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Levels of Maternal Plasma Corticotropin-Releasing Factor and Urocortin During Labor

Luigi Cobellis, MD, PhD

Jaqueline Woodman, PhD

Filiberto M. Severi, MD

Elizabeth A. Linton, PhD

Department of Obstetrics and Gynecology, University of Siena, Siena, Italy; Nuffield Department of Obstetrics and Gynecology, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom

Felice Petraglia, MD

Department of Obstetrics and Gynecology, University of Siena, Siena, Italy; Nuffield Department of Obstetrics and Gynecology, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom; Chair of Obstetrics and Gynecology, University of Siena, Policlinico "Le Scotte," Viale Bracci, 53100 Siena, Italy petraglia{at}unsisi.it

Objective: Corticotropin-releasing factor (CRF) is produced by the placenta and intrauterine tissues and secreted in increasing amounts from early to term pregnacy. In the presecnce of labor, a more incisive increase in CRF levels has been described, and women with preterm labor or hose destined to have premature delivery have higher midpregnancy CRF levels than hose who deliver at term. Urocortin is a 40-amino acid peptide belonging to the CRF family, expressed by human trophoblast and fetal membranes, which has the same biologic effects as CRF. Acting on the same CRF receptors, urocortin stimulates myometrial contractility and ACTH and prostaglandin release from cultured human placental cells. Because no data exist about urocortin levels in the maternal circultation at parturition, we investigated whether maternal plasma urocortin and CRF levels change according to cervical dilatation in healthy pregnant women at term labor.

Methods: In a cross-sectional study of labor, a single maternal blood sample was collected from healthy pregnant women at term (n = 40); in a second longitudinal sudy, plama samples were collected longitudinally in a subset of patients (n = 8) throughout labor, according to a Bishop score evaluation.

Results: Both maternal plasma CRF and urocortin levels were higher in labor than those previously reported during pregnancy, but they did not change significantly during the different stages of labor when evaluated longitudinally. Some patients showed a trend toward increasing levels, whereas others had variable concentrations.

Conclusion: Neither CRF nor urocortin levels changed during the progression of spontaneous labor.

Key Words: Placenta • neurohormones • uterotonic • parturition • cervical dilatation

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