The impact of severe asthma during pregnancy on placental function and fetal hypothalamic-pituitary-adrenal function

孕期严重哮喘对胎盘功能及胎儿下丘脑-垂体-肾上腺功能的影响

• 批准号: nhmrc : 100900
• 负责人: Prof Vicki Clifton
• 金额: $ 13.95万
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2000
• 资助国家: 澳大利亚
• 起止时间: 2000-01-01 至 2002-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/impact-severe-asthma-adrenal-function/82012
• 关键词: impact; severe; asthma; during; pregnancy

This study will examine whether the glucocorticoids administered for the control of severe asthma during pregnancy affects placental and fetal function. It is known that severe asthma during pregnancy is associated with low birth weight babies but the events that cause reduced growth of the baby are unknown. However in both animal and human pregnancies, increased exposure of the baby to glucocorticoids from the mother causes growth restriction of the baby. Therefore we propose that the increased intake of glucocorticoids for the treatment of asthma during pregnancy changes how the placenta functions and allows the fetus to be exposed to maternal glucocorticoids causing changes in fetal development. We will examine placental blood flow and measure some placental enzymes that may be involved in the control of blood flow in placentas collected from women with mild, moderate and severe asthma and compare them to non-asthmatic women. We will look at placental blood flow in utero using Doppler ultrasound and also in vitro after the placenta is delivered. We want to see if the fetus is affected by increased intake of glucocorticoids by the mother by measuring a hormone estriol, which originates from the fetus. We will measure estriol throughout pregnancy as it can easily be detected in the mothers' urine. These studies will tell us if glucocorticoid intake for the treatment of asthma can exert effects on the placenta and baby during pregnancy. These studies will make a significant contribution both scientifically and clinically. At a scientific level we will be able to examine how increased maternal glucocorticoid intake during pregnancy affects placental mechanisms and whether these changes affect the fetus and clinically the outcome of this study will allow us to optimize asthma therapy during pregnancy so that we can improve the outcome for the baby.

本研究将探讨糖皮质激素用于控制妊娠期严重哮喘是否会影响胎盘和胎儿功能。众所周知，怀孕期间的严重哮喘与低出生体重婴儿有关，但导致婴儿生长迟缓的事件尚不清楚。然而，在动物和人类怀孕中，婴儿从母亲那里接触到更多的糖皮质激素会导致婴儿生长受限。因此，我们提出，在妊娠期间增加糖皮质激素的摄入来治疗哮喘会改变胎盘的功能，并使胎儿暴露于母体糖皮质激素中，从而导致胎儿发育的变化。我们将检查胎盘血流，测量一些可能参与控制轻度、中度和重度哮喘妇女胎盘血流的胎盘酶，并将其与非哮喘妇女进行比较。我们将使用多普勒超声观察子宫内胎盘血流以及胎盘娩出后的体外血流。我们想看看胎儿是否会受到母亲摄入糖皮质激素增加的影响通过测量激素雌三醇，雌三醇来源于胎儿。我们将在整个怀孕期间测量雌三醇，因为它很容易在母亲的尿液中检测到。这些研究将告诉我们，用于治疗哮喘的糖皮质激素摄入是否会对怀孕期间的胎盘和婴儿产生影响。这些研究将在科学和临床上做出重大贡献。在科学水平上，我们将能够检查怀孕期间增加的母亲糖皮质激素摄入量如何影响胎盘机制，以及这些变化是否影响胎儿，这项研究的临床结果将使我们能够优化怀孕期间的哮喘治疗，从而改善婴儿的预后。