title: 17-Hydroxyprogesterone in premature infants as a marker of intrauterine stress.
abstract: OBJECTIVE
  Amniotic infection (AI) and preeclampsia (PE), which are commonly the reason for prematurity, inflict stress of different duration on immature fetuses. Whether chronic stress, as reflected by intrauterine growth retardation, influences the level of 17-OH progesterone (17-OHP), was not previously examined.
  
  
  METHODS
  We analyzed 17-OHP and TSH levels during neonatal screenings in the first hours of life of 90 premature infants born between 25 and 33 weeks of gestation in infants with AI (n=37) or with PE (n=53). Control of acute stress parameters was derived from umbilical arterial cord blood pH and base excess (BE).
  
  
  RESULTS
  Mean 17-OHP levels of infants born to mothers with PE were 85.7 nmol/L compared to 54.6 nmol/L (P<0.001) in AI infants. 17-OHP was even higher when intrauterine growth restriction was present (99.8 nmol/L). Antenatal steroids and mode of delivery did not significantly affect 17-OHP levels.
  
  
  CONCLUSIONS
  Stress of relatively long duration, as in cases of PE, leads to a significant increase of 17-OHP level in preterm infants. The postnatal 17-OHP level may be considered as a measure for severity of intrauterine stress and might be used as an individualized indicator for earlier intensive care.
authors.affiliation: Department of Neonatology, Zurich University, Switzerland.
authors.forename: Jörg
authors.initials: J
authors.lastname: Ersch
authors.forename: Ernst
authors.initials: E
authors.lastname: Beinder
authors.forename: Thomas
authors.initials: T
authors.lastname: Stallmach
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Bucher
authors.forename: Toni
authors.initials: T
authors.lastname: Torresani
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002821:Chorioamnionitis / Q000097:blood*; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D013312:Stress, Physiological / Q000097:blood / Q000209:etiology; D013972:Thyrotropin / Q000097:blood
chemical_list: D015415:Biomarkers; D019326:17-alpha-Hydroxyprogesterone; D013972:Thyrotropin