Corticotropin-releasing hormone and pituitary-adrenal hormones in pregnancies complicated by chronic hypertension.
OBJECTIVE
We hypothesized that maternal plasma corticotropin-releasing hormone levels are elevated in chronic hypertension and that elevations modulate maternal and fetal pituitary-adrenal function.


METHODS
Venous blood samples and 24-hour urine specimens were obtained in normal and hypertensive pregnancies at 21 to 40 weeks of gestation. Corticotropin-releasing hormone, corticotropin, cortisol, dehydroepiandrosterone sulfate, and total estriol levels were measured by radioimmunoassay. Mean hormone levels were compared by unpaired t test or two-way analysis of variance.


RESULTS
Plasma corticotropin-releasing hormone levels were elevated early in hypertensive pregnancies but did not increase after 36 weeks. Levels of pituitary and adrenal hormones were not different in normal and hypertensive women. However, maternal plasma estriol levels were lower in hypertensive pregnancies compared with normal pregnancies.


CONCLUSIONS
Fetal 16-hydroxy dehydroepiandrosterone sulfate, the major precursor to placental estriol production, has been reported to be lower than normal in hypertensive pregnancies, possibly explaining the decreased plasma estriol levels reported here. Early stimulation of placental corticotropin-releasing hormone production or secretion may be related to accelerated maturation of placental endocrine function in pregnancies complicated by chronic hypertension.
Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY 10032.
W B
WB
Warren
E D
ED
Gurewitsch
R S
RS
Goland
D000324:Adrenocorticotropic Hormone / Q000097:blood; D002908:Chronic Disease; D003346:Corticotropin-Releasing Hormone / Q000097:blood*; D004964:Estriol / Q000097:blood*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006973:Hypertension / Q000097:blood*; D011247:Pregnancy / Q000097:blood; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood*
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D004964:Estriol; D006854:Hydrocortisone