Indian Institute of Public Health Gandhinagar, Lekawada, Gandhinagar, India.
University of Canberra, Bruce, Australia.
Horm Metab Res. 2021 Sep;53(9):602-607. doi: 10.1055/a-1551-3722. Epub 2021 Sep 8.
During pregnancy, circulatory cortisol levels increase, remaining steady over the second-third trimester. In contrast, profile of salivary cortisol during pregnancy is debatable, more influenced by factors like time of sample collection in the day. Circulatory DHEA-S decrease by at least 50% over the second-third trimester of pregnancy. However, profile of salivary DHEA-S is unclear. Objective was to determine changes in salivary cortisol and DHEA-S in healthy pregnant women, compared to non-pregnant women during late morning-early afternoon sampling to avoid fluctuations associated with other times. Pregnant women in their second-third trimester prospectively (n=500) and non-pregnant women (n=133) were enrolled in study with informed consent. Live birth outcome with no pregnancy complications and≥2.5 Kg infant birth weight were included. Concentrations of salivary cortisol and DHEA-S were determined through ELISA assays. Compared to non-pregnant women, pregnant women demonstrated significant increases in salivary cortisol [median (interquartile range)=4.2 (5.1) nmol/l vs. 17.2 (13.9) nmol/l, p<0.001] and salivary DHEA-S median (interquartile range)=2.7 (2.9) nmol/l vs. 3.8 (3.2) nmol/l, p<0.001). Consistently, quartile scores representing higher levels of salivary cortisol and DHEA-S concentrations demonstrated significant association with pregnancy. Quartile scores representing higher salivary cortisol/DHEA-S ratio demonstrated significant association with pregnancy. Study suggests the indicated time range of saliva sampling might best parallel the established profile of circulatory cortisol in pregnant women. However, unlike cortisol, study indicates that the salivary DHEA-S profile is distinct from the well-known profile of circulatory DHEA-S during pregnancy. A combinatorial approach involving both salivary and circulatory compartments could provide comprehensive picture of DHEA-S and hypothalamus-pituitary-adrenal axis during pregnancy.
在怀孕期间,循环皮质醇水平升高,在第二至第三孕期保持稳定。相比之下,怀孕期间唾液皮质醇的特征是有争议的,更多地受到样本采集时间等因素的影响。循环 DHEA-S 在第二至第三孕期至少下降 50%。然而,唾液 DHEA-S 的特征尚不清楚。本研究的目的是确定与非孕期相比,在清晨至午后早期采样期间,健康孕妇唾液皮质醇和 DHEA-S 的变化,以避免与其他时间相关的波动。前瞻性纳入第二至第三孕期孕妇(n=500)和非孕期女性(n=133),并获得知情同意。纳入标准为无妊娠并发症和婴儿出生体重≥2.5kg 的活产儿。通过 ELISA 检测唾液皮质醇和 DHEA-S 的浓度。与非孕期女性相比,孕妇唾液皮质醇[中位数(四分位距)=4.2(5.1)nmol/L 比 17.2(13.9)nmol/L,p<0.001]和唾液 DHEA-S[中位数(四分位距)=2.7(2.9)nmol/L 比 3.8(3.2)nmol/L,p<0.001]均显著升高。同样,代表更高唾液皮质醇和 DHEA-S 浓度的四分位评分与妊娠显著相关。代表更高唾液皮质醇/DHEA-S 比值的四分位评分与妊娠显著相关。研究表明,指示的唾液采样时间范围可能与孕妇循环皮质醇的既定特征最相似。然而,与皮质醇不同的是,研究表明,唾液 DHEA-S 特征与怀孕期间循环 DHEA-S 的已知特征不同。涉及唾液和循环两个部分的组合方法可以提供怀孕期间 DHEA-S 和下丘脑-垂体-肾上腺轴的全面情况。