Chair and Department of Biopharmacy, Faculty of Pharmacy, Medical University of Lodz,, Poland.
Chair and Department of Biopharmacy, Faculty of Pharmacy, Medical Univeristy of Lodz, Poland.
Ginekol Pol. 2021;92(7):481-486. doi: 10.5603/GP.a2021.0068. Epub 2021 Apr 12.
The aim of the study was to determine how the type of delivery affects the stress response cycle and the level of cortisol, progesterone and corticoliberin.
The study was conducted among 26 pregnant women admitted to the Gynecology and Obstetrics Ward due to an approaching delivery date or the onset of labor. The participants were aged between 20 and 41 years, with a mean age of approximately 30 years. After delivery, blood was drawn in parallel from the maternal antecubital vein, the umbilical cord vein and the umbilical cord artery. The levels of stress hormones were assessed by ELISA. The results were subjected to statistical analyses, and correlation coefficients were calculated for individual variable pairs. The analysis also examined the participation of pregnant woman in antenatal education.
A high correlation was observed between cortisol and progesterone levels in venous and arterial cord blood and physiological delivery. The mean cortisol level was 247.37 ng/mL in venous cord blood and 233.59 ng/mL in arterial blood and the respective mean progesterone levels were 331.81 ng/mL and 342.36 ng/mL. The highest cortisol concentration was determined in the primiparas umbilical cord blood (236.182 ng/mL in the vein, 230.541 ng/mL in the artery). Correlation between cortisol level in venous and arterial cord blood and prenatal education was also noted (venous cord blood: r = -0.5477; F = 10.2833; p = 0.0038; cord arterial blood: r = -0, 4436; F = 5.8789; p = 0.0232).
The results obtained emphasize the importance of the hypothalamic-pituitary-adrenal (HPA) axis as one of the potential mechanisms actively involved in childbirth. The determined levels of cortisol and progesterone in the maternal and umbilical cord blood varied significantly depending on the type of delivery, with higher concentrations being observed in the case of natural delivery. In addition, the highest levels of cortisol were determined in primiparas; however, lowered umbilical cord blood cortisol levels were observed in pregnant women who had participated in antenatal education, regardless of the number of deliveries.
本研究旨在确定分娩方式如何影响应激反应循环以及皮质醇、孕酮和皮质醇释放激素的水平。
该研究纳入了 26 名因接近分娩日期或分娩开始而入住妇科和产科病房的孕妇。参与者年龄在 20 至 41 岁之间，平均年龄约为 30 岁。分娩后，同时从产妇肘前静脉、脐静脉和脐动脉抽取血液。通过 ELISA 评估应激激素水平。对结果进行了统计分析，并计算了个别变量对的相关系数。分析还检查了孕妇参与产前教育的情况。
在静脉和动脉脐带血以及生理分娩中，观察到皮质醇和孕酮水平之间存在高度相关性。静脉脐带血中的平均皮质醇水平为 247.37ng/mL，动脉血中的平均皮质醇水平为 233.59ng/mL，相应的平均孕酮水平分别为 331.81ng/mL 和 342.36ng/mL。皮质醇浓度最高的是初产妇的脐血（静脉血中为 236.182ng/mL，动脉血中为 230.541ng/mL）。还观察到皮质醇水平与静脉和动脉脐带血与产前教育之间的相关性（静脉脐带血：r=-0.5477；F=10.2833；p=0.0038；脐动脉血：r=-0.4436；F=5.8789；p=0.0232）。
研究结果强调了下丘脑-垂体-肾上腺（HPA）轴作为参与分娩的潜在机制之一的重要性。母体和脐带血中皮质醇和孕酮的测定水平因分娩方式而异，自然分娩时浓度较高。此外，皮质醇水平最高的是初产妇；然而，无论分娩次数如何，参与产前教育的孕妇的脐带血皮质醇水平较低。
