Use of hair cortisol as a biomarker for chronic stress in pregnancy

Abstract

Background Both chronic stress and depression, when left untreated during pregnancy, are associated with deleterious maternal and neonatal health effects. Depressed pregnant women have been shown to exhibit high levels of acute stress, via validated biological markers. No such biomarkers exist for chronic stress. Methods In this pilot study, we prospectively enrolled 50 women (25 pregnant/depressed, 25 pregnant/non-depressed), each of whom provided a scalp hair sample and completed two validated questionnaires to measure their levels of depression (CES-D) and chronic stress (PSS). Hair samples were analyzed for cortisol levels using ELISA and measurements were confirmed via HPLC. Results Chronic stress correlated strongly with depressive symptoms in all patients (rs=0.86, p<0.000001). In depressed patients, both PSS and CES-D scores were significantly negatively correlated with hair cortisol levels (rs=−0.40, p<0.05 and rs=−0.39, p<0.05 respectively). In contrast, PSS scores of non-depressed patients were significantly positively correlated with hair cortisol measurements (rs=0.36; p<0.05). Conclusions Stress and depression were highly correlated, suggesting that women who were depressed were also chronically stressed. However, women who were most depressed and most stressed appeared to have the lowest levels of hair cortisol, suggesting that different mechanisms modulate stress in depressed and non-depressed pregnant women. Clinical Pharmacology & Therapeutics (2005) 77, P69–P69; doi: 10.1016/j.clpt.2004.12.155