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\begin{document}

\title{Parity-related variation in cortisol concentrations in hair during
pregnancy and in the postpartum period: a prospective cohort study}



\author[1]{Ina Marteinsdottir}%
\author[2]{Gunilla Sydsjo}%
\author[3]{Åshild Faresjö}%
\author[3]{Elvar Theodorsson}%
\author[3]{Ann Josefsson}%
\affil[1]{Linnaeus University}%
\affil[2]{Linkoping University}%
\affil[3]{Linköping University}%


\vspace{-1em}



  
  \date{June 13, 2024}


\begingroup
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\selectlanguage{english}
\begin{abstract}
Objective: To investigate hair cortisol concentrations (HCC) monthly in
pregnant women and to explore the effect of parity. Design: Prospective
cohort study from gestational week (GW) 26, at childbirth and
postpartum. Setting: An antenatal care clinic in southeast Sweden.
Sample: 390 pregnant women. Methods: Cortisol was measured using
radioimmunoassay in methanol extracts of ground hair samples. Main
outcome measures: Hair cortisol concentrations Results: Both primi- and
multiparae exhibited an increase in HCC throughout pregnancy. Primiparae
had significantly higher HCC in the latter part of the last trimester
compared to multiparae (one month p=0.003 and two months p=0.038). The
use of psychotropic medication in the first trimester correlated to HCC
postpartum (p\textless{}0.001). HCC in GW 14-17 were associated with HCC
in GWs 18-21 (primiparae and multiparae, p\textless{}0.001), GW 22-25
(primiparae p=0.036 and multiparae p=0.033), and two months postpartum
(primiparae p=0.049). HCC in GW 18-21 was associated with GW 22-25 among
both primiparae (p\textless{}0.001) and multiparae (p\textless{}0.001)
as well as two months prior to childbirth among primiparae
(\textless{}0.037). In general, all estimates of HCC in pregnancy and
postpartum showed a significant association between HCC for a specific
month and the HCC in the previous month (all p\textless{}0.001), except
for the association of HCC among primiparae in GW 22-25 and three months
prior to childbirth. Conclusions: Increased cortisol concentrations in
hair were observed during pregnancy, which decreased three months prior
to childbirth in multiparae. The results indicate a quicker suppression
of the hypothalamic CRH production by placenta CRH in multiparous women.%
\end{abstract}%



\sloppy


\textbf{Introduction}

The interest in the function of the hypothalamic-pituitary-adrenal
(HPA)-axis of pregnant women is growing, as evidenced by the evolving
literature revealing the influence of maternal stress on the offspring\selectlanguage{ngerman}´s
physical and mental health outcomes \textsuperscript{1-5}.

However, the evidence regarding whether prenatal maternal cortisol
levels are the sole or main mediating link is
conflicting\textsuperscript{6}. It also seems that foetal vulnerability
to high maternal cortisol levels varies across the gestational
phases\textsuperscript{4, 6-8}.

Research regarding the impact of cortisol in the mediation of maternal
stress upon the foetus is complicated by the fact that the HPA-axis
activity shows substantial diurnal variability \textsuperscript{9} in
addition to individual differences. Single cortisol measures in plasma
or saliva may therefore not sufficiently reflect the overall long-term
biological activity of cortisol. Analysis of hair cortisol
concentrations (HCC) is used to overcome such
limitations\textsuperscript{10-12}, where one cm of hair corresponds to
about one month´s cortisol accumulation\textsuperscript{13}. This method
has been validated against cortisol in saliva across the pregnancy and
postpartum periods and has proved to be a reliable metric of HPA
activity, enabling estimation of integrated cortisol
release\textsuperscript{14}\textsubscript{.}

Reports on HCC throughout pregnancy have revealed varying results,
probably due to the different analysis methods used\textsuperscript{11,
14-18}. The research focus has also been wide-ranging and has shown
several factors of importance for HCC, including season,
obesity\textsuperscript{11,19} and delivery mode \textsuperscript{11}.
In addition, some \textsuperscript{18-19} researchers have noted a
relation between psychosocial and lifetime stress exposure on HCC during
pregnancy, while others \textsuperscript{20} have concluded that neither
psychological distress, nor chronic stress or psychiatric symptoms had
any impact.

Higher cortisol levels have been reported in primiparae versus
multiparae\textsuperscript{21-22}, probably related to more pregnancy
distress \textsuperscript{23}. However, Federenko et al. in 2006 could
not detect any effect of parity on cortisol levels\textsuperscript{22}.

