Pancheri P, Zichella L, Fraioli F, Carilli L, Perrone G, Biondi M, Fabbri A, Santoro A, Moretti C
Psychoneuroendocrinology. 1985;10(3):289-301. doi: 10.1016/0306-4530(85)90006-x.
We investigated the psychoneuroendocrine and emotional correlates of the natural stress situation of human labor. State anxiety, subjective pain, plasma ACTH, peripheral plasma beta-lipotropin (Beta-LPH), beta-endorphin (Beta-EP), and met-enkephalin (Met-Enk) were serially evaluated at six predetermined time points before, and after labor in a sample of 14 women with normal pregnancies. State anxiety and subjective pain showed a progressive increase during labor, with a levelling during the final stage. Plasma Beta-EP and ACTH showed a similar progressive increasing from baseline until the end of labor. Beta-LPH showed no significant modification. Met-Enk remained at nearly baseline values throughout labor, with a marked progressive rise in the postpartum stage. The findings of this study seem to confirm the role of plasma Beta-EP as a stress hormone. Possible relationship between pain and anxiety curves and plasma Beta-EP are discussed in light of psychobiological studies on stress, the opioid system and analgesia. Plasma Met-Enk, according to our findings, should probably not be regarded as a stress hormone. Its rise in the postpartum stage might be as one of the psychoneuroendocrine mechanisms maintaining elevated prolactin levels during lactation.
我们研究了人类分娩这一自然应激状况下的心理神经内分泌及情绪关联。在14名正常妊娠女性样本中，于分娩前和分娩后的六个预定时间点，对状态焦虑、主观疼痛、血浆促肾上腺皮质激素（ACTH）、外周血浆β-促脂素（β-LPH）、β-内啡肽（β-EP）和甲硫氨酸脑啡肽（Met-Enk）进行了连续评估。状态焦虑和主观疼痛在分娩过程中呈逐渐上升趋势，在最后阶段趋于平稳。血浆β-EP和ACTH从基线到分娩结束呈现类似的逐渐上升趋势。β-LPH未显示出显著变化。Met-Enk在整个分娩过程中基本保持在基线值，在产后阶段显著逐渐上升。本研究结果似乎证实了血浆β-EP作为应激激素的作用。结合关于应激、阿片系统和镇痛的心理生物学研究，讨论了疼痛和焦虑曲线与血浆β-EP之间可能的关系。根据我们的研究结果，血浆Met-Enk可能不应被视为应激激素。其在产后阶段的上升可能是哺乳期维持催乳素水平升高的心理神经内分泌机制之一。
