Elena Venizelou Maternity Hospital, 6th Department of Obstetrics and Gynaecology, Athens, Greece. fstamatelou@ yahoo.com
Ann Acad Med Singap. 2009 Nov;38(11):1011-6.
This study examined whether maternal plasma progesterone and corticotropin releasing hormone (CRH) concentrations can predict the likelihood of preterm labour.
Maternal plasma progesterone and CRH concentrations were examined in a total of 51 women. The subject cohort included 20 women who were followed from the beginning of the third trimester (28 to 34 weeks gestation), half of whom delivered early preterm and half of whom were not in labour and subsequently delivered at full term (n = 10 per group). In a follow-up experiment, 31 women who were admitted during labour for delivery were examined, 15 of whom delivered preterm and 16 of whom delivered at full term. Comparisons between women who delivered preterm and those who delivered at full term were made by t-tests.
Mean progesterone concentration was approximately 30% lower at 28 to 34 weeks gestation in women who delivered prematurely than in women who delivered at term (P < 0.001). Meanwhile, mean CRH concentration was 6-fold higher at 28 to 34 weeks gestation in women who experienced spontaneous preterm labour than in those who went into labour at term (P < 0.001). Preterm mothers had lower progesterone (P < 0.05) and CRH (P < 0.01) levels during active labour than full-term mothers. Progesterone levels normalised within 24 hours of delivery in preterm mothers, while CRH levels remained slightly elevated (P < 0.01).
Maternal progesterone and CRH measurements taken early in the third trimester may be of use as biochemical markers of pregnancies at high risk of premature labour.
本研究旨在探讨母体血浆孕酮和促肾上腺皮质激素释放激素(CRH)浓度是否可预测早产的可能性。
共检测了 51 名女性的母体血浆孕酮和 CRH 浓度。该研究队列包括 20 名从孕晚期(28-34 周)开始随访的女性,其中一半发生早产,另一半未进入产程且随后足月分娩(每组各 10 名)。在后续实验中,检测了 31 名因分娩而入院的女性,其中 15 名早产,16 名足月分娩。采用 t 检验比较早产组和足月分娩组的女性。
与足月分娩的女性相比,早产女性在孕 28-34 周时的平均孕酮浓度低约 30%(P<0.001)。同时,自发性早产的女性在孕 28-34 周时的平均 CRH 浓度比足月分娩的女性高 6 倍(P<0.001)。早产的母亲在活跃分娩时的孕酮(P<0.05)和 CRH(P<0.01)水平均低于足月分娩的母亲。早产母亲的孕酮水平在分娩后 24 小时内恢复正常,而 CRH 水平仍略有升高(P<0.01)。
孕晚期早期的母体孕酮和 CRH 测量值可能可作为早产风险较高的妊娠的生化标志物。