Owens P C, Smith R, Brinsmead M W, Hall C, Rowley M, Hurt D, Lovelock M, Chan E C, Cubis J, Lewin T
Faculty of Medicine, University of Newcastle, New South Wales, Australia.
Life Sci. 1987 Oct 5;41(14):1745-50. doi: 10.1016/0024-3205(87)90603-5.
We recently observed that the characteristic insensitivity of the pituitary-adrenal system in women to feedback inhibition during pregnancy persists for at least four days postnatally. We therefore examined women during the first five weeks after delivery to assess when the sensitivity of plasma cortisol to glucocorticoid inhibition returns to normal. Dexamethasone (DEXA, 1 mg) was ingested at 11 pm by normal healthy women, once between the 3rd and 27th postnatal days, and again on day 35. Blood plasma was collected at 4 pm on the following day for cortisol assay. Plasma cortisol levels (nmol/L, mean +/- sem [n]) after DEXA in the first two weeks (216 +/- 28, [47]) were higher (p less than 0.001) than in nonmedicated nonpregnant women (47.4 +/- 8.9 [12]) and were normal by the 35th day after delivery (41.7 +/- 4.8 [74]). A negative association was found between post-DEXA cortisol and time after delivery in the first 4 post-partum weeks (r = -0.46, p less than 0.001). The study confirms that insensitivity of plasma cortisol to feedback inhibition persists beyond normal pregnancy in a significant proportion of healthy women for two to three weeks, and is absent by the 5th postnatal week.
我们最近观察到，女性垂体-肾上腺系统在孕期对反馈抑制具有特征性不敏感性，这种情况在产后至少持续四天。因此，我们对产后前五周的女性进行了检查，以评估血浆皮质醇对糖皮质激素抑制的敏感性何时恢复正常。正常健康女性在晚上11点口服地塞米松（DEXA，1毫克），在产后第3天至第27天之间服用一次，在第35天再次服用。在次日下午4点采集血浆进行皮质醇测定。前两周（216±28，[47]）服用DEXA后的血浆皮质醇水平（纳摩尔/升，平均值±标准误[n]）高于未用药的非孕期女性（47.4±8.9 [12]）（p<0.001），且在产后第35天恢复正常（41.7±4.8 [74]）。在产后前4周，服用DEXA后的皮质醇水平与产后时间呈负相关（r = -0.46，p<0.001）。该研究证实，在相当一部分健康女性中，血浆皮质醇对反馈抑制的不敏感性在正常孕期后会持续两到三周，而在产后第5周时消失。
