Supplemental Table S1. Adrenal-related hormone levels in pregnant and non-pregnant women Concentration in nonConcentration during pregnant women pregnancy (third trimester) CRH 0.77-2.5 pmol/l Rises by 1000-fold 1 ACTH 2.2-13.3 pmol/L Circulating maternal ACTH is (10-60 pg/ml) increased above nonpregnancy levels, but still remains within the normal range2 Total plasma cortisol 276-690 nmol/L 2-to-3-fold elevation3,4 (10-25 µg/dL) Free plasma cortisol 140-700 nmol/L 2-to-4-fold elevation5,6,7,8 (5-25 µg/dL) Salivary cortisol 7-20 nmol/L More than 2 fold elevation8,9 (253 – 717 ng/dL) 11-deoxycorticosterone <303 pmol/L 2 fold during the first (DOC) trimester to 10-fold in the third trimester10,11 11-deoxycortisol 7-18 nmol/L 2-fold increase12 17-OH progesterone Follicular phase : Up to 84 nmol/L13 < 2.4 nmol/L (<80 ng/dL) Luteal phase: <8.6 nmol/L (<285 ng/dL) Progesterone 17βEstradiol Estrone Estriol Plasma renin activity Aldosterone DHEA-S <0.64-51 nmol/L (<0.2-16 ng/mL ) depending on the menstrual cycle phase 147-1835 pmol/L (40-500 pg/ml) depending on the menstrual cycle phase 111-740 pmol/L (3-20 ng/dL) depending on the menstrual cycle phase 0.01-0.05 nmol/L 0.003-0.016 ng/ml (depending on the menstrual cycle phase) 6.4-44.8 pmol/L/min (0.5-3.5 ng/mL/h) 221-831 pmol/L (8-30 ng/dL) Up to 10-15 fold elevation above luteal phase levels 14 22-110 nmol/L15 (6-30 ng/mL) 7.4-111 nmol/L15 (200-3000 ng/dL) 34.67-104 nmol/L15 (10-30 ng/mL) 3-to-7-fold increase14,16,17 5-to-7-fold elevation during the 1st trimester; up to 1020fold elevation at the 38th week12,18,19 0.8-6.5 µmol/L13 18-29 years: 1.14-8.63 µmol/L (0.44-3.32 µg/mL) Levels decline with aging Supplemental TableS1. Reference values in non pregnant normal women and during the third trimester of pregnancy. Bibliography for Table S1 1. Hillhouse, E.W. & Grammatopoulos, D.K. Role of sress peptides during human pregnancy and labour. Reproduction 124, 323-329 (2002). 2. Carr, B.R., Parker, Jr C.R., Madden, J.D., MacDonald, P.C. & Porter, J.C. Maternal plasma adrenocorticotropin and cortisol relationship throughout human pregnancy. Am J Obstet Gynecol 139, 416-422 (1981). 3. Nolten, W.E., Linderheimer, M.D., Rueckert, P.A., Oparil, S., Ehrlich, E.N. Diurnal patterns and regulation of cortisol secretion in pregnancy. J Clin Endocrinol Metab 51, 466-472 (1980). 4. Odagiri, E. et al. Hypercortisolisn and the resistance to dexamethasone suppression during gestation. Endocrinol Jpn, 35, 685-690 (1988). 5. Cousins, L., Rigg, L., Hollingsworth, D., Meis, P. & Halberg, F. Qualitative and quantitative assessment of the circadian rhythm of cortisol in pregnancy. Am J Obstet Gynecol 145, 411-416 (1983). 6. Nolten, W.E. & Rueckert, P.A. Elevated free cortisol index in pregnancy: possible regulatory mechanisms. Am J Obstet Gynecol 139, 492-498 (1981). 7. Burke, C.W. & Roulet, F. Increased exposure of tissue to cortisol in late pregnancy. Br Med J 1, 657-659 (1970). 8. Allolio, B. et al. Diurnal salivary cortisol pattern during pregnancy and after delivery: relationship to plasma corticotrophin releasing-hormone. Clin Endocrino (Oxf) 33, 279-289 (1990). 9. Scott, E.M., McGarrigle, H.H. & Lachelin, G.C. The increase in plasma and saliva cortisol levels in pregnancy is not due to the increase in corticosteroid binding globulin levels. J Clin Endocrinol Metab 71, 639-644 (1990). 10.Nolten, W.E., Lindheimer, M.D., Oparil, S. & Ehrlich, E.N. Desoxycorticosterone in normal pregnancy. I. Sequential studies of the secretory patterns of desoxycorticosterone, aldosterone, and cortisol. Am J Obstet Gynecol 132, 414-420 (1978) 11.Nolten, W.E., Lindheimer, M.D., Oparil, S., Rueckert, P.A. & Ehrlich, E.N. Desoxycorrticosterone in normal pregnancy. II. Cortisol-dependent fluctuations in free plasma desoxycorticosterone. Am J Obstet Gynecol 133, 644-648 (1978) 12.Dorr, H.G. et al. Longitudinal study of progestins, mineralcorticoids and glucocorticoids throughout human pregnancy. J Clin Endocrinol Metab 68, 863-868 (1989). 13.Abbassi-Ghanavati, M., Greer, L.G. & Cunningham, F.G. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol 114, 1326-1331 (2009). 14.Wilson, M., Morganti, A.A., Zervoudakis, I., Letcher, R.L. & Romney, B. Blood pressure, the reninaldosterone system and sex steroids throughout normal pregnancy. Am J Med 68, 97-104 (1990). 15. During Pregnancy: Yen SS: Endocrine-metabolic adaptations in pregnancy. p. 947. In Yen SSC, Jaffe RB, Barbieri RL [eds.] Reproductive endocrinology: physiology, pathophysiology and clinical management. WB Saunders Company, Philadelphia, 1991 16.Brown, M.A., Wang, J. & Whitworth, J.A. The renin-angiotensin-aldosterone system in pre-eclampsia. Clin Exp Hypertens 19, 713-726 (1997). 17.Brown, M.A., Zammit, V.C., Mitar, D.A. & Whitworth, J.A. Renin aldosterone relationship in pregnancyinduced hypertension. Am J Hypertens 5, 366-371 (1992). 18.Ehrlich, E.N. Mineralocorticoids in normal and hypertensive pregnancies. Semin Perinatol 2, 61-71 (1978). 19.Nolten, W.E. & Ehrlich, E.N. Sodium and mineralocorticoids in normal pregnancy. Kidney Int 18, 162-172 (1980).