Ca. Liapi et al., CORTICOTROPIN-RELEASING-HORMONE LEVELS IN PREGNANCY-INDUCED HYPERTENSION, European journal of obstetrics, gynecology, and reproductive biology, 68(1-2), 1996, pp. 109-114
High levels of corticotropin-releasing hormone (CRH) circulate in the
plasma of pregnant women especially during the third trimester and eve
n higher levels have been reported in abnormal pregnancies of various
etiologies. One of these etiologies is pregnancy-induced hypertension
(PIH). Objective: To measure CRH blood levels with a sensitive method
in a large number of pregnant women with PIH, starting from very early
stages of gestation, and to compare them with those in normal control
s. Study design: Venous blood was withdrawn from, (a) 10 healthy women
aged 20-35 years, (b) 62 pregnant women with PIH (109 samples), mean
age 29.1 years and (c) 75 healthy pregnant women (81 samples), mean ag
e 28.5 years, used as matched controls. In pregnant women, blood colle
ction started at the 10th week of gestation. In 14 women from group b
and in 22 from group c blood was withdrawn during labor as well. CRH w
as assayed by RIA. Results: Levels in non-pregnant women were between
19.0-40.6 pg/ml (28.37 +/- 2.53 pg/ml, mean +/- S.E.M.). In both group
s of pregnant women there was a progressive increase in plasma CRH lev
els becoming quite sharp towards the end of gestation. Between 10 and
20 weeks, CRH (mean +/- S.E.M.) in PIH group was 69.3 +/- 3.2 pg/ml ve
rsus 41.6 +/- 2.4 pg/ml in matched controls, at 21-25 weeks 168.0 +/-
12.8 pg/ml versus 58.5 +/- 3.8 pg/ml, at 32-35 weeks 1378.5 +/- 61.4 p
g/ml versus 298.3 +/- 16.9 pg/ml and at 38 weeks 2800.0 +/- 114.1 pg/m
l versus 825.0 +/- 59.8 pg/ml. At term, CRH levels were 3784.0 +/- 197
.3 pg/ml in PIH, versus 1386.0 +/- 101.8 pg/ml in normal pregnancy. St
atistically, at every stage of gestation, CRH levels were highly signi
ficantly different in the PIH group (P < 0.0005). One hour postpartum
there was a c. 60% decrease in plasma CRH levels in both b and c group
s. In three women with pre-eclampsia who underwent premature labor due
to a dead fetus around the 30th week, very high levels were noticed i
n sequential blood samples for 4-5 weeks prior to labor. Conclusions:
(a) CRH levels in women with PIH are significantly higher compared to
healthy pregnant women at any stage of gestation starting from week 10
; (b) very high levels during pregnancy might be predictive of prematu
re labor or fetal loss; and (c) CRH measurement might prove to be a he
lpful diagnostic tool in women with pregnancy-induced hypertension.