414 - A feasibility study: measurement of hair cortisol concentrations (HCC) in opioid-exposed mother-infant dyads at two time points

Poster Number: 414
Publication Number: 414.136

Tierney Morrison, Boston Children's Hospital, Boston, MA, United States; Davida Schiff, Massachusetts General Hospital, Boston, MA, United States; Abigael Olson, Boston University School of Medicine, Boston, MA, United States; Richard G. Hunter, UMass Boston, Boston, MA, United States; Mayuri Jain, Icahn School of Medicine at Mount Sinai, Boston, MA, United States; Hira shrestha, Boston University School of Medicine, Boston, MA, United States; Jeffery O. Boateng, Boston Medical Center, Boston, MA, United States; Ginny Carter, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States; Hendree E. Jones, UNC at Chapel Hill, Chapel Hill, NC, United States; Elisha Wachman, Boston Medical Center, Boston, MA, United States

Background: Women with opioid use disorder (OUD) commonly face chronic stressors which can have physiological effects on both mother and infant. Hair cortisol has been shown to serve as a reliable method of quantifying total cortisol release throughout pregnancy, and could be used to quantify stress experienced by pregnant women with OUD and their infants.

Objective: We sought to determine the feasibility of measuring serial hair cortisol concentrations (HCCs) as a proxy for chronic stress by conducting a pilot study of pregnant women with OUD and their infants at delivery and one month following delivery.

Design/Methods: This prospective single-center pilot cohort study in which participants were recruited between January 2019 and March 2020. Eligibility criteria were pregnant persons with a diagnosis of OUD on prescribed buprenorphine-naloxone, singleton pregnancy, between 6-30 weeks of pregnancy, and infants born at least 35 weeks gestational age. Hair samples were obtained within 24-72 hours of delivery and at one month. Descriptive analyses of maternal demographics, maternal outcomes, and neonatal outcomes were completed. Wilcoxon signed rank test was used to determine if there was a significant change in maternal and infant cortisol at delivery and one month. Spearman rank-order correlation coefficient was also used to determine if there was a correlation between maternal and infant HCCs.

Results: Ten mother-infant dyads were evaluated. Hair samples were successfully obtained in all ten dyads at the two time points. Maternal HCCs at delivery were elevated compared to previously cited levels (15.9+/-19.5 pg/mg) in postpartum women without OUD, with median levels of 926.92 pg/mg (IQR 676.94-1287.12). The difference between maternal HCC at delivery [median 926.92 pg/mg (IQR 676.94-1287.12)] and at one-month postpartum [median 834.42 pg/mg (IQR 676.94-911.85)] failed to reach statistical significance (p=0.43). There was a significant increase in infant HCCs during the same time period, with median 715.68 pg/mg (IQR 594.07-897.36) at delivery to median 1288.19 pg/mg (IQR 1002.94-2583.75) at one month of age (p=0.02). There was no significant correlation between maternal and infant HCCs at delivery and one month.Conclusion(s): This demonstrates the feasibility of measuring HCCs in pregnant women with OUD and their infants. Use of HCCs may improve our understanding of chronic stress and aid in development of interventions that improve care in this population.

Figure 1: Box Plots of Maternal and Infant Cortisol at Delivery and Four Weeks