Preterm birth: Associated neuroendocrine, medical, and behavioral risk factors

被引:109
作者
Erickson, K
Thorsen, P
Chrousos, G
Grigoriadis, DE
Khongsaly, O
McGregor, J
Schulkin, J
机构
[1] Georgetown Univ, Dept Physiol & Biophys, Washington, DC 20007 USA
[2] Univ Colorado, Dept Obstet & Gynecol, Denver, CO 80217 USA
[3] Neurocrine Biosci Inc, San Diego, CA 92121 USA
[4] NICHHD, Pediat & Reprod Emdocrinol Branch, NIH, Bethesda, MD 20892 USA
[5] Univ Aarhus, Danish Epidemiol Sci Ctr, Aarhus, Denmark
[6] Ctr Dis Control & Prevent, Div Child Dev Disabil & Hlth, Atlanta, GA 30333 USA
[7] American Univ, Dept Psychol, Washington, DC 20016 USA
关键词
D O I
10.1210/jc.86.6.2544
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Increased CRH secretion by the placenta of pregnant women has been associated with preterm birth. Certain indices of risk, both medical and psychosocial in nature, have been linked to preterm delivery. Levels of total, bound, and free CRH, CRH-binding protein (CRH-BP), and cortisol were measured prospectively in a large sample of pregnant Danish women who delivered preterm and term infants. Measures of maternal serum hormones were taken at 7-23 and 27-37 weeks gestation and, for those who delivered at term, at 37-43 weeks gestation. At 7-23 weeks gestation, maternal levels of total CRH (P = 0.01), bound CRH (P = 0.03), and CRH-BP (P = 0.01) were higher in the preterm than in the term group. At 27-37 weeks gestation, levels of total CRH (P < 0.0001), bound CRH (P < 0.0001), free CRH (P < 0.0001), and cortisol (P < 0.0001) were all higher in the preterm than the term group, whereas levels of CRH-BP (P < 0.0001) were lower in the preterm than in the term group. The best medical and behavioral factors associated with preterm delivery were, respectively, previous preterm delivery (P < 0.0001) and engagement in certain risk-taking behaviors (P = 0.008). The positive relations between preterm delivery and various adverse medical and socioeconomic variables with increases in placental secretion of CRH suggest that the latter may participate in the pathophysiology of preterm delivery.
引用
收藏
页码:2544 / 2552
页数:9
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