ArticleBMC pregnancy and childbirth2022
Increased risk of preterm delivery with high cortisol during pregnancy is modified by fetal sex: a cohort study.
Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 20 citations in OpenAlex.
- Gestational urinary concentrations of glyphosate and aminomethylphosphonic acid in relation to preterm birth: the MIREC study.Journal of exposure science & environmental epidemiology · 2025Article
- Review
- Unraveling the Molecular Links between Fine Particulate Matter Exposure and Early Birth Risks in African American Mothers: A Metabolomics Study in the Atlanta African American Maternal-Child Cohort.Environmental science & technology · 2025Article
- Elevated serum cortisol levels and associated factors among postpartum mothers in Mbarara district, rural south western Uganda.Discover medicine · 2025Article
- Autophagy in reproduction and pregnancy-associated diseases.iScience · 2024Review
- Environmental Justice Index and adverse pregnancy outcomes.AJOG global reports · 2024Article
- Seasonal variation in air pollutant levels and its effects on the sex ratio at birth on Fukue island, Japan.BMC public health · 2023Article
- The Relationship between Psychological Suffering, Value of Maternal Cortisol during Third Trimester of Pregnancy and Breastfeeding Initiation.Medicina (Kaunas, Lithuania) · 2023Article
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Authors and funding
8 authors at 5 institutions in 3 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies show an association between maternal plasma and salivary cortisol and preterm birth but have been primarily conducted in high-income countries. It is unknown whether salivary cortisol is a risk factor for preterm birth in Ghana. Our objective was to determine whether maternal salivary cortisol during pregnancy was associated with pregnancy duration and preterm delivery in Ghana.
methodsWe conducted a cohort study of 783 pregnant women in Ghana. We measured salivary cortisol at baseline (mean 16 wk), 28 wk., and 36 wk. gestation. Pregnancy duration was determined primarily by ultrasound. We used adjusted linear regression models to examine the association between cortisol and pregnancy duration and Poisson regression models to determine the risk of preterm delivery among women with high cortisol at baseline or 28 wk. gestation.
resultsMean pregnancy duration was 39.4 ± 1.8 wk. and 6.6% had a preterm delivery. Mean maternal cortisol increased throughout pregnancy, from 4.9 ± 2.7 nmol/L at baseline (16 wk) to 6.4 ± 3.2 nmol/L at 28 wk. and 7.9 ± 3.0 nmol/L at 36 wk. gestation. In adjusted analyses, higher cortisol concentrations at baseline (β = - 0.39, p = .002) and 28 wk. (β = - 0.49, p = .001), but not 36 wk. (β = - 0.23, p = .084) were associated with a shorter pregnancy duration. Women with high cortisol at baseline (> 6.3 nmol/L) had an increased relative risk of preterm delivery (RR (95% CI): 1.96 (1.13, 3.40)), but the association between high cortisol at 28 wk. and preterm delivery was not significant. There was a significant interaction with fetal sex (p-for-interaction = 0.037): among women carrying male fetuses, high cortisol at baseline increased the risk of preterm delivery threefold (3.18 (1.51, 6.71)) while there was no association (1.17 (0.50, 2.74)) among women carrying female fetuses.
conclusionHigher maternal cortisol is associated with a shorter pregnancy duration and an increased risk of preterm delivery. Subgroup analysis by fetal sex revealed that this association is evident primarily among women carrying male fetuses. Future studies of cortisol and preterm delivery should include consideration of fetal sex as a potential effect modifier.
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