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Endocrine Care: Ada Nierop, Aliki Bratsikas, Ariadne Klinkenberg, Urs M. Nater, Roland Zimmermann, and Ulrike Ehlert Prolonged Salivary Cortisol Recovery in Second-Trimester Pregnant Women and Attenuated Salivary -Amylase Responses to Psychosocial Stress in Human Pregnancy J Clin Endocrinol Metab 2006; 91: 1329-1335 [Abstract] [Full text] [PDF]

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Stress tests in pregnancy and importance of timing

Martin Kammerer MD, Brida von Castelberg, MD and Alyx Taylor, PhD   (30 October 2006)

Stress tests in pregnancy and importance of timing 30 October 2006
Martin Kammerer MD, Adult and Child Psychiatrist and Psychotherapist Institute of Reproductive and Developmental Biology, Imperial College London, UK, Brida von Castelberg, MD and Alyx Taylor, PhD Send letter to journal: Re: Stress tests in pregnancy and importance of timing M.Kammerer{at}imperial.ac.uk Martin Kammerer MD, et al.	The finding by Nierop et al. (1) that women in the beginning of the third trimester did not show a blunted stress response to a widely used social stress test (Trier Social Stress Test) is in contrast, as they point out, with our observations in women at the end of pregnancy, who showed a blunted response to the cold test (2). Although they discuss the possibility that the different stress tests may explain the disparate findings, we would like to highlight that the timing of sample collection also differed in the two studies. Our sample was at the end of the last trimester (36.8 ± 2.5 wk gestation), whereas theirs was at the beginning of the last trimester of pregnancy (26-31 wk gestation). Furthermore the time of day when the stress tests were conducted differed (1200 ± 1.2 h versus 1400-1700 h). Length of gestation has been shown to correlate positively with cortisol levels by Lommatzsch et al. (3); see also Chrousos et al. (4). It has also been noted by others that time of day has an important impact (5) on the cortisol level. Therefore, we think that the timing of the sample collection by Nierop et al may account for the difference in their findings from ours. Clearly, more research is needed in order to establish the possible confounding effect of gestational age on stress tests under study. References 1. Nierop A, Bratsikas A, Klinkenberg A, Nater UM, Zimmermann R, Ehlert U. 2006. Prolonged Salivary Cortisol Recovery in Second-Trimester Pregnant Women and Attenuated Salivary α-Amylase Responses to Psychosocial Stress in Human Pregnancy. J Clin Endocrinol Metab 91:1329-1335. 2. Kammerer M, Adams D, von Castelberg B, Glover V. 2002 Pregnant women become insensitive to cold stress. BMC Pregnancy Childbirth 2:8. 3. Lommatzsch M, Hornych K, Zingler C, Schuff-Werner P, Höppner J, Virchow JC. 2006. Maternal serum concentrations of BDNF and depression in the perinatal period. Psychoneuroendocrinology 31:388-394. 4. Chrousos GP, Torpy DJ, Gold PW. 1998. Interactions between the Hypothalamic-Pituitary-Adrenal Axis and the Female Reproductive System: Clinical Implications. Ann Intern Med 129:229-240. 5. Kudielka BM, Schommer NC, Hellhammer DH, Kirschbaum C. 2004. Acute HPA axis responses, heart rate, and mood changes to psychosocial stress (TSST) in humans at different times of day. Psychoneuroendocrinology 29:983-992.