Association of Differential Symptoms of Stress to Hair Cortisol and Cortisone Concentrations among Pregnant Women in Kenya
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Date
2020
Authors
Musana, Joseph W
Cohen, Craig R
Kuppermann, Miriam
Gerona, Roy
Wanyoro, Anthony
Aguilar, David
Santos, Nicole
Temmerman, Marleen
Weiss, Sandra J
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor \& Francis
Abstract
Objectives: The purpose of this study was to characterize the stress experienced by pregnant women
in Kenya and assess the relationship between perceived stress and stress-related biomarkers of cortisol
and cortisone.
Background: Kenyan women are exposed to multiple stressors that may result in chronic stress.
However, antenatal stress has not been examined and characterized in Kenya; nor has the relationship
between pregnant women’s self-reported stress and stress biomarkers been established.
Methods: One hundred and fifty women were recruited between 22 and 28 weeks gestation.
Participants completed the Perceived Stress Scale (PSS) and a sociodemographic questionnaire. Hair
samples were obtained for analysis of cortisol and cortisone. Factor analysis was used to extract unique
clusters of stress symptoms from items in the PSS. Regression models were computed to examine relationships of stress to cortisone and cortisol, controlling for obstetric risk.
Results: Mean age of the women was 25 years (SD ¼ 5, ±16–41). Their degree of perceived stress and
cortisol/cortisone concentrations both indicated moderate levels of stress. There was no association
between general perceived stress and either hair cortisol or cortisone. However, factor analysis of the
PSS identified three clusters of stress symptoms and one cluster - a woman’s negative frame of mind
regarding life and inefficacy in handling its problems - was associated with higher levels of cortisone
(b¼ .231, p ¼ 0.011).
Conclusions: Specific stress symptoms may have unique relationships to specific biomarkers and be
more useful in assessment than general perceived stress. Assays of both hair cortisol and cortisone
might enable a more comprehensive assessment of glucocorticoid activity and better prediction of
health risks from stress.
Description
Article
Keywords
Mother, pregnancy, perceived stress, hair, cortisol, cortisone
Citation
Musana, J. W., Cohen, C. R., Kuppermann, M., Gerona, R., Wanyoro, A., Aguilar, D., ... & Weiss, S. J. (2020). Association of differential symptoms of stress to hair cortisol and cortisone concentrations among pregnant women in Kenya. Stress, 23(5), 556-566.