Elevated maternal cortisol leads to relative maternal hyperglycemia and increased stillbirth in ovine pregnancy

Keller‐Wood, Maureen; Feng, Xiaodi; Wood, Charles E.; Richards, Elaine M.; Anthony, Russell V.; Dahl, Geoffrey E.; Tao, Sha

doi:10.1152/ajpregu.00530.2013

Cited by 48 publications

(68 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2014). Continuous maternal cortisol infusion resulted in chronically elevated maternal glucose and insulin concentrations, and slowed glucose disappearance after administration of a glucose bolus intravenously.…”

Section: Discussionmentioning

confidence: 99%

“…2008), although longer term infusion until birth did not significantly increase wall thickness later in gestation (Keller-Wood et al. 2014). Higher doses of glucocorticoids increase fetal blood pressure, resulting in hypertrophy of the left ventricle (Tangalakis et al.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, we had found that chronic continuous infusion of cortisol to the ewe not only resulted in chronic increase in maternal glucose, but also resulted in an increased incidence of peripartum fetal death (Keller-Wood et al. 2014). Therefore, a model using 12 h of cortisol infusion, producing half the daily total dose, but similar increase in nighttime plasma cortisol concentrations, was used in the present study.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Increased maternal nighttime cortisol concentrations in late gestation alter glucose and insulin in the neonatal lamb

et al. 2015

Self Cite

View full text Add to dashboard Cite

Previous studies in our laboratory have shown that a modest chronic increase in maternal cortisol concentrations impairs maternal glucose metabolism and increases the incidence of perinatal stillbirth. The dramatic outcomes prevented our ability to study the effects of maternal hypercortisolemia on neonatal growth, glucose metabolism, and hypothalamo–pituitary–adrenal axis response. Therefore, we developed a model in which pregnant ewes are infused for 12 h/day at 0.5 mg·kg–1·day–1 from day 115 of gestation until delivery (˜145), elevating nighttime plasma cortisol concentrations. This pattern of elevation of cortisol mimics that in patients with elevated evening cortisol concentrations, as in Cushing’s syndrome or chronic depression. Plasma cortisol, glucose, insulin, and electrolytes were measured during pregnancy and postpartum in control and cortisol-infused ewes and their postnatal lambs for the first 14 days after delivery. Neonatal growth and plasma ACTH, aldosterone, renin activity, and electrolytes, and organ weights at 14 days of age were also measured. Infusion of cortisol increased maternal plasma cortisol during pregnancy but not postpartum, and did not alter neonatal ACTH or cortisol. Although maternal glucose and insulin concentrations were not changed by the maternal infusion of cortisol, neonatal plasma glucose was increased and plasma insulin was decreased compared to those in the control group. Neonatal ponderal index and kidney weight were reduced, left ventricular wall thickness was increased, and plasma sodium and creatinine were increased after maternal cortisol infusion. These results suggest that excess maternal cortisol concentrations in late gestation alter growth, glucose and insulin regulation, and organ maturation in the neonate.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Increased maternal nighttime cortisol concentrations in late gestation alter glucose and insulin in the neonatal lamb

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Past studies suggest that elevated cortisol in pregnancy may place women at increased risk for health problems during pregnancy including pre-eclampsia, gestational diabetes, and increased weight gain (Damjanovic et al, 2009; Keller-Wood et al, 2014; Redman & Sacks, 1999). Women may also be at elevated risk for disorders in the postpartum period such as thyroiditis and rheumatoid arthritis (Elenkov et al, 2001; Mastorakos & Ilias, 2000) and postpartum mood disorders (Mastorakos & Ilias, 2000; A Nierop, Bratsikas, Zimmerman, & Ehlert, 2006).…”

Section: Discussionmentioning

confidence: 99%

The effects of childhood sexual abuse on cortisol trajectories in pregnancy are moderated by current family functioning

