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HPA axis activity increased in adolescent offspring of mothers with preeclampsia
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Adolescent offspring of mothers with preeclampsia have increased hypothalamic–pituitary–adrenal axis activity that results in mild hypercortisolism, according to study findings published in Clinical Endocrinology.
“We hypothesized that low maternal cortisol levels may influence fetal [hypothalamic–pituitary–adrenal] programming, which may alter the disease patterns later in life,” the researchers wrote. “Specifically, that the [hypothalamic–pituitary–adrenal] axis of offspring of mother with [preeclampsia] will be upregulated.”
David Henley, MBBS, FRACP, PhD, of the department of endocrinology and diabetes at Sir Charles Gairdner Hospital in Australia, and colleagues evaluated data from the Western Australian Pregnancy Cohort study on 707 adolescents (mean age, 17.1 years) to determine the effect of reduced maternal total and free cortisol concentrations during preeclampsia and gestational hypertension on offspring’s hypothalamic–pituitary–adrenal (HPA) axis function.
Participants provided fasting morning blood samples for basal HPA axis and concomitant clinical assessments. Blood samples collected at home before 10 a.m. were used to calculate plasma adrenocorticotropic hormone (ACTH), total cortisol, corticosteroid-binding globulin and free cortisol. Participants were divided into groups based on their mothers’ hypertensive disorders: controls (n = 528), gestational hypertension (n = 136), pre-existing hypertension (n = 26) and preeclampsia (n = 17).
Compared with controls, the preeclampsia group had higher total plasma cortisol (P = .024), calculated free cortisol (P = .052) and ACTH (P = .04), and the pre-existing hypertension group had lower ACTH/plasma free cortisol ratio (P = .02) and corticosteroid-binding globulin (P = .004). Within the pre-existing hypertension group, boys had lower ACTH (P = .047) and ACTH/plasma free cortisol ratio (P = .05) and girls had lower corticosteroid-binding globulin (P = .006) compared with controls.
Compared with controls, the gestational hypertension (P = .01), combined gestational hypertension and preeclampsia group (P = .006) and pre-existing hypertension group (P = .005) had higher systolic blood pressure.
“ACTH and cortisol levels were significantly elevated in 17-year-old offspring of mothers with [preeclampsia], perhaps in response to the low maternal transplacental cortisol exposure in fetal life,” the researchers wrote. “This reflects a further example of changes in offspring HPA axis activity associated with an altered glucocorticoid exposure in utero, persisting into adult life. Elevated [BP] may represent a clinical effect of elevated cortisol section and in the longer term, other metabolic syndrome and neuropsychiatric manifestations may ensue.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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