A longitudinal study of plasma and urinary cortisol in pregnancy and postpartum

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dc.contributor.authorJung, C.
dc.contributor.authorHo, J.
dc.contributor.authorTorpy, D.
dc.contributor.authorRogers, A.
dc.contributor.authorDoogue, M.
dc.contributor.authorLewis, J.
dc.contributor.authorCzajko, R.
dc.contributor.authorInder, W.
dc.date.issued2011
dc.description.abstractCONTEXT: There is a paucity of longitudinal data on plasma and urinary cortisol levels during pregnancy using modern assays. Furthermore, conflicting data exist as to the effect of the low-dose oral contraceptive pill (OCP) on cortisol. DESIGN, SUBJECTS, AND MEASUREMENTS: We conducted a prospective longitudinal study on morning plasma cortisol (total and free), corticosteroid-binding globulin (CBG), and 24-h urinary free cortisol (UFC) levels in 20 pregnant women during the first, second, and third trimesters and 2–3 months postpartum compared with 12 subjects on low-dose OCP and 15 nonpregnant subjects not taking the OCP (control group). RESULTS: A progressive rise in total plasma cortisol, CBG, and 24-h UFC was demonstrated during pregnancy, peaking during the third trimester (mean 3-fold rise compared with controls). Plasma free cortisol increased 1.6-fold by the third trimester. In the OCP group, total plasma cortisol and CBG were 2.9- and 2.6-fold elevated, respectively, whereas 24-h UFC and plasma free cortisol were not significantly different from controls. Compared with liquid chromatography-mass spectrometry, a commercial immunoassay underestimated mean total plasma cortisol concentrations by 30% during second and third trimesters and in OCP users and overestimated UFC levels by 30–35% during pregnancy. CONCLUSIONS: Our study demonstrated elevations in total plasma cortisol and CBG concentrations during pregnancy and with low-dose OCP use. Pregnancy was also associated with significant increases in plasma free cortisol and UFC, suggesting that the rise in total plasma cortisol is contributed to by up-regulation of the maternal hypothalamic-pituitary-adrenal axis in addition to elevated CBG.
dc.description.statementofresponsibilityCaroline Jung, Jui T. Ho, David J. Torpy, Anne Rogers, Matt Doogue, John G. Lewis, Raymond J. Czajko and Warrick J. Inder
dc.identifier.citationJournal of Clinical Endocrinology and Metabolism, 2011; 96(5):1533-1540
dc.identifier.doi10.1210/jc.2010-2395
dc.identifier.issn0021-972X
dc.identifier.issn0021-972X
dc.identifier.orcidTorpy, D. [0000-0002-5069-0981]
dc.identifier.urihttp://hdl.handle.net/2440/71450
dc.language.isoen
dc.publisherEndocrine Society
dc.rightsCopyright © 2011 by The Endocrine Society
dc.source.urihttps://doi.org/10.1210/jc.2010-2395
dc.subjectPituitary-Adrenal System
dc.subjectHypothalamo-Hypophyseal System
dc.subjectHumans
dc.subjectCortisone
dc.subjectHydrocortisone
dc.subjectContraceptives, Oral, Hormonal
dc.subjectTranscortin
dc.subjectBody Mass Index
dc.subjectImmunoassay
dc.subjectChromatography, High Pressure Liquid
dc.subjectLongitudinal Studies
dc.subjectProspective Studies
dc.subjectPostpartum Period
dc.subjectPregnancy
dc.subjectPregnancy Trimester, Third
dc.subjectAdult
dc.subjectFemale
dc.subjectTandem Mass Spectrometry
dc.titleA longitudinal study of plasma and urinary cortisol in pregnancy and postpartum
dc.typeJournal article
pubs.publication-statusPublished

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