HCC covering single-month periods may give more precise and more
coherent results when investigating relations to childbirth and neonatal
outcomes, but to our knowledge, no reports of measurements conducted on
a monthly basis are available regarding HCC during pregnancy and
postpartum. We hypothesised that there may be variations in cortisol
hair levels during pregnancy and postpartum, possibly influenced by
parity. Hence, the purpose of this study is to add to the knowledge of
normal HPA-axis functioning during pregnancy and postpartum by
determining HCC levels on a monthly basis. A second aim was to explore
further differences in HCC levels associated with parity during
pregnancy.



\textbf{Methods}

\textbf{Sample}

The Swedish antenatal health care system is used by almost 100 \% of
pregnant women in the country. The antenatal and delivery care is free
of charge. At the antenatal care clinics (ANC) healthy pregnant women
are recommended to attend the regular antenatal programme with seven to
nine visits to a midwife during pregnancy, and, if needed, extra
appointments with an obstetrician and/or with the midwife. Women
attending the antenatal clinic at Värnamo Hospital, a small hospital in
the south of Sweden, were asked to participate. They were given written
and oral information about the study by their midwife at the first visit
to the antenatal clinic around gestational week 12. At the next visit
(around gestational week 26) those interested in participating signed an
informed consent. A total of 953 women were enrolled at the antenatal
clinic during the study period. Of these, 740 women were approached and
asked to participate in the study, 154 were excluded due to difficulties
in understanding Swedish, and 186 declined participation. During the
study period, nine women did not provide the study nurse with any hair
samples and one woman changed her mind and asked to be removed from the
study. Thus, 390 women were included in the study. Samples of hair were
taken at around gestational week 26, at childbirth and finally at the
postpartum check-up. The numbers of hair samples of sufficient quantity
and quality to perform HCC analyses were: taken around gestational week
26, n=330; at childbirth, n=303; and at the postpartum control, n=311
(Figure S1). The total sample was divided into primiparous women and
multiparous women in most analyses. Demographic information as well as
data on mental health and use of medications are presented in Table 1.

\textbf{Patient involvement statement}

At the time of the study no patients or patient organisations were
involved.

\textbf{Hair cortisol measures}

HCC) were expressed as pg/mg with a method developed in-house using a
competitive radioimmunoassay on methanol extracts of pulverised hair. A
hair sample approximately 3 mm thick and 3 cm long was cut close to the
scalp from the posterior vertex area of the head. The hair samples were
further cut into 1.25 cm lengths to reflect the cortisol accumulations
for each month, based on an assumption of an average hair growth rate of
1 cm per month (13). The hair samples analysed in this study weighed
between 5 mg and 6 mg. In the laboratory, each sample was put into a 2
mL QiaGenRB sample tube along with a 0.5 mm QiaGen stainless steel bead
and weighed on a Sartorius MC 210p microscale. The samples were put in
specially made aluminium cylinders accommodating five 2 mL Eppendorf
tubes, and frozen in liquid nitrogen for two minutes. This was followed
by mincing in a Retch Tissue Lyser II at 23 Hz for two minutes to
produce a fine hair powder. The cortisol was extracted by adding 1 mL of
methanol (Chromasolv, Sigma-Aldrich) to each tube and placing the tubes
in a metal holder on a plate with a 5-degree inclination on a horizontal
shaker at room temperature, keeping the steel beads in constant gentle
motion within the tubes for a minimum of 10 hours. Finally, the tubes
were centrifuged for one minute at 13000 rpm at +4°C in a
microcentrifuge, Thermo Scientific Heraus, Picotm \& Frescotm 17/21, and
800 \selectlanguage{greek}μ\selectlanguage{english}L of the supernatant was moved to another plastic sample tube for
lyophilisation in a SpeedVac Plus SC210A (Savant) using an Edwards XDS 5
vacuum pump for at least three hours. The samples were dissolved in
radioimmunoassay buffer and analysed as described by Morelius et al.
2004 (24). A hair sample of 3--10 mg is needed to maintain a total
inter-assay coefficient of variation below 8\% for the combination of
hair extraction and measurement of cortisol by the radioimmunoassay. The
intra-assay coefficient of variation for the radioimmunoassay itself was
7\% at 10 nmol/L. The antiserum cross-reacts 137\% with
5\selectlanguage{greek}α-\selectlanguage{english}dihydroxycortisol, 35.9\% with 21-deoxycortisol, and 35.9\% with
prednisolone, but less than 1\% with endogenous steroids (15).

