Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery

Alicia K. Smith, Donald J Newport, Morgan P. Ashe, Patricia A. Brennan, Jamie L. Laprairie, Martha Calamaras, Charles Nemeroff, James C. Ritchie, Joseph F. Cubells, Zachary N. Stowe

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective Clinical and preclinical studies indicate that maternal stress during pregnancy may exert long-lasting adverse effects on offspring. This investigation sought to identify factors mediating the relationship between maternal and neonatal hypothalamic-pituitary-adrenal (HPA) axes in pregnant women with past or family psychiatric history. Patients Two hundred and five pairs of maternal and umbilical cord blood samples from a clinical population were collected at delivery. Measurements Maternal and neonatal HPA axis activity measures were plasma adrenocorticotrophic hormone (ACTH), total cortisol, free cortisol and cortisol-binding globulin concentrations. The effects of maternal race, age, body mass index, psychiatric diagnosis (DSM-IV), birth weight, delivery method and estimated gestational age (EGA) at delivery on both maternal and neonatal HPA axis measures were also examined. Incorporating these independent predictors as covariates where necessary, we evaluated whether neonatal HPA axis activity measures could be predicted by the same maternal measure using linear regression. Results Delivery method was associated with umbilical cord plasma ACTH and both total and free cord cortisol concentrations (T = 10·53-4·21; P < 0·0001-0·010). After accounting for method of delivery and EGA, we found that maternal plasma ACTH concentrations predicted 23·9% of the variance in foetal plasma ACTH concentrations (T = 6·76; P < 0·0001), and maternal free and total plasma cortisol concentrations predicted 39·8% and 32·3% of the variance in foetal plasma free and total cortisol concentrations (T = 5·37-6·90; P < 0·0001), respectively. Conclusion These data suggest that neonatal response is coupled with maternal HPA axis activity at delivery. Future investigations will scrutinize the potential long-term sequelae for the offspring.

Original languageEnglish
Pages (from-to)90-95
Number of pages6
JournalClinical Endocrinology
Volume75
Issue number1
DOIs
StatePublished - Jul 1 2011

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Mothers
Hydrocortisone
Adrenocorticotropic Hormone
Gestational Age
Umbilical Cord
Maternal Age
Fetal Blood
Birth Weight
Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry
Pregnant Women
Linear Models
Body Mass Index
Pregnancy
Population

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Smith, A. K., Newport, D. J., Ashe, M. P., Brennan, P. A., Laprairie, J. L., Calamaras, M., ... Stowe, Z. N. (2011). Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery. Clinical Endocrinology, 75(1), 90-95. https://doi.org/10.1111/j.1365-2265.2011.03998.x

Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery. / Smith, Alicia K.; Newport, Donald J; Ashe, Morgan P.; Brennan, Patricia A.; Laprairie, Jamie L.; Calamaras, Martha; Nemeroff, Charles; Ritchie, James C.; Cubells, Joseph F.; Stowe, Zachary N.

In: Clinical Endocrinology, Vol. 75, No. 1, 01.07.2011, p. 90-95.

Research output: Contribution to journalArticle

Smith, AK, Newport, DJ, Ashe, MP, Brennan, PA, Laprairie, JL, Calamaras, M, Nemeroff, C, Ritchie, JC, Cubells, JF & Stowe, ZN 2011, 'Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery', Clinical Endocrinology, vol. 75, no. 1, pp. 90-95. https://doi.org/10.1111/j.1365-2265.2011.03998.x
Smith, Alicia K. ; Newport, Donald J ; Ashe, Morgan P. ; Brennan, Patricia A. ; Laprairie, Jamie L. ; Calamaras, Martha ; Nemeroff, Charles ; Ritchie, James C. ; Cubells, Joseph F. ; Stowe, Zachary N. / Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery. In: Clinical Endocrinology. 2011 ; Vol. 75, No. 1. pp. 90-95.
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abstract = "Objective Clinical and preclinical studies indicate that maternal stress during pregnancy may exert long-lasting adverse effects on offspring. This investigation sought to identify factors mediating the relationship between maternal and neonatal hypothalamic-pituitary-adrenal (HPA) axes in pregnant women with past or family psychiatric history. Patients Two hundred and five pairs of maternal and umbilical cord blood samples from a clinical population were collected at delivery. Measurements Maternal and neonatal HPA axis activity measures were plasma adrenocorticotrophic hormone (ACTH), total cortisol, free cortisol and cortisol-binding globulin concentrations. The effects of maternal race, age, body mass index, psychiatric diagnosis (DSM-IV), birth weight, delivery method and estimated gestational age (EGA) at delivery on both maternal and neonatal HPA axis measures were also examined. Incorporating these independent predictors as covariates where necessary, we evaluated whether neonatal HPA axis activity measures could be predicted by the same maternal measure using linear regression. Results Delivery method was associated with umbilical cord plasma ACTH and both total and free cord cortisol concentrations (T = 10·53-4·21; P < 0·0001-0·010). After accounting for method of delivery and EGA, we found that maternal plasma ACTH concentrations predicted 23·9{\%} of the variance in foetal plasma ACTH concentrations (T = 6·76; P < 0·0001), and maternal free and total plasma cortisol concentrations predicted 39·8{\%} and 32·3{\%} of the variance in foetal plasma free and total cortisol concentrations (T = 5·37-6·90; P < 0·0001), respectively. Conclusion These data suggest that neonatal response is coupled with maternal HPA axis activity at delivery. Future investigations will scrutinize the potential long-term sequelae for the offspring.",
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AU - Newport, Donald J

