Urinary cortisol and depression in early pregnancy: role of adiposity and race
详细信息 查看全文
- 作者：John W Luiza ; Marcia J Gallaher ; Robert W Powers
- 关键词：Pregnancy ; Depression ; Obesity ; Cortisol ; Race
- 刊名：BMC Pregnancy and Childbirth
- 出版年：2015
- 出版时间：December 2015
- 年：2015
- 卷：15
- 期：1
- 全文大小：561 KB
- 参考文献：1. Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med. 2007;20(3):189-09. CrossRef
2. Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012-4. CrossRef
3. Cassidy-Bushrow AE, Peters RM, Johnson DA, Templin TN. Association of depressive symptoms with inflammatory biomarkers among pregnant African-American women. J Reprod Immunol. 2012;94(2):202-. CrossRef
4. Vianna P, Bauer ME, Dornfeld D, Chies JAB. Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids. Med Hypotheses. 2011;77(2):188-1. CrossRef
5. Evans LM, Myers MM, Monk C. Pregnant women’s cortisol is elevated with anxiety and depression - but only when comorbid. Arch Women Ment Health. 2008;11(3):239-8. CrossRef
6. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al. Harrison’s Principles of Internal Medicine. 17th ed. New York: McGraw-Hill Medical; 2008.
7. Liggins GC. The role of cortisol in preparing the fetus for birth. Reprod Fertil Dev. 1994;6(2):141-0. CrossRef
8. Ho JT, Lewis JG, O’Loughlin P, Bagley CJ, Romero R, Dekker GA, et al. Reduced maternal corticosteroid-binding globulin and cortisol levels in pre-eclampsia and gamete recipient pregnancies. Clin Endocrinol (Oxf). 2007;66(6):869-7. CrossRef
9. Sandman CA, Glynn L, Schetter CD, Wadhwa P, Garite T, Chicz-DeMet A, et al. Elevated maternal cortisol early in pregnancy predicts third trimester levels of placental corticotropin releasing hormone (CRH): priming the placental clock. Peptides. 2006;27(6):1457-3. CrossRef
10. Aufdenblatten M, Baumann M, Raio L, Dick B, Frey BM, Schneider H, et al. Prematurity is related to high placental cortisol in preeclampsia. Pediatr Res. 2009;65(2):198-02. CrossRef
11. Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119-8. CrossRef
12. Canady RB, Tiedje LB, Lauber C. Preconception care & pregnancy planning: voices of African American women. MCN Am J Matern Child Nurs. 2008;33(2):90-. CrossRef
13. Deverts DJ, Cohen S, DiLillo VG, Lewis CE, Kiefe C, Whooley M, et al. Depressive symptoms, race, and circulating C-reactive protein: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Psychosom Med. 2010;72(8):734-1. CrossRef
14. National Research Council (US). Panel on Race, Ethnicity, and Health in Later Life. In: Anderson NB, Bulatao RA, Cohen B, editors. Critical Perspectives on Racial and Ethnic Differences in Health in Late Life. Washington (DC): National Academies Press (US); 2004.
15. Egede LE. Race, ethnicity, culture, and disparities in health care. J Gen Intern Med. 2006;21(6):667-. CrossRef
16. Bergink V, Kooistra L, Lambregtse-van den Berg MP, Wijnen H, Bunevicius R, van Baar A, et al. Validation of the Edinburgh Depression Scale during pregnancy. J Psychosom Res. 2011;70(4):385-.
文摘
Background Depression before and during pregnancy is associated with adverse birth outcomes including low birth weight and preterm birth. Abnormal maternal cortisol has been hypothesized as one mediator between depression and adverse birth outcomes. The relationship between cortisol and depression in pregnancy is exhibited most strongly in the African American population, and most studies have focused either on circulating or placental levels of cortisol. The utility of urinary cortisol in early pregnancy related to depression and adiposity has not been investigated. Methods Twenty-five pregnant African American women identified by the Edinburgh Depression Scale as having depression were investigated and matched by body mass index (BMI), age, race, and infant birth weight centile to non-depressed subjects. Maternal urine and plasma cortisol in early pregnancy were quantified and investigated in relation to depression and adiposity. Results Morning urine cortisol levels tracked positively with plasma cortisol (r2--.25, p--.001). However, no differences were observed in either urinary or plasma cortisol between depressed and non-depressed pregnant women. Plasma cortisol was significantly negatively associated with several measures of maternal adiposity including percent body fat (r2-??0.10, p--.05), however this relationship was present only in the non-depressed women. In a post-hoc analysis, non-depressed non-obese women were found to have significantly higher cortisol levels compared to women with depression, obesity or both (p--.05). Conclusions Depressed pregnant women and non-depressed obese pregnant women evidence atypical cortisol levels compared to non-depressed non-obese pregnant women. Plasma cortisol in early pregnancy is negatively associated with measures of maternal adiposity. Atypical low circulating maternal cortisol among depressed (lean and obese) and non-depressed obese pregnant African American women may indicate hypothalamic-pituitary axis dysfunction in early pregnancy.