Mental health in pregnancy and capillary cortisol: Associations with biopsychosocial factors, obstetric complications and placental morphometry

Objective To determine the relationship between capillary cortisol, maternal mental health and biopsychosocial factors, along with obstetric pathologies and placental morphometry. Methods We studied a cohort of 114 pregnant women admitted after their first prenatal visit from Family Health Centers in Concepción, Chile. Sociodemographic data, mental health and obstetric pathologies were collected. Lifetime violence was assessed, and depressive symptoms were evaluated using the Edinburgh Postnatal Depression Scale and the psychosocial risk factors scale. Cortisol levels were measured in hair samples during the first, second, and third gestational trimesters. An analysis of the morphology and morphometry of term placentas was also performed. Results Average capillary cortisol levels were 4.1 ± 4.3 ng/ml in the first trimester, 11.5 ± 14.8 ng/ml in the second, and 6.6 ± 4.5 ng/ml in the third trimester. A significant association was observed between capillary cortisol and a history of emotional and/or physical violence (p = 0.042). An association was also found between pre-existing mental health conditions, gestational diabetes, and hypertensive disorders of pregnancy (p < 0.05). Regarding placental analysis, a significant difference in terminal villi volume density was identified between groups with different cortisol levels (p = 0.008). Conclusion Levels of capillary cortisol are associated with pre-pregnancy mental health history, biopsychosocial factors, obstetric complications, and placental villous volume density, highlighting the relevance of preconception screening to reduce fetal and infant morbidity and mortality.