High Maternal Cortisol Serum Levels as A Risk Factor for Preterm Labor

Abstract

Preterm delivery is the leading cause of death for children under 5 years of age worldwide. Preterm delivery is one of the significant factors causing neonatal death due to complications associated with preterm birth. Complications of preterm delivery account for about 16% of all deaths in children under 5 years, and 35% of total deaths of newborns. There are several broad outlines of factors associated with preterm labor, including stress, inflammation or infection, overdistention of the uterus and the hypothalamic-pituitary-adrenal axis. Several studies show the role of cortisol caused by these factors. This study aimed to assess the relationship of maternal serum cortisol levels with the risk of preterm delivery. This study used a case-control design conducted at Sanglah Hospital, Denpasar from May to August 2021. A sample of 50 women was obtained which was divided into case groups and control groups. Serum cortisol examination used a 3 mL blood sample which was then examined using the ELISA method at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. The results were analyzed using the chi square test. There was no significant difference in the characteristics of the two groups. There was a significant relationship between high serum cortisol levels and the incidence of preterm labor in pregnant women (p < 0.001; 95% CI; 2.768-38.22; OR 10.29). High cortisol serum levels can increase the risk of preterm labor 10 times in pregnant women when compared to pregnant women with low cortisol blood serum levels.