산모 혈청 Dehydroepiandrosterone(DHEA)-sulfate 농도와 유도분만에서의 유용성

Abstract

Dehydroepiandrosterone (DHEA)-sulfate is a weak androgenic steroid produced by the adrenal cortexes of the pregnant woman and her fetus, and has been known to promote cervical ripening. However the influence of endogeneous maternal serum DHEA-sulfate levels upon the outcome of an induction attempt has not been defined. This study was performed to evaluate the maternal serum DHEA-sulfate level as a factor influencing labor efficiency at term. Ninty-five pregnant women admitted to labor and delivery unit were sellected and they were not complicated by maternal corticosteroid use, antepartum chorioamnionitis, diabetes mellitus, hypertension and fetal growth restriction. Venous blood was collected before initiation of labor induction, and serum DHEA-sulfate level were measured by radio-immunoassay to compare with the outcome of each induction of labor. A success was defined as progression to active labor. In women (n=78) who progressed to active labor serum DHEA-sulfate level was higher than in whom (n=17) with unsuccessful attempt (110.5 + 13.20 ㎍/㎗ versus 79.31 + 9.81 ㎍/㎗, respectively, p<0.05). Comparing with women with DHEA sulfate levels of above 85 ㎍/㎗, the women with less DHEA-sulfate levels had an unsuccessful induction odds ratio (OR) of 4.64 (95% confidence interval, P=0.42). The DHEA-sulfate levels more decreased, the ORs more increased. It is concluded that endogenous DHEA-sulfate may play a role in the mechanism of labor and an important factor in efficient labor induction.