\textbf{Statistical analysis}

Statistical analyses were performed using the Statistical Package for
the Social Sciences (SPSS version 26, IBM Inc., Armonk, NY, USA). The
original HCC values were both divided into quintiles and also
transformed into logarithm values. The associations between
sociodemographic variables and parity as well as use of medications were
tested by Pearson's chi\textsuperscript{2}-test. The medians of the
original values were used as measures of central tendency and variation,
respectively. Due to the non-normal distribution of the original HCC
values, Spearman's correlation coefficient was used when determining
whether cortisol levels were correlated with possible confounding
variables. Multivariate linear regression analyses were based on
logarithm-transformed values and were made to assess possible
associations among the nine HCC measurements for each participant. A
p-value p \textless{} 0.05 (two-sided) was considered statistically
significant.

\textbf{Results}

\textbf{Demographic data}

The majority of the women were married or cohabiting, had been born in
Sweden, had secondary or higher education and were gainfully employed.
Significant differences were seen concerning age and educational
background when comparing primiparae with multiparae. First time mothers
were younger and had lower education. Tobacco use decreased during
pregnancy among primiparae women but remained at a low level among
multiparae women, see Table 1.

\textbf{Cortisol concentrations during pregnancy; impact of parity}

The median HCC for the total group of pregnant women during pregnancy,
at childbirth and postpartum are shown in Figure 1. Primiparae had
higher levels of HCC than multiparae at two months (p=0.038) and one
month (p=0.003) prior to childbirth, see Figure 1.

\textbf{Associations between monthly cortisol levels during pregnancy}

A multivariate linear analysis performed separately in the total (see
Table S1), primiparae (see Table 2a), and multiparae (see Table 2b),
groups revealed significant associations between HCC at gestational
weeks (GW) 14-17 with HCC at GW 18-21 (all groups: p\textless{}0.001)
and GW 22-25 (total: p\textless{}0.001, primiparae: p=\textless{}0.001)
and a tendency of association with the HCC at two months postpartum in
the primiparae group (p=0.049). HCC at GW 18-21 was significantly
associated also with HCC at GW 22- 25 (all groups; p\textless{}0.001).
HCC at three months prior to childbirth was associated with the HCC two
months prior to childbirth - (all groups: p\textless{}0.001). HCC at two
months prior to childbirth was associated with HCC at one month prior to
childbirth (all groups: p\textless{}0.001). HCC at one month prior to
childbirth was associated with HCC at one (multiparae: p=0.003) and two
months postpartum (multiparae: p=0.043). HCC at one month postpartum
also including childbirth was associated with HCC at two and three
months postpartum (p\textless{}0.001 in all groups). Spearman's
correlation revealed no associations between HCC levels with the use of
steroids and analgesics nor any other medications, while the use of
psychotropic medication correlated to HCC levels in all postpartum
measurements (r=0.28, p=0.008), (r=0.23, p=0.003) and (r=0.30, p=0.004).

\textbf{Discussion}

\textbf{Main findings}

Measures of cortisol in hair clearly demonstrate an increase in cortisol
levels throughout pregnancy with a peak around childbirth. This is in
line with prior reports based on salivary cortisol, and supports the
validity of measurement of cortisol in hair samples since these levels
mirror the activity of the HPA axis throughout pregnancy. In the third
trimester the increase in hair cortisol was significantly more
pronounced in women expecting their first child compared to multiparae
that showed a decrease in hair cortisol three months prior to
childbirth.

\textbf{Strengths and limitations}

The possible uncertainty when extracting and measuring cortisol in hair
samples has been minimised in this study since the applied method has
previously been tested in several studies and proven
valid\textsuperscript{15,19,25}. Measurements of cortisol in hair
instead of in saliva, blood, and urine have advantages, e.g. the
measurements are non-invasive and hair samples can be stored at room
temperature. There is also evidence for a high level of intra-individual
stability in hair cortisol concentrations\textsuperscript{11}.

