Polin R A, Husain M K, James L S, Frantz A G
J Perinat Med. 1977;5(3):114-9. doi: 10.1515/jpme.1977.5.3.114.
Marked elevations in the vasopressin concentrations in human umbilical cord blood have been reported previously (4, 8). This could either be a part of generalized increase in the activity of fetal endocrine system at the time of birth, a phenomenon that has led to the concept of fetal participation in the onset of labor, or simply due to the stress of delivery. The present study is an attempt to examine the later possibility. Plasma vasopressin was determined by radioimmunoassay [9] in separately collected arterial and venous blood from the umbilical cords of 24 babies spontaneously delivered and 14 babies born after Caesarian Section in the absence of labor. Arterial acid-base determinations were done in each case. The Apgar Score was evaluated by one individual. In order to obtain a general idea of circulating concentration of this hormone in the neonatal period, vasopressin concentrations were determined in the systemic venous blood of 12 normal and 10 stressed babies. Vasopressin concentrations in the umbilical arterial blood of babies born after spontaneous delivery were remarkably high, as compared to all the other groups. Despite a wide range, between 5-2200 pg/ml, there was no correlation between the magnitude of vasopressin elevation and the severity of fetal asphyxia (Fig. 1). The present finding in part, confirms and expands previously observed increased vasopressin levels in the cord blood after spontaneous vaginal delivery. In addition, a lack of correlation between fetal asphyxia and the vasopressin levels suggests that these high levels may not be related to this form of stress.
先前已有报道称,人脐带血中血管加压素浓度显著升高(4, 8)。这可能是出生时胎儿内分泌系统活动普遍增加的一部分,这一现象导致了胎儿参与分娩发动的概念,也可能仅仅是由于分娩压力所致。本研究旨在探讨后一种可能性。采用放射免疫分析法[9]测定了24例自然分娩婴儿和14例剖宫产非临产婴儿脐带动脉血和静脉血中血浆血管加压素的含量。对每例进行动脉酸碱测定。由一人评估阿氏评分。为了大致了解新生儿期这种激素的循环浓度,测定了12例正常婴儿和10例应激婴儿的体循环静脉血中血管加压素浓度。与所有其他组相比,自然分娩婴儿脐带动脉血中的血管加压素浓度显著升高。尽管血管加压素升高幅度在5 - 2200 pg/ml之间变化很大,但血管加压素升高幅度与胎儿窒息严重程度之间并无相关性(图1)。本研究结果部分证实并扩展了先前观察到的自然阴道分娩后脐带血中血管加压素水平升高的现象。此外,胎儿窒息与血管加压素水平之间缺乏相关性表明,这些高水平可能与这种应激形式无关。