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BMC Pregnancy and Childbirth

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Open Access 01-12-2016 | Research article

Hair cortisol as a hypothalamic-pituitary-adrenal axis biomarker in pregnant women with asthma: a retrospective observational study

Authors: Laura Smy, Kaitlyn Shaw, Ursula Amstutz, Anne Smith, Howard Berger, Bruce Carleton, Gideon Koren

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Abstract

Background

Cortisol is a hormone involved in many physiological functions including fetal maturation and epigenetic programming during pregnancy. This study aimed to use hair cortisol as a biomarker of chronic inhaled corticosteroid (ICS) exposure and assess the potential effects of asthma on the hypothalamic-pituitary-adrenal (HPA) axis in pregnant women. We hypothesized that pregnant women with asthma treated with ICS would exhibit lower hair cortisol concentrations, indicative of adrenal suppression, compared to women with asthma not using ICS and women who do not have asthma.

Methods

We performed an observational retrospective cohort study. Hair samples were analyzed from pregnant women with asthma, with (n = 56) and without (n = 31) ICS treatment, and pregnant women without asthma (n = 31). Hair samples were segmented based on the growth rate of 1 cm/month and analyzed by enzyme immunoassay to provide cortisol concentrations corresponding to preconception, trimesters 1–3, and postpartum. Hair cortisol concentrations were compared within and among the groups using non-parametric statistical tests.

Results

Hair cortisol concentrations increased across trimesters for all three groups, but this increase was dampened in women with asthma (P = 0.03 for Controls vs. ICS Treated and Controls vs. No ICS). ICS Treated women taking more than five doses per week had hair cortisol concentrations 47 % lower in third trimester than Controls. Linear regression of the third trimester hair cortisol results identified asthma as a significant factor when comparing consistent ICS use or asthma as the predictor (F_{(1, 25)} = 9.7, P = 0.005, R² _adj = 0.257).

Conclusions

Hair cortisol successfully showed the expected change in cortisol over the course of pregnancy and may be a useful biomarker of HPA axis function in pregnant women with asthma. The potential impact of decreased maternal cortisol in women with asthma on perinatal outcomes remains to be determined.

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Title: Hair cortisol as a hypothalamic-pituitary-adrenal axis biomarker in pregnant women with asthma: a retrospective observational study
Authors: Laura Smy
Kaitlyn Shaw
Ursula Amstutz
Anne Smith
Howard Berger
Bruce Carleton
Gideon Koren
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-016-0962-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Hair cortisol as a hypothalamic-pituitary-adrenal axis biomarker in pregnant women with asthma: a retrospective observational study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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