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RecruitingNCT05969431Updated Nov 27, 2024

Hair Cortisol as Marker of Chronic Stress in Preterm and Term Fathers - Fathair-study

An observational study in Stress, Psychological, Father-Child Relations and Premature Birth, sponsored by University of Cologne. Recruiting at 1 site in Germany. Open to participants aged 1 Day to 7 Days, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-11-27.

Sponsored by University of Cologne · Observational

From the registry’s dates

  • Primary completion was expected by Jun 2025, 1 year 3 months ago, but the record still lists the study as recruiting.
  • Started Oct 2024; still recruiting 2 years later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
120
Ages
1 Day to 7 Days
Sex
All
01

Study summary

The goal of this observational study is to compare the paternal hair cortisol as a marker for chronic stress in prematurely born children to maturely born children.

The main questions it aims to answer are:

  • How differ the cortisol level between groups?
  • How change the cortisol level over time?
  • Are there secondary outcomes associated to the cortisol level of fathers? Participants will give a hair sample to analyse the cortisol level and fill out questionnaires at three time points. At six months of the infant's age, the investigators will also measure the paternal sensitivity.
Read the detailed description

For expectant parents, the birth of a child is often a stressful situation. In the case of a premature birth, the psychological stress is usually increased because the parents frequently could not prepare for the birth. Therefore, the researcher would like to investigate this stress of fathers of newborn children.

For this purpose, the stress hormone cortisol in the fathers' hair will be analysed and questionnaires on the fathers' mental health will be collected. Subsequently, the differences between fathers of prematurely born and of maturely born children will be compared.

The investigators will do the analyses at three time points: the first time point will be at the first week after birth, the second three months and the third six months after birth. At six months of the infant's age, additionally the paternal sensitivity will be measured.

The compared groups will differ with respect to gestational age: Group 1 includes preterm infants with a gestational age below 32 weeks and a birth weight \<1500 grams (very low birthweight infants), group 2 preterm infants with a gestational age between 32 0/7 to 36 6/7 (moderate and late preterm infants) and group 3 consists of mature infants (over 37 weeks gestational age).

02

Conditions studied

  • Stress, Psychological
  • Father-Child Relations
  • Premature Birth
03

In context

Premature Birth

2,554 studies on the registry are indexed under Premature Birth; 498 are open to participants now.

This study's planned enrollment of 120 is close to the median of 112 across 777 observational studies indexed under Premature Birth.

Browse Premature Birth studies →

Lead sponsor

University of Cologne is the lead sponsor of 199 studies on the registry; 26 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
1 Day to 7 Days
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Probability sample

Study population

Fathers of newborns born at the university hospital of Cologne

Inclusion criteria

  • Premature or mature infant (22 0/7 to 42 0/7 weeks of gestation)
  • For mature infants (37 0/7 to 42 0/7 weeks of gestation) undisturbed neonatal period
  • No severe malformations or genetic diseases of the newborn child
  • Sufficient knowledge of German of the father
  • written consent of the custodial parents

Exclusion criteria

Exclusion Criteria:

  • adoptive or foster paternity
  • hair length below 3 cm at the posterior vertex region of the back of the father's head
  • endocrine disorders, especially of the adrenocortical system (e.g. Cushing syndrome, adrenal insufficiency)
  • taking steroidal medications or other drugs that affect the activity of the hypothalamic-pituitary-adrenocortical system
  • paternal psychological or severe physical illness
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
120 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • fathers of mature infants

    Fathers of newborns' above 37 weeks of gestation

    Diagnostic Test: measurement of cortisol level

  • fathers of moderate and late preterm infants

    Fathers of moderate and late preterm infants, i.e. gestational age from 32 0/7 to 36 6/7 weeks of gestation.

    Diagnostic Test: measurement of cortisol level

  • fathers of very low birth weight preterm infants

    Fathers of very low birth weight preterm infants, i.e. gestational age from 22 0/7 to 31 6/7 weeks of gestation and with a birth weight below 1500 g.

    Diagnostic Test: measurement of cortisol level

Interventions

  • Diagnostic testmeasurement of cortisol level

    We will measure the cortisol level from the hair sample of the father at three time points. Furthermore the father will answer questionnaires at three time points and the paternal sensitivity is measured once.

    Also known as: questionnaire

06

What researchers measure

Primary outcomes

  1. hair cortisol level

    The level of cortisol will be measured in the hair of the fathers by liquid chromatography with tandem mass spectrometry. This test is validated in human hair and the current gold standard method in hair steroid analysis. The analytic procedure follows a published laboratory protocol that has excellent sensitivity, specificity and reliability.

    Time frame: first week after birth, 3 and 6 months after birth

Secondary outcomes

  1. Cortisone, testosterone, progesterone, dehydroepiandrosterone level in the paternal hair

    The level of these hormones (cortisone, testosterone, progesterone, dehydroepiandrosterone) will be measured in the hair of the fathers by liquid chromatography with tandem mass spectrometry. This test is validated in human hair and the current gold standard method in hair hormone analysis. The analytic procedure follows a published laboratory protocol that has excellent sensitivity, specificity and reliability.

