Pregnancy: low cortisol/cortisone ratio predicts preeclampsia

  • Jayasuriya NA & al.
  • J Clin Endocrinol Metab
  • 15 Feb 2019

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • A low ratio of maternal cortisol to cortisone is associated with preeclampsia and preterm fetal growth restriction (FGR) during pregnancy.

Why this matters

  • Predictive factors can help guide patient management.

Key results

  • At 28 weeks of gestational age, the cortisol/cortisone ratio was negatively associated with preterm preeclampsia (OR, 0.34; P<.001 term preeclampsia and preterm fgr in adjusted analysis. style="list-style-type:circle;">
  • The negative association with preeclampsia was also observed in women who did not receive steroids antenatally (OR, 0.10 [P<.05 for preterm preeclampsia or term>
  • At 36 weeks of gestational age, the cortisol/cortisone ratio was negatively associated with term preeclampsia (OR, 0.42; P<.001 but not term fgr>.05), in adjusted analysis.
    • The negative associated with term preeclampsia was also observed in women who did not receive steroids antenatally (OR, 0.41; P<.001>
  • Study design

    • 658 pregnant women, 194 with preeclampsia, 185 with FGR, and 279 healthy control patients, were analyzed for maternal serum cortisol to cortisone ratio.
    • Funding: National Institute for Health Research; Cambridge Comprehensive Biomedical Research Centre; Medical Research Council; GE Healthcare.

    Limitations

    • Circadian rhythms and some other external factors not accounted for.

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