{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:48:28Z","timestamp":1793911708868,"version":"4.8.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2020,9,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Chronic hypothalamic-pituitary-adrenal (HPA) axis activity role in the pathogenesis of preterm birth (PTB) remains unclear due to inconsistent measures with limited ability to monitor long-term cortisol concentrations. We explored this relationship using the novel method of assessing cortisol in hair, which is a valid and reliable measure of chronic HPA axis activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>137 participants (40 PTB cases and 97 controls from a birth cohort of pregnant women in Peru) were interviewed and invited to provide a 9-cm hair sample from the posterior vertex position of the scalp (mean\u200a=\u200a13 weeks gestation). Hair cortisol concentration (HCC) was determined using luminescence immunoassay and values were natural-log transformed. PTB cases were defined as women who delivered before 37 gestational weeks. Case-control differences were assessed using multivariable linear and logistic regressions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Overall, combined pre-conception and first-trimester HCC was 13% lower among cases as compared with controls ( p-value\u200a=\u200a0.01). Compared with controls, maternal HCC among PTB cases were 14% ( p\u200a=\u200a0.11), 10% ( p\u200a=\u200a0.22) and 14% ( p\u200a=\u200a0.08) lower for 3\u20136 months pre-conception, 0\u20133 months pre-conception, and first trimester, respectively. After adjusting for putative confounders, a 1-unit increase in HCC was associated with 55% reduced odds of PTB (aOR\u200a=\u200a0.45; 95% CI: 0.17\u20131.17). For a 1-unit increase in HCC in the scalp-intermediate and scalp-distal segments (representing HCC concentrations in 0\u20133 months pre-conception and first trimester), the corresponding odds for PTB were 0.53 (95% CI: 0.19\u20131.48) and 0.39 (95% CI: 0.13\u20131.13), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Women who deliver preterm, as compared with those who deliver at term, have lower preconception and first trimester HCC. Our findings suggest that HPA axis activation, integral to the adaptive stress-response system, may be chronically dysregulated in women at increased risk of PTB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/npm-180139","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T08:21:45Z","timestamp":1573633305000},"page":"313-321","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Chronic HPA activity in mothers with preterm delivery: A pilot nested case-control study"],"prefix":"10.1177","volume":"13","author":[{"given":"B.","family":"Gelaye","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kirschbaum","sequence":"additional","affiliation":[{"name":"Technische Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.Y.","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.E.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Universidad San Martin de Porres, Lima, Peru"},{"name":"Asociaci\u00f3n Civil PROESA, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.B.","family":"Rondon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru Instituto Nacional Materno Perinatal, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.C.","family":"Koenen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"ref001","unstructured":"Centers for Disease Control and Prevention, 2018. Preterm Birth | Maternal and Infant Health | Reproductive Health | CDC [WWW Document]. 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