Peripartum prolactin and cortisol level changes. A prospective pilot study.

OBJECTIVES: Although the role of prolactin and cortisol in the human lactation process seems to be undisputed, the changes in postpartum serum concentrations in mothers make data interpretation difficult. MATERIAL AND METHODS: To determine the factors that possibly influence these hormones, we examined a group of patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznan for labor induction and/or in the active phase of the first labor period. The serum levels of cortisol and prolactin were assessed in these full-term pregnant women during admission to labor, in the third stage of labor, and on the second day postpartum. The prolactin and cortisol levels were also measured in the umbilical cord for the assessment of newborn babies. RESULTS: The results showed a significant relationship between maternal age and the level of prolactin measured before childbirth and fluctuations in cortisol level with respect to labor duration. In addition, we observed a strong correlation between the level of prolactin assessed before childbirth and the pH and base excess of the umbilical cord artery. Most importantly, a correlation was noted between breastfeeding within 2 hours after the labor and the level of cortisol measured after childbirth. CONCLUSIONS: We observed a significant correlation between a summarized labor duration and maternal and umbilical cord cortisol levels measured right after the labor. The fact of breastfeeding within 2 hours after the labor strongly correlated with lower levels of maternal cortisol as well as a cortisol level in umbilical cord blood and it suggests that immediate initiation of breastfeeding reduces stress level for both, mother and newborn.

Neonatal breast-suckling skills in the context of lactation and peripartum hormonal changes and additional factors-a pilot study.

BACKGROUND: Childbirth and lactation are intricate processes, involving several hormones, the most important of which are prolactin (a protein hormone) and cortisol (one of the glucocorticoids). The early postpartum period is crucial for both mother and newborn and has an impact on the lactation and breastfeeding process. METHODS: The study included 78 patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznan for labor induction and/or in the active phase of the first labor stage. The levels of cortisol and prolactin in serum were assessed in these women during admission in labor, during the third labor stage, and on the second day postpartum. The levels of cortisol and prolactin in the umbilical cord serum were assessed immediately after cord clamping. The "Protocol for the assessment of breast-suckling skills" was used to assess the neonatal breast-suckling skills on the second day postpartum. Some additional parameters were evaluated in mothers via a telephone interview at three and six months postpartum. The study was conducted from January to August 2020, however the study was suspended during April-July 2020 due to the SARS-CoV-2 pandemic, which led to restrictions in the hospital limiting access to the hospital wards unless necessary. RESULTS: Early breastfeeding with skin-to-skin contact was associated with low levels of hormones, cortisol levels were lower in serum (p = 0.0108) and umbilical vein (p = 0.0273) in mothers who breastfed immediately after childbirth. At three months postpartum, 88% of the mothers who did not offer a pacifier to the child during the first few days of life breastfed the child naturally (p = 0.037), and at six months, 96% of those who did not offer a pacifier continued to breastfeed (p = 0.0008). Multiple, statistically significant correlations were observed between the variables assessed according to the "Protocol for the assessment of breast-suckling skills" and breastfeeding after three months. CONCLUSIONS: Breastfeeding immediately after childbirth, appropriate assessment of the breast-suckling skills of newborns, avoiding pacifiers and infant formula feeding, and offering support to new mothers in the early days after childbirth seem to be important factors for sustaining breastfeeding after three and six months of childbirth.

Placental growth hormone (PGH), pituitary growth hormone (GH1), insulin-like growth factor (IGF-I) and ghrelin in pregnant women's blood serum.

OBJECTIVES: The aim of this work is to evaluate levels of placental growth hormone (PGH), pituitary growth hormone (GH1), insulin-like growth factor (IGF-I) and ghrelin in pregnant women's blood serum before, during and after delivery. Furthermore, the aim is to search for links and interdependence of GH1, PGH and IGF-I concentrations. MATERIAL AND METHODS: Seventy nine blood samples were taken one to two hours before, during and half an hour after expulsion of placenta. All proteins studied were determined by ELISA method, using ELISA Kit. RESULTS: The highest PGH concentration and IGF-I concentration in pregnant women's blood serum was observed before delivery while GH1 concentration was lowest. During and after delivery PGH and IGF-I concentration decreased proportionately and pituitary growth hormone concentration increased accordingly. About half an hour after delivery of the placenta, GH1 concentration was highest. CONCLUSIONS: In pregnant women's blood there is a metabolic interdependence between PGH and IGF-I. Their concentration increases proportionately during pregnancy and decreases after delivery. It appears that labor and delivery releases GH1 blockade, which level rises three-fold during delivery. After parturition its role and concentration returns to levels before pregnancy.