Several confounding factors should be discussed when interpreting
cortisol levels, especially since previous research has shown
conflicting results. Age and sex and to a weaker degree use of oral
contraceptives, hair washing frequency and hair treatment may influence
hair cortisol levels\textsuperscript{26}. However, in our previous
studies (unpublished data) frequent washing with shampoo, and the use of
hair spray, gel and wax did not affect HCC levels, in line with a prior
report\textsuperscript{27}. On the other hand, the use of chemicals in
hair treatments including; bleaching, dying, straightening, or permanent
waves may interfere with the cortisol
concentrations\textsuperscript{27-28}, although results are
conflicting\textsuperscript{11, 29}. Our use of radioimmuno- assay
minimises the risks of confounding caused by treated, e.g. coloured,
hair.

To our knowledge the highest possible physiological HCC level is
unknown, and no clinical standards or reference values have so far been
presented. An international interlaboratory process is ongoing to
establish benchmark reference values\textsuperscript{30}. The biological
samples of HCC that could be considered extreme values in this study
were replicated and analysed on two independent occasions giving
practically identical results. The cortisol values were logarithmically
transformed in the statistical analyses to reduce the variation possibly
caused by extreme values.

A strength of this study was that the hair was cut into pieces as part
of the analytical process in the laboratory to ensure that all analysed
hair samples were from the latest month. Another strength is that
pulverised hair was used in our analyses. Recent research has concluded
that pulverising hair prior to hormone extraction is
crucial\textsuperscript{31}.

In addition, the study is of a well characterised population. The
attrition was mainly explained by language difficulties and therefore,
we assume that it has negligible impact on data.

\textbf{Interpretation}

The observed progressive increase in cortisol levels during pregnancy is
consistent with previous evidence of increased maternal mean cortisol
level from about gestational week 25 - 28 as assessed by monthly
measurement of cortisol in saliva \textsuperscript{32}. Our present data
indicate a slightly earlier increase of cortisol concentrations during
pregnancy compared to previous studies as we found increased cortisol
levels as early as gestational weeks 18- 21 \textsuperscript{16}. This
echoes the benefit of using HCC which reflects the average cortisol
concentrations over extended periods of time. The previously established
transient increase in cortisol levels associated with labour and the
subsequent decrease during the subsequent four
days\textsuperscript{33-34} was not evident in our results. This was
expected, as each measurement covers one month which makes short-lived
fluctuations difficult to measure using hair extracts, and the hair
sample taken during labour also included one week before until three
weeks after childbirth. Hence, the elevation of cortisol associated with
labour was probably outweighed by the downswing in cortisol in the first
three postpartum weeks, in agreement with prior
findings\textsuperscript{33, 35}. In our study, the cortisol levels at
the first three months postpartum remained slightly higher than in the
second trimester, consistent with earlier reports of prolonged cortisol
elevation for two to three postpartum months \textsuperscript{36-38}.
This is in accordance with the reported suppressed dexamethasone test up
to six weeks postpartum and blunted ACTH response to CRH up to 12 weeks
postpartum \textsuperscript{39} suggesting a slow restoration of the HPA
system functions. It seems possible that ACTH has a role in the observed
slow normalisation of cortisol level postpartum.

The present finding of higher cortisol levels among primiparous women in
line with prior reports may reflect these women's worries, anxiety and
stress about the upcoming labour \textsuperscript{21-22, 40-42}. It is
notable that the tendency for slowly escalating cortisol levels observed
between weeks 14 and 25 is broken thereafter in multiparae, and the
cortisol level becomes lower in the third month before childbirth, and
then increases again following the same pattern as for primiparae but
remaining lower. The explanation for this could be a more rapid
inhibition of the mothers\selectlanguage{ngerman}´ hypothalamic secretion of CRH by the placenta
CRH secondary to adaptive processes during the longstanding inhibition
during previous pregnancies. The influence of parity on the cortisol
level vanished directly after the childbirth and remained that way,
consistent with previous observations on salivary cortisol
levels\textsuperscript{22}.

The postpartum cortisol levels, were not related to those in the former
part of the second trimester but rather to those from about GW 18 until
childbirth, a period when the placenta CRH is becoming more dominant in
the regulation of the rising cortisol level \textsuperscript{32}. This
suggests that the HPA-axis has not fully normalised in the first three
postpartum months but is still under the influence of pregnancy-related
HPA alterations.

Taken together, the results suggest that the HPA axis may respond
differently to the placenta production of cortisol in multiparae. One
explanation could be that the negative feedback system is more prepared
and suppresses the cortisol production of the adrenal cortex quicker and
more effectively secondary to the initiation of cortisol placenta
production. Such a theory would not only explain the lower concentration
of cortisol in multiparae but also the lack of association between
cortisol levels in GW 14 -17 and the levels found in the periods when
placenta production has started. Similarly, in primiparae, the
concentrations are dominated for longer by the woman's own secretion,
thereby explaining the closely related monthly cortisol levels of the
second trimester and the lack of relation to the levels found in the
third trimester.

