Abnormal umbilical artery Doppler waveforms and cord blood corticotropin-releasing hormone.
OBJECTIVE
To determine whether placental secretion of corticotropin-releasing hormone into the fetal circulation is increased in pregnancies complicated by umbilical-placental vascular insufficiency.


METHODS
Twenty women with abnormal Doppler umbilical artery flow velocity waveforms and six women with uncomplicated term pregnancies and normal umbilical artery flow velocity waveforms had cord blood concentrations of corticotropin-releasing hormone, ACTH, cortisol, and beta-hCG estimated.


RESULTS
The mean cord blood corticotropin-releasing hormone concentration was significantly higher in pregnancies with abnormal umbilical artery flow velocity waveforms than in normal pregnancies (108 +/- 27 versus 24 +/- 8 pg/mL, P = .019). Elevated cord blood corticotropin-releasing hormone levels were seen in the abnormal group regardless of the presence or absence of preeclampsia or fetal growth restriction. There were no significant differences in cord blood cortisol, ACTH, or beta-hCG concentrations.


CONCLUSIONS
The concentration of corticotropin-releasing hormone in the fetal circulation is significantly increased in pregnancies complicated by abnormal umbilical artery flow velocity waveforms. This may represent a stress-responsive compensatory mechanism in the human placenta.
Maternal Health Research Centre, John Hunter Hospital, Newcastle, Australia.
W B
WB
Giles
M
M
McLean
J J
JJ
Davies
R
R
Smith
D000328:Adult; D003346:Corticotropin-Releasing Hormone / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000378:metabolism; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*
D003346:Corticotropin-Releasing Hormone