Placental corticotropin-releasing hormone and the hypercortisolism of pregnancy.
OBJECTIVE
Our purpose was to clarify whether placental corticotropin-releasing hormone regulates pituitary-adrenal function in human pregnancy.


METHODS
We examined the relationship between maternal plasma corticotropin-releasing hormone concentrations and levels of pituitary-adrenal hormones at 5-week intervals in 21 uncomplicated term pregnancies.


RESULTS
Maternal plasma corticotropin-releasing hormone concentrations rose significantly from 115 +/- 45 pg/ml at 11 to 15 weeks to 4346 +/- 754 pg/ml at 36 to 40 weeks (p < 0.001). Afternoon plasma corticotropin concentrations also rose significantly from 8.8 +/- 2.8 pg/ml to 18 +/- 2.6 pg/ml (p < 0.005). Urinary free cortisol concentrations rose from 54.8 +/- 7.3 micrograms per 24 hours to 111 +/- 8.7 micrograms per 24 hours (p < 0.005). Maternal dehydroepiandrosterone sulfate levels fell from 102 +/- 14 micrograms/dl to 63.8 +/- 7.1 micrograms/dl (p < 0.005). Maternal plasma corticotropin-releasing hormone was significantly correlated with afternoon plasma corticotropin concentrations (r = 0.6, p < 0.0001) and with urinary free cortisol concentrations (r = 0.04, p < 0.01).


CONCLUSIONS
Similar modest elevations of corticotropin and cortisol, as occur in pregnancy, have been reported in vitro and in vivo studies of long-term administration of corticotropin-releasing hormone. Our findings support the concept that placental corticotropin-releasing hormone modulates pituitary-adrenal function in pregnancy.
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032.
R S
RS
Goland
S
S
Jozak
I
I
Conwell
D000305:Adrenal Cortex Hormones / Q000097:blood; D000324:Adrenocorticotropic Hormone / Q000097:blood; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008659:Metabolic Diseases / Q000378:metabolism; D009994:Osmolar Concentration; D010907:Pituitary Hormones / Q000097:blood; D010920:Placenta / Q000378:metabolism*; D011247:Pregnancy / Q000097:blood*; D011248:Pregnancy Complications; D011863:Radioimmunoassay; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D010907:Pituitary Hormones; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone