Feto-neonatal hormonology in premature delivery

Abstract

The adrenal of the newborn infant is morphologically and functionally similar to the fetal one, and so the study of steroid excretion at birth can provide some information about fetal adrenal activity. We have studied (GLC Mass spectrometry) the behaviour of some 16 oxidated steroids: 16α-hydroxy-dehydroepiandrostcrone (16α-OH-DHA); 16β-hydroxy-dehydroepiandrosterone (16β-OH-DHA); 16-oxo-androstenediol (16-oxo-A); 16α-estriol (16α-OH-E 3) in maternal urine, amniotic fluid, fetal plasma (cord blood) and urine of newborn infants, in pregnancies with premature delivery. Our results are as follows: 1. During pregnancy (mother's urine) 16-oxidated steroids, particularly estriol, are not significantly lower than normal; 2. In amniotic fluid all the steroid values are significantly reduced; 3. Fetal plasma values are significantly reduced, except for 16-oxo-A and 16β-OH DHA; 4. In the urine of newborns, both those born at term or those of the same gestational age from planned deliveries, all the 16-oxidated steroid values are significantly diminished. The evidence of normal values of 16-oxidated steroids in the mother would indicate that the decrease in the fetuses occurs just before labour. On the other hand, fetal plasma cortisol in premature delivery without maternal complications shows similar values to those found in spontaneous deliveries at term. So it is possible that these two events play some role in determining the initiation of premature labour.