Sybulski S, Maughan G B
Am J Obstet Gynecol. 1976 May 15;125(2):236-8. doi: 10.1016/0002-9378(76)90599-8.
Cortisol was determined by a competitive protein-binding method in umbilical cord plasma from pregnancies of 37 or more weeks' gestation. In 162 cases of vaginal delivery following spontaneous labor the mean +/- S.E. of cortisol values was 7.43 +/- 0.29 mug per 100 ml. of plasma. This cortisol level was not significantly different from that observed in 51 cases of vaginal delivery after oxytocin-induced labor (6.53 +/- 0.49 mug per 100 ml.) or in 47 cases of delivery by emergency cesarean section following labor (6.21 +/- 0.66 mug per 100 ml.). The mean cortisol level in cases of elective cesarean section with no prior labor (4.67 +/- 0.60 mug per 100 ml.) was significantly less than the value for vaginal delivery after spontaneous or induced labor. The cord plasma and amniotic fluid concentrations of cortisol in a pregnancy complicated by fetal anencephaly and terminated at 44 weeks by induction were normal. It is concluded that labor and vaginal delivery resulted in a significant increase in cord plasma cortisol levels but there was no significant difference between spontaneous and induced labors. These findings do not support the hypothesis that a surge in fetal cortisol production immediately precedes and initiates spontaneous labor in human pregnancy.
采用竞争性蛋白结合法测定妊娠37周及以上孕妇脐带血血浆中的皮质醇。在162例自然分娩的阴道分娩病例中，皮质醇值的平均值±标准误为每100毫升血浆7.43±0.29微克。该皮质醇水平与51例催产素引产阴道分娩病例（每100毫升6.53±0.49微克）或47例分娩后急诊剖宫产病例（每100毫升6.21±0.66微克）中观察到的水平无显著差异。未经历过分娩的择期剖宫产病例的平均皮质醇水平（每100毫升4.67±0.60微克）显著低于自然分娩或引产阴道分娩的数值。一例合并胎儿无脑畸形且在44周时引产终止妊娠的孕妇，其脐带血血浆和羊水皮质醇浓度正常。研究得出结论，分娩和阴道分娩导致脐带血血浆皮质醇水平显著升高，但自然分娩和引产之间无显著差异。这些发现不支持胎儿皮质醇分泌激增紧接并引发人类妊娠自然分娩这一假说。
