Changes of serum cortisol during pregnancy and labor initiation: an onsite cross-sectional study

作者全名：Chai, Yujuan; Wang, Hairong; Tang, Daiyu; Wu, Yi; Sun, Zhonghao; Zeng, Yuping; Zhang, Binmao; Niu, Ben; Dong, Xiaojing

作者地址：[Chai, Yujuan; Sun, Zhonghao; Zeng, Yuping; Zhang, Binmao] Shenzhen Univ, Sch Med, Dept Biomed Engn, Shenzhen, Guangdong, Peoples R China; [Wang, Hairong] Shenzhen Univ, Greater Bay Area Int Inst Innovat, Shenzhen, Guangdong, Peoples R China; [Tang, Daiyu] Guizhou Prov Peoples Hosp, Dept Obstet & Gynecol, Guiyang, Guizhou, Peoples R China; [Wu, Yi; Dong, Xiaojing] Chongqing Med Univ, Dept Obstet & Gynecol, Affiliated Hosp 2, Chongqing, Peoples R China; [Niu, Ben] Shenzhen Univ, Dept Management, Shenzhen 518060, Guangdong, Peoples R China

通信作者：Dong, XJ (通讯作者)，Chongqing Med Univ, Dept Obstet & Gynecol, Affiliated Hosp 2, Chongqing, Peoples R China.

来源：FRONTIERS IN ENDOCRINOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001232780500001

JCR分区：Q2

影响因子：3.9

年份：2024

卷号：15

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：serum cortisol; threatened labor; labor initiation; point-of-care testing; diagnosis of labor

摘要：Background: Increased maternal cortisol secretion has been observed during pregnancy and labor. However, due to the limitations in diagnostic methods, the dynamic change of cortisol during the short period between threatened labor and labor is unknown. In this study, we aim to evaluate the changes in serum cortisol during late pregnancy and full-term labor initiation, verifying if cortisol could serve as a biomarker for the diagnosis of labor initiation from threatened labor. Methods: This cross-sectional onsite study involved 564 participants of 6 different gestational stages (C: Control; T1: Trimester 1; T3: Trimester 3; E: expectant; TL: threatened labor; L: labor), all patients in the E, TL, and L groups were at full term. The serum cortisol concentration was quantified with a point-of-care test (POCT), and the gestation, age, parity, and BMI of participants were documented. Morning serum cortisol was collected between 8:00 and 10:00 a.m., except for the TL and L group women who were tested upon arrival or during latent labor. With cortisol levels or all five variables, L was distinguished from TL using machine learning algorithms. Results: Significant elevation of cortisol concentration was observed between T1 and T3, or TL and L group (P< 0.001). Women belonging to the E and TL group showed similar gestation week and cortisol levels. Diagnosis of labor initiation using cortisol levels (cutoff = 21.46 mu g/dL) yielded sensitivity, specificity, and AUC of 86.50%, 88.60%, and 0.934. With additional variables, a higher specificity (89.29%) was achieved. The diagnostic accuracy of all methods ranged from 85.93% to 87.90%. Conclusion: Serum cortisol could serve as a potential biomarker for diagnosis of L form TL. The rapid onsite detection of serum cortisol with POCT could facilitate medical decision-making for admission and special treatments, either as an additional parameter or when other technical platforms are not available.

基金机构：Guangdong Young Innovative Talents Project [2022KQNCX067]; Guangdong Innovation Team "Intelligent Management and Interdisciplinary Innovation" [2021WCXTD002]; Shenzhen Overseas Talent Program [827-000511]; Guangdong province University Key Project [2022ZDZX2054]; Shenzhen Basic Research Project of Natural Science Foundation [JCYJ20230808105701004]; Medical-Engineering Interdisciplinary Research Foundation of Shenzhen University; Chongqing Natural Science Foundation [CSTC2019jcyj-msxmX0318]; Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University [13-003-003]; Program for Youth Innovation in Future Medicine of Chongqing Medical University [W0122]

基金资助正文：The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Guangdong Young Innovative Talents Project (2022KQNCX067); Guangdong Innovation Team "Intelligent Management and Interdisciplinary Innovation" (2021WCXTD002); Shenzhen Overseas Talent Program (827-000511); Guangdong province University Key Project (2022ZDZX2054); Shenzhen Basic Research Project of Natural Science Foundation (JCYJ20230808105701004), and Medical-Engineering Interdisciplinary Research Foundation of Shenzhen University; Chongqing Natural Science Foundation (CSTC2019jcyj-msxmX0318); Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University (13-003-003), and Program for Youth Innovation in Future Medicine of Chongqing Medical University (W0122).