Premium
Chronic Maternal Hypercortisolemia Results in Adverse Birth Outcomes and Alters Cardiac Function at the Time of Birth
Author(s) -
Li Mengchen,
Wood Charles,
KellerWood Maureen
Publication year - 2021
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2021.35.s1.02470
Subject(s) - hypercortisolemia , medicine , gestation , fetus , gestational age , in utero , heart rate , pregnancy , endocrinology , blood pressure , obstetrics , physiology , hydrocortisone , biology , genetics
Previous studies in our laboratory have shown used an ovine model to explore the effects of maternal stress or hypercortisolemia on pregnancy outcomes. These studies found that chronic elevation of maternal cortisol concentration during late gestation led to an increased incidence of stillbirth and altered fetal heart rate and blood pressure immediately prior to delivery. In the current study, we tested the effect of chronically elevated maternal cortisol on the cardiac adaption from in utero life to ex utero life, extended these studies to the first two days of postnatal life. Ewes were infused with cortisol (CORT; 1mg/kg/day; gestational day 115 to delivery, n=23); control ewes were not treated with cortisol (Control; n=12). On gestational day 123±1, a telemetry transmitter was implanted into the fetus for continuous recording of fetal blood pressure (BP), heart rate (HR), electrocardiogram (ECG) and temperature throughout gestation and during the early neonatal period. BP, HR and ECG derivatives from 5h prior to birth to 40h after birth were calculated as 10‐minute means and those from 1h prior to birth to 1h after birth were calculated as minute means and analyzed by two‐way ANOVA for repeated measures across time. P values <0.05 were considered significant. Although overall the gestational age at delivery was similar in the two groups (control:140±1, CORT: 140±1), 17% of the fetuses of cortisol‐infused ewes were born preterm and live (gestational age 132‐136d). In addition, 9% of the fetuses of cortisol‐infused ewes were stillborn at term, and fetal demise or stillbirth at preterm delivery occurred in 35% of CORT as compared to 17% of control lambs. In the lambs of cortisol‐infused ewes that were born at full term with telemetry devices, there was a significant increase in mean arterial pressure (MAP) over the hour preceding delivery, but MAP was decreased compared to control lambs for the first 9 hours after birth (62.4±1.2 mmHg in control, n=7; 57.3±1.3 mmHg in CORT, n=6). The RPP after birth was significantly lower in CORT lambs compared to that in control lambs (20,700±1,640 in control, n=5; 15,455±1,386 in CORT, n=7) for the first hour after birth. HR tended to be lower during immediately perinatal period (1h before and 1h after birth) in the fetuses of the CORT ewes, although overall there were no significant differences in the changes in HR over time between the groups. The time course of QRS was significantly changed during immediately perinatal period in CORT lambs which was higher before birth and lower after birth compare to that in control lambs. QT interval was significantly reduced prior to birth in the fetuses of the CORT ewes, but was significantly increased in the immediate postnatal period in this group compared to the control lambs. These findings suggest that chronically excess in utero cortisol exposure adversely affects fetal cardiac adaptation to ex utero life and indicates that the first hours after birth are critical for the survival of these lambs.