Kacerovsky Marian, Vavrova Jaroslava, Musilova Ivana, Lesko Daniel, Flidrova Eva, Andrys Ctirad, Hornychova Helena, Dosedla Erik, Jacobsson Bo
Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital, Hradec Kralove, Czech Republic.
J Matern Fetal Neonatal Med. 2012 Oct;25(10):1889-94. doi: 10.3109/14767058.2012.679713. Epub 2012 Apr 28.
The main aim of this study was to determine the levels of cortisol and dehydroepiandrosterone sulfate (DHEA-S) and the cortisol/DHEA-S ratio in the umbilical cord blood according to the presence of histological chorioamnionitis and fetal inflammatory response in pregnancies complicated by prelabor rupture of membranes at fewer than 34 gestational weeks.
Seventy-two women with singleton pregnancies complicated by preterm prelabor rupture of membranes between gestational ages 24+0 and 33+6 weeks were included in the study. The sample of blood was obtained from the umbilical cord after delivery of the newborn. The umbilical cord blood cortisol and DHEA-S levels were evaluated using commercial immunoassay kits. A cortisol/DHEA-S ratio was calculated.
The presence of histological chorioamnionitis was not associated with higher median levels of cortisol (32.1 nmol/L vs. 33.0 nmol/L; p = 0.53), DHEA-S (2.6 μmol/L vs. 2.5 μmol/L; p = 0.83), or cortisol/DHEA-S ratio (19.5 vs. 18.7;p = 0.90). Higher median levels of DHEA-S (3.1 μmol/L vs. 2.3 μmol/L; p = 0.03) but not cortisol (91.0 nmol/L vs. 32.0 nmol/L; p = 0.06) or cortisol/DHEA-S ratio (24.5 vs. 18.7; p = 0.46) were observed when fetal inflammatory response was present.
The presence of fetal inflammatory response but not the presence of histological chorioamnionitis per se was associated with increased DHEA-S levels in the umbilical cord blood.
本研究的主要目的是根据孕周小于34周且合并胎膜早破的妊娠中组织学绒毛膜羊膜炎和胎儿炎症反应的情况，确定脐带血中皮质醇和硫酸脱氢表雄酮（DHEA-S）的水平以及皮质醇/DHEA-S比值。
本研究纳入了72名单胎妊娠且孕周在24+0至33+6周之间合并早产胎膜早破的女性。新生儿出生后从脐带采集血样。使用商用免疫测定试剂盒评估脐带血皮质醇和DHEA-S水平。计算皮质醇/DHEA-S比值。
组织学绒毛膜羊膜炎的存在与皮质醇（32.1 nmol/L对33.0 nmol/L；p = 0.53）、DHEA-S（2.6 μmol/L对2.5 μmol/L；p = 0.83）或皮质醇/DHEA-S比值（19.5对18.7；p = 0.90）的较高中位数水平无关。当存在胎儿炎症反应时，观察到DHEA-S的中位数水平较高（3.1 μmol/L对2.3 μmol/L；p = 0.03），但皮质醇（91.0 nmol/L对32.0 nmol/L；p = 0.06）或皮质醇/DHEA-S比值（24.5对18.7；p = 0.46）并非如此。
胎儿炎症反应的存在而非组织学绒毛膜羊膜炎本身与脐带血中DHEA-S水平升高有关。
