Umbilical cord blood levels of cortisol and dehydroepiandrosterone sulfate in preterm prelabor rupture of membrane pregnancies complicated by the presence of histological chorioamnionitis

Abstract

Objective: The main aim of this study was to determine the levels of cortisol and dehydroepiandrosterone sulfate (DHEA-S) and the cortisol/DHEA-S ratio in the umbilical cord blood according to the presence of histological chorioamnionitis and fetal inflammatory response in pregnancies complicated by prelabor rupture of membranes at fewer than 34 gestational weeks. Methods: Seventy-two women with singleton pregnancies complicated by preterm prelabor rupture of membranes between gestational ages 24+0 and 33+6 weeks were included in the study. The sample of blood was obtained from the umbilical cord after delivery of the newborn. The umbilical cord blood cortisol and DHEA-S levels were evaluated using commercial immunoassay kits. A cortisol/DHEA-S ratio was calculated. Results: The presence of histological chorioamnionitis was not associated with higher median levels of cortisol (32.1 nmol/L vs. 33.0 nmol/L; p = 0.53), DHEA-S (2.6 μmol/L vs. 2.5 μmol/L; p = 0.83), or cortisol/DHEA-S ratio (19.5 vs. 18.7;p = 0.90). Higher median levels of DHEA-S (3.1 μmol/L vs. 2.3 μmol/L; p = 0.03) but not cortisol (91.0 nmol/L vs. 32.0 nmol/L; p = 0.06) or cortisol/DHEA-S ratio (24.5 vs. 18.7; p = 0.46) were observed when fetal inflammatory response was present. Conclusions: The presence of fetal inflammatory response but not the presence of histological chorioamnionitis per se was associated with increased DHEA-S levels in the umbilical cord blood.

Key words::

• Adrenal gland
• intrauterine inflammation
• stress index
• preterm delivery

Declaration of Interest:This work was supported by grants from the Czech Science Foundation (No. 304-09-0494), from the Ministry of Health of the Czech Republic (NS 10382-3/2009) and from the Research Project (MZO 00179906).