Brown W, Singer D B
Department of Pathology, Women and Infants Hospital of Rhode Island, Providence.
Obstet Gynecol. 1988 Aug;72(2):190-4.
Adrenal weights and histologic features in an autopsy population of 759 fetuses and neonates were correlated with the presence or absence of pregnancy-induced hypertension. Hypoplastic fetal adrenals with normal proportions of fetal and adult cortical layers (miniature histologic type) had combined adrenal weights less than 1 g, and were noted in 11 fetuses and neonates born to 39 mothers with pregnancy-induced hypertension, two born to 35 mothers with suggested pregnancy-induced hypertension, and 45 born to 685 mothers with no pregnancy-induced hypertension. Hypoplastic fetal adrenals were associated significantly with pregnancy-induced hypertension by chi 2 analysis (P less than .01). When a more stringent criterion for fetal adrenal hypoplasia was used (combined adrenal weight/body weight ratio of less than 1:1000), five cases were associated with pregnancy-induced hypertension, three with suggested pregnancy-induced hypertension, and seven with normal maternal blood pressures (P less than .001). This study confirms the relationship between pregnancy-induced hypertension and reduced fetal adrenal mass. We speculate that reduced production of dehydroepiandrosterone sulfate by the small adrenals may be related to maternal hypertension.
在759例胎儿和新生儿尸检人群中，肾上腺重量和组织学特征与妊娠高血压的有无相关。具有正常比例胎儿和成人皮质层的发育不全胎儿肾上腺（微小组织学类型），其肾上腺总重量小于1克，在39例患有妊娠高血压的母亲所生的11例胎儿和新生儿、35例疑似患有妊娠高血压的母亲所生的2例以及685例无妊娠高血压的母亲所生的45例中被发现。通过卡方分析，发育不全胎儿肾上腺与妊娠高血压显著相关（P<0.01）。当采用更严格的胎儿肾上腺发育不全标准（肾上腺总重量/体重比小于1:1000）时，5例与妊娠高血压相关，3例与疑似妊娠高血压相关，7例与母亲血压正常相关（P<0.001）。本研究证实了妊娠高血压与胎儿肾上腺质量降低之间的关系。我们推测，小肾上腺硫酸脱氢表雄酮分泌减少可能与母亲高血压有关。
