Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Italy.
Gynecol Obstet Invest. 2013;76(1):69-73. doi: 10.1159/000351873. Epub 2013 Jun 22.
The purpose of this study was to evaluate whether the diurnal fluctuation of salivary cortisol and its overall diurnal secretion are associated with the length of gestation in patients who were admitted to the hospital with an assigned diagnosis of possible preterm labor (PL) at a gestational age of 28-33 weeks.
In 22 patients, maternal saliva samples were collected for a cortisol assay 4 times per day (8 AM, 12 AM, 4 PM and 8 PM) on day 4 and day 6 after antenatal corticosteroid prophylaxis to prevent neonatal respiratory distress syndrome.
Eight patients who ultimately delivered before term (32.6 ± 1.7 gestation weeks) showed an inverted fluctuation of salivary cortisol on both days 4 and 6, morning cortisol levels being significantly lower than evening levels. In contrast, in 14 patients who delivered at term (39.5 ± 0.6 gestation weeks), the physiological diurnal fluctuation of salivary cortisol was maintained. In addition, a distinctive feature of women delivering before term was a significantly hampered salivary cortisol diurnal production measured on day 6.
Corticoadrenal activity is dysregulated and anticipates very preterm delivery in women with an assigned diagnosis of possible PL.
本研究旨在评估在妊娠 28-33 周因疑似早产（PL）而住院的患者中，唾液皮质醇的昼夜波动及其整体昼夜分泌是否与妊娠时间有关。
在 22 名患者中，在产前皮质类固醇预防新生儿呼吸窘迫综合征后第 4 天和第 6 天，每天采集 4 次（8 AM、12 AM、4 PM 和 8 PM）的母体唾液样本进行皮质醇测定。
最终在足月前分娩的 8 名患者（32.6±1.7 妊娠周）在第 4 天和第 6 天都出现了唾液皮质醇的反转波动，早晨皮质醇水平明显低于傍晚水平。相比之下，在 14 名足月分娩的患者（39.5±0.6 妊娠周）中，维持了唾液皮质醇的生理性昼夜波动。此外，足月前分娩的女性的一个显著特征是第 6 天唾液皮质醇的昼夜分泌明显受阻。
皮质肾上腺活动失调并预测了疑似 PL 的女性极早产的发生。
