Yamashiro Chizu, Kanenishi Kenji, Akiyama Masashi, Tanaka Hirokazu, Shiota Atsuko, Hata Toshiyuki
Department of Perinatology and Gynecology, Kagawa Medical University, Miki, Kagawa, Japan.
Gynecol Obstet Invest. 2002;54(2):99-104. doi: 10.1159/000067720.
The purpose of this study was to evaluate whether adrenomedullin concentrations in the early 2nd-trimester amniotic fluid predict preterm delivery or fetal growth at birth.
The adrenomedullin concentrations in early 2nd-trimester amniotic fluid were measured in 70 pregnancies with term delivery and in 3 pregnancies with preterm delivery. Total and free adrenomedullin concentrations were measured from early 2nd-trimester amniotic fluid samples using an immunoradiometric assay.
The amniotic fluid total adrenomedullin concentrations in women with preterm delivery were significantly higher (129.7 +/- 19.6 fmol/ml) than those in women with term delivery (92.5 +/- 28.2 fmol/ml; p < 0.05). There were no significant differences for amniotic fluid free adrenomedullin concentrations and free/total adrenomedullin ratios between the two groups. Total or free adrenomedullin concentrations in the early 2nd-trimester amniotic fluid showed an inverse correlation both with birth weight (r = 0.27, p < 0.05, and r = 0.21, p < 0.05) and height (r = 0.30, p < 0.05, and r = 0.28, p < 0.05). There were no correlations between placental weight and total or free adrenomedullin concentrations in the early 2nd-trimester amniotic fluid.
These results suggest that adrenomedullin concentrations in the early 2nd-trimester amniotic fluid might be related to further in utero fetal growth and that high levels of adrenomedullin in the early 2nd-trimester amniotic fluid may be involved in the occurrence of preterm delivery.
本研究旨在评估孕中期早期羊水内肾上腺髓质素浓度是否可预测早产或出生时的胎儿生长情况。
对70例足月分娩孕妇和3例早产孕妇的孕中期早期羊水内肾上腺髓质素浓度进行了测定。采用免疫放射分析法测定孕中期早期羊水样本中的总肾上腺髓质素浓度和游离肾上腺髓质素浓度。
早产孕妇羊水内总肾上腺髓质素浓度（129.7±19.6 fmol/ml）显著高于足月分娩孕妇（92.5±28.2 fmol/ml；p<0.05）。两组间羊水游离肾上腺髓质素浓度及游离/总肾上腺髓质素比值无显著差异。孕中期早期羊水内总肾上腺髓质素浓度或游离肾上腺髓质素浓度与出生体重（r=0.27，p<0.05；r=0.21，p<0.05）及身高（r=0.30，p<0.05；r=0.28，p<0.05）均呈负相关。孕中期早期羊水内总肾上腺髓质素浓度或游离肾上腺髓质素浓度与胎盘重量无相关性。
这些结果表明，孕中期早期羊水内肾上腺髓质素浓度可能与胎儿在子宫内的进一步生长有关，且孕中期早期羊水内肾上腺髓质素水平升高可能与早产的发生有关。
