Cortisol and DHEA-S levels in pregnant women with severe anxiety

• Published in: BMC psychiatry Vol. 20; no. 1; pp. 393 - 14
• Main Authors: Leff-Gelman, Philippe, Flores-Ramos, Mónica, Carrasco, Ariela Edith Ávila, Martínez, Margarita López, Takashima, María Fernanda Sarabia, Coronel, Fausto Manuel Cruz, Labonne, Blanca Farfán, Dosal, José Antonio Zorrilla, Chávez-Peón, Paola Barriguete, Morales, Saul Garza, Camacho-Arroyo, Ignacio
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05.08.2020; BioMed Central; BMC
• Subjects: Anxiety; Anxiety Disorders; Birth weight; Cortisol; Cortisol/DHEA-S ratio; Dehydroepiandrosterone; Enzymes; Female; Glucocorticoids; Hormones; Humans; Hydrocortisone; Laws, regulations and rules; Mental depression; Physiology; Placenta; Postpartum period; Pregnancy; Pregnant Women; Premature birth; Serum levels; Sex hormones; Steroids; Stress; Stress (Psychology); Women's health; Womens health; Mexico; Pregnancy; Serum levels; Cortisol/DHEA-S ratio; Anxiety; Cortisol; Steroids
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-020-02788-6

A complex interaction between cortisol and dehydroepiandrosterone-sulphate (DHEA-S) is crucial in the stress system balance; several studies have reported increased cortisol levels during chronic stress and a weak counter-regulation by DHEA-S. During pregnancy, scarce information about this system is available, although cortisol and DHEA-S play an important role in the initiation and acceleration of labor. We conducted the present study in order to determine both cortisol and DHEA-S levels during the last trimester of pregnancy in patients exhibiting severe anxiety. Pregnant women during the 3rd trimester of pregnancy were evaluated by using the self-reported version of the Hamilton Anxiety Rating Scale (HARS). According to the scores obtained from the psychometric scale, participants were divided into two groups: 1) patients exhibiting a cutoff score > 15 were considered with severe anxiety (ANX) (n = 101), and control pregnant subjects (CTRL) (n = 44) with a cutoff score < 5. Morning cortisol, DHEA-S and Cortisol/DHEA-S index were measured in all participants. Comparisons between groups were performed; additionally, correlations between clinical variables, biochemical data and HARS were calculated. Cortisol levels were significantly higher in the ANX group (p < 0.001), whereas those of DHEA-S were significantly lower in the same group (p < 0.01) when compared to healthy pregnant subjects. An increased cortisol/DHEA-S index was observed in the ANX group (p < 0.05). A significant association between cortisol and HARS scores (p = 0.03), was observed even after adjusting by gestational weeks (p = 0.004). Our data support that the cortisol/DHEA-S index is higher in pregnant women with high anxiety levels as compared with healthy pregnant women.