脐血清皮质醇和硫化脱氢表雄酮在足月分娩时的作用

Concentrations of cortisol and dehydroepiandrosterone sulfate in fetal umbilical cord blood for term labor

目的 探讨脐血清皮质醇和硫化脱氢表雄酮在足月分娩时的作用。方法 采用放射免疫法测定 10 0例足月分娩新生儿脐血清中皮质醇和硫化脱氢表雄酮的含量 ,其中A组 18例 ,为无阵痛、选择性剖宫产产妇 ;B组 10例 ,为潜伏期剖宫产产妇 ;C组 12例 ,为活跃期剖宫产产妇 ;D组 60例 ,为阴道分娩产妇。结果 (1)新生儿脐血清皮质醇含量随孕周增加而增加 ,至 3 9周时脐血清皮质醇含量达峰值 ,为 (2 86± 5 0 ) μg/L ,42周时 ,皮质醇含量下降 ,接近孕 3 7周水平 (194± 70 ) μg/L ,血清硫化脱氢表雄酮含量变化与之相平行 ,两者呈正相关 [相关系数 (r) =0 .46,P <0 .0 5 ]。 (2 )A、B、C组随着产程进展 ,皮质醇含量增加 ,硫化脱氢表雄酮含量不增加。 (3 )D组新生儿脐血清皮质醇含量较其他 3组高 (P <0 .0 1)。硫化脱氢表雄酮含量变化无差异。

Objective To study the effect of cortisol and dehydroepiandrosterone sulfate(DHEA S)in fetal umbilical cord blood on term labor. Methods Cortisol and DHEA S concentrations were measured By radioimmunoassay in 100 term fetal umbilical cord blood. They were divided into four groups. Group A selective cesarean section without any birth pain ( n =18),Group B cesarean section in latent phase( n =10),Group C cesarean section in active phase( n =12),Group D spontaneous vaginal deliver( n =60). Results The concentrations of fetal umbilical cord cortisol in spontaneous vaginal deliver group was gradually increased with gestational week. The peak level was in the 39th gestation week,by the 42th gestation week,the concentration of cortisol declined to the 37th gestation week. DHEA S changed paralleled with cortisol ( r =0.46, P <0.05). Active birth pain was associated with increased fetal umbilical cortisol concentration, but not with DHEA S. The concentrations of fetal umbilical cord cortisol in vaginal deliver group was higher than all the cesarean section groups. Conclusion Concentrations of cortisol and DHEA S played an important role in the initiation and acceleration of labor.