Elevated maternal cortisol early in pregnancy predicts third trimester levels of placental corticotropin releasing hormone (CRH): Priming the placental clock

Abstract

The purposes of this study were to determine the intervals when placental corticotrophic-releasing hormone (CRH) was most responsive to maternal cortisol. A sample of 203 women each were evaluated at 15, 19, 25 and 31 weeks gestation and followed to term. Placental CRH and maternal adrenocorticotropin hormone (ACTH), B-endorphin and cortisol were determined from plasma. CRH levels increased faster and were higher in women who delivered preterm compared with women who delivered at term (F3,603 = 5.73, p < .001). Simple effects indicated that CRH levels only at 31 weeks predicted preterm birth (F1,201 = 5.53, p = .02). Levels of cortisol were higher in women who delivered preterm at 15 weeks gestation (F1,201 = 4.45, p = .03) with a similar trend at 19 weeks gestation. Hierarchical regression suggested that the influence on birth outcome of maternal cortisol early in pregnancy was mediated by its influence on placental CRH at 31 weeks. Elevated cortisol at 15 weeks predicted the surge in placental CRH at 31 weeks (R = .49, d.f. = 1,199, Fchange = 61.78, p < .0001). Every unit of change in cortisol (microg/dl) at 15 weeks was associated with a 34 unit change of CRH (pg/ml) at 31 weeks. These findings suggested that early detection of stress signals by the placenta stimulated the subsequent release of CRH and resulted in increased risk for preterm delivery.

The influence of meteorological factors on the emergence of preterm delivery and preterm premature rupture of membrane

“…19,20 Moreover, corticotropin-releasing hormone has been proposed as the placental clock and patients with elevated corticotropinreleasing hormone concentrations (that may results from any stress including environmental) delivered preterm. 20 Although the influence of temperature and humidity on birth complications is expected, [21][22][23] this effect becomes smoother with improved housing conditions and indoor occupation. Generally, although cooling and heating apparatus reduce the impact of external weather conditions, a significant increase in health disorders for heat waves or extremely cold days was documented.…”

Timing of fetal exposure to stress hormones: Effects on newborn physical and neuromuscular maturation

“…In addition, the timing of exposure to stress hormones during pregnancy may be critical in determining the length of gestation. Specifically, recent evidence suggests that elevated maternal cortisol at 15 weeks' gestation led to a surge of placental CRH at 31 weeks' gestation, which, in turn, was associated with preterm delivery (Sandman et al, 2006). These data suggest that a stress-related signal early in pregnancy could prepare the placenta to activate labor-inducing signaling mechanisms later in gestation.…”

“…Stress hormones also have been consistently associated with preterm delivery and shorter gestational periods (Hobel et al, 1999;Mancuso, Schetter, Rini, Roesch, & Hobel, 2004;Mullings et al, 2001;Sandman et al, 2006;Sandman et al, 1994;Wadhwa, Sandman, Porto, Dunkel-Schetter, & Garite, 1993). In addition, the timing of exposure to stress hormones during pregnancy may be critical in determining the length of gestation.…”

Association between maternal antenatal depression and infant development: a hospital-based prospective cohort study

“…The influence of antenatal depression on gestational age may be explained by a potential biological pathway. According to recent studies, cortisol increases the release of a placental corticotropin-releasing hormone (CRH) [39,40], which plays a key role in triggering parturition [40][41][42][43]. Antenatal depression is related to a greater incidence of premature delivery and to elevated antenatal cortisol levels compared to non-depressed women [38].…”

“…Antenatal depression is related to a greater incidence of premature delivery and to elevated antenatal cortisol levels compared to non-depressed women [38]. Higher levels of cortisol and CRH have also been detected in women who delivered preterm infants compared with those who delivered at term [40]. In our study, it was not possible to analyse the relation between preterm birth and maternal depression during pregnancy due to only five women (3.2 %) in our cohort giving birth to preterm infants.…”