Institut de Recherche en Sciences de la Santé-Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso.
Unité de Recherche et de Formation en Sciences de la Vie et de la Terre (URF-SVT), Université Joseph Ki-Zerbo Ouaga 1, Ouagadougou, Burkina Faso.
PLoS One. 2024 Nov 4;19(11):e0310372. doi: 10.1371/journal.pone.0310372. eCollection 2024.
The hormonal shift occurring in pregnant women is crucial for the outcome of pregnancy. We conducted a study in pregnant women living in a malaria endemic area to determine the potential effect of gestational age on the modulation of the endocrine system by cortisol and prolactin production during pregnancy.
Primigravidae and multigravidae with a gestational age between 16-20 weeks were included in the study and followed up to delivery and 6-7 weeks thereafter. Venous blood was collected at scheduled visit: Visit 1 (V1; 16-20 weeks of amenorrhea), Visit 2 (V2; 28 ±1 weeks of pregnancy), Visit 3 (V3; 32 ±1 weeks of pregnancy), Visit4 (V4; delivery) and Visit5 (V5; 6-7 weeks after delivery). In addition, a cord blood sample was also collected during labour at delivery. Nulliparous and primiparous/multiparous non-pregnant women were enrolled in the control group. Cortisol and prolactin plasma concentrations were measured using ichroma II and i-chamber apparatus. Light microscopy was used to detect Plasmodium falciparum infections. A linear mixed-effects regression (LMER) model was used to assess the association between the variation of cortisol titres and prolactin levels during the pregnancy and the post-partum.
Results showed that cortisol and prolactin levels in the peripheral blood were globally up-regulated during pregnancy. Concentrations of cortisol during follow-up was significantly higher in primigravidae than in multigravidae during the whole pregnancy (p<0.024). Moreover, the level of prolactin which was higher before delivery in primigravidae reversed at delivery and postpartum visit, but the difference was not statistically significant during the follow-up (V1 to V5) (p = 0.60). The cortisol level in peripheral blood at delivery was higher than that in the cord blood, and conversely for prolactin. Cortisol and prolactin levels decreased after delivery, though the level of prolactin was still higher than that at enrolment. An increase of one unit of prolactin was associated with the decrease of the average concentration of cortisol by 0.04 ng/ml (p = 0.009). However, when cortisol increases with one unit, the average concentration of prolactin decreases by 1.16 ng/ml (p = 0.013).
These results showed that the up-regulation effects of cortisol and prolactin are related to gestational age. A The downward regulation effect that both hormones have on each other during the pregnancy when each increase to 1 unit (1.0 ng/ml) was also reported.
孕妇体内发生的激素变化对妊娠结局至关重要。我们在疟疾流行地区的孕妇中进行了一项研究，以确定妊娠年龄对皮质醇和催乳素产生的内分泌系统调节的潜在影响。
将 16-20 周龄的初产妇和多产妇纳入研究，并随访至分娩和产后 6-7 周。在预定就诊时采集静脉血：就诊 1（V1；闭经 16-20 周）、就诊 2（V2；妊娠 28±1 周）、就诊 3（V3；妊娠 32±1 周）、就诊 4（V4；分娩）和就诊 5（V5；分娩后 6-7 周）。此外，在分娩时还采集了脐带血样本。将未产妇和初产妇/多产妇非孕妇纳入对照组。使用 ichroma II 和 i-chamber 仪器测量皮质醇和催乳素的血浆浓度。使用光镜检测恶性疟原虫感染。使用线性混合效应回归（LMER）模型评估妊娠和产后期间皮质醇滴度和催乳素水平变化之间的关联。
结果表明，外周血中的皮质醇和催乳素水平在整个孕期均呈上调趋势。在整个孕期，初产妇的皮质醇浓度在随访中明显高于多产妇（p<0.024）。此外，初产妇在分娩前催乳素水平升高，但在分娩和产后就诊时逆转，但在随访期间（V1 至 V5）无统计学差异（p=0.60）。分娩时外周血中的皮质醇水平高于脐带血，反之催乳素水平亦然。分娩后皮质醇和催乳素水平下降，但催乳素水平仍高于入组时。催乳素增加 1 个单位与皮质醇平均浓度下降 0.04ng/ml（p=0.009）相关。然而，当皮质醇增加 1 个单位时，催乳素的平均浓度下降 1.16ng/ml（p=0.013）。
这些结果表明，皮质醇和催乳素的上调作用与妊娠年龄有关。当每个激素增加 1 个单位（1.0ng/ml）时，两者之间也存在相互下调作用。
