Cohort studyindependent cross-checkabstract only checked★ key study I-INTB-22 in-depth review

Cortisol rises during pregnancy

A longitudinal study of plasma and urinary cortisol in pregnancy and postpartum.

Overview

Jung C et al.. J Clin Endocrinol Metab 2011 · PMID 21367926 · DOI 10.1210/jc.2010-2395

Total cortisol rose about threefold and free cortisol 1.6-fold by the third trimester.

Does the study support the specific claim? No · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: Measure cortisol in pregnancy
How was the study done?: Longitudinal study
How many people, animals or samples were studied?: 20 pregnant women + controls
What was actually found?: Cortisol rises progressively
How large was the observed effect?: 3-fold total; 1.6-fold free
What do the results mean in everyday life?: In normal pregnancy the body makes more cortisol, not less.
What are the study's limitations?: Small study; abstract only
What does it say about Elawady's specific claim?: Contradicts 'cortisol deficiency in pregnancy'.
Do the results apply to Germany and Europe?: High
What can explicitly not be concluded from this study?: Does not address rare adrenal insufficiency in pregnancy.

Authors: Jung C et al.
Journal: J Clin Endocrinol Metab
Year: 2011
Identifier: PMID 21367926 DOI 10.1210/jc.2010-2395
Verification: verified – PubMed efetch 2026-10-25
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: Research Support, Non-U.S. Gov't (publication type); no COI statement in record

How do plasma and urinary cortisol change across pregnancy?

Study design: Cohort study – Prospective longitudinal study with LC-MS and immunoassay
Population: 20 pregnant women, 12 OCP users, 15 controls
Country: not stated in abstract
Period: trimesters 1-3 and 2-3 months postpartum
Sample size: 47
Inclusion and exclusion criteria: not stated in abstract

Results: Progressive rise in total plasma cortisol, CBG and 24-h urinary free cortisol during pregnancy, peaking in the third trimester (mean 3-fold rise vs controls). Plasma free cortisol increased 1.6-fold by the third trimester.
Absolute risks: not applicable
Authors' conclusion: Pregnancy is associated with elevated total and free cortisol, suggesting up-regulation of the maternal HPA axis in addition to elevated CBG.

Large, consistent direction; small n.

Directly contradicts 'pregnancy causes cortisol deficiency'.

High; physiology universal.

Cortisol rises, not falls, during normal pregnancy.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	low
Directness	direct
Reproducibility	replicated
Consistency with the overall evidence	consistent
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable