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Psychiatr Danub. 2015 Dec;27 Suppl 2:578-85.

Correlation of psychological symptoms with cortisol and CRP levels in pregnant women with metabolic syndrome.

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University of Mostar, School of Medicine, Petra Krešimira bb, 88000 Mostar, Bosnia and Herzegovina,



In pregnancy occurs series of physiological, organic and psychological changes in the female organism. Particularly are significant hormonal and metabolic changes. Elevated cortisol levels are reduced by linking the transport of globulin (transcortin). Triglycerides were increased 50% and other lipids from 20 to 30%. The values of CRP were slightly elevated in the third trimester of pregnancy (10-15 mg/L). To investigate the association of psychological symptoms with the level of cortisol and CRP in women with metabolic syndrome.


From 1646 pregnant women cross-sectional, prospective study included 180 pregnant women divided into three groups by applying the inclusion and exclusion criteria. Research methods are laboratory and clinical tests and questionnaires. Every pregnant woman have been made complete laboratory findings and determined cortisol in 8 and 17 hours using the chemiluminescent immunoassay method. All pregnant women filled in several questionnaires: socio-demographic, obstetrical-gynecological, standardized psychometric questionnaire (SCL 90-R), a questionnaire syndrome of depression according to ICD 10 and Beck self depression scale. The study was conducted from August 2011 to mid-November 2012.


From the total of 1646 hospitalized pregnant women, 176 pregnant women had a BMI>30 and 120 of them were tested, but 60 had criteria for MS. The concentration of morning and afternoon cortisol is increased in pregnant women with the metabolic syndrome Obese pregnant women have a statistically higher level and morning and afternoon cortisol levels than women with normal body weight and without the metabolic syndrome, but these differences are smaller than in the case of pregnant women with the metabolic syndrome. CRP is significantly higher in women with metabolic syndrome. CRP concentration is significantly higher in obese pregnant women compared to pregnant women with normal weight and without the metabolic syndrome, but it is lower than in pregnant women with the metabolic syndrome. The incidence of psychological symptoms as somatization, obsessive-compulsive symptoms, depression, anxiety, phobia, and nonspecific symptoms is statistically increased in pregnant women with elevated morning cortisol, but in women with elevated afternoon cortisol also occurring aggressiveness and paranoia. In pregnant women with elevated CRP is statistically higher incidence of psychological symptoms such as somatization, obsessive-compulsive symptoms, depression, anxiety, and nonspecific symptoms.


There is a statistically significantly higher levels of cortisol and C-reactive protein in obese pregnant women and pregnant women with the criteria of MS. Morning cortisol has a specific predictive value for the diagnosis of MS, but the values of CRP are changing in numerous physiological and pathological conditions and cannot be taken as a predictive factor in the diagnosis of MS. Pregnant women with MS and elevated morning and evening levels of cortisol and CRP shows a statistically significant higher number of complications in pregnancy and psychological symptoms.


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