Investigating Non-Pharmacological Stress Reduction Interventions in Pediatric Patients Confirmed with Salivary Cortisol Levels: A Systematic Review
Grigoropoulou et al.
The finding, in our words
Nine studies of non-pharmacological interventions in hospitalised children demonstrated reduced anxiety and distress when outcomes were confirmed by salivary cortisol, supporting saliva as an objective stress biomarker in paediatric settings. The authors concluded that higher-quality studies are needed to strengthen the evidence base for saliva cortisol as a reliable anxiety measurement tool.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
This study used home self-collected saliva samples to successfully monitor cytokines and cortisol in mothers and infants, finding that a community singing intervention significantly reduced salivary interleukin-6 levels in mothers with postnatal depression.
A validated LC-MS/MS assay successfully measured 13 steroid hormones and two synthetic steroids in saliva, requiring only 50 microlitres, or down to 2 to 5 microlitres for nine analytes. This shows saliva's viability for non-invasive, patient-centric microsampling and decentralised monitoring in paediatric, neonatal and adult populations.
During ACTH stimulation, salivary cortisol correlated only weakly with serum and gave modest accuracy: saliva does not reliably replace serum cortisol for adrenal insufficiency. A concrete limit.
Salivary glucocorticoid concentrations were comparable across Salivette Cortisol, passive drool and SalivaBio collection methods, and remained stable for 72 hours at room temperature and 4 degrees Celsius with no significant degradation after repeated freeze-thaw cycles. In children under six years, the SaliPac pacifier swab was well tolerated and collected sufficient saliva for steroid analysis in under four minutes.
Maternal choline intake was found to reduce the impact of adverse childhood experiences on maternal and infant cortisol responses, highlighting the role of nutrition in buffering stress biology. This supports decentralised diagnostics by demonstrating the feasibility and value of self-collected saliva samples for longitudinal, patient-centric monitoring of hormonal biomarkers in real-world settings.