atrial-natriuretic-factor and Fetal-Distress

To compare venous cord plasma concentrations of 4 vasoactive peptide precursors: carboxy-terminal proarginine vasopressin, CT-prondothelin (ET)-1, midregional proadrenomedullin, and MR-proatrial natriuretic peptide, between fetuses with intrauterine growth restriction and appropriate for gestational age controls.. Matched-pair analysis of 12 fetuses with significant intrauterine growth restriction and 42 healthy appropriate for gestational age control fetuses. All infants were singletons, delivered by elective section after 34 weeks and without chromosomal abnormalities.. Umbilical cord plasma copeptin levels (median [range]) were 4-fold higher in intrauterine growth restriction infants than in matched appropriate for gestational age controls: 23.2 (6.7-449) vs 5.1 (2.5-53) pmol/L (P < .001). Multivariate regression analysis revealed an association between copeptin and umbilical artery resistance index z-score (P = .034). The 3 other precursor peptides showed no changes.. High copeptin concentrations in the cord blood of intrauterine growth restriction newborns reflect a fetal stress response and support the fetal programming hypothesis.

Topics: Adult; Arginine Vasopressin; Atrial Natriuretic Factor; Biomarkers; Case-Control Studies; Endothelin-1; Female; Fetal Blood; Fetal Distress; Fetal Growth Retardation; Glycopeptides; Humans; Middle Aged; Peptide Fragments; Young Adult

Topics: Acid-Base Imbalance; Atrial Natriuretic Factor; Blood Flow Velocity; Constriction; Female; Fetal Blood; Fetal Distress; Humans; Hypertension; Infant, Newborn; Pregnancy; Pregnancy Complications, Cardiovascular; Prognosis; Respiratory Distress Syndrome, Newborn; Umbilical Arteries; Umbilical Cord

We measured, by a specific radioimmunoassay, brain-natriuretic-peptide-like immunoreactive (BNP-LI) levels in the umbilical venous and arterial plasma of normal and distressed newborns. The indicated BNP-LI level in umbilical arterial plasma of normal newborns (3.5 +/- 0.9 fmol/ml, mean +/- SEM, n = 10) was significantly higher than that in umbilical venous plasma of the same newborns (2.2 +/- 0.5 fmol/ml). In the distressed newborns at term, the indicated BNP-LI level in umbilical venous plasma was 62.2 +/- 25.7 fmol/ml (n = 4), which was 19-fold higher than that of elective cesarean section cases (3.2 +/- 0.3 fmol/ml, n = 6; p < 0.05). The findings demonstrated that BNP was present in the human fetal circulation and that the plasma BNP level was elevated under fetal distress conditions.

Topics: Atrial Natriuretic Factor; Cesarean Section; Chromatography, Gel; Delivery, Obstetric; Female; Fetal Blood; Fetal Distress; Humans; Infant, Newborn; Natriuretic Peptide, Brain; Nerve Tissue Proteins; Pregnancy; Radioimmunoassay; Reference Values; Umbilical Arteries; Umbilical Veins

Topics: Atrial Natriuretic Factor; Female; Fetal Blood; Fetal Distress; Humans; Natriuretic Peptide, Brain; Nerve Tissue Proteins; Pregnancy

Topics: Atrial Natriuretic Factor; Female; Fetal Blood; Fetal Distress; Humans; Pregnancy; Reference Values

Little is known about atrial natriuretic peptide metabolism or secretion in the human fetus. The purpose of this study was to determine if both the placenta and umbilical vessels are possible sites of atrial natriuretic peptide metabolism and to evaluate the effects that labor, route of delivery, prolonged pregnancy, preeclampsia, and fetal distress have on umbilical arterial atrial natriuretic peptide levels. We found that plasma atrial natriuretic peptide levels in the umbilical artery are significantly greater than those in the vein (p less than 0.001). Umbilical arterial and umbilical venous atrial natriuretic peptide levels were higher in plasma samples collected immediately at delivery when compared with those obtained 10 minutes later (p less than 0.001). Umbilical arterial atrial natriuretic peptide levels were elevated in pregnancies complicated by preeclampsia and fetal distress (p less than 0.01). Labor, route of delivery, and prolonged pregnancy had no effect on umbilical arterial atrial natriuretic peptide levels. We propose that both the placenta and umbilical vessels contain atrial natriuretic peptide receptors that are involved in the clearance or metabolism of atrial natriuretic peptide. The increased umbilical arterial atrial natriuretic peptide levels present in preeclampsia and fetal distress may reflect an attempt by the fetus to regulate blood flow.

Topics: Atrial Natriuretic Factor; Cesarean Section; Female; Fetal Blood; Fetal Distress; Humans; Labor, Obstetric; Maternal-Fetal Exchange; Placenta; Pre-Eclampsia; Pregnancy; Pregnancy, Prolonged; Umbilical Arteries; Umbilical Veins

Topics: Acetates; Asphyxia Neonatorum; Atrial Natriuretic Factor; Biomedical Research; Central Nervous System Stimulants; Female; Fetal Distress; Humans; Infant, Newborn; Meclofenoxate; Obstetrics; Pregnancy; Research