Context: Pregnant tissues express corticotropin-releasing factor (CRF), a peptide modulating fetal and placental ACTH and cortisol secretion. These actions are modulated by the locally expressed CRF-binding protein (CRF-BP).Objective: The objective of the study was to determine whether CRF, CRF-BP, ACTH, and cortisol concentrations change in amniotic fluid and umbilical cord plasma in the presence of intraamniotic infection/inflammation (IAI) in women with spontaneous labor at term.Design: This was a cross-sectional study.
Setting:The study was conducted at a tertiary referral center for obstetric care.
Patients:Patients included women in active labor at term with (n ϭ 39) and without (controls; n ϭ 78) IAI.
Main Outcome Measures:Amniotic fluid and umbilical cord plasma concentrations of CRF, CRF-BP, ACTH, and cortisol measured by RIA and immunoradiometric assays were measured.
Results:In patients with IAI, amniotic fluid CRF (0.97 Ϯ 0.18 ng/ml) and CRF-BP (33.06 Ϯ 5.54 nmol/liter) concentrations were significantly (P Ͻ 0.001) higher than in controls (CRF: 0.32 Ϯ 0.04 ng/ml; CRF-BP: 14.69 Ϯ 2.79 ml). The umbilical cord plasma CRF and CRF-BP concentrations were significantly (P Ͻ 0.001 for all) higher in women with IAI than in controls (CRF: 2.96 Ϯ 0.35 ng/ml vs. 0.38 Ϯ 0.18 ng/ml; CRF-BP: 152.12 Ϯ 5.94 nmol/liter vs. 106.9 Ϯ 5.97 nmol/liter). In contrast, amniotic fluid and umbilical cord plasma ACTH and cortisol concentrations did not differ between groups.
Conclusions