AU - Ashe, Morgan P.

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AU - Laprairie, Jamie L.

AU - Calamaras, Martha

AU - Nemeroff, Charles

AU - Ritchie, James C.

AU - Cubells, Joseph F.

AU - Stowe, Zachary N.

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N2 - Objective Clinical and preclinical studies indicate that maternal stress during pregnancy may exert long-lasting adverse effects on offspring. This investigation sought to identify factors mediating the relationship between maternal and neonatal hypothalamic-pituitary-adrenal (HPA) axes in pregnant women with past or family psychiatric history. Patients Two hundred and five pairs of maternal and umbilical cord blood samples from a clinical population were collected at delivery. Measurements Maternal and neonatal HPA axis activity measures were plasma adrenocorticotrophic hormone (ACTH), total cortisol, free cortisol and cortisol-binding globulin concentrations. The effects of maternal race, age, body mass index, psychiatric diagnosis (DSM-IV), birth weight, delivery method and estimated gestational age (EGA) at delivery on both maternal and neonatal HPA axis measures were also examined. Incorporating these independent predictors as covariates where necessary, we evaluated whether neonatal HPA axis activity measures could be predicted by the same maternal measure using linear regression. Results Delivery method was associated with umbilical cord plasma ACTH and both total and free cord cortisol concentrations (T = 10·53-4·21; P < 0·0001-0·010). After accounting for method of delivery and EGA, we found that maternal plasma ACTH concentrations predicted 23·9% of the variance in foetal plasma ACTH concentrations (T = 6·76; P < 0·0001), and maternal free and total plasma cortisol concentrations predicted 39·8% and 32·3% of the variance in foetal plasma free and total cortisol concentrations (T = 5·37-6·90; P < 0·0001), respectively. Conclusion These data suggest that neonatal response is coupled with maternal HPA axis activity at delivery. Future investigations will scrutinize the potential long-term sequelae for the offspring.

AB - Objective Clinical and preclinical studies indicate that maternal stress during pregnancy may exert long-lasting adverse effects on offspring. This investigation sought to identify factors mediating the relationship between maternal and neonatal hypothalamic-pituitary-adrenal (HPA) axes in pregnant women with past or family psychiatric history. Patients Two hundred and five pairs of maternal and umbilical cord blood samples from a clinical population were collected at delivery. Measurements Maternal and neonatal HPA axis activity measures were plasma adrenocorticotrophic hormone (ACTH), total cortisol, free cortisol and cortisol-binding globulin concentrations. The effects of maternal race, age, body mass index, psychiatric diagnosis (DSM-IV), birth weight, delivery method and estimated gestational age (EGA) at delivery on both maternal and neonatal HPA axis measures were also examined. Incorporating these independent predictors as covariates where necessary, we evaluated whether neonatal HPA axis activity measures could be predicted by the same maternal measure using linear regression. Results Delivery method was associated with umbilical cord plasma ACTH and both total and free cord cortisol concentrations (T = 10·53-4·21; P < 0·0001-0·010). After accounting for method of delivery and EGA, we found that maternal plasma ACTH concentrations predicted 23·9% of the variance in foetal plasma ACTH concentrations (T = 6·76; P < 0·0001), and maternal free and total plasma cortisol concentrations predicted 39·8% and 32·3% of the variance in foetal plasma free and total cortisol concentrations (T = 5·37-6·90; P < 0·0001), respectively. Conclusion These data suggest that neonatal response is coupled with maternal HPA axis activity at delivery. Future investigations will scrutinize the potential long-term sequelae for the offspring.

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