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Predictors of neonatal hypothalamic–pituitary–adrenal axis activity at delivery
Author(s) -
Smith Alicia K.,
Newport D. Jeffrey,
Ashe Morgan P.,
Brennan Patricia A.,
LaPrairie Jamie L.,
Calamaras Martha,
Nemeroff Charles B.,
Ritchie James C.,
Cubells Joseph F.,
Stowe Zachary N.
Publication year - 2011
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2011.03998.x
Subject(s) - medicine , endocrinology , offspring , population , pregnancy , umbilical cord , gestational age , body mass index , adrenocorticotropic hormone , birth weight , hormone , cortisol awakening response , hydrocortisone , biology , immunology , genetics , environmental health
Summary Objective Clinical and preclinical studies indicate that maternal stress during pregnancy may exert long‐lasting adverse effects on offspring. This investigation sought to identify factors mediating the relationship between maternal and neonatal hypothalamic–pituitary–adrenal (HPA) axes in pregnant women with past or family psychiatric history. Patients Two hundred and five pairs of maternal and umbilical cord blood samples from a clinical population were collected at delivery. Measurements Maternal and neonatal HPA axis activity measures were plasma adrenocorticotrophic hormone (ACTH), total cortisol, free cortisol and cortisol‐binding globulin concentrations. The effects of maternal race, age, body mass index, psychiatric diagnosis (DSM‐IV), birth weight, delivery method and estimated gestational age (EGA) at delivery on both maternal and neonatal HPA axis measures were also examined. Incorporating these independent predictors as covariates where necessary, we evaluated whether neonatal HPA axis activity measures could be predicted by the same maternal measure using linear regression. Results Delivery method was associated with umbilical cord plasma ACTH and both total and free cord cortisol concentrations ( T = 10·53–4·21; P < 0·0001–0·010). After accounting for method of delivery and EGA, we found that maternal plasma ACTH concentrations predicted 23·9% of the variance in foetal plasma ACTH concentrations ( T = 6·76; P < 0·0001), and maternal free and total plasma cortisol concentrations predicted 39·8% and 32·3% of the variance in foetal plasma free and total cortisol concentrations ( T = 5·37–6·90; P < 0·0001), respectively. Conclusion These data suggest that neonatal response is coupled with maternal HPA axis activity at delivery. Future investigations will scrutinize the potential long‐term sequelae for the offspring.