PATTERNS OF SALIVARY CORTISOL IN PREGNANT WOMEN AT RISK FOR PRETERM LABOR (TEENAGE PREGNANCY, MIDWIVES).
Contributors: University of California, San Francisco.
Published: 1996
Number of pages: 119
Subjects: Health Sciences, Obstetrics and Gynecology.; Biology, Animal Physiology.; Health Sciences, Nursing.
Description: To begin to describe the relationship between stress and pregnancy outcome, a basic question posed for this study was: what is the stress response pattern to pregnancy (as measured by salivary cortisol) of pregnant women at high risk and low risk for preterm labor? The purpose of this study was to describe the pattern(s) of salivary cortisol level during pregnancy of women at risk for preterm labor.

The Creasy risk scoring for preterm birth was used to categorize the women from a rural health clinic in the Philippines. SCL-90R was used to exclude women with depression. Of the Filipino 15 women, three rated high, four rated medium, and seven rated low risk for preterm birth. However, only nine (one high risk with history of preterm birth, two medium risk, and six low risk women) collected daily saliva samples for cortisol assay at least up to 28 weeks' gestation. Two of the high risk women had spontaneous abortions. Time-resolved fluorometric end point measurement (TR-FIA) was the method used for the cortisol assay.

This study showed that salivary cortisol (F) levels reflected the stress response of each pregnant woman as she went through her pregnancy experience. Autoregression graphs of salivary F levels from 15 to 29 weeks' gestation showed a flat fit trend with occasional salivary F levels reaching 95% upper confidence limit (UCL) for the low risk group. The high risk woman showed a decreasing trend with salivary F levels frequently reaching 95% UCL during this period. The teenager at medium risk also showed a decreasing trend with levels reaching 95% LCL and UCL from 15 to 22 weeks.

Autoregression analysis also showed no significant difference in any of the gestational periods when compared with 25 to 29 weeks' gestation in the low risk afebrile women. The high risk woman showed significant difference between the salivary F values from 20 to 24 weeks compared with 25 to 29 weeks' gestation. Missing data was a problem for the women who were unable to collect daily saliva samples. Autoregression analysis was, therefore, done on the salivary F of women who consistently collected daily saliva samples. The mean salivary F values for both the low risk (mean = 0.67-1.22, SD = 0.5-0.9) and high risk (mean = 2.99, SD = 2.52) are below the average normal salivary F mean of 5-6 nmol/liter during pregnancy. Further study with larger samples is warranted to establish the normal values for women from different population groups.
Notes: Source: Dissertation Abstracts International, Volume: 57-04, Section: B, page: 2490.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1996.

School code: 0034.