목적: 코르티졸은 스트레스나 우울증의 대표적인 지표로 쓰이고 있다. 본 연구는 임신주수에 따른 타액내 코르티졸의 농도변화를 확인하고, 임신의 경과와의 연관성을 알아보고자 하는 전향적 연구이다. 연구 방법: 2007년 4월에서 2008년 3월까지 본원 산부인과에서 외래 진찰 및 분만까지 한 단태임신 산모를 대상으로 임신 10~13주, 임신 20~23주, 분만 후 2일째, 총 3회에 걸쳐서 Salivette®를 이용하여 타액을 채취하였다. 일중 변화를 고려하여 오전 10~12시 사이로 제한하여 검체를 채취하였고, 임신 20~23주에 도플러 초음파로 제대동맥, 자궁동맥 혈류를 측정하였다. 결과: 총 39명의 산모가 위 조건을 만족시켰으며 이들 중 한 명에서만 임신의 합병증으로 조산이 발생하였다. 이들 산모의 타액내 코르티졸 농도는 산모의 나이, 분만력, 직업유무, 체질량지수, 혈압, 분만방법, 태아의 성별, 크기와 연관성이 없었다. 통계학적 의미는 없었지만 자궁동맥 저항지수와는 음의 관계를 보여주었다. 결론: 본 연구에서는 산모의 코르티졸 농도와 임신의 경과간 특별한 의미를 발견할 수 없었다. 그러나 대상군을 늘리고 방법학적, 개념적으로 향상된 연구계획을 세워 시행한다면 의미 있는 결과를 얻을 수 있을 것임을 제시하였다.

Objective: The impact of maternal stress on pregnancy outcome has been a focus of research and cortisol is known as a biomarker of psychological stress. The aim of this study is to evaluate the relationship between salivary cortisol levels and pregnancy outcomes prospectively. Methods: The subjects of this study were healthy pregnant women who collected morning samples of saliva (10~12 AM) at 10~13, 20~23 weeks of gestation, and postpartum 2 days between April 2007 to March 2008. Saliva was collected with commercial collector, Salivette®, and cortisol level was analyzed by enzyme immunoassay. They also underwent ultrasonographic examination of umbilical and uterine artery Doppler between 20~23 weeks of gestation. Statistical analysis was assessed between salivary cortisol levels and pregnancy outcomes, including Doppler findings. Results: A total 39 pregnant women collected salivary cortisol as indicated. They showed increase in cortisol level in 2nd trimester compared to 1st trimester, which decreased after delivery. Salivary cortisol level was not associated with maternal age, parity, occupation, body mass index, blood pressure, delivery mode, fetal sex, and fetal weight. However higher cortisol level was associated with lower resistance index of uterine artery, even there was no statistical significance. Conclusion: Our data could not show any association between salivary cortisol levels and pregnancy outcomes. Although this study presents a number of methodological and conceptual challenges, this does not necessarily preclude the use of salivary cortisol measures, but rather point to the importance of careful research design.

Objective: The impact of maternal stress on pregnancy outcome has been a focus of research and cortisol is known as a biomarker of psychological stress. The aim of this study is to evaluate the relationship between salivary cortisol levels and pregnancy outcomes prospectively. Methods: The subjects of this study were healthy pregnant women who collected morning samples of saliva (10~12 AM) at 10~13, 20~23 weeks of gestation, and postpartum 2 days between April 2007 to March 2008. Saliva was collected with commercial collector, Salivette®, and cortisol level was analyzed by enzyme immunoassay. They also underwent ultrasonographic examination of umbilical and uterine artery Doppler between 20~23 weeks of gestation. Statistical analysis was assessed between salivary cortisol levels and pregnancy outcomes, including Doppler findings. Results: A total 39 pregnant women collected salivary cortisol as indicated. They showed increase in cortisol level in 2nd trimester compared to 1st trimester, which decreased after delivery. Salivary cortisol level was not associated with maternal age, parity, occupation, body mass index, blood pressure, delivery mode, fetal sex, and fetal weight. However higher cortisol level was associated with lower resistance index of uterine artery, even there was no statistical significance. Conclusion: Our data could not show any association between salivary cortisol levels and pregnancy outcomes. Although this study presents a number of methodological and conceptual challenges, this does not necessarily preclude the use of salivary cortisol measures, but rather point to the importance of careful research design.

Salivary cortisol, Stress, Pregnancy