(849) Preconception hormone levels are associated with preterm birth and measures of maternal stress and mood.

Chronic stress during pregnancy has been associated with adverse pregnancy outcomes (APOs) including preterm birth (PTB). In addition, progesterone is crucial in the maintenance of pregnancy and deficiency can increase the risk of miscarriage and PTB. Assessment of hormone levels in human hair provides a stable, non-invasive measurement of chronic hormonal activity. Our objective was to determine the association between preconception maternal hair cortisol and progesterone levels and APOs.

Study Design: Preconception hair hormone levels (HHLs), mood, and APOs were evaluated in participants who were part of a larger prospective cohort study during which maternal hair was cut 3 times during pregnancy: around 16 weeks, 28 weeks, and delivery. As the proximal 1cm of hair from the scalp represents ~one preceding month of hair growth, segments longer than 3 cm at 16 weeks were considered to represent the preconception period.  HHLs were analyzed using mass spectrometry.  Participant data was collected via chart review and interview.  Our primary outcome was the relationship between preconception HHLs and delivery < 37 weeks (PTB). Secondary outcomes included: pre-eclampsia/PIH (PREE) and maternal mood questionnaires including the State-Trait Anxiety Inventory (STAI), Center for Epidemiologic studies-depression scale (CESD). Data were analyzed using Spearman correlations, p < 0.05 considered significant.

Results: Of 163 participants, 110 and 34 participants had preconception cortisol and progesterone HHLs available for analysis, respectively. Correlations were noted between cortisol and PTB (r = 0.20, p = 0.04) and progesterone and STAI and CESD scores (r = 0.34, p = 0.03 and r = 0.33, p = 0.042). Additional correlations (p >0.05) included positive relationships between cortisol and: PREE and CESD score at all gestational ages.

Conclusion:      Higher preconception cortisol is correlated with higher risk of PTB and higher preconception progesterone correlates with depression and anxiety.  These data improve our understanding of the complex relationships between preconception stress, mood, and pregnancy outcomes.