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早产儿对人乳中糖皮质激素变异性的影响。

Impact of Preterm Birth on Glucocorticoid Variability in Human Milk.

机构信息

1 Liggins Institute, The University of Auckland, Auckland, New Zealand.

2 Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

出版信息

J Hum Lact. 2018 Feb;34(1):130-136. doi: 10.1177/0890334417729339. Epub 2017 Sep 13.

Abstract

BACKGROUND

Preterm birth is a stressful event for both the mother and infant. Whereas the initiation of breastfeeding is important for preterm infant health, little is known of the glucocorticoid hormones (cortisol and cortisone) in human milk following preterm birth. Research aim: The aim of this study was to investigate the relationship between human milk glucocorticoid concentrations and preterm birth.

METHODS

Human milk was sampled weekly for up to 6 weeks from 22 women who delivered a preterm infant at 28 to 32 weeks' gestation. Human milk was analyzed for total and free cortisol and cortisone concentrations using liquid chromatography-tandem mass spectrometry.

RESULTS

Milk sampled from mothers of preterm infants had more cortisone than cortisol ( p < .001), with a strong correlation between both hormones ( p = .001, r = .85). The cortisone was significantly higher in the milk of mothers who delivered infants after 30 weeks compared with those who delivered before 30 weeks of gestation ( p = .02). Glucocorticoid concentrations did not change over the sampling time (weeks 1 to 6 postpartum) and did not differ by infant gender.

CONCLUSION

Glucocorticoids were present in all milk samples following preterm birth. Cortisone concentration tended to be higher in those who delivered after 30 weeks' gestation but did not increase further over the weeks following birth.

摘要

背景

早产对母婴都是一种压力事件。尽管母乳喂养的开始对早产儿的健康很重要,但对于早产儿出生后母乳中的糖皮质激素(皮质醇和可的松)知之甚少。

研究目的

本研究旨在探讨母乳中糖皮质激素浓度与早产之间的关系。

方法

从 22 名在 28 至 32 周妊娠时分娩早产儿的女性中每周采集母乳样本,持续 6 周。使用液相色谱-串联质谱法分析母乳中总皮质醇和游离皮质醇及可的松的浓度。

结果

早产儿母亲的母乳中可的松含量高于皮质醇(p <.001),两种激素之间具有很强的相关性(p =.001,r =.85)。与在 30 周前分娩的母亲相比,在 30 周后分娩的母亲的母乳中可的松含量明显更高(p =.02)。糖皮质激素浓度在产后第 1 周到第 6 周的采样时间内没有变化,且不受婴儿性别影响。

结论

早产儿出生后所有母乳样本中均存在糖皮质激素。在 30 周后分娩的人群中,可的松浓度趋于更高,但在出生后的几周内没有进一步增加。

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