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Korean Journal of Obstetrics & Gynecology 2001;44(9):1685-1690.
Published online September 1, 2001.
Fetal Plasma Cortisol and Dehydroepiandrosterone Sulfate in Pregnancy and Term Parturition.
Soo Young Oh, Bo Hyun Yoon
1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
2Laboratory of Fetal Medicine Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
Abstract
OBJECTIVE
The role of steroid hormones in the control of human parturition has been a subject of debate. The objective of the study was to examine if changes in fetal plasma cortisol or dehydroepiandrosterone sulfate (DHEA-S) are associated with human term parturition. METHODS: Fetal plasma cortisol and DHEA-S were measured in 374 singleton pregnancies delivered at term. Umbilical cord blood was obtained from patients in the following 6 groups: 1) preterm gestations undergoing cordocentesis for clinical indications before 36 weeks of gestation (n=93), 2) women undergoing cordocentesis for clinical indications after 36 weeks of gestation (n=9), 3) elective cesarean section (C/S) at term without labor (n=140), 4) C/S at term with early labor (cervical dilatationp< or = 3 cm) (n=18), 5) C/S at term with active labor (cervical dilatation 4cm or greater) (n=26), 6) vaginal delivery at term (n=88). Corticosteroids were not administered before blood collection. RESULTS: 1) Fetal plasma cortisol remain unchanged until 36 weeks of gestation and increased thereafter to term; 2) Active labor was associated with a significant increase in fetal plasma cortisol; 3) Fetal plasma DHEA-S increased in term gestation (>36 weeks) but did not increase during active labor; 4) The cortisol/ DHEA-S ratio (stress index) increased with advancing gestation and with active labor at term. CONCLUSION: Human parturition at term is associated with an increase in fetal plasma cortisol and cortisol/DHEA-S ratio, but not DHEA-S.
Key Words: human parturition, term, cordocentesis, cortisol, DHEA-S, cortisol/DHEA-S ratio
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