Which adrenal changes occur during pregnancy?

Which adrenal changes occur during pregnancy?

• A. Cortisol increases to eightfold due to elevated ACTH; aldosterone increases; testosterone increases around 28 weeks
• B. Cortisol decreases; aldosterone decreases; testosterone decreases
• C. No significant changes
• D. Only aldosterone increases with no cortisol change

Answer: (A)

During pregnancy the adrenal system ramps up to support both mother and fetus. Placental CRH rises and stimulates the pituitary to secrete more ACTH, which drives the adrenal cortex to produce more cortisol. This cortisol surge is substantial and helps with energy mobilization and fetal organ maturation, especially near term. At the same time, the renin–angiotensin–aldosterone system is upregulated and estrogen increases angiotensinogen, leading to higher aldosterone to support expanded plasma volume and sodium retention for adequate placental perfusion. Androgens also rise as placental and fetal adrenal sources increase androgen production, with a notable rise around mid-to-late pregnancy, around 28 weeks. Overall, these coordinated changes reflect the major shifts in adrenal hormones that support the pregnant state.

During pregnancy the adrenal system ramps up to support both mother and fetus. Placental CRH rises and stimulates the pituitary to secrete more ACTH, which drives the adrenal cortex to produce more cortisol. This cortisol surge is substantial and helps with energy mobilization and fetal organ maturation, especially near term. At the same time, the renin–angiotensin–aldosterone system is upregulated and estrogen increases angiotensinogen, leading to higher aldosterone to support expanded plasma volume and sodium retention for adequate placental perfusion. Androgens also rise as placental and fetal adrenal sources increase androgen production, with a notable rise around mid-to-late pregnancy, around 28 weeks. Overall, these coordinated changes reflect the major shifts in adrenal hormones that support the pregnant state.