Dehydroepiandrosterone at birth: Response to stress and relation to demographic, pregnancy and delivery factors
Dehydroepiandrosterone at birth: Response to stress and relation to demographic, pregnancy and delivery factors
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DOI：
10.1111/jne.12906
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发表时间：
2020-10-01
影响因子：
3.2
通讯作者：
Kertes, Darlene A.
中科院分区：
文献类型：
--
作者：
Kamin, Hayley S.;Bhatt, Samarth S.;Kertes, Darlene A.
胎儿下丘脑-垂体-肾上腺（HPA）轴增强脱氢表雄酮（DHEA）的产生使得对引产和新生儿适应至关重要的成熟事件成为可能。尽管我们知道母体和胎儿生理的相互联系以及出生后脱氢表雄酮产生的巨大变化，但很少有研究检测新生儿的脱氢表雄酮水平，也没有研究检测脱氢表雄酮对急性应激的反应。了解早期脱氢表雄酮活动的规范模式是准确评估与健康和发育相关的生物应激系统功能的必要条件。本研究分析了93名新生儿的脱氢表雄酮浓度和应激后的变化，以及与妊娠、分娩和人口危险因素的关系。三个唾液样本，收集之前和之后抽血应激源，用于确定基线和应激反应性脱氢表雄酮水平。母亲自我报告怀孕期间的健康行为。关于产科因素的数据来自医疗记录。脱氢表雄酮水平从压力评估前下降到压力评估后。研究结果还显示，应激源后DHEA变化与用于治疗疼痛和加速分娩的药物管理显著相关。然而，脱氢表雄酮的应激前水平和应激后的变化作为出生后时间的函数没有显著变化。通过捕捉出生后的脱氢表雄酮水平，本研究提供了一个窗口到产前健康的HPA系统。该研究还通过提供参考水平和重要协变量的数据，提高了对新生儿DHEA的认识。这些关于肾上腺生理学基础的信息为进一步了解早期下丘脑-垂体-肾上腺轴活动提供了基础。
Enhanced production of dehydroepiandrosterone (DHEA) by the foetal hypothalamic-pituitary-adrenal (HPA) axis enables maturational events critical for labour induction and neonatal adaptation. Despite knowledge of the interconnected nature of maternal and foetal physiology and dramatic changes in DHEA production after birth, few studies have examined DHEA levels in newborns and none have examined DHEA's response to acute stress. Understanding normative patterns of early DHEA activity is needed to accurately assess functioning of the biological stress system with relevance for health and development. The present study analysed DHEA concentrations and change after stress among 93 newborns and associations with pregnancy, delivery and demographic risk factors. Three saliva samples, collected prior to and following a blood draw stressor, were used to determine baseline and stress reactive DHEA levels. Mothers self-reported on health behaviours during pregnancy. Data on obstetric factors were obtained from medical records. DHEA levels declined from pre- to post-stressor assessments. Results also showed that post-stressor DHEA change was significantly associated with administration of medications used to treat pain and accelerate labour. However, there was no significant variation in DHEA pre-stress levels or change after stress as a function of time after birth. By capturing DHEA levels after birth, the present study provides a window into prenatal health of the HPA system. The study also advances knowledge of DHEA in newborns by providing data on reference levels and important covariates. This information on basic adrenal physiology provides a foundation that can be expanded on to enhance understanding of early hypothalamic-pituitary-adrenal axis activity.