Placental growth hormone, pituitary growth hormone, insulin-like growth factor, and ghrelin in umbilical cord blood serum and amniotic fluid.

INTRODUCTION: In the search for biomarkers that allow the prediction of neonatal growth and development, placental growth hormone(PGH), pituitary growth hormone (GH1), insulin-like growth factor 1 (IGF-1), and ghrelin concentrations were assessed in the amniotic fluid and in the umbilical cord blood of 92 neonates. MATERIAL AND METHODS: The proteins were assayed by the ELISA method. Their concentration values were compared in 57 full-term neonates and 35 prematurely born neonates, as well as in both large (> 4,000 g) and small neonates (< 2,500 g). Also, body mass and placenta mass were compared. RESULTS: Statistically significant differences both between prematurely born neonates and full-term neonates and between large and small neonates were obtained only in terms of the body mass of neonates and placenta mass. The concentration values of the hormones studied did not show statistically significant differences. A distinct tendency was noticed towards an increase in PGH concentration in both prematurely born and small neonates. In large neonates, statistically significantly higher IGF-1 concentrations were found compared to the prematurely born neonates. CONCLUSIONS: Our studies indicate an important role for PGH in maintaining a proper IGF-1 pool and demonstrate the existence of a direct influence on the function of the placenta in prematurely born neonates through the activation of compensation mechanisms,which stimulate IGF-1 synthesis.

[Risk assessment of chronic HPV HR infection in babies who contacted the virus in the perinatal period]. / Ocena ryzyka rozwoju przewleklego zakazenia typami wysokoonkogennymi wirusa brodawczaka ludzkiego (HPV HR) u noworodków zakazonych w okresie perinatalnym.

INTRODUCTION: One of the potential ways of HPV transmission to fetuses and newborns is a direct perinatal infection, manifested as juvenile laryngeal papillomatosis (JLP). This applies to children after traditional birth, born to mothers in whom the DNA sequences of the HPV HR in the paraepidermal epithelium of cervix were found during pregnancy and delivery OBJECTIVES: Risk assessment of the development of chronic HPV HR infection in babies who had contact with the virus in the perinatal period. MATERIALS AND METHODS: During the pre- and perinatal period, research was carried out among 185 pregnant women and a group of 105 newborns (5 pairs of twins), hospitalized in the Delivery Room of the Gynecology and Obstetrics Clinic of the Poznan Medical University between 2005-2007. Cellular material from the uterine cervical canal using a brush-type Cervex Brush was collected from each woman participating in the study and oral swabs using swab sticks were taken from the newborns. The second phase of testing was conducted following the postpartum, 3 to 6 months after the delivery Uterine cervix swabs were re-collected from 28 HPV HR positive women and swab from the mouth and nasopharynx were taken from their children (29 samples--1 pair of twins). The study was conducted with the use of PCR, trade named AMPLICOR Human Papilloma Virus (HPV) Test by Roche. RESULTS: DNA HPV HR was found in 55 cases of the cellular material derived from 185 swabs taken from the cervical canal, representing 29.7% of researched women. The chronic HPV HR viral infection was detected in 25 cases out of the 28 HPV HR positive women, representing 89.2% of the study group. Of the 105 infants from whom oral swabs were taken in the perinatal period, presence of DNA HPV HR was found in 2 infants (2%) after traditional birth. Whereas the repeated test, within 3-6 months after delivery revealed the presence of DNA HPV HR viruses in swab oral in 1 infant, who had been DNA HPV HR positive. CONCLUSIONS: Perinatal transmission of Human Papillomavirus of the high-risk oncogenic type is rare and concerns below 2% of babies of HPV HR positive mothers. Prolonged infection by the Human Papillomavirus is an extremely rare complication of pregnancy and delivery and concerns below 1% of children of HPV HