足月正常自发性分娩中母胎两室中脂肪因子内脂素的差异调节证据。
Evidence for differential regulation of the adipokine visfatin in the maternal and fetal compartments in normal spontaneous labor at term.
机构信息
Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI, USA.
出版信息
J Perinat Med. 2010 May;38(3):281-8. doi: 10.1515/jpm.2010.045.
OBJECTIVE
Visfatin, a novel adipokine with metabolic and immunoregulatory properties, has been implicated in the regulation of fetal growth, as well as in preterm labor. A gap in knowledge is whether spontaneous labor at term is associated with changes in the maternal and fetal concentrations of visfatin. The aim of this study was to determine if the presence of labor at term is associated with alterations in maternal and neonatal plasma visfatin concentrations.
STUDY DESIGN
This cross-sectional study included 50 normal pregnant women at term and their appropriate-for-gestational age (AGA) neonates in the following groups: 1) 25 mother-neonate pairs delivered by elective cesarean section without spontaneous labor, and 2) 25 mother-neonate pairs who delivered vaginally following spontaneous labor. Maternal plasma and cord blood visfatin concentrations were determined by ELISA. Non-parametric statistics were used for analyses.
RESULTS
- The median visfatin concentration was higher in umbilical cord plasma of neonates born following a spontaneous labor at term than that of those who were born by an elective cesarean section (P=0.02); 2) in contrast, the median maternal plasma visfatin concentration did not differ significantly between patients with and without labor (P=0.44); and 3) there was a significant correlation between umbilical cord plasma concentration of visfatin and both maternal visfatin concentration (r=0.54, P=0.005) and gestational age (GA) at delivery (r=0.58; P=0.002) only in the absence of labor.
CONCLUSION
Term labor is associated with increased fetal, but not maternal, circulating visfatin concentrations. Previous reports indicate that preterm labor leading to preterm delivery is characterized by an increase in maternal plasma concentrations of visfatin. The observations reported herein support the view that there are fundamental differences in the endocrine and metabolic adaptations in normal labor at term and preterm labor.
目的
脂联素是一种具有代谢和免疫调节特性的新型脂肪因子，它与胎儿生长的调节以及早产有关。目前尚不清楚足月自发性分娩是否与母胎脂联素浓度的变化有关。本研究旨在确定足月分娩时是否存在与母胎血浆脂联素浓度变化相关的情况。
研究设计
这项横断面研究纳入了 50 名足月正常孕妇及其适合胎龄（AGA）的新生儿，分为以下两组：1）25 对母婴通过择期剖宫产且无自发性分娩，2）25 对母婴通过自发性分娩阴道分娩。通过 ELISA 测定母血浆和脐血脂联素浓度。采用非参数统计分析。
结果
1）与择期剖宫产分娩的新生儿相比，自发性足月分娩新生儿的脐血浆脂联素浓度中位数更高（P=0.02）；2）相反，无自发性分娩的患者与有自发性分娩的患者之间，母血浆脂联素浓度中位数无显著差异（P=0.44）；3）仅在无自发性分娩的情况下，脐血浆脂联素浓度与母脂联素浓度（r=0.54，P=0.005）和分娩时的孕龄（GA）（r=0.58；P=0.002）呈显著相关。
结论
足月分娩与胎儿、而非母体的循环脂联素浓度升高有关。先前的报告表明，导致早产分娩的早产与母体血浆脂联素浓度升高有关。本研究的观察结果支持这样一种观点，即在足月正常分娩和早产分娩中，内分泌和代谢的适应性存在根本差异。
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