Adamcová K, Kolátorová L, Škodová T, Šimková M, Pařízek A, Stárka L, Dušková M
Department of Obstetrics and Gynecology of the First Faculty of Medicine and General Teaching Hospital, Prague, Czech Republic, Institute of Endocrinology, Prague, Czech Republic.
Physiol Res. 2018 Nov 28;67(Suppl 3):S489-S497. doi: 10.33549/physiolres.934019.
Progesterone, estrogens, androgens and glucocorticoids all play important roles during pregnancy, from implantation to delivery. Focusing on selected steroid hormones in the peripartum period, we defined reference ranges measured using LS-MS/MS, and assessed relationships with maternal age, pregnancy weight gain, delivery type, and fetal sex. Samples were taken from 142 healthy women with physiological gravidity at the 37th week, during the first period of labor, and from newborn mixed cord blood. We found higher cortisol and 17-OH-pregnenolone plasma levels in mothers at the 37th week that carried male fetuses (p=0.03), but no significant differences in any studied hormones in newborns of different sex. Neither maternal age nor weight gain nor newborn birth weight had any relationships to any of the studied hormones. However, there were differences depending on vaginal versus planned cesarean section deliveries. In women carrying a male fetus we found significantly higher levels of 17-OH-pregnenolone, progesterone, cortisol, corticosterone and significantly lower levels of estradiol in those undergoing spontaneous vaginal delivery. However, we found no significant differences in the cord blood of newborn males from either delivery type. We established reference ranges for our analysis methods, which should be useful for further studies as well as in standard clinical practice.
从着床到分娩，孕酮、雌激素、雄激素和糖皮质激素在孕期均发挥着重要作用。聚焦围产期特定的甾体激素，我们定义了采用液相色谱-串联质谱法（LS-MS/MS）测定的参考范围，并评估了其与产妇年龄、孕期体重增加、分娩方式及胎儿性别的关系。样本取自142名孕37周、处于第一产程的生理妊娠健康女性以及新生儿混合脐血。我们发现，孕37周怀有男胎的母亲血浆中皮质醇和17-羟孕烯醇酮水平较高（p=0.03），但不同性别的新生儿所研究的任何激素均无显著差异。产妇年龄、体重增加及新生儿出生体重与所研究的任何激素均无关联。然而，根据经阴道分娩与计划剖宫产存在差异。在怀有男胎的女性中，我们发现自然阴道分娩者的17-羟孕烯醇酮、孕酮、皮质醇、皮质酮水平显著较高，雌二醇水平显著较低。然而，两种分娩方式的男婴脐血中均未发现显著差异。我们建立了分析方法的参考范围，这对进一步研究及标准临床实践均应有用。
