During pregnancy, cortisol levels rise to approximately how many times the pre-pregnancy level?

• A. Twofold
• B. Eightfold
• C. Tenfold
• D. Not changed

Answer: (B)

Cortisol rises significantly during pregnancy due to placental CRH driving increased maternal (and fetal) glucocorticoid production. By late gestation, maternal cortisol is about eight times higher than pre-pregnancy levels. This substantial rise supports fetal maturation, especially lung development and surfactant production, and helps meet energy needs for both mother and fetus. The placenta provides some protection to the fetus by converting much cortisol to cortisone via 11β-HSD2, but fetal exposure still increases as pregnancy progresses.