Abstract：
OBJECTIVE: The aim of this study was to demonstrate the establishment of adrenal sparing in intrauterine growth restricted (IUGR) human fetuses. IUGR fetuses are a subgroup of small for gestational age (SGA) fetuses that are unable to reach their own growth potential because of chronic hypoxia and undernutrition. We hypothesized that in IUGR fetuses the adrenal gland is relatively larger and secretion of noradrenaline (NA), adrenaline (A), and cortisol is increased.
METHODS: This is a prospective observational study including 65 singleton pregnancies (42 IUGR and 23 controls). Using two-dimensional ultrasound, we measured fetal adrenal diameters and adrenal/abdominal circumference (AD/AC) ratio between 25 and 37 weeks. We considered only one measurement per fetus. In 21 pregnancies we also measured NA, A, and cortisol levels in arterial and venous fetal cord blood collected at the time of delivery.
RESULTS: The AD/AC ratio was significantly higher in IUGR fetuses than in controls. Cord NA and A levels were significantly higher in IUGR fetuses than in controls. An increase in cortisol secretion in IUGR fetuses was observed but the difference was not statistically significant.
CONCLUSIONS: Adrenal sparing correlates with a relative increase in adrenal measurements and function.
METHODS: This is a prospective observational study including 65 singleton pregnancies (42 IUGR and 23 controls). Using two-dimensional ultrasound, we measured fetal adrenal diameters and adrenal/abdominal circumference (AD/AC) ratio between 25 and 37 weeks. We considered only one measurement per fetus. In 21 pregnancies we also measured NA, A, and cortisol levels in arterial and venous fetal cord blood collected at the time of delivery.
RESULTS: The AD/AC ratio was significantly higher in IUGR fetuses than in controls. Cord NA and A levels were significantly higher in IUGR fetuses than in controls. An increase in cortisol secretion in IUGR fetuses was observed but the difference was not statistically significant.
CONCLUSIONS: Adrenal sparing correlates with a relative increase in adrenal measurements and function.
摘要：
目的：本研究的目的是证明在宫内生长受限（IUGR）人类胎儿中保留肾上腺。IUGR胎儿是小于胎龄（SGA）胎儿的一个亚组，由于慢性缺氧和营养不良而无法达到自身的生长潜力。我们假设IUGR胎儿的肾上腺相对较大，分泌去甲肾上腺素（NA），肾上腺素(A),皮质醇增加。
方法：这是一项前瞻性观察性研究，包括65例单胎妊娠（42例IUGR和23例对照）。使用二维超声，我们测量了25至37周的胎儿肾上腺直径和肾上腺/腹围（AD/AC）比率。我们认为每个胎儿只有一次测量。在21次怀孕中，我们还测量了NA，A,分娩时收集的动脉和静脉胎儿脐带血中的皮质醇水平。
结果：IUGR胎儿的AD/AC比率明显高于对照组。IUGR胎儿的脐带NA和A水平明显高于对照组。观察到IUGR胎儿皮质醇分泌增加，但差异无统计学意义。
结论：肾上腺保留与肾上腺测量值和功能的相对增加相关。
方法：这是一项前瞻性观察性研究，包括65例单胎妊娠（42例IUGR和23例对照）。使用二维超声，我们测量了25至37周的胎儿肾上腺直径和肾上腺/腹围（AD/AC）比率。我们认为每个胎儿只有一次测量。在21次怀孕中，我们还测量了NA，A,分娩时收集的动脉和静脉胎儿脐带血中的皮质醇水平。
结果：IUGR胎儿的AD/AC比率明显高于对照组。IUGR胎儿的脐带NA和A水平明显高于对照组。观察到IUGR胎儿皮质醇分泌增加，但差异无统计学意义。
结论：肾上腺保留与肾上腺测量值和功能的相对增加相关。
