Pullano J G, Cohen-Addad N, Apuzzio J J, Ganesh V L, Josimovich J B
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103-2757.
J Clin Endocrinol Metab. 1989 Dec;69(6):1180-6. doi: 10.1210/jcem-69-6-1180.
A study was performed on 94 women delivering at 34-44 weeks gestation, whose pregnancies were uncomplicated to determine the role of PRL in human fetal and neonatal salt and water conservation. Ultrasonic estimation of amniotic fluid (AF) volume and sampling of maternal blood, AF, cord blood, and 2-h neonatal blood were performed to analyze PRL, osmolality, sodium ion concentration ([Na]), and blood solids [hematocrit (Hct), total serum solids (tss), and total protein concentration]. In this report, which addresses the role of fetal PRL, Pearson correlations showed the following significant relationships: 1) approximation of cord serum osmolality and [Na] in cord and maternal serum, as well as parallel changes in cord blood Hct, tss, and total protein; 2) reduced estimated AF volume and increased AF osmolality in the face of elevated cord serum osmolality and [Na]; 3) a shift toward normal in cord Hct and tss over the first 2 h of neonatal life after an initially increased or decreased cord serum osmolality, [Na], Hct, or tss; and 4) relationship between fetal pituitary PRL levels of 230 micrograms/L or less and cord serum osmolality, [Na], and Hct. The entire range of cord serum PRL levels correlated with changes in AF osmolality and [Na] as well as with neonatal changes in Hct and tss. These findings support the hypotheses that osmotic equilibrium exists between maternal and fetal circulations; that disturbances in this balance lead to changes in fetal and neonatal water excretion; and that fetal PRL, stimulated by increases in cord serum osmolality and [Na], acts as an antidiuretic, leading to restoration of the offspring's extracellular fluid volume.
对94名妊娠34 - 44周、孕期无并发症的分娩女性进行了一项研究，以确定催乳素（PRL）在人类胎儿和新生儿水盐潴留中的作用。进行超声估计羊水（AF）量，并采集母体血液、羊水、脐带血和出生后2小时的新生儿血液，以分析PRL、渗透压、钠离子浓度（[Na]）和血液固体成分[血细胞比容（Hct）、总血清固体成分（tss）和总蛋白浓度]。在本报告中，探讨了胎儿PRL的作用，Pearson相关性显示了以下显著关系：1）脐带血清渗透压与脐带和母体血清中的[Na]相近，以及脐带血Hct、tss和总蛋白的平行变化；2）面对升高的脐带血清渗透压和[Na]，估计的AF量减少且AF渗透压升高；3）在脐带血清渗透压、[Na]、Hct或tss最初升高或降低后，新生儿出生后前2小时内脐带Hct和tss向正常转变；4）胎儿垂体PRL水平为230微克/升或更低与脐带血清渗透压、[Na]和Hct之间的关系。脐带血清PRL水平的整个范围与AF渗透压和[Na]的变化以及新生儿Hct和tss的变化相关。这些发现支持以下假设：母体和胎儿循环之间存在渗透平衡；这种平衡的紊乱会导致胎儿和新生儿水排泄的变化；并且脐带血清渗透压和[Na]升高刺激产生的胎儿PRL起到抗利尿作用，导致后代细胞外液量恢复。