\textbf{Conclusion}

Monthly measurements of HCC appear to closely mirror the activity of the
HPA-axis during pregnancy. Increasing cortisol concentrations were found
during pregnancy, with a decrease three months prior to childbirth in
multiparae. The results suggest a quicker suppression of the
hypothalamic CRH production by placenta CRH in multiparous women.

\textbf{Acknowledgement}

We thank coordinating midwife Sonja Ekerstam, Department of Obstetrics
and Gynaecology, Värnamo, for the excellent practical work with the
study, and PhD Marie Bladh, for statistical analysis and advice.

\textbf{Funding:} The Medical Research Council of Southeast Sweden

\textbf{Disclosure of interest:} The authors report no conflicts of
interest

\textbf{Contribution to authorship}

IM had the original idea for the study.

GS, ÅF, ET and AJ planned and performed the study and interpreted the
results.

All authors contributed to the interpretation of the data and revision
of the manuscript, and gave input at all stages of the study

\textbf{Details of ethical approval:} The study was approved by the
Regional Ethical Review Board in Linköping nr 2011/499-31 (13-03-12).

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2008;31(1):92-106.

35. Cheng CY, Pickler RH. Maternal psychological well-being and salivary
cortisol in late pregnancy and early post-partum. Stress and Health.
2010;26(3):215-24.

36. Groer MW. Differences between exclusive breastfeeders,
formula-feeders, and controls: a study of stress, mood, and endocrine
variables. Biol Res Nurs. 2005;7(2):106-17.

37. Jung C, Ho JT, Torpy DJ, Rogers A, Doogue M, Lewis JG, et al. A
longitudinal study of plasma and urinary cortisol in pregnancy and
postpartum. J Clin Endocrinol Metab. 2011;96(5):1533-40.

38. Kammerer M, Adams D, Castelberg Bv BV, Glover V. Pregnant women
become insensitive to cold stress. BMC Pregnancy Childbirth.
2002;2(1):8.

39. Magiakou MA, Mastorakos G, Rabin D, Dubbert B, Gold PW, Chrousos GP.
Hypothalamic corticotropin-releasing hormone suppression during the
postpartum period: implications for the increase in psychiatric
manifestations at this time. J Clin Endocrinol Metab. 1996;81(5):1912-7.

40. Bouyou-Akotet MK, Issifou S, Meye JF, Kombila M, Ngou-Milama E, Luty
AJ, et al. Depressed natural killer cell cytotoxicity against Plasmodium
falciparum-infected erythrocytes during first pregnancies. Clin Infect
Dis. 2004;38(3):342-7.

41. Grajeda R, Perez-Escamilla R. Stress during labor and delivery is
associated with delayed onset of lactation among urban Guatemalan women.
J Nutr. 2002;132(10):3055-60.

42. Valsamakis G, Papatheodorou DC, Chalarakis N, Vrachnis N,
Sidiropoulou EJ, Manolikaki M, et al. In pregnancy increased maternal
STAI trait stress score shows decreased insulin sensitivity and
increased stress hormones. Psychoneuroendocrinology. 2017;84:11-6.

\textbf{Table 1. Sociodemographic data and characteristics for primi-
and multiparas}\selectlanguage{english}
\begin{longtable}[]{@{}llllll@{}}
\toprule
\begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
\textbf{Primipara}\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
\textbf{Multipara}\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
\textbf{p-value}\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{n=125}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{\%}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{n=232}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{\%}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Age-groups}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
15-24 years\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
25\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
20.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
21\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
9.1\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
25-34 years\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
94\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
75.2\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
167\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
72.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
35-39 years\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4.8\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
36\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
15.5\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
40 or older\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
8\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3.4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Civil status}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.438\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Married/co-habited\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
125\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
100\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
226\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
98.7\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Partner\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Single\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Ethnicity}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.191\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Swedish\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
115\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
93.5\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
207\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
91.2\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
European\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
8\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6.5\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
14\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6.2\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Non-European\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2.6\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Education}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.055\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Primary school\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1.3\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1.6\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Secondary school\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
44\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
35.5\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
110\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
47.6\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
University college\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
43\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
34.4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
51\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
22.1\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
University\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
36\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
28.8\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
67\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
29.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Employment}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Employee\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
85\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
68.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
146\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
62.7\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.314\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Self-employed\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4.8\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
12\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5.2\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.885\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Student\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3.9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.949\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Unemployed\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4.0\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3.9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.949\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Long sick-leave\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.8\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.654\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Tobacco use}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Before pregnancy\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
48\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
20.9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
20.8\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.988\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Until GW 25\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
12\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5.2\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1.6\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1.6\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.094\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Medication until GW 25}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Steroids\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
9.4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
12\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
16.9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.316\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Psychotropic\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
12.5\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
12\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
16.9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.568\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Analgesic\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
9.4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
14\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
19.7\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.191\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Other\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
27\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
84.4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
45\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
64.3\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.039\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

