Abstract
During pregnancy, circulatory cortisol levels increase, remaining steady over the
second-third trimester. In contrast, profile of salivary cortisol during
pregnancy is debatable, more influenced by factors like time of sample
collection in the day. Circulatory DHEA-S decrease by at least 50% over
the second-third trimester of pregnancy. However, profile of salivary DHEA-S is
unclear. Objective was to determine changes in salivary cortisol and DHEA-S in
healthy pregnant women, compared to non-pregnant women during late morning-early
afternoon sampling to avoid fluctuations associated with other times. Pregnant
women in their second-third trimester prospectively (n=500) and
non-pregnant women (n=133) were enrolled in study with informed consent.
Live birth outcome with no pregnancy complications and≥2.5 Kg
infant birth weight were included. Concentrations of salivary cortisol and
DHEA-S were determined through ELISA assays. Compared to non-pregnant women,
pregnant women demonstrated significant increases in salivary cortisol [median
(interquartile range)=4.2 (5.1) nmol/l vs. 17.2 (13.9)
nmol/l, p<0.001] and salivary DHEA-S median (interquartile
range)=2.7 (2.9) nmol/l vs. 3.8 (3.2) nmol/l,
p<0.001). Consistently, quartile scores representing higher levels of
salivary cortisol and DHEA-S concentrations demonstrated significant association
with pregnancy. Quartile scores representing higher salivary
cortisol/DHEA-S ratio demonstrated significant association with
pregnancy. Study suggests the indicated time range of saliva sampling might best
parallel the established profile of circulatory cortisol in pregnant women.
However, unlike cortisol, study indicates that the salivary DHEA-S profile is
distinct from the well-known profile of circulatory DHEA-S during pregnancy. A
combinatorial approach involving both salivary and circulatory compartments
could provide comprehensive picture of DHEA-S and hypothalamus-pituitary-adrenal
axis during pregnancy.
Key words
cortisol - DHEA-S - saliva - pregnancy
