胎儿肾上腺系统在分娩发动中的作用研究进展  

Progress in study on roles of fetal HPA axis in initiation of labor

作　　者：王婷[1] 吴晓荣[1] 屈新中[1] 

机构地区：[1]西安交通大学第一附属医院妇产科,陕西西安710061

出　　处：《中国妇幼健康研究》2009年第5期582-585,共4页Chinese Journal of Woman and Child Health Research

摘　　要：妊娠晚期胎儿肾上腺系统发育成熟后，胎儿肾上腺大量分泌脱氢表雄酮硫酸脂和皮质醇，在促进自身成熟的同时，引发了胎盘内分泌的一系列变化，如雌激素的生成、胎盘促肾上腺皮质激素释放激素的分泌等等；同时，胎儿来源的糖皮质激素与分娩发动本身也有着直接的联系；而且胎儿肾上腺成熟后，糖皮质激素分泌的不断增加在分娩发动撤退理论及前列腺素生成过程中也扮演了重要的角色。这些反应很有可能是诱发分娩的关键因素，因此，胎儿肾上腺系统的发育成熟参与了分娩发动的各个环节，与分娩发动关系密切。研究分娩发动的决定因素对于预测分娩启动的时间，降低孕产妇分娩风险，提高新生儿存活能力有重要意义。该文就胎儿肾上腺系统与分娩发动关系的研究现状作以综述。The mechanism of initiation of labor is complex and mysterious.The matured fetal adrenal glands in late pregnancy secretes large amount of dehydroepiandrosterone sulfate （DHA） and hydrocortisone, which not only promotes maturation of adrenal glands themselves, but also results in a series of endocrine changes of the placenta, for example, production of estrogen, secretion of ACTHreleasing hormone by placenta and so on. Meanwhile, fetusderived glucocorticoid （GC） is also related to initiation of labor. Moreover, after maturation of fetal adrenal glands, contineously increased secretion of GC plays important roles in the withdrawal theory of initiation of labor and production process of prostaglandin （PG）. These responses may be key factors to induce parturition. So, matured development of fetal adrenal system takes part in every steps of inifiation of labor and is closely related with initiation of labor. The study on determinants of initiation of labor is of important significances for predicting initiation time of labor and reducing maternal risks in labor and improving neonatall surviving ability. In this review, we summarized current status of study on relationship between fetal HPA axis and initiation of labor.

关 键 词：分娩动因 胎儿肾上腺 胎盘 糖皮质激素 

分 类 号：R714[医药卫生—妇产科学]