The relation of psychological distress to salivary and serum cortisol levels in pregnant women shortly after the diagnosis of a structural fetal anomaly.

摘要

OBJECTIVE: To examine the association between psychological distress and levels of salivary cortisol (SalC) and the ratio of serum cortisol to cortisol-binding globulin (SC/CBG) in pregnant women shortly after the diagnosis of a structural fetal anomaly. DESIGN. A prospective, observational study. SETTING: Tertiary referral center for fetal medicine. POPULATION: Pregnant women with (study group, n=126) and without a fetal structural anomaly (comparison group, n=106) were included. Gestational age (GA) was >12weeks. METHODS: Psychological distress was assessed by Impact of Event Scale (IES-22), General Health Questionnaire (GHQ-28) and Edinburgh Postnatal Depression Scale (EPDS). Salivary cortisol was measured in the evening and SC/CBG in the morning. MAIN OUTCOME MEASURES. Levels of SalC (in nanomoles per liter) and SC/CBG. RESULTS: Median (range) GA at assessment was 19 (12-38) and 19 (13-22)weeks in the study and the comparison group, respectively. The study group had significantly higher psychological distress levels (p