Cortisol as a predictor of preclampsia: Role of anxiety. A Systematic Review

Background: Pregnancy is a physiological state of great vulnerability for women, in which physical and mental changes occur, which if they become pathological, can significantly alter the health of the mother and the baby. This period can be related to an increase in the possibility of developing psychiatric disorders such as anxiety. Maternal anxiety has been associated in multiple studies with adverse outcomes during pregnancy such as hypertensive disorders, particularly pre-eclampsia. Anxiety disorders represent chronic stress states that have been linked to alterations in cortisol levels. Objective: To determine if the cortisol level can be useful as a marker of preeclampsia in pregnant women with anxiety disorders.

Methods
A systematic review of the literature was carried out using the PRISMA methodology. Studies published between 2011 and 2021 in Primary databases were included: PubMed, Science Direct, Lilacs; Clinical trial databases: ClinicalTrials.gov. Systematic review databases: Cochrane Gray Literature Review and Search Database: Academic Google in Spanish and English. Reviews were evaluated using the Rayyan tool.

Results
A total of 1828 articles were found with the initial search, of which 511 presented duplicates and were excluded. Through 6 reviewers, a total of 1317 abstracts found using the search equations, including gray literature, were evaluated.

Conclusions
it is possible to consider a relationship between cortisol levels, as anxiety markers, and their ability to predict the risk of developing pre-eclampsia, taking into account the growing interest in the search for biological markers in different psychiatric entities at present.