(1136) Early Pregnancy Cortisol Levels in Women with and without a History of Preterm Deliveries

Objective: Elevated cortisol levels during pregnancy have been associated with an increased risk for preterm delivery (PTD). However, the precise nature of this relationship and its potential mechanisms remain poorly understood, particularly concerning cortisol levels in early pregnancy. The present prospective study was designed to investigate the association between early pregnancy cortisol levels and perceived stress, and adverse pregnancy outcomes in women with and without a history of PTD.

Study Design: In this prospective study, women with or without a history of PTD were recruited during 11-13 weeks of gestation at a tertiary medical center. All participants provided a saliva sample and answered a health and stress questionnaire. Pregnancy outcomes were compared between women with high and low salivary cortisol levels. Mean salivary cortisol levels were also compared between women with and without a history of PTD and between women with and without selected pregnancy complications.

Results: The study included 375 women, out of them 194 with, and 181 without previous PTD. The levels of cortisol were higher among women with vs. without PTD (0.1440 ug/dL ± 0.095 and 0.297 ug/dL ± 0.23, respectively, p-value< 0.001) in total, and when comparing the groups at each gestational week (Figure 1). Women who had high cortisol levels were not at increased risk for adverse pregnancy outcomes including PTD (Table 1). No association was found between the perceived stress based on the questionnaire and the measured cortisol levels.

Conclusion: Although cortisol levels were higher among women with previous PTD, cortisol levels were not associated with the risk for PTD and other adverse pregnancy outcomes, possibly due to the early gestational age at which the cortisol was measured. Further study on early pregnancy markers for potential complications is needed to facilitate effective intervention and prevention.