Improving ambulatory saliva-sampling compliance in pregnant women

  • \(\textit {Objective:}\) Noncompliance with scheduled ambulatory saliva sampling is common and has been associated with biased cortisol estimates in nonpregnant subjects. This study is the first to investigate in pregnant women strategies to improve ambulatory saliva-sampling compliance, and the association between sampling noncompliance and saliva cortisol estimates. \(\textit {Methods:}\) We instructed 64 pregnant women to collect eight scheduled saliva samples on two consecutive days each. Objective compliance with scheduled sampling times was assessed with a Medication Event Monitoring System and self-reported compliance with a paper-and-pencil diary. In a randomized controlled study, we estimated whether a disclosure intervention (informing women about objective compliance monitoring) and a reminder intervention (use of acoustical reminders) improved compliance. A mixed model analysis was used to estimate associations between women's objective compliance and their diurnal cortisol profiles, and between deviation from scheduled sampling and the cortisol concentration measured in the related sample. \(\textit {Results:}\) Self-reported compliance with a saliva-sampling protocol was 91%, and objective compliance was 70%. The disclosure intervention was associated with improved objective compliance (informed: 81%, noninformed: 60%), \(\it F\)(1,60)  = 17.64, \(\it p\)<0.001, but not the reminder intervention (reminders: 68%, without reminders: 72%), \(\it F\)(1,60)  = 0.78, \(\it p\) = 0.379. Furthermore, a woman's increased objective compliance was associated with a higher diurnal cortisol profile, \(\it F\)(2,64) = 8.22, \(\it p\)<0.001. Altered cortisol levels were observed in less objective compliant samples, \(\it F\)(1,705) = 7.38, \(\it p\) = 0.007, with delayed sampling associated with lower cortisol levels. \(\textit {Conclusions:}\) The results suggest that in pregnant women, objective noncompliance with scheduled ambulatory saliva sampling is common and is associated with biased cortisol estimates. To improve sampling compliance, results suggest informing women about objective compliance monitoring but discourage use of acoustical reminders.

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Metadaten
Author:Julian MöllerGND, Roselind LiebGND, Andrea Hans MeyerGND, Katharina LötscherGND, Bettina KrastelGND, Gunther MeinlschmidtGND
URN:urn:nbn:de:hbz:294-73260
DOI:https://doi.org/10.1371/journal.pone.0086204
Parent Title (English):PLoS ONE
Subtitle (English):a randomized controlled study
Publisher:Public Library of Science
Place of publication:San Francisco
Document Type:Article
Language:English
Date of Publication (online):2020/07/14
Date of first Publication:2014/01/22
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Volume:9
Issue:1, Artikel e86204
First Page:e86204-1
Last Page:e86204-8
Institutes/Facilities:LWL-Universitätsklinikum Bochum, Klinik für Psychosomatische Medizin und Psychotherapie
Research Department of Neuroscience
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International