How Elevated Cortisol Levels Can Impact Maternal Health Outcomes

What exactly is Cortisol?

Cortisol is a steroid hormone that is naturally produced by the body’s adrenal glands that are located on top of the kidneys. This hormone plays a major role in the functions of the body, namely an individual’s stress response. If cortisol is produced in the appropriate amounts, the body is able to use it in a healthy manner to alleviate stress. Generally, cortisol is used to help “your body respond to stress or danger, increase the body’s metabolism of glucose, control blood pressure, and reduce inflammation” (HealthDirect, 2019). Another key role of cortisol is in the body’s sympathetic fight or flight response. This helps spring the body into action when it is needed. According to the book, The Impact of Inequality, “Cortisol is the most important endocrine hormone involved in preparing the body for sustained physical activity in meeting a threat. To make energy available, it raises blood sugar levels by counteracting the effects of insulin, releasing fatty acids from the body’s fat deposits into the bloodstream” (Wilkinson, 2005). As a result of all of these pathway's cortisol is involved in, it is very important in maintaining a healthy individual.

So, what is the problem?

When cortisol levels are elevated for prolonged periods of time, problems begin to arise. This can be the result of a variety of factors, including genetics, chronic stress, medications, and more. Chronic stress is one of the primary drivers for the overproduction of cortisol, as this hormone works to bring the body back to normal. As mentioned above, cortisol works by shutting down the body’s stress response, restoring the metabolic energy level back to normal, and suppressing the immune system. When stress remains high, the adrenal glands continue to produce this hormone and prevents the body from returning to normal. This is what creates some of the side effects of this condition, including weight gain, fatigue, muscle weakness, thinning of the skin, and more.

Cortisol’s impact on maternal health:

In women, chronic stress can lead to an increased risk of miscarriage or irregular menstrual cycles. Elevated cortisol can interfere with the normal production of sex hormones in women, namely estrogen (which plays a role in controlling the uterine lining, signaling the start of the menstrual cycle) and progesterone (which is crucial for a successful pregnancy as it maintains the uterine lining and prevents early contractions during pregnancy). When these hormones are interrupted or disturbed, this can lead to irregular periods, the inability to ovulate, or miscarriages. A study by Davis and Sandman (2010) writes, “Exposure to elevated concentrations of cortisol early in gestation was associated with a slower rate of development over the first postnatal year. Elevated levels of maternal cortisol late in gestation, however, were associated with accelerated development over the first.” This study provides an interesting look into the effects of extended exposure to cortisol throughout pregnancy. It has been observed that high levels of cortisol in early pregnancy can lead to both mental and physical developmental defects. This may be due to the lack of development of the fetus in early pregnancy as it lacks the methods of absorbing or using this cortisol in any way. After the birth of a child to a mother with elevated cortisol levels, it has been observed that the development of emotion and cognitive function has been impacted. “Prenatal exposure to administration of high levels of synthetic cortisol has profound and lasting consequences for offspring including increased stress reactivity, poorer performance on cognitive tasks and impaired brain development, particularly in terms of reduced hippocampal volume” (Davis & Sandman, 2010).

Conclusion:

Cortisol is an instrumental hormone in the body’s response to stress. When expressed in the correct amount, this hormone is beneficial, with problems arising with the overproduction of it. This overproduction can lead to a range of issues, including poor fetal development, adverse maternal outcomes, and long-term growing and development delays. Additionally, prolonged stress can impact pregnancy outcomes, increasing the risk of miscarriages and post-birth rates of physical and mental developmental issues. With many around the globe dealing with high stress, it is important to be aware of the complications related to elevated cortisol levels, taking the appropriate steps to promote proper maternal and physical health.

References:

Davis, E. P., & Sandman, C. A. (2010). The Timing of Prenatal Exposure to Maternal Cortisol and Psychosocial Stress Is Associated With Human Infant Cognitive Development. Child Development, 81(1), 131–148. https://doi.org/10.1111/j.1467-8624.2009.01385.x

HealthDirect. (2019, February 11). The Role of Cortisol in the Body. Healthdirect.gov.au; Healthdirect Australia. https://www.healthdirect.gov.au/the-role-of-cortisol-in-the-body

Wilkinson, Richard G. The Impact of Inequality: How to Make Sick Societies Healthier. New York: The New Press, 2005.

Assessed and Endorsed by the MedReport Medical Review Board