Ohrlander S, Gennser G, Batra S, Lebech P
Obstet Gynecol. 1977 Feb;49(2):148-53.
As part of a series of studies on the endocrine consequences of corticosteroid treatment during late pregnancy, the levels of unconjugated estrone (E1), estradiol-14 beta (E2), and progesterone were followed in maternal plasma and amniotic fluid before and after treatment. Ten gravidas in the 30th-35th gestational week received 12 mg betamethasone daily for 3 days for prevention of idiopathic respiratory distress syndrome (IRDS) and were compared to 5 controls. The steroid concentrations were determined by radioimmunoassay. The plasma levels of E1 and E2 were depressed to 38% and 29%, respectively, while that of progesterone was not affected. No significant change of the steroid concentrations in amniotic fluid was observed. The decreased E2: progesterone ratio in maternal blood after betamethasone treatment in the human is in contrast to the increased ratio observed in ruminants after corticosteroid administration and preceding the spontaneous onset of labor. The fall in the E2: progesterone ratio accords with the earlier observed inability of intramuscular corticosteroid treatment of elicit labor in women at this stage of gestation. The earlier demonstrated marked depression of cortisol in fetal plasma after betamethasone seems paradoxical in view of the seemingly high availability of progesterone, considered as a precursor for the cortisol biosynthesis in the human fetal adrenal cortex.
作为关于妊娠晚期皮质类固醇治疗的内分泌后果系列研究的一部分，在治疗前后对母体血浆和羊水中的游离雌酮（E1）、雌二醇-14β（E2）和孕酮水平进行了跟踪。10名妊娠30至35周的孕妇每天接受12毫克倍他米松，共3天，以预防特发性呼吸窘迫综合征（IRDS），并与5名对照组进行比较。通过放射免疫测定法测定类固醇浓度。E1和E2的血浆水平分别降至38%和29%，而孕酮水平未受影响。羊水中的类固醇浓度未观察到显著变化。人类在倍他米松治疗后母体血液中E2与孕酮比值降低，这与反刍动物在皮质类固醇给药后且在自然分娩开始前观察到的比值升高形成对比。E2与孕酮比值的下降与早期观察到的在妊娠这个阶段肌肉注射皮质类固醇不能诱发妇女分娩相一致。鉴于孕酮被认为是人类胎儿肾上腺皮质中皮质醇生物合成的前体，其可用性看似很高，早期显示倍他米松后胎儿血浆中皮质醇明显降低似乎自相矛盾。
