BMC Psychiatry (Aug 2020)

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

  • Philippe Leff-Gelman,
  • Mónica Flores-Ramos,
  • Ariela Edith Ávila Carrasco,
  • Margarita López Martínez,
  • María Fernanda Sarabia Takashima,
  • Fausto Manuel Cruz Coronel,
  • Blanca Farfán Labonne,
  • José Antonio Zorrilla Dosal,
  • Paola Barriguete Chávez-Peón,
  • Saul Garza Morales,
  • Ignacio Camacho-Arroyo

DOI
https://doi.org/10.1186/s12888-020-02788-6
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 14

Abstract

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Abstract Background 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. Methods 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. Results 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). Conclusions Our data support that the cortisol/DHEA-S index is higher in pregnant women with high anxiety levels as compared with healthy pregnant women.

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