GW = gestational week

\textbf{Other -- folic acid, iron, proton-pump inhibitors,
antihistamines, aspirin, thyroxine}

\textbf{Table 2a:} Multivariate analysis of cortisol concentration (HCC)
in relation to each of the nine measurements, for
\textbf{primiparae}(log values)\selectlanguage{english}
\begin{longtable}[]{@{}llllllllll@{}}
\toprule
\begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
GW 14-17\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
GW 18-21\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
GW 22-25\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
3 months prior to childbirth\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
2 months prior to childbirth\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
1 month prior to childbirth\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Childbirth and 1 month postpartum\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
2 months postpartum\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
3 months postpartum\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
GW 14-17\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.810 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.181 (0.036)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.258 (0.166)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.060 (0.472)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.093 (0.362)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.237 (0.116)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.276 (0.049)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.130 (0.377)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
GW 18-21\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.705 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.072 (0.756)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.085 (0.406)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.103 (0.414)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.263 (0.137)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.087 (0.595)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.118 (0.492)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
GW 22-25\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.052 (0.798)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.018 (0.841)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.025 (0.819)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.086 (0.578)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.023 (0.870)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.150 (0.314)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3 months prior to childbirth\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.905 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.119 (0.378)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.241 (0.160)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.256 (0.107)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.229 (0.233)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 months prior to childbirth\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.744 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.075 (0.702)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.201 (0.262)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.225 (0.233)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1 month prior to childbirth\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.417 (0.003)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.273 (0.043)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.187 (0.183)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Childbirth and 1 month postpartum\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.508 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.553 (\textless{}0.001)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
2 months postpartum\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
3 months postpartum\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

GW = gestational week

\textbf{Table 2b:} Multivariate analysis of cortisol concentration (HCC)
in relation to each of the nine measurements for \textbf{multiparae}(log
values)\selectlanguage{english}
\begin{longtable}[]{@{}llllllllll@{}}
\toprule
\begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
GW 14-17\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
GW 18-21\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
GW 22-25\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
3 months prior to childbirth\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
2 months prior to childbirth\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
1 month prior to childbirth\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
birth and 1 month postpartum\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
2 months postpartum\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
3 months postpartum\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Standardised coefficients Beta (p-value)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
GW 14-17\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.561 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.390 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.205 (0.033)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.080 (0.232)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.012 (0.822)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.025 (0.809)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.046 (0.388)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.011 (0.879)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
GW 18-21\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.211 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.105 (0.269)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.136 (0.037)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.014 (0.793)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.086 (0.448)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.101 (0.089)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.060 (0.442)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
GW 22-25\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.152 (0.099)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.036 (0.577)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.034 (0.520)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.135 (0.169)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.009 (0.857)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.031 (0.643)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3 months prior to childbirth\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.740 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.037 (0.567)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.138 (0.296)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.037 (0.591)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-0.115 (0.204)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 months prior to childbirth\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.875 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.230 (0.198)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.013 (0.886)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.002 (0.984)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1 month prior to childbirth\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.024 (0.856)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.014 (0.845)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.012 (0.895)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Childbirth and 1 month postpartum\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.875 (\textless{}0.001)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.846 (\textless{}0.001)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
2 months postpartum\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
-\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
3 months postpartum\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
-\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

GW = gestational week

\textbf{Hosted file}

\verb`HCC Figure.200616.docx`  available at \url{https://authorea.com/users/335624/articles/461482-parity-related-variation-in-cortisol-concentrations-in-hair-during-pregnancy-and-in-the-postpartum-period-a-prospective-cohort-study}

\selectlanguage{english}
\FloatBarrier
\end{document}

