Maternal cortisol linked to birth complications


A study revealed a correlation between maternal cortisol levels, stress, and adverse birth outcomes, shedding light on potential implications for perinatal health.

Maternal cortisol linked to birth complications | Image Credit: © Rido - © Rido -

Maternal cortisol linked to birth complications | Image Credit: © Rido - © Rido -

Maternal cortisol levels may be associated with adverse birth outcomes, according to a recent study published in Psychoneuroendocrinology.1


  1. The study suggests a potential association between high maternal cortisol levels and unpredicted birth complications (UBCs).
  2. Cortisol, a hormone associated with stress, undergoes a natural increase during pregnancy. Prolonged exposure to elevated cortisol levels is linked to adverse health outcomes such as diabetes and high blood pressure.
  3. Participants with UBCs reported significantly higher levels of stress, anxiety, and depression (SAD) scores during the third trimester and 2 months post-birth. However, these scores declined by 6 months post-birth.
  4. Hair cortisol concentration (HCC), measured during the third trimester and 6 months post-birth, showed a positive association with SAD scores. Patients with UBCs had higher average HCC levels, indicating a potential link between elevated cortisol and UBC risk.
  5. The association between HCC, SAD scores, and UBC risk decreased by 6 months postpartum, suggesting that the impact of psychological distress and cortisol levels on birth outcomes might diminish over time.

Cortisol is a stress regulating hormone with associated adverse health outcomes for prolonged exposure including diabetes and high blood pressure. A 2-fold to 4-fold rise in cortisol levels occurs naturally during pregnancy, and since perinatal well-being and stress may impact birth outcomes,2 investigators conducted a study to evaluate this association.

There were 53 patients aged a mean 31.1 years included in the analysis. Participants responded to surveys with information about perceived stress, state anxiety, and depression. These surveys were completed during the third trimester and at 2- and 6-months following birth.

Unpredicted birth complications (UBCs) were reported in 24.5% of participants. Composite stress, anxiety, and depression (SAD) scores were significantly increased among patients with UBCs 2 months after birth, though a decline was observed by 6 months.

Cortisol was measured using hair cortisol concentration (HCC), collected during the third trimester and 6 months after birth. A positive association was reported between HCC and SAD scores, and patients with UBCs on average had increased HCC. In logistic regression, HCC was associated with UBCs but SAD scores were not.

The association between HCC and SAD scores and the impact of UBCs had decreased in patients 6 months postpartum. This indicates psychological distress and HCC are associated during pregnancy and 2 months postpartum, with increased cortisol linked to UBC risk during pregnancy and early postpartum.

“There was otherwise nothing about these women that would suggest a disease or anything else complicating the pregnancy,” said Erica Crespi, corresponding author of the study and WSU developmental biologist.1 “This confirmed some hypotheses that levels of stress, related specifically to cortisol levels, might be associated with adverse birth outcomes.”


  1. Potential link between high maternal cortisol, unpredicted birth complications. EurekAlert. January 31, 2024. Accessed February 6, 2024.
  2. Madigan JA, Waters SF, Gartstein MA, Mattera JA, Connolly CP, Crespi EJ. Perinatal hair cortisol concentrations linked to psychological distress and unpredicted birth complications. Psychoneuroendocrinology. 2024;161. doi:10.1016/j.psyneuen.2023.106921
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