Chronic maternal hypercortisolemia models stress-induced adverse birth outcome and altered cardiac function in newborn lambs.
Chronic maternal hypercortisolemia models stress-induced adverse birth outcome and altered cardiac function in newborn lambs.
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慢性母体高皮质醇血症模拟了应激引起的不良出生结果和新生羔羊心脏功能的改变。
DOI：
10.1152/ajpregu.00041.2022
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Keller-Wood,Maureen
中科院分区：
文献类型：
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作者：
Li,Mengchen;Wood,CharlesE;Keller-Wood,Maureen
怀孕期间的母亲压力被认为是不良妊娠结局的一个促成因素，包括死产和早产。我们实验室以前的研究表明，在妊娠后期，母羊母体皮质醇浓度的慢性升高（通过母体输注1 mg/kg/天）增加了死胎的发生率，并改变了出生时的胎心率和血压。我们设计当前的研究是为了测试长期升高的母体皮质醇对胎儿从宫内生活到宫外生活的心脏适应的影响。死产或早产的综合风险显着更大的妊娠与产妇高皮质醇血症，在这个队列中，40%的皮质醇注入母羊的羔羊死于子宫内或出生时相比，25%的对照母羊的羔羊，和24%的皮质醇注入母羊的羔羊早产，而没有羔羊早产在对照组。与对照羔羊相比，在足月出生的皮质醇注入母羊的羔羊表现出显着增加，平均主动脉压出生前和显着降低，平均主动脉压是明显的，在出生后的第一个9小时。与对照组羔羊相比，皮质醇处理母羊的新生儿出生前QT间期下降，出生后立即增加。这些研究结果表明，在子宫内过量皮质类固醇暴露不利地影响胎儿心脏适应宫外生活和慢性母体压力或皮质类固醇分泌过多可能会导致不良产科结局。
Maternal stress in pregnancy is thought to be a contributing factor in adverse pregnancy outcomes, including stillbirth and prematurity. Previous studies in our laboratory have shown that chronic elevation in maternal cortisol concentration in ewes (by maternal infusion of 1 mg/kg/day) during the late gestation increased the incidence of stillbirth and altered fetal heart rate and blood pressure at birth. We designed the current study to test the effect of chronically elevated maternal cortisol on fetal cardiac adaption from in utero life to ex utero life. The combined risk of stillbirth or prematurity was significantly greater in the pregnancies with maternal hypercortisolemia; in this cohort, 40% of the lambs of cortisol-infused ewes died in utero or at birth compared with 25% of lambs of control ewes, and 24% of lambs of cortisol-infused ewes were born preterm, whereas no lamb was born preterm in the control group. Compared with control lambs, the lambs of cortisol-infused ewes born at full term exhibited a significant increase in mean aortic pressure just before birth and a significant decrease in mean aortic pressure that was evident during the first 9 h after birth. The QT interval was decreased before birth and increased immediately after birth in the newborns of cortisol-treated ewes compared with control lambs. These findings suggest that excess in utero corticosteroid exposure adversely affects fetal cardiac adaptation to extrauterine life and that chronic maternal stress or hypersecretion of corticosteroids may contribute to adverse obstetric outcomes.