title: Relationship between the cortisol levels in umbilical cord blood and neonatal RDS/TTN in twin pregnancies.
abstract: OBJECTIVE
  Twin neonates have a higher risk of respiratory complications, such as respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN), than singleton neonates. The purpose of this study was to evaluate the relationship between the cortisol levels in the umbilical cord and neonatal RDS/TTN in twin pregnancies.
  
  
  METHODS
  We analyzed data obtained from 106 neonates (53 twin pairs), comprising 33 dichorionic twin (DCT) and 20 monochorionic twin (MCT) gestations. All infants were delivered via scheduled cesarean section without labor. We measured the cortisol levels in umbilical vein blood using enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The cortisol levels in the umbilical vein were significantly lower in the RDS/TTN group than in the no RDS/TTN group (p = 0.004). The umbilical cortisol levels in the TTN group were between the values observed in the RDS group and no RDS/TTN group. We subsequently analyzed the cut-off cortisol values for RDS/TTN and observed higher accuracy in the DCTs than in the MCTs.
  
  
  CONCLUSIONS
  Neonates who develop RDS/TTN have significantly lower cortisol levels in the umbilical cord at birth than no RDS/TTN neonates in twin pregnancies. When applying these data in clinical practice, physicians should pay attention to differences based on chorionicity.
authors.affiliation: a Department of Obstetrics and Gynecology , Nagoya University School of Medicine , Nagoya , Japan and.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuda
authors.affiliation: a Department of Obstetrics and Gynecology , Nagoya University School of Medicine , Nagoya , Japan and.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kotani
authors.affiliation: a Department of Obstetrics and Gynecology , Nagoya University School of Medicine , Nagoya , Japan and.
authors.forename: Seiji
authors.initials: S
authors.lastname: Sumigama
authors.affiliation: a Department of Obstetrics and Gynecology , Nagoya University School of Medicine , Nagoya , Japan and.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Mano
authors.affiliation: a Department of Obstetrics and Gynecology , Nagoya University School of Medicine , Nagoya , Japan and.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nakano
authors.affiliation: a Department of Obstetrics and Gynecology , Nagoya University School of Medicine , Nagoya , Japan and.|b Bell Research Center for Reproductive Health and Center , Nagoya , Japan.
authors.forename: Li
authors.initials: L
authors.lastname: Hua
authors.affiliation: a Department of Obstetrics and Gynecology , Nagoya University School of Medicine , Nagoya , Japan and.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
mesh_terms: D000328:Adult; D004200:Diseases in Twins / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000097:blood*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D059285:Pregnancy, Twin / Q000097:blood*; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood*; D012189:Retrospective Studies; D059245:Transient Tachypnea of the Newborn / Q000097:blood*
chemical_list: D006854:Hydrocortisone
keywords: Cortisol; respiratory distress syndrome; transient tachypnea of the newborn; twin pregnancy; umbilical cord