Okamoto E, Takagi T, Makino T, Sata H, Iwata I, Nishino E, Mitsuda N, Sugita N, Otsuki Y, Tanizawa O
Department of Obstetrics and Gynecology, Osaka University Medical School, Japan.
Horm Metab Res. 1989 Oct;21(10):566-72. doi: 10.1055/s-2007-1009289.
The activity of the hypothalamo-pituitary adrenal axis was examined, by measuring the levels of immunoreactive (IR) corticotropin-releasing hormone (CRH), adrenocorticotropin (ACTH) and cortisol (F) in human plasma during normal pregnancy and after delivery with or without complications and during normal postpartum using a specific RIA. The level of IR-CRH in maternal plasma increased progressively during pregnancy, increased further at delivery and declined rapidly to the non-pregnant level on the 1st day postpartum. The level of IR-F in maternal plasma also increased progressively during pregnancy, increased further at delivery, but decreased slowly postpartum, not returning to the non-pregnant level within 5 days. Significant correlations were found between the level of IR-CRH and IR-ACTH, IR-CRH and IR-F, and IR-ACTH and IRF in maternal plasma both during pregnancy and after delivery. It is noteworthy that the concentration of IR-CRH in the maternal plasma at delivery was higher in multiple pregnancy than in normal pregnancy, and that the level of IR-CRH in the umbilical cord in uncomplicated cases was much lower than that in the maternal plasma, and was significantly lower than those in the umbilical cord plasma in cases of asphyxia, IUGR or premature delivery. The level of IR-F, not IR-CRH and IR-ACTH, at normal vaginal delivery was significantly higher than that at elective cesarean section. On these results, we investigated the feto-maternal-hypothalamo-pituitary adrenal axis during pregnancy and delivery, in which CRH plays an important role.
采用特异性放射免疫分析法（RIA），检测正常妊娠期间、有无并发症的分娩后及正常产后人血浆中免疫反应性（IR）促肾上腺皮质激素释放激素（CRH）、促肾上腺皮质激素（ACTH）和皮质醇（F）的水平，以研究下丘脑 - 垂体 - 肾上腺轴的活性。孕妇血浆中IR - CRH水平在孕期逐渐升高，分娩时进一步升高，产后第1天迅速降至非妊娠水平。孕妇血浆中IR - F水平在孕期也逐渐升高，分娩时进一步升高，但产后缓慢下降，5天内未恢复至非妊娠水平。孕期和产后孕妇血浆中IR - CRH与IR - ACTH、IR - CRH与IR - F以及IR - ACTH与IR - F水平之间均存在显著相关性。值得注意的是，多胎妊娠分娩时孕妇血浆中IR - CRH浓度高于正常妊娠，无并发症病例脐带血中IR - CRH水平远低于孕妇血浆，且显著低于窒息、宫内生长受限或早产病例脐带血血浆中的水平。正常阴道分娩时IR - F水平显著高于择期剖宫产，而非IR - CRH和IR - ACTH。基于这些结果，我们研究了妊娠和分娩期间胎儿 - 母体 - 下丘脑 - 垂体 - 肾上腺轴，其中CRH起着重要作用。
