Maternal hair cortisol concentrations and its association with increased insulin resistance in midpregnancy

Purpose: Stress and elevated maternal glycemia have negative effects on pregnancy. We evaluated the as-sociation of hair cortisol concentrations (HCC), a marker of chronic stress, with insulin resistance and ge-stational diabetes (GDM).Methods: In total, 527 women from Lima, Peru, provided a hair sample in the second trimester of their pregnancy to measure HCC using liquid chromatography-tandem mass spectrometry. Each 6 cm of hair captured HCC in early (T1=1-12 weeks) and midpregnancy (T2 = 13-24 weeks). GDM diagnosis was con-ducted in midpregnancy. Multivariable regression models adjusted for putative risk factorsincluding ma-ternal sociodemographic factors, diabetes history, and hair characteristics, were used to estimate the association of HCC with GDM and various glycemic traits.Results: GDM was diagnosed in 122 (23%) women. Mean HCC across pregnancy was T1 = 3.7 ( +/- 3.4) pg/mg and T2 = 4.8 ( +/- 3.4) pg/mg. HCC was associated with increased log-transformed units of fasting insulin (T1 = 0.15 [0.03, 0.27], T2 = 0.17 [0.04, 0.30]), homeostasis model assessment for insulin resistance (T1 = 0.14 [0.01, 0.26], T2 = 0.17 [0.03, 0.30]), and homeostasis model assessment for beta-cell function (T1 = 0.20 [0.05, 0.34], T2 = 0.20 [0.04, 0.36]), but not with GDM (T1 = 0.95 [0.63, 1.40], T2 = 1.11 [0.74, 1.67]).Conclusions: Elevated maternal HCC was associated with abnormal insulin homeostasis in pregnancy. Dysregulation of the hypothalamic-pituitary-adrenal axis, as reflected by high HCC, may also contribute to insulin resistance syndrome in pregnancy.(c) 2023 Elsevier Inc. All rights reserved.