beta-endorphin and Fetal-Distress

Labour and modes of delivery can influence the plasma levels of stress hormones and cytokines involved in pathophysiologic cascade, potentially damaging brain development of the newborn. This prospective observational, single-centre, case-control, non-profit study aimed to detect potential differences in foetal well-being such as stress neuroendocrine responses. Quantitative determinations of the stress markers interleukin (IL)-1β, IL-8, and β-endorphin were compared between the control group and the epidural analgesia group. We found higher IL1-β levels but lower IL-8 and β-endorphin levels in the epidural analgesia group than in the control group. No significant inter-group differences were observed for any parameters. Our findings demonstrate that epidural analgesia for pain relief during labour does not result in significant differences in blood stress response markers.IMPACT STATEMENT

Topics: Adult; Analgesia, Epidural; Analgesia, Obstetrical; beta-Endorphin; Case-Control Studies; Female; Fetal Blood; Fetal Distress; Humans; Infant, Newborn; Interleukin-1beta; Interleukin-8; Labor Pain; Male; Pregnancy; Prospective Studies

A deleterious fetal stress response, although not fully elucidated, may account for poor outcomes after experimental fetal cardiac surgery. We set out to characterize this fetal stress response and its potential role in placental dysfunction.. Fifteen ovine fetuses at gestational day 100 to 114 were placed on extracorporeal support for 30 minutes and were then followed 2 hours after cardiopulmonary bypass. Fetal plasma samples were analyzed for vasopressin, cortisol, and beta-endorphin levels, and correlated to fetal hemodynamics and placental gas exchange.. Unique temporal patterns of response were seen in release of the three stress hormones. Vasopressin demonstrated the most profound and early response followed by cortisol and beta-endorphin, the latter continuing to rise in the post-bypass period. A sharp rise in fetal mean arterial pressure and placental vascular resistance strongly correlated with rising vasopressin levels. Post-bypass deterioration of fetal gas exchange and hemodynamics correlated with the ensuing rise in cortisol and beta-endorphin. Rising fetal lactate levels correlated with elevations in all three stress hormones.. Fetal cardiopulmonary bypass leads to a profound, early rise in vasopressin concentrations that strongly correlates with placental dysfunction after fetal bypass. Vasopressin may play an important mechanistic role in pathogenesis of this placental dysfunction.

Topics: Acid-Base Equilibrium; Animals; beta-Endorphin; Carbon Dioxide; Cardiopulmonary Bypass; Female; Fetal Distress; Fetoscopy; Heart Defects, Congenital; Hemodynamics; Hydrocortisone; Lactic Acid; Maternal-Fetal Exchange; Oxygen; Placenta; Pregnancy; Sheep; Sternum; Vascular Resistance; Vasopressins

Topics: Animals; beta-Endorphin; Cardiopulmonary Bypass; Female; Fetal Distress; Fetoscopy; Heart Defects, Congenital; Hydrocortisone; Lactic Acid; Maternal-Fetal Exchange; Placenta; Pregnancy; Sheep; Sternum; Vasopressins

To evaluate the role of endogenous opioid peptides (EOP) in the fetal distress.. Forty three patients with fetal distress (fetal distress group) and 40 healthy pregnant women (control group) in their third trimester were studied. The concentrations of plasma EOP (beta-endorphin, dorphin A(1 - 13) and leu-enkephalin) were measured by radioimmunoassay. Umbilical artery pH, PO(2) and PCO(2) were also measured.. The levels of umbilical artery plasma EOP (beta-endorphin, dorphin A(1 - 13) and leu-enkephalin) in fetal distress group were (453 +/- 68) ng/L, (242 +/- 33) ng/L, and (498 +/- 68) ng/L, respectively. In control group, the levels of EOP were (251 +/- 39) ng/L, (103 +/- 22) ng/L, and (322 +/- 40) ng/L, respectively. The levels of umbilical artery plasma EOP (beta-endorphin, dorphin A(1 - 13) and leu-enkephalin) in fetal distress group were significantly higher than that in the control group (P < 0.01,P < 0.05). The umbilical artery blood gas analysis: pH was (7.0 +/- 0.1), PO(2) was (1.7 +/- 0.6) kPa, PCO(2) was (8.9 +/- 0.7) kPa; the levels of beta-endorphin and dorphin A(1 - 13) were negatively correlated to pH and PO(2) in umbilical artery plasma (P < 0.01; P < 0.05), significant correlation was found between the EOP and PCO(2) (P < 0.05). In fetal distress group, the levels of maternal plasma EOP were (40 +/- 13) ng/L, (64 +/- 16) ng/L and (219 +/- 40) ng/L respectively. In control group, the levels were (37 +/- 9) ng/L, (59 +/- 15) ng/L and (199 +/- 37) ng/L respectively. There was no statistical difference in the levels of maternal plasma EOP between the control group and fetal distress group (P > 0.05).. The fetal distress was associated with EOP, the changes of EOP levels in umbilical artery plasma may play an important role in the pathophysiological changes in fetal distress.

Topics: Adult; beta-Endorphin; Dynorphins; Enkephalin, Leucine; Female; Fetal Blood; Fetal Distress; Humans; Opioid Peptides; Pregnancy

Elevated plasma concentrations of beta-lipotropin (beta-LPH) and beta-endorphin (beta-EP) are present in vaginally delivered babies in the first 24 h of life. To establish if fetal distress or different types of delivery influence the secretion of these peptides in the neonatal period, we studied 16 vaginally delivered newborns (VD), 11 neonates extracted through elective cesarean section (CS) and 8 babies suffering from acute intralabor fetal distress (FD). In all groups of newborns the plasma levels of beta-LPH and beta-EP were measured in arterial and venous cord blood, at 1 and 24 h from delivery. beta-LPH and beta-EP were determined by specific radioimmunoassays after silicic acid extraction and Sephadex G-75 column chromatography. In cord plasma, there were no differences between arterial and venous concentrations of either beta-LPH or beta-EP in any of the groups. In the 1st h after delivery the plasma levels of VD newborns were similar to umbilical cord values (beta-LPH: 19.9 +/- 5.2; beta-EP: 18.1 +/- 2.4), while those of CS (beta-LPH: 30.6 +/- 4.5; beta-EP: 30.1 +/- 5.8) and FD (beta-LPH: 64.9 +/- 11.8; beta-EP: 65.7 +/- 24.4) showed a significant increase. At the 24th h of life the plasma concentrations of both peptides decreased significantly in the three groups, but CS and FD babies showed significantly higher plasma values than VD newborns (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: beta-Endorphin; beta-Lipotropin; Blood Glucose; Cesarean Section; Delivery, Obstetric; Endorphins; Female; Fetal Blood; Fetal Distress; Humans; Infant, Newborn; Pregnancy; Umbilical Arteries; Umbilical Veins