Prolactin Levels in Umbilical Cord Serum and Its Relation to Fetal Adrenal Activity in Newborns of Women with Pregnancy-Induced Hypertension

Abstract

ABSTRACT. The effect of hypertension in pregnant women on fetal maturation is an issue of considerable importance. Because of a possible role of prolactin in fetal adrenal steroidogenesis and in fetal lung maturation, we have investigated the relationship between hypertension in pregnant women and levels of prolactin and dehydroepiandrosterone sulfate in serum of newborn infants. It was found that with the mild-to-moderate form of pregnancyinduced hypertension (PIH), there was little effect on prolactin levels in newborn serum. In newborns of women with severe PIH, however, serum prolactin levels were significantly greater (p < 0.01) than those in newborns of women with uncomplicated pregnancies. Conversely, umbilical serum concentrations of dehydroepiandrosterone sulfate in newborns of women with severe PIH were significantly less (p < 0.05) than those in newborns of women with uncomplicated pregnancies. These findings are supportive of the view that pituitary function and adrenocortical function of fetuses of women with PIH are different from those of fetuses of normotensive women. These findings are suggestive that PIH alters the function of the fetal pituitary and adrenal cortex. (Pediatr Res 20: 876-878, 1986) Abbreviations PIH, pregnancy-induced hypertension DS, dehydroepiandrosterone sulfateThe effects of disorders of pregnant women on the processes of human fetal development are varied. Perhaps the most common complication of pregnancy is PIH. In the current study, we investigated the effects of PIH on the levels of prolactin and DS in serum of newborns. Prolactin was chosen for study since it is a major secretory product of the fetal pituitary that has been proposed to serve a role in fetal adrenal steroidogenesis (1-6), and also in fetal lung maturation (7-10). DS was chosen for study since it is the major secretory product of the fetal adrenal cortex and is the principal precursor of estrogens formed in the placenta during human pregnancy (1 1). Received February 20,1986; accepted April 28, 1986. Correspondence and reprint requests to Dr. C. Richard Parker, Jr., Department of Obstetrics and Gynecology, University of Alabama at Birmingham, University Station, Birmingham, AL 35294.These studies were supported, in part, by USPHS Grants HD14513 and HD13912. METHODSThe subjects of this study were 157 newborn infants of women who were normotensive and whose pregnancies were considered to be otherwise uncomplicated and 7 1 newborn infants ofwomen whose pregnancies were complicated by PIH. All newborns were delivered between 28 and 40 wk of gestation: gestational age being the number of weeks since the last menstrual period minus 2 wk. Newborns of hypertensive women with additional complications (i.e. chronic hypertension, diabetes, etc.) were omitted from this study. PIH was classified as severe when the onset of hypertension occurred prior to or during the 32nd wk of gestation. In instances when the onset of hypertension occurred after the 32nd wk of gestation, PIH was classified according to the magnit...

The Role of Prolactin in Fetal Lung Maturation

“…Maternal preeclampsia and pregnancy-induced hypertension, conditions in which the incidence of RDS is lower than expected, 38 have been shown to be associated with significantly elevated levels of fetal plasma prolactin. The association of preeclampsia with elevated cord serum prolactin levels was first reported by Grosso et al 36 and was subsequently confirmed by Parker et al 39 in infants of women with severe pregnancy-induced hypertension. The incidence of RDS is also reduced in premature infants of heroin-addicted mothers.…”

“…Interestingly, there was no difference between the control and diabetic population with respect to the cord serum levels of thyroxine, triiodothyronine, estrone, or estradiol. 40 However, Parker and coworkers, 39 did not observe any alteration of prolactin levels in newborns of diabetic mothers. Since the characteristics of the diabetic population were not stated in either study, 39,42 it is possible that the diabetic populations in these two studies differed and that this factor accounts for the divergent observations in the two studies.…”

“…40 However, Parker and coworkers, 39 did not observe any alteration of prolactin levels in newborns of diabetic mothers. Since the characteristics of the diabetic population were not stated in either study, 39,42 it is possible that the diabetic populations in these two studies differed and that this factor accounts for the divergent observations in the two studies. In another study, Parker and coworkers 43 studied a population of premature infants of diabetic mothers who developed RDS and had significantly lower levels of prolactin than matched infants of nondiabetic mothers.…”