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- W2048883982 abstract "The fetal adaptive response to stress is regulated in part by the adrenocortical system. Dehydroepinadrosterone sulfate (DHEAS) and cortisol have opposing effects: cortisol suppresses while DHEAS enhances the innate immune system. We sought to determine the impact of IAI on the fetal molar ratio of cortisol/DHEAS in inflammation-associated preterm birth. The relationship between IAI, fetal adrenal gland volume (AGV), umbilical cord interleukin-6 (IL-6), cortisol and DHEAS was analyzed in 51 consecutive singleton fetuses of mothers who had an indicated amniocentesis to rule out infection. Proteomic profiling of the amniotic fluid [Mass restricted (MR) score] identified presence or absence of IAI. The MR score ranged from 0 (biomarkers absent) to 4 (all biomarkers present). An MR 3 or 4 confirmed severe IAI. Fetal AGV was assessed by ultrasonographic multiplanar technique (VOCAL). IL-6, cortisol and DHEAS were measured by sensitive immunoassays. Parametric and nonparametric analysis was employed. 1) Women with IAI (n=16) delivered at earlier GA (27±0.8 wks) compared to those without IAI (32±0.5 wks, p=<0.001, n=35); 2) Fetuses exposed to IAI had higher AGVs (p=0.02) and cord blood IL-6 (p=0.008) compared to those of women with normal MR scores (p=0.007); 3) There was a direct relationship between cord blood IL-6 and AGVs (r=0.37, p=0.025 Fig A), fetal cortisol (r=0.37, p=0.026) and DHEAS (r=0.50, p=0.002); 4) Fetuses exposed to IAI had lower cortisol/DHEAS ratios (p=0.034 Fig B). These results were maintained after adjusting for GA, contractions, and steroid exposure. This study provides evidence for the involvement of stress hormones in the fetal adaptive response to inflammation in utero." @default.
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- W2048883982 date "2007-12-01" @default.
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- W2048883982 title "200: Intra-amniotic inflammation (IAI) is associated with a low fetal plasma cortisol / dehydroepi- androsterone sulfate ratio (fetal stress index)" @default.
- W2048883982 doi "https://doi.org/10.1016/j.ajog.2007.10.213" @default.
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