Corticotropin-releasing hormone and related pituitary-adrenal axis hormones in fetal and maternal blood during the second half of pregnancy

Abstract

There is little information available concerning the ontologic development of the human hypothalamic-pituitary-adrenal (HPA) axis nor of the potential interactions among fetal, maternal and placental-derived HPA axis hormones. This study evaluated levels of these hormones in matched maternal and fetal pairs during the second half of uncomplicated pregnancies. Immunoassays were used to measure serum concentrations of corticotropin-releasing hormone (CRH), adrenocorticotropin (ACTH) and cortisol in 104 matched fetal and maternal blood samples. Fetal specimens were obtained by percutaneous umbilical blood sampling (PUBS) between 18 and 40 weeks in patients whose pregnancies resulted in healthy, term infants. Correlations among these hormones, and the effect of gestational age were assessed. Maternal CRH concentrations [median (range)] [1.10 ng/ml (0.15 to 23.69)] were significantly greater than fetal values [0.35 ng/ml (0.07 to 1.0)]. Levels of maternal CRH (r = 0.73; p < 0.001) but not fetal CRH (r = 0.01; p = 0.98) correlated with gestational age. Maternal ACTH decreased (r = -0.21; p = 0.04) while fetal ACTH increased (r = 0.35; p < 0.003) with gestational age. Both maternal (r = 0.45; p < 0.001) and fetal (r = 0.57; p < 0.001) cortisol levels increased with gestational age. Maternal serum CRH values correlated best with fetal cortisol (r = 0.40; p = 0.0002) and correlated modestly with maternal cortisol (r = 0.28; p = 0.01), fetal ACTH (r = 0.24; p = 0.03) and fetal CRH (r = 0.23; p = 0.04); but not with maternal ACTH (r = -0.12; p = 0.3). Maternal CRH concentrations increase in the third trimester and correlate with rising fetal cortisol levels.

Second-trimester amniotic fluid corticotropin-releasing hormone and urocortin in relation to maternal stress and fetal growth in human pregnancy

“…Studies to date have produced contradictory findings on whether fetal concentrations rise with advancing gestation. While some have not found any significant association between gestational age and fetal plasma CRH during the second half of gestation (Gitau et al, 2004;Lockwood et al, 1996) or between gestational age and amniotic CRH within the third trimester (Emanuel et al, 1994), others have reported a significant increase in amniotic CRH from the second trimester to birth (Laatikainen, Räisänen, & Salminen, 1988). Taken together, it is assumed that fetal CRH levels increase from early to late gestation (Smith, 2007), but probably at a slower pace than maternal levels.…”

“…During pregnancy, the placenta likewise produces CRH, and placental mRNA expression in humans is detectable by seven weeks' gestation . The placenta secretes CRH predominantly into the maternal bloodstream causing maternal plasma levels to rise gradually from about 16 weeks' gestation with a more rapid increase setting in from approximately 24 and 30 weeks' gestation onwards (Campell et al, 1987;Golan, Jozak, & Conwell, 1994;Lockwood et al, 1996;McLean et al, 1995). Placental CRH reaches the maternal pituitary and stimulates adrenocorticotropic hormone (ACTH) and cortisol production.…”

Análise endócrino-comportamental dos macacos-prego (cebus nigritus) que habitam o Parque Estadual Carlos Botelho

“…Como justificar esse resultado se estudos com humanos, calitriquídeos e lagomorfos mostraram que os níveis circulantes de cortisol aumentam de duas a três vezes no último período da gestação, voltando a cair somente após o parto (Mulay et al 1973;Carr et al 1981;Kriesten & Murawski 1988;Allolio et al 1990;Ziegler et al 1995;Lockwood et al 1996)?…”

Pregnancy and sexual function in liver transplantation

“…Evidence suggests that the major foetal risks regarding steroids are cleft palate (particularly with high dose exposure in the first trimester), premature rupture of the membranes and intrauterine growth retardation [71,72]. A systematic review of studies of women who took corticosteroids during pregnancy for non-transplant-related conditions, demonstrated a 3.4-fold increased risk of cleft palate [73].…”