    Time frame: first week after birth, 3 and 6 months after birth

  2. paternal sensitivity

    The paternal sensitivity and the father-child-interaction will be measured during a five-minute-videotape of the father changing the infants' diapers and playing with the infant. The paternal sensitivity will be measured by a 9-point scale. The score can range from 1 to 9, where 1 means lack of sensitivity and 9 means very sensitive. The classification is a validated tool and is done by two trained and reliable evaluators from the Department of Developmental Science and Special Education. The evaluators are blinded.

    Time frame: 6 months after birth

  3. father-child-interaction

    The father-infant-interaction is investigated during the same video as the paternal sensitivity using Mannheim Rating Scales by a blinded psychologist. Mannheim Rating Scale is a good validated standardized observation instrument. Stimulation and response from the father as well from the infant are being recorded. Different communication channels can be used by father and child (vocal, facial or motor). All behaviors are analyzed at intervals of five seconds (event coding). The values are formed from the sum of the coded events. The scale ranges from 0 to 60. If there is no interaction, the scale is 0. If there is an interaction in each interval (every 5 seconds in a 5 minute videotape), the scale is 60. The father-child interaction is better if the scale is higher.

    Time frame: six months of age

  4. paternal depression

    Paternal depression is assessed with the Edinburgh Postnatal Depression Scale (EPDS). It is a self-report questionnaire to measure depressive symptoms especially after birth and it consists of 10 questions. For each question the response choice are assigned point values (how often a symptom occurred during the last week). The point values are summed to a total measure score. The score ranges from 0 to 30. Zero points represents no symptoms of depression, a score of 13 or higher is interpreted to indicate a risk of depression.

    Time frame: first week, 3 and 6 months after birth

  5. socioeconomic status

    There will be questions to the household income per month, the parents' highest school-leaving certificate and the housing situation

    Time frame: first week after birth

  6. social support

    Social support is assessed with the short German version of the questionnaire on social support (F-SozU K-22). The questionnaire records the subjectively perceived or anticipated support from the social environment. There are 22 items and the test person can indicate the degree of agreement on a five-level Likert scale (from 1 = does not apply to 5 = applies completely). The scale ranges from a minimum of 22 points to a maximum of 110 points. The higher the score, the better the subjectively perceived or anticipated support.

    Time frame: three months after birth

  7. impact of event scale

    Symptoms for post-traumatic stress is assessed with the impact of event scale - revised (IES-R). It is a self-report questionnaire and consists of 22 questions. For each question the response choice are assigned point values (how often a symptom occurred during the last week). The sub-scale values are summed by the corresponding sub-scale items. The three sub-scales are: intrusion, avoidance and hyperarousal. The overall result is calculated by a formula. The score ranges from -4,36 to 2,99. A result above 0 is interpreted to indicate a risk for post-traumatic stress disorder.

    Time frame: six months after birth

  8. Parental Bonding

    Parental Bonding is assessed with the parental bonding questionnaire (PBQ). It consists of 25 items and each item is rated on a scale from 0 to 3 points (response range from "very like" to "very unlike"). There are four sub-scales and the point values of each sub-scale are summed to a total measure score. The four sub-scales are: impaired bonding, rejection and anger, anxiety about care, risk of abuse. The higher the score, the higher the risk of a disorder in each area of the sub-scale.

    Time frame: first week, 3 and 6 months after birth

  9. Parental Stress

    Parental stress is assessed with the German form of the parenting stress index (PSI). It consists of 48 items. The test person can indicate the degree of agreement on a five-level Likert scale (from 1 = does not apply to 5 = applies completely). There are 12 subscales, each consisting of 4 items and the points on the Likert scale are added. In each subscale there can be a minimum of 4 and a maximum of 20 points. The higher the score, the higher the parental stress.

    Time frame: six months after birth

  10. Parental Stress

    The perceived parental stress is assessed by the German version from the perceived stress scale (PSS-10). It is a self-report questionnaire to measure symptoms of stress and it consists of 10 questions. For each question the response choice are assigned point values (how often a symptom occurred during the last month). There are two subscales (perceived helplessness and perceived self-efficacy). The subscale perceived self-efficacy are reversed score for the total score. The point values of both subscales are summed to a total measure score. The score ranges from 0 to 50. Zero points represents no symptoms of stress, higher scores reflect greater levels of stress.

    Time frame: first week, 3 and 6 months after birth

07

Study locations

1 of 1 sites recruiting
  • University Hospital of Cologne
    Cologne, Northrhine-westfalia 50931, Germany
    Recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 27, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05969431
Lead sponsor
University of Cologne
Collaborators
University of Siegen
Responsible party
Katrin Mehler (Associate Professor, University of Cologne) — Principal investigator
First posted
Aug 1, 2023
Start date
Oct 1, 2024
Primary completion
Jun 30, 2025 (estimated)
Completion
Dec 31, 2025 (estimated)
Last update
Nov 27, 2024

Study contacts

Eva Heine, Dr. med.
Contact
eva.heine@uk-koeln.de
004922147885663
Katrin Mehler, PD Dr.
Contact
katrin.mehler@uk-koeln.de
004922147885663
Katrin Mehler, PD Dr.
principal investigator · University of Cologne

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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