Bublitz

Parade

Stroud

2014

Biological Psychology

View full text Add to dashboard Cite

The goal of this study was to understand the roles of maternal history of childhood sexual abuse (CSA) and current family functioning on the cortisol awakening response (CAR) in pregnancy. Participants were 185 pregnant women (ages 18–40) who completed items from the Adverse Childhood Experiences scale to measure child maltreatment history and the Family Assessment Device to measure current family functioning. Participants provided saliva samples at wake-up and 30 minutes after wake-up at 25, 29, and 35 weeks gestation to measure CAR. A moderation effect was found such that participants with more severe CSA histories and poorer perceived family functioning had increasing CAR in pregnancy compared to participants with less severe CSA histories and better family functioning. These findings highlight the importance of considering stress in both childhood and current environments in predicting maternal cortisol in pregnancy.

show abstract

“…, ; Keller‐Wood et al . ). In part, these changes may relate to alterations in uteroplacental metabolism and, hence, fetal nutrition.…”

Section: Introductionmentioning

confidence: 97%

A physiological increase in maternal cortisol alters uteroplacental metabolism in the pregnant ewe

Vaughan

Davies

Ward

et al. 2016

The Journal of Physiology

View full text Add to dashboard Cite

Key points Fetal nutrient supply is dependent, in part, upon the transport capacity and metabolism of the placenta.The stress hormone, cortisol, alters metabolism in the adult and fetus but it is not known whether cortisol in the pregnant mother affects metabolism of the placenta.In this study, when cortisol concentrations were raised in pregnant sheep by infusion, proportionately more of the glucose taken up by the uterus was consumed by the uteroplacental tissues while less was transferred to the fetus, despite an increased placental glucose transport capacity. Concomitantly, the uteroplacental tissues produced lactate at a greater rate.The results show that maternal cortisol concentrations regulate uteroplacental glycolytic metabolism, producing lactate for use in utero.Prolonged increases in placental lactate production induced by cortisol overexposure may contribute to the adverse effects of maternal stress on fetal wellbeing. AbstractFetal nutrition is determined by maternal availability, placental transport and uteroplacental metabolism of carbohydrates. Cortisol affects maternal and fetal metabolism, but whether maternal cortisol concentrations within the physiological range regulate uteroplacental carbohydrate metabolism remains unknown. This study determined the effect of maternal cortisol infusion (1.2 mg kg−1 day−1 i.v. for 5 days, n = 20) on fetal glucose, lactate and oxygen supplies in pregnant ewes on day ∼130 of pregnancy (term = 145 days). Compared to saline infusion (n = 21), cortisol infusion increased maternal, but not fetal, plasma cortisol (P < 0.05). Cortisol infusion also raised maternal insulin, glucose and lactate concentrations, and blood pH, PnormalCO2 and HCO3 − concentration. Although total uterine glucose uptake determined by Fick's principle was unaffected, a greater proportion was consumed by the uteroplacental tissues, so net fetal glucose uptake was 29% lower in cortisol‐infused than control ewes (P < 0.05). Concomitantly, uteroplacental lactate production was > 2‐fold greater in cortisol‐ than saline‐treated ewes (P < 0.05), although uteroplacental O2 consumption was unaffected by maternal treatment. Materno‐fetal clearance of non‐metabolizable [3H]methyl‐d‐glucose and placental SLC2A8 (glucose transporter 8) gene expression were also greater with cortisol treatment. Fetal plasma glucose, lactate or α‐amino nitrogen concentrations were unaffected by treatment although fetal plasma fructose and hepatic lactate dehydrogenase activity were greater in cortisol‐ than saline‐treated ewes (P < 0.05). Fetal plasma insulin levels and body weight were also unaffected by maternal treatment. During stress, cortisol‐dependent regulation of uteroplacental glycolysis may allow increased maternal control over fetal nutrition and metabolism. However, when maternal cortisol concentrations are raised chronically, prolonged elevation of uteroplacental lactate production may compromise fetal wellbeing.

show abstract

Elevated maternal cortisol leads to relative maternal hyperglycemia and increased stillbirth in ovine pregnancy

Cited by 48 publications

References 38 publications

Increased maternal nighttime cortisol concentrations in late gestation alter glucose and insulin in the neonatal lamb

Increased maternal nighttime cortisol concentrations in late gestation alter glucose and insulin in the neonatal lamb

The effects of childhood sexual abuse on cortisol trajectories in pregnancy are moderated by current family functioning

A physiological increase in maternal cortisol alters uteroplacental metabolism in the pregnant ewe

Contact Info

Product

Resources

About