Duffy Allyson R, Schminkey Donna L, Groer Maureen W, Shelton Melissa, Dutra Samia
1 University of South Florida College of Nursing, Tampa, FL, USA.
2 University of Virginia School of Nursing, Charlottesville, VA, USA.
Biol Res Nurs. 2018 May;20(3):292-299. doi: 10.1177/1099800418758952. Epub 2018 Feb 28.
To evaluate relationships between hair cortisol levels and perceived stress in mothers who deliver preterm and term. We hypothesized that the rate of change in cortisol levels would be greater in the preterm delivery group.
This preliminary study compared hair cortisol levels and Perceived Stress Scale (PSS) scores in predominately Caucasian mothers who delivered preterm ( n = 22) and term ( n = 30). We collected PSS and hair samples of ≥10 cm in length from mothers after delivery. Hair was segmented into three sections, and cortisol was measured using enzyme-linked immunosorbent assay.
The mean gestational age was 31.45 ( SD = 4.2) weeks for preterm deliveries and 39.45 ( SD = 1.1) for term. Cortisol differed significantly in the third trimester between mothers delivering term and preterm ( t = 2.16, df = 48, p = .04) and trended toward significance in the second trimester ( t = 1.88, df = 48, p = .06). PSS differed significantly between the two groups ( t = -2.96, df = 50, p = .05). Our data did not provide support for our hypothesis.
There appeared to be a blunted, flattened pattern of change in cortisol levels across gestation in the women who delivered preterm, suggesting diminished hypothalamic-pituitary-adrenal axis responsiveness in mechanisms that promote preterm labor. Future studies are needed to further evaluate best strategies for measuring the mechanisms of allostatic load during pregnancy along with the psychoneuroendocrine and immune triggers and placental responses that lead to premature birth.
评估早产和足月分娩母亲的头发皮质醇水平与感知压力之间的关系。我们假设早产组皮质醇水平的变化率会更大。
这项初步研究比较了主要为白人的早产（n = 22）和足月分娩（n = 30）母亲的头发皮质醇水平和感知压力量表（PSS）得分。我们在母亲分娩后收集了PSS和长度≥10厘米的头发样本。头发被分成三段，使用酶联免疫吸附测定法测量皮质醇。
早产的平均孕周为31.45（标准差 = 4.2）周，足月分娩的平均孕周为39.45（标准差 = 1.1）周。足月和早产母亲在孕晚期的皮质醇有显著差异（t = 2.16，自由度 = 48，p = 0.04），在孕中期有差异有统计学意义的趋势（t = 1.88，自由度 = 48，p = 0.06）。两组之间的PSS有显著差异（t = -2.96，自由度 = 50，p = 0.05）。我们的数据没有支持我们的假设。
早产女性在整个孕期皮质醇水平的变化似乎呈现出钝化、平缓的模式，这表明在促进早产的机制中下丘脑 - 垂体 - 肾上腺轴反应性降低。未来需要进一步研究来评估测量孕期应激负荷机制的最佳策略，以及导致早产的心理神经内分泌和免疫触发因素及胎盘反应。
