy. These nine patients were matched and compared with nine controls. Diurnal cortisol levels were obtained by collecting saliva samples at 17-18 and 27-28 weeks gestation. Salivary cortisol levels were determined by radioimmunoassay. Maternal anxiety was determined by Spielberger's State-Trait Anxiety Inventory (STAI) and a pregnancy-specific stress questionnaire.
For both patients and controls, a similar pattern of salivary cortisol excretion was observed. Salivary cortisol levels and anxiety scores (general and pregnancy-specific) did not differ significantly between patients and controls.
Our findings do not lend support to a role for maternal anxiety or second trimester increases in circulating stress hormones in the pathogenesis of PE.
比较发生先兆子痫（PE）的孕妇与血压正常的孕妇在妊娠中期早期和晚期的唾液皮质醇水平及母体焦虑（一般焦虑和特定于妊娠的焦虑）情况。
巢式病例对照研究。在一项对250名孕妇进行前瞻性研究的队列中，有9名女性在妊娠晚期发生了PE。将这9名患者与9名对照进行匹配和比较。通过在妊娠17 - 18周和27 - 28周收集唾液样本获取昼夜皮质醇水平。唾液皮质醇水平通过放射免疫测定法测定。母体焦虑通过斯皮尔伯格状态 - 特质焦虑量表（STAI）和一份特定于妊娠的应激问卷进行测定。
对于患者和对照，均观察到相似的唾液皮质醇排泄模式。患者和对照之间的唾液皮质醇水平及焦虑评分（一般焦虑和特定于妊娠的焦虑）无显著差异。
我们的研究结果不支持母体焦虑或妊娠中期循环应激激素增加在PE发病机制中起作用的观点。
