Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.
PLoS One. 2021 Apr 23;16(4):e0250459. doi: 10.1371/journal.pone.0250459. eCollection 2021.
The hypothalamic-pituitary-adrenal axis, with cortisol as its final metabolite, has been proposed as a potential underlying biological mechanism for associations between depression and stress symptoms during pregnancy and adverse perinatal outcomes. In this study, we explored associations between salivary cortisol as a potential biomarker for stress and depressive symptoms and several self-completed psychological measurement scales among pregnant women. In total, 652 pregnant women participating in the PRegnancy and Infant DEvelopment (PRIDE) Study completed the Edinburgh Depression Scale (EDS), Patient Health Questionnaire-2 (PHQ-2), Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R), and Tilburg Pregnancy Distress Scale (TPDS) and collected a single awakening salivary cortisol sample around gestational week 17. Odds ratios, Spearman's correlation coefficients (ρs) and Cohen's Kappa coefficients (κ) were calculated to examine the associations between the EDS, PHQ-2, PRAQ-R, TPDS, and maternal cortisol levels. The overall correlation coefficient between the score on the EDS and the salivary cortisol level was 0.01 (p = 0.89) with κ = -0.01 (95% confidence interval [CI] -0.08-0.06). We did not observe agreement between the PHQ-2 and cortisol levels either (κ = 0.06 (95% CI -0.02-0.14)). The results for the PRAQ-R and TPDS were similar with overall correlations with maternal cortisol levels of ρs = 0.01 (p = 0.81) and ρs = 0.06 (p = 0.35) and agreements of κ = 0.02 (95% CI -0.06-0.09) and κ = -0.02 (95% CI -0.11-0.07), respectively. Maternal awakening salivary cortisol levels and measures of maternal psychological distress, anxiety, depressive symptoms, and pregnancy-related anxiety, assessed by self-completed questionnaires, did not seem to be related in mid-pregnancy.
下丘脑-垂体-肾上腺轴，以皮质醇作为其最终代谢产物，被认为是怀孕期间抑郁和压力症状与不良围产期结局之间关联的潜在生物学机制。在这项研究中，我们探讨了唾液皮质醇作为压力和抑郁症状的潜在生物标志物与孕妇多项自我完成的心理测量量表之间的关系。共有 652 名参与妊娠和婴儿发育研究（PRIDE）的孕妇完成了爱丁堡抑郁量表（EDS）、患者健康问卷-2（PHQ-2）、修订版妊娠相关焦虑问卷（PRAQ-R）和蒂尔堡妊娠压力量表（TPDS），并在妊娠 17 周左右采集了单次觉醒唾液皮质醇样本。计算比值比、斯皮尔曼相关系数（ρs）和科恩氏κ系数（κ），以检验 EDS、PHQ-2、PRAQ-R、TPDS 和产妇皮质醇水平之间的关系。EDS 评分与唾液皮质醇水平之间的总相关系数为 0.01（p = 0.89），κ = -0.01（95%置信区间 [CI] -0.08-0.06）。我们也没有观察到 PHQ-2 与皮质醇水平之间存在一致性（κ = 0.06（95% CI -0.02-0.14））。PRAQ-R 和 TPDS 的结果相似，与母体皮质醇水平的总相关系数为 ρs = 0.01（p = 0.81）和 ρs = 0.06（p = 0.35），一致性为 κ = 0.02（95% CI -0.06-0.09）和 κ = -0.02（95% CI -0.11-0.07）。在妊娠中期，母体觉醒唾液皮质醇水平与自我完成问卷评估的产妇心理困扰、焦虑、抑郁症状和妊娠相关焦虑的测量值似乎没有关系。
