Hair Cortisol Concentrations in Opioid-Exposed versus Nonexposed Mother–Infant Dyads

Abstract

Objective To pilot measurement of hair cortisol concentration (HCC) in pregnant women with opioid use disorder and their infants over time and study the potential utility of hair cortisol as a biomarker of chronic stress in this population.

Study Design In this pilot prospective cohort study of mother–infant dyads with and without prenatal opioid exposure, we obtained mother–infant HCCs at delivery and again within 1 to 3 months' postpartum. HCCs were compared between the opioid and control groups and between the two time points.

Results There were no significant differences between opioid and control group maternal or infant HCCs at either time point. However, within the opioid-exposed group, there was a significant increase in infant HCCs across the two time points.

Conclusion This pilot study describes our experience with the measurement of HCCs in opioid-exposed mother–infant dyads.

Key Points

• Maternal stress impacts fetal and child health.

• Many stressors in pregnant women with opioid use disorder.

• Hair cortisol may be a useful stress biomarker.

Keywords

hair cortisol - chronic stress - opioid use disorder - NOWS

• References

• 1 Busada JT, Cidlowski JA. Mechanisms of glucocorticoid action during development. Curr Top Dev Biol 2017; 125: 147-170
• 2 Lautarescu A, Craig MC, Glover V. Prenatal stress: effects on fetal and child brain development. Int Rev Neurobiol 2020; 150: 17-40
• 3 Rose-Jacobs R, Trevino-Talbot M, Vibbert M, Lloyd-Travaglini C, Cabral HJ. Pregnant women in treatment for opioid use disorder: material hardships and psychosocial factors. Addict Behav 2019; 98: 106030
• 4 Conradt E, Crowell SE, Lester BM. Early life stress and environmental influences on the neurodevelopment of children with prenatal opioid exposure. Neurobiol Stress 2018; 9 (09) 48-54
• 5 Franks AL, Berry KJ, DeFranco DB. Prenatal drug exposure and neurodevelopmental programming of glucocorticoid signalling. J Neuroendocrinol 2020; 32 (01) e12786
• 6 Duthie L, Reynolds RM. Changes in the maternal hypothalamic-pituitary-adrenal axis in pregnancy and postpartum: influences on maternal and fetal outcomes. Neuroendocrinology 2013; 98 (02) 106-115
• 7 Yamada J, Stevens B, de Silva N. et al. Hair cortisol as a potential biologic marker of chronic stress in hospitalized neonates. Neonatology 2007; 92 (01) 42-49
• 8 El Mlili N, Ahabrach H, Cauli O. Hair cortisol concentration as a biomarker of sleep quality and related disorders. Life (Basel) 2021; 11 (02) 81
• 9 D'Anna-Hernandez KL, Ross RG, Natvig CL, Laudenslager ML. Hair cortisol levels as a retrospective marker of hypothalamic-pituitary axis activity throughout pregnancy: comparison to salivary cortisol. Physiol Behav 2011; 104 (02) 348-353
• 10 Kalra S, Einarson A, Karaskov T, Van Uum S, Koren G. The relationship between stress and hair cortisol in healthy pregnant women. Clin Invest Med 2007; 30 (02) E103-E107
• 11 Liu CH, Snidman N, Leonard A, Meyer J, Tronick E. Intra-individual stability and developmental change in hair cortisol among postpartum mothers and infants: implications for understanding chronic stress. Dev Psychobiol 2016; 58 (04) 509-518
• 12 Wachman EM, Hunter RG, Shrestha H. et al. Maternal hair cortisol levels as a novel predictor of neonatal abstinence syndrome severity: a pilot feasibility study. Dev Psychobiol 2020; 62 (01) 116-122
• 13 Hoffman MC, D'Anna-Hernandez K, Benitez P, Ross RG, Laudenslager ML. Cortisol during human fetal life: characterization of a method for processing small quantities of newborn hair from 26 to 42 weeks gestation. Dev Psychobiol 2017; 59 (01) 123-127
• 14 Wachman EM, Grossman M, Schiff DM. et al. Quality improvement initiative to improve inpatient outcomes for neonatal abstinence syndrome. J Perinatol 2018; 38 (08) 1114-1122
• 15 Meyer JS, Novak MA. Minireview: hair cortisol: a novel biomarker of hypothalamic-pituitary-adrenocortical activity. Endocrinology 2012; 153 (09) 4120-4127
• 16 Meyer J, Novak M, Hamel A, Rosenberg K. Extraction and analysis of cortisol from human and monkey hair. J Vis Exp 2014; e50882 (83) e50882
• 17 Metcalf L, Casey W. Introduction to Data Analysis. In: Cybersecurity and Applied Mathematics. Elsevier B.V; 2016: 43-65
• 18 Stoye DQ, Andrew R, Grobman WA. et al. Maternal glucocorticoid metabolism across pregnancy: a potential mechanism underlying fetal glucocorticoid exposure. J Clin Endocrinol Metab 2020; 105 (03) e782-e790
• 19 Tegethoff M, Pryce C, Meinlschmidt G. Effects of intrauterine exposure to synthetic glucocorticoids on fetal, newborn, and infant hypothalamic-pituitary-adrenal axis function in humans: a systematic review. Endocr Rev 2009; 30 (07) 753-789
• 20 Miller GE, Chen E, Zhou ES. If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychol Bull 2007; 133 (01) 25-45
• 21 Ouellette SJ, Russell E, Kryski KR. et al. Hair cortisol concentrations in higher- and lower-stress mother-daughter dyads: a pilot study of associations and moderators. Dev Psychobiol 2015; 57 (05) 519-534
• 22 Meyer MC, Johnston AM, Crocker AM, Heil SH. Methadone and buprenorphine for opioid dependence during pregnancy: a retrospective cohort study. J Addict Med 2015; 9 (02) 81-86