Doerr H G, Versmold H T, Bidlingmaier F, Sippell W G
Department of Pediatrics, University of Munich, Federal Republic of Germany.
Pediatr Res. 1989 Feb;25(2):115-8. doi: 10.1203/00006450-198902000-00001.
We evaluated adrenocortical steroid concentrations at birth and during postnatal adaptation (2 h until 7 days) in 10 vaginally delivered term small-for-gestational-age (SGA) infants and 12 term appropriate-for-gestational age infants. Plasma aldosterone, 11-deoxycorticosterone, corticosterone, progesterone, 17-hydroxyprogesterone, 11-deoxycortisol, cortisol, and cortisone were longitudinally measured by specific RIA after Sephadex LH-20 chromatography. Mean aldosterone was significantly higher in SGA than in appropriate-for-gestational-age infants (2 h to 7 days; p less than 0.001). In SGA infants, cortisone and cortisol levels were significantly lower in umbilical artery (p less than 0.05), and all glucocorticoid levels were significantly lower 12 h after birth (p less than 0.05). Thereafter (24 h to 7 days), only 11-deoxycortisol levels remained significantly lower in SGA; corticosterone and cortisol levels were even higher (p less than 0.05) in SGA 24 h after birth. The data suggest that SGA infants maintain high aldosterone levels throughout the 1st wk of life. Low cortisol and cortisone levels in umbilical artery as well as low glucocorticoid levels at 2 h and/or 12 h compared to term appropriate-for-gestational-age infants may reflect either a less stressful postnatal adaptation or, more likely, a reduced adrenocortical synthesis in term SGA infants.
我们评估了10名经阴道分娩的足月小于胎龄（SGA）婴儿和12名足月适于胎龄婴儿出生时及出生后适应期（2小时至7天）的肾上腺皮质类固醇浓度。通过Sephadex LH - 20柱层析后用特异性放射免疫分析法纵向测定血浆醛固酮、11 - 脱氧皮质酮、皮质酮、孕酮、17 - 羟孕酮、11 - 脱氧皮质醇、皮质醇和可的松。SGA婴儿的平均醛固酮水平显著高于适于胎龄婴儿（2小时至7天；p < 0.001）。在SGA婴儿中，脐动脉中的可的松和皮质醇水平显著较低（p < 0.05），且出生后12小时所有糖皮质激素水平均显著较低（p < 0.05）。此后（24小时至7天），仅SGA婴儿的11 - 脱氧皮质醇水平仍显著较低；出生后24小时SGA婴儿的皮质酮和皮质醇水平甚至更高（p < 0.05）。数据表明，SGA婴儿在出生后的第1周内维持较高的醛固酮水平。与足月适于胎龄婴儿相比，脐动脉中低可的松和皮质醇水平以及出生后2小时和/或12小时的低糖皮质激素水平可能反映出出生后适应压力较小，或者更可能是足月SGA婴儿肾上腺皮质合成减少。
