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Preterm Delivery as a Predictor of Diurnal Cortisol Profiles in Adulthood: Evidence from Cebu, Philippines


Lee, James; Fried, Ruby; Thayer, Zaneta M.; & Kuzawa, Christopher W. (2014). Preterm Delivery as a Predictor of Diurnal Cortisol Profiles in Adulthood: Evidence from Cebu, Philippines. American Journal of Human Biology, 26(5), 598-602.


Objectives: Fetal exposure to elevated maternal cortisol can permanently modify hypothalamic–pituitary–adrenal (HPA) axis function, and thereby have long-term health impacts. Maternal cortisol steadily increases throughout normal pregnancy, but is abnormally high in preterm deliveries (<37 weeks). Prematurity remains a widespread public health problem, yet little is known about its potential long-term effects on adult HPA function. Here we test the hypothesis that diurnal cortisol profiles measured in young adulthood will vary based upon an individual's preterm status. Methods: Diurnal salivary cortisol profiles, a marker of HPA-axis function, were measured in 1,403 young adults (ages 21–23 years) participating in the Cebu Longitudinal Health and Nutrition Survey, located in Metropolitan Cebu City, Philippines. Results: Males who had been born preterm exhibited lower morning cortisol and non-significantly elevated evening cortisol, resulting in a more adverse, flatter rate of decline across the day. In contrast, there were no significant differences by preterm status in cortisol measured at any time of day in females. Conclusions: These findings point to potential long-term effects of having been born preterm on adult HPA-axis function, and add to evidence from this and other populations for sex differences in the biological and health impacts of prenatal stress exposure.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Human Biology


Lee, James
Fried, Ruby
Thayer, Zaneta M.
Kuzawa, Christopher W.