Third trimester cortisol status is associated with offspring sex and polycystic ovary syndrome status: Odense Child Cohort

Fertil Steril. 2019 Oct;112(4):764-772. doi: 10.1016/j.fertnstert.2019.05.013. Epub 2019 Jul 4.


Objective: To determine predictors of maternal serum (S) and urinary (U) cortisol and cortisone levels during the third trimester and to examine associations between maternal cortisol status, offspring sex, and maternal polycystic ovary syndrome (PCOS) status.

Design: Prospective observational study.

Setting: The study is part of the prospective Odense Child Cohort.

Patient(s): The study cohort included 1,489 women (with PCOS, n = 145; without PCOS, n = 1,344).

Intervention(s): Fasting blood samples, 24-hour urinary samples.

Main outcome measure(s): Fasting morning S-cortisol and 24-hour U-cortisol/U-cortisone (24-hour U-C/C) were collected at gestational week 28 and measured by liquid chromatography-tandem mass spectrometry.

Result(s): Maternal S-cortisol levels were significantly higher in women pregnant with girls (n = 702) vs. boys (n = 787): mean (mean - SD; mean + SD) 833 (643; 1,079) vs. 799 (588; 1,083) nmol/L. In multiple regression analyses, maternal S-cortisol was positively associated with female offspring and inversely associated with maternal age and parity. When women were divided according to PCOS status, 24-hour U-cortisone was higher: 467 (334; 652) vs. 415 (286; 604) nmol/24 hours; and 24-hour U-C/C was lower in women with PCOS compared with women without PCOS.

Conclusion(s): Maternal third trimester S-cortisol levels were positively associated with female offspring. Cortisol metabolism was higher in women with PCOS vs. women without PCOS.

Keywords: Cortisol; Odense Child Cohort; PCOS.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Humans
  • Hydrocortisone / analysis*
  • Hydrocortisone / blood
  • Hydrocortisone / urine
  • Infant, Newborn
  • Linear Models
  • Male
  • Polycystic Ovary Syndrome / metabolism*
  • Pregnancy
  • Pregnancy Trimester, Third
  • Prospective Studies


  • Hydrocortisone