Document Detail


Fetal adrenal gland volume and cortisol/dehydroepiandrosterone sulfate ratio in inflammation-associated preterm birth.
MedLine Citation:
PMID:  18310376     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Fetal adaptation to stress is regulated in part by the pituitary-adrenocortical system. The stress hormones dehydroepiandrosterone sulfate (DHEAS) and cortisol have opposing effects: cortisol suppresses while DHEAS enhances immune functions. We sought to estimate the impact of intraamniotic inflammation on fetal adrenal gland volume and cortisol-to-dehydroepiandrosterone sulfate ratio (fetal stress ratio) in pregnancies complicated by preterm birth.
METHODS: Fifty-one consecutive singleton fetuses of mothers who had an indicated amniocentesis to rule out infection were analyzed. Intraamniotic inflammation was assessed by proteomic profiling of amniotic fluid for the biomarkers of the Mass Restricted score. The Mass Restricted score ranges from 0 (biomarkers absent) to 4 (all biomarkers present), with Mass Restricted scores of 3 or 4 indicating severe intraamniotic inflammation. Fetal adrenal gland volume was assessed by three-dimensional ultrasonography and corrected for estimated fetal weight. Interleukin-6 (IL-6), cortisol, and DHEAS were measured by immunoassay.
RESULTS: Women with intraamniotic inflammation delivered earlier (27.8+/-3.4 weeks, n=16, compared with 32.3+/-3.0 weeks, n=35, P<.001), and their fetuses had higher cord blood IL-6 (P=.011) and higher corrected adrenal gland volumes (P=.027). Cord blood IL-6 levels were in direct relationship with corrected adrenal volume (r=0.372, P=.019), fetal cortisol (r=0.428, P=.010), and DHEAS (r=0.521, P<.001). However, fetuses exposed to intraamniotic inflammation had an overall lower fetal stress ratio (P=.034). These results maintained after adjusting for gestational age, uterine contractions, and steroid exposure.
CONCLUSION: Fetuses exposed to intraamniotic inflammation have higher adrenal gland volumes and lower cortisol-to-DHEAS ratios, suggesting that the fetal adrenocortical axis plays a role in the intrauterine adaptation to inflammation.
Authors:
Catalin S Buhimschi; Ozhan M Turan; Edmund F Funai; Humberto Azpurua; Mert-Ozan Bahtiyar; Sifa Turan; Guomao Zhao; Antonette Dulay; Vineet Bhandari; Joshua A Copel; Irina A Buhimschi
Related Documents :
15683096 - Pituitary apoplexy presenting during pregnancy.
15233556 - Genetic prenatal ret testing and pregnancy management of multiple endocrine neoplasia t...
16822826 - Reproductive outcome of women with 21-hydroxylase-deficient nonclassic adrenal hyperpla...
2248596 - Prolactin and related peptides in pregnancy.
17052196 - Maternal nutrition during pregnancy and health of the offspring.
17535086 - Microscopic chorionic pseudocysts in placental membranes: a histologic lesion of in ute...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  111     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-04-24     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  715-22     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adrenal Glands / anatomy & histology*
Adult
Amniotic Fluid / chemistry
Biological Markers / analysis
Chorioamnionitis / physiopathology*,  ultrasonography
Dehydroepiandrosterone Sulfate / blood*
Female
Fetal Blood / chemistry*
Humans
Hydrocortisone / blood
Infant, Newborn
Infant, Premature / blood
Interleukin-6 / blood
Organ Size
Pituitary-Adrenal System
Pregnancy
Premature Birth / physiopathology*
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Ultrasonography, Prenatal*
Grant Support
ID/Acronym/Agency:
R01 HD 047321-01/HD/NICHD NIH HHS; R01 HD047321/HD/NICHD NIH HHS; R01 HD047321-01/HD/NICHD NIH HHS; R01 HD047321-02/HD/NICHD NIH HHS; R01 HD047321-03/HD/NICHD NIH HHS; R01 HD047321-04/HD/NICHD NIH HHS; R01 HD047321-05/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Interleukin-6; 57B09Q7FJR/Dehydroepiandrosterone Sulfate; WI4X0X7BPJ/Hydrocortisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Miscarriage risk for asymptomatic women after a normal first-trimester prenatal visit.
Next Document:  Hospital, simulation center, and teamwork training for eclampsia management: a randomized controlled...