Comparative profiling of prenatal cortisol and DHEA‐S among pregnant women with poor birth outcome and pregnant women with normal birth outcome.

Context: Cortisol and dehydroepiandrosterone‐sulfate (DHEA‐S) are indispensable hormones for normal pregnancy. It is unclear if these hormones, specifically DHEA‐S can offer value for predicting poor birth outcome. Objective: To compare prenatal cortisol and DHEA‐S levels among pregnant women with normal or poor birth outcome. Methods: Plasma and saliva were collected prospectively from women in second‐third trimester of pregnancy. Women with normal birth outcome (NBO) (n = 501) included live birth, no pregnancy complications and ≥2.5 kg infant birth weight. Women with poor birth outcome included adverse birth outcome (ABO) (n = 50) or low birth weight outcome (LBW) (n = 147). Enzyme‐linked immunosorbent assay was performed to measure hormone concentrations in plasma and saliva. Results: Circulatory‐DHEA‐S levels in pregnant women with ABO were higher than women with NBO (p =.043). Among ABO, only stillbirth cases demonstrated significant increase in circulatory‐DHEA‐S levels (p =.006). Circulatory and salivary cortisol/DHEA‐S ratio was lower among women with stillbirth (p =.004) and ABO outcome (p =.043) respectively compared with women with NBO. Consistently, increased odds of ABO were observed in pregnant women with highest circulatory‐DHEA‐S levels (odds ratio quartile score 1 vs. 4, 2.79, p =.027) and lowest salivary cortisol/DHEA‐S ratio (score 4 vs. 2, 2.83, p =.025). Increased odds of stillbirth outcome were observed in pregnant women with highest circulatory‐DHEA‐S levels (odds ratio quartile score 1 vs. 4, 8.47, p =.046) and lowest circulatory cortisol/DHEA‐S ratio (score 4 vs. 1, 4.803, p =.048). Associations remained significant after adjusting for confounders. Women with LBW did not demonstrate significant changes in cortisol or DHEA‐S levels. Conclusion: Prenatal measurement of DHEA‐S or cortisol/DHEA‐S ratio may offer significant value for predicting adverse birth, specifically stillbirth outcome. [ABSTRACT FROM AUTHOR]