Prasanth Kaninghat, Kamat Medha, Khilfeh Manhal, Davis Vanessa
J Perinat Med. 2014 Nov;42(6):699-703. doi: 10.1515/jpm-2014-0244.
To evaluate cord blood concentrations of adrenocorticotropic hormone (ACTH) and cortisol in well term infants born with and without meconium-stained amniotic fluid (MSAF) and term infants born with MSAF who experienced respiratory distress (RD).
This was a prospective observational study. Fifty-four term infants were enrolled in the study in three groups: group 1 consisted of 18 well infants who were born with clear amniotic fluid, group 2 had 18 well infants born with MSAF, and group 3 had 18 infants born with MSAF who experienced RD in the first 24 h of age. Cord blood ACTH and cortisol concentrations were measured in infants born in all three groups. Groups 2 and 3 had serum ACTH and cortisol levels re-measured at 22-26 h of age.
The mean ACTH and cortisol levels at birth in group 3 infants were 18.3 pg/mL and 12.6 mg/dL, respectively. These were significantly lower than those in group 2 infants.
Term infants born with MSAF and who experienced respiratory distress had significantly lower levels of ACTH and cortisol at birth compared with well term infants born with MSAF or clear amniotic fluid. This study suggests that inadequate response of ACTH and cortisol hormones may play a role in the development of respiratory distress in term infants with MSAF.
评估足月健康婴儿出生时有无羊水胎粪污染（MSAF）以及有MSAF且出现呼吸窘迫（RD）的足月婴儿脐带血中促肾上腺皮质激素（ACTH）和皮质醇的浓度。
这是一项前瞻性观察性研究。54名足月婴儿被纳入该研究，分为三组：第1组由18名羊水清澈的健康婴儿组成，第2组有18名出生时伴有MSAF的健康婴儿，第3组有18名出生时伴有MSAF且在出生后24小时内出现RD的婴儿。测量了所有三组婴儿的脐带血ACTH和皮质醇浓度。第2组和第3组在出生后22 - 26小时重新测量血清ACTH和皮质醇水平。
第3组婴儿出生时ACTH和皮质醇的平均水平分别为18.3 pg/mL和12.6 mg/dL。这些水平显著低于第2组婴儿。
与出生时伴有MSAF或羊水清澈的足月健康婴儿相比，出生时伴有MSAF且出现呼吸窘迫的足月婴儿出生时ACTH和皮质醇水平显著降低。这项研究表明，ACTH和皮质醇激素反应不足可能在伴有MSAF的足月婴儿呼吸窘迫的发生中起作用。
