Parker C R, Carr B R, Winkel C A, Casey M L, MacDonald P C
Am J Obstet Gynecol. 1984 Nov 15;150(6):754-7. doi: 10.1016/0002-9378(84)90680-x.
In the present investigation, we determined the levels of deoxycorticosterone sulfate in mixed umbilical cord plasma of anencephalic abortuses and newborn infants. The anencephalic fetus is an interesting model with respect to the production of deoxycorticosterone and deoxycorticosterone sulfate on several accounts. There is profound adrenal atrophy in most such fesuses, and, in consequence, there also is relatively profound hypoestrogenism. This is an important consideration in the formation of deoxycorticosterone and deoxycorticosterone sulfate since it is known that estrogen acts to stimulate extra-adrenal steroid 21-hydroxylase and 21-hydroxysteroid sulfotransferase activities. The plasma levels of deoxycorticosterone sulfate in 22 anencephalic abortuses and newborn infants delivered between 21.5 and 45.5 weeks of gestation ranged from 1.8 to 30.3 ng/ml. The concentrations of deoxycorticosterone sulfate in umbilical cord plasma of anencephalic fetuses and newborn infants were not related to gestational age or method of delivery and, at term, were less than 13% of those in umbilical cord plasma of normal newborn infants. These data can be interpreted to indicate (1) that deoxycorticosterone sulfate normally is secreted directly by the fetal adrenal or (2) that placental estrogen normally derived largely from fetal adrenal dehydroisoandrosterone sulfate is essential for the maintenance of plasma deoxycorticosterone sulfate levels in the fetus by stimulating extra-adrenal deoxycorticosterone sulfate production from plasma progesterone, or both.
在本研究中，我们测定了无脑儿流产儿和新生儿混合脐血中硫酸脱氧皮质酮的水平。无脑儿胎儿在多个方面对于脱氧皮质酮和硫酸脱氧皮质酮的产生来说是一个有趣的模型。大多数此类胎儿存在严重的肾上腺萎缩，因此也存在相对严重的雌激素缺乏。这在硫酸脱氧皮质酮和脱氧皮质酮的形成中是一个重要的考虑因素，因为已知雌激素可刺激肾上腺外类固醇21 -羟化酶和21 -羟类固醇磺基转移酶的活性。22例妊娠21.5至45.5周的无脑儿流产儿和新生儿的硫酸脱氧皮质酮血浆水平在1.8至30.3 ng/ml之间。无脑儿胎儿和新生儿脐血中硫酸脱氧皮质酮的浓度与胎龄或分娩方式无关，足月时低于正常新生儿脐血中浓度的13%。这些数据可以解释为表明：（1）硫酸脱氧皮质酮通常由胎儿肾上腺直接分泌；（2）通常主要来源于胎儿肾上腺硫酸脱氢表雄酮的胎盘雌激素对于通过刺激血浆孕酮产生肾上腺外硫酸脱氧皮质酮来维持胎儿血浆硫酸脱氧皮质酮水平是必不可少的，或者两者皆有。
