Phillippe M
Am J Obstet Gynecol. 1983 Aug 1;146(7):840-55. doi: 10.1016/0002-9378(83)91088-8.
Experimental data from fetal human and animal research suggest that the fetal sympathoadrenal system, composed of the adrenal medulla, sympathetic neurons, and extra-adrenal chromaffin tissue functions from early fetal life to maintain fetal homeostasis. The extra-adrenal chromaffin tissue undergoes maturation at 9 to 11 weeks of gestation, whereas the adrenal medulla and sympathetic nervous system mature later in fetal life. The fetal catecholamine response to hypoxia, mediated predominantly by norepinephrine, is an important component of the fetal cardiovascular response to hypoxia, i.e., through alpha-receptor stimulation, fetal cardiac output redistribution occurs. Fetal catecholamine secretion in response to substrate availability, through alpha- and beta-receptor stimulation, provide a mechanism by which the fetus can utilize its own substrate stores. Pulmonary beta-receptor stimulation by catecholamines has been demonstrated to increase lecithin synthesis, increase surfactant secretion, and decrease lung fluid production near term. beta-Receptor stimulation has also been demonstrated to have trophic effects on the development of thermogenic brown adipose tissue. Although the exact stimulus for the initiation of parturition in the primate is unknown, fetal catecholamines, through direct myometrial alpha-adrenergic or dopaminergic receptor stimulation and/or through the stimulation of prostaglandin production, have the potential of facilitating the onset of parturition.
来自人类胎儿和动物研究的实验数据表明，由肾上腺髓质、交感神经元和肾上腺外嗜铬组织组成的胎儿交感肾上腺系统在胎儿早期就开始发挥作用，以维持胎儿体内平衡。肾上腺外嗜铬组织在妊娠9至11周时成熟，而肾上腺髓质和交感神经系统在胎儿后期成熟。胎儿对缺氧的儿茶酚胺反应主要由去甲肾上腺素介导，是胎儿对缺氧的心血管反应的重要组成部分，即通过α受体刺激，胎儿心输出量重新分布。胎儿对底物可用性的儿茶酚胺分泌通过α和β受体刺激，提供了一种胎儿可以利用自身底物储备的机制。已证明儿茶酚胺对肺β受体的刺激可增加卵磷脂合成、增加表面活性剂分泌并在接近足月时减少肺液生成。β受体刺激也已证明对产热棕色脂肪组织的发育具有营养作用。虽然灵长类动物分娩开始的确切刺激因素尚不清楚，但胎儿儿茶酚胺通过直接刺激子宫肌层的α肾上腺素能或多巴胺能受体和/或通过刺激前列腺素的产生，有可能促进分娩的开始。
