Cortisol Analysis Using a Novel Method of Saliva Collection

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Date

2025-05

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The Ohio State University

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Abstract

Background: Preterm infants in the neonatal intensive care unit (NICU) experience many stressors. Salivary cortisol levels can quantify preterm infants' stress responses. However, better methods are needed to obtain saliva from preterm infants. This study aimed to (1) compare cortisol levels from saliva collected using standard methods to saliva collected using swabs, and (2) determine if duration of saliva collection using standard methods affects cortisol concentration.   Methods: In a cross-sectional study, adults recruited via convenience sampling provided two saliva samples using spit or passive drool methods and timed their collections. The first sample was split into two aliquots, with the first aliquot undergoing no further processing and the second aliquot utilized to saturate a flocked polyester swab. Swabs were centrifuged to extract the saliva. For aim 1, cortisol levels from the first participant-collected sample and the sample absorbed and subsequently extracted from swabs were compared. For aim 2, cortisol levels in the two sequentially collected samples provided using standard methods were compared.   Results: Samples were collected from 24 adults. Cortisol levels from saliva collected by standard methods had a strong positive correlation with cortisol levels from saliva extracted from swabs (rho=0.98, p<.0005). Additionally, the cortisol levels from two saliva samples collected sequentially from each participant were strongly correlated (rho=0.97, p<.0005).   Conclusions: Flocked polyester swabs provide a solution to collecting adequate saliva volumes for cortisol analysis in populations that cannot provide samples using standard spit or drool methods, including preterm infants. In future studies, researchers should consider the amount of time participants take to collect their samples, as cortisol concentrations change over time.

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cortisol, saliva, preterm, NICU, stress, infant

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