Main Article Content

Authors

Objective: To determine the usefulness of salivary cortisol as a predictor of preeclampsia in adolescents.
Methods: We carried out a nested case- control study. Somatometric, clinical, and biochemical data were obtained from 100 healthy pregnant adolescents and salivary cortisol was measured at 8:00, 12:00, and 20:00 hours on two
occasions during pregnancy, before 20 weeks, and after 30 weeks of gestation. The cortisol values between the group of healthy pregnant women and the group that developed preeclampsia were compared by using the Student’s t, Mann-Whitney, and Wilcoxon tests. Also, the ROC curve of cortisol values and the Positive and Negative Predictive values of cortisol were estimated.
Results: Values >14.9 nmol/L of cortisol were observed in the group that developed preeclampsia, providing a positive predictive value of 1 (100%). Values <10.1 nmol/L were observed in the control group, the negative
predictive value was 1 (100%). The cutoff point of the ROC curve -before 20 weeks of gestation- in the members of the cohort was 13.9 nmol/L.
Conclusions: The salivary cortisol values observed in the two evaluations made to each of the groups showed statistically significant differences between the groups at 8 and 12 hours of the day. The values obtained enable establishing gradients that allow separating the group of healthy women that got ill with preeclampsia from the group that did not develop the illness before week 20. After week 30, the cortisol gradients are established more clearly in the group with preeclampsia and in the control group. The validation of these findings in larger samples would allow
implementing this procedure as a screening test for preeclampsia in groups of pregnant adolescents.
Salvador-Moysén, J., Ramírez-Aranda, J. M., Martínez-López, Y., & Aguilar-Durán, M. (2012). Salivary cortisol levels as a predictor of preeclampsia in adolescents. Colombia Medica, 43(1), 46–53. https://doi.org/10.25100/cm.v43i1.1058

Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005; 365: 785-99.

Rudra C, Williams M. Monthly variation in preeclampsia prevalence: Washington State, 1987-2001. J Matern Fetal Neonatal Med. 2005; 18: 319-24.

World Health Organization. Maternal mortality in 1995. Estimates developed by WHO, UNICEF and UNFPA. WHO/ RHR/01.9. Geneve: World Health Organization, Department of Reproductive Health and Research; 2001.

Roberts J, Cooper D. Pathogenesis and genesis and genetics of preeclampsia. Lancet. 2001; 357: 53-6.

Luft F. Pieces of the preeclampsia puzzle. Nephrol Dial Transplant. 2003; 18: 2209-10.

Redman C, Sargent I. Latest advances in understanding preeclampsia. Science. 2005; 308: 1592-4.

Walker J. Pre-eclampsia. Lancet. 2000; 356: 1260-5.

Salvador J, Martínez Y, Lechuga A, Terrones A, Ruiz R. Situación psicosocial de las adolescentes y toxemias del embarazo. Salud Publica Mex. 2000; 42: 99-105.

Salvador J, Martínez Y, Lechuga A, Terrones A. Hipertensión inducida por el embarazo en adolescentes: un estudio multicéntrico. Ansiedad y Estres. 2005; 11:17-25.

Cerón M, Harlow S, Sánchez C, Nuñez, R. Risk factors for pre-eclampsia among working women in Mexico City. Paediatr Perinat Epidemiol. 2001; 15:40-6.

Herrera JA, Ersheng G, Shahabuddin AKM, Lixia D, Wei Y, Faisal M, et al. Evaluación periódica del riesgo biopsicosocial prenatal en la predicción de las complicaciones maternas y perinatales en Asia 2002-2003. Colomb Med. 2006; 37 (Supl 1): 6-14.

Terrones A, Salvador J, Lechuga A, Martínez Y, Garvalena MJ, Nápoles C. Diferencias en ansiedad estado-rasgo entre adolescentes con hipertensión inducida por el embarazo y adolescentes embarazadas sanas. Ansiedad y Estres. 2003; 9: 7-16.

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwing LM, et al. Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD initiative. Clin Chem. 2003; 49: 1-6.

De Weerth C, Graat G, Buitelaar J K, Thijssen JH. Measurement of cortisol in small quantities of saliva. Clin Chem. 2003; 49: 658-60.

Covelli M. Prevalence of behavioral and physiological risk factors of hypertension in African American adolescents. Pediatr Nurs. 2007; 33:323-32.

De Weerth C, Gispen De Wied C, Jansen L, Buitelaar J. Cardiovascular and cortisol responses to a psychological stressor during pregnancy. Acta Obstet Gynecol Scand. 2007; 86: 1181-92.

Browner WS, Newman TB, Hulley SB .Tamaño de muestra necesario por grupo cuando se usa la prueba de z para comprobar las proporciones de las variables dicotómicas.En: Hulley SB, Cummings SR, Browner WS, Grady DG,Newman TB (eds.). Diseño de investigaciones clínicas. 3a ed.Barcelona: Williams & Wilkinns; 2008: 97-9.

Secretaría de Salud. Norma oficial mexicana NOM-030- SSA2-1999, para la prevención, tratamiento y control de la hipertensión arterial. México, DF: Secretaría de Salud.

Ávila RH, Tejero BE. Evaluación del estado de nutrición. En: Casanueva E, Kaufer HM, Pérez LA, Arroyo P (eds.). Nutriología médica. México: Editorial Médica Panamericana; 2001: 593-669.

Last JM. A dictionary of epidemiology. 4th ed. Oxford: International Epidemiological Association; 2001, p 32.

Sikkema J, Robles de Medina P, Schaad R, Mulder E. Salivary cortisol levels and anxiety are not increased in woman destines to develop preeclampsia. J Psychosom Res. 2001; 50: 45-9.

Downloads

Download data is not yet available.
Received 2012-02-23
Accepted 2012-02-23