β2-adrenergic receptor genotype and other variables that contribute to labor pain and progress.
β2-adrenergic receptor genotype and other variables that contribute to labor pain and progress.
复制标题
β2-肾上腺素能受体基因型和其他有助于分娩疼痛和进展的变量。
DOI：
10.1097/aln.0b013e318211004e
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发表时间：
2011
期刊：
影响因子：
8.8
通讯作者：
Flood,Pamela
中科院分区：
文献类型：
--
作者：
Reitman,Elena;Conell-Price,Jessamyn;Evansmith,Jennifer;Olson,Luke;Drosinos,Sofia;Jasper,Nancy;Randolph,Paula;Smiley,RichardM;Shafer,Steven;Flood,Pamela
背景β 2肾上腺素能受体（β2AR）活性影响分娩，其基因型影响早产的发生率。我们确定了β 2 AR基因型对足月产程进展和疼痛的影响。方法对150例孕晚期初产妇进行前瞻性研究，获取其感觉阈值、人口统计学信息和DNA。提取宫颈扩张、疼痛评分和分娩管理数据以及相关时间。遗传和人口统计学因素与分娩的关联用混合效应模型进行了检验。结果β 2 AR基因27位Gln表达者产程明显减慢（P<0.03）。他们在大约21小时内从1- 10 cm扩张，而其他患者为14小时。以前与产程缓慢相关的亚洲种族与该多态性高度相关（P<0.0001）。体重较重和黑人患者的潜伏产程较慢（P<0.01，0.01），而椎管内镇痛与产程进展较慢相关（P<0.0001）。最重的产妇和黑人产妇从宫颈扩张1cm过渡到活跃分娩可能需要长达36小时;然而，一旦活跃期开始，分娩率与其他患者相同。结论我们检测到β 2 AR基因型与产程减慢之间存在强相关性。亚裔可能是β 2 AR基因型的代表。黑人和肥胖妇女的潜伏产程较慢。这些结果证实了当这个数学模型被应用于一个大型的回顾性economy时发现的许多关联，进一步验证了这种描述和分析劳动力进步的方法。
Background Beta-2-adrenergic receptor (β2AR) activity influences labor and its genotype affects the incidence of preterm delivery. We determined the effect of β2AR genotype on term labor progress and pain. Methods We prospectively enrolled 150 nulliparous parturients in the third trimester and obtained sensory thresholds, demographic information and DNA. Cervical dilation, pain scores and labor management data were extracted with associated times. The association of genetic and demographic factors with labor was tested with mixed effects models. Results Parturients who express Gln at the 27 position of the β2AR had slower labor (P<0.03). They progressedfrom 1–10cm dilation in approximately 21 hours compared to 14 hours in otherpatients. Asian ethnicity, previously associated with slower labor, is highly associated with this polymorphism (P<0.0001). Heavier and Black patients had slower latent labor (P<0.01, 0.01) and neuraxial analgesia was associated with slower labor progress (P<0.0001). It could take up to 36 hours for the heaviest and the Black parturients to transition from 1cm cervical dilation to active labor; however once the active phase began, labor rate was the same as other patients’. Conclusion We detected a strong association between β2AR genotype and slower labor. Asian ethnicity may be a proxy for β2AR genotype. Black and heavy women have slower latent labor. These results confirm many of the associations found when this mathematical model was applied to a large retrospectivecohort, further validating this approach to description and analysis of labor progress.