Intrauterine infection and preterm delivery: Evidence for activation of the fetal hypothalamic-pituitary-adrenal axis

摘要: Abstract Objective: We studied pregnant women in preterm labor with and without intrauterine infection to determine whether fetal hypothalamic-pituitary-adrenal axis activation occurs the setting of infection-induced parturition. Study Design: Amniotic fluid collected by amniocentesis maternal blood from patients intact membranes at 24 34 weeks' gestation were analyzed radioimmunoassay for steroid hormones estrone, estradiol, progesterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, cortisol. was also obtained microbial culture interleukin 6 measurements enzyme immunoassay. Results: Patients (n = 11) had significantly higher amniotic concentrations (539 ± 79 pg/mL) cortisol (5.28 1.0 μg/dL) than did delivery 11; 273 82 pg/mL 1.61 1.05 μg/dL, respectively) or subsequent term 202 1.82 respectively). Furthermore those who delivered within 7 days after enrollment (who more likely have infection) not both estrone (586 101 vs 314 98 estradiol (238 44 91 43 pg/mL). Conclusion: Intrauterine associated increased adrenal androgen biosynthesis, onset placental estrogen synthesis. These data are consistent infection-associated delivery. (Am J Obstet Gynecol 2000;182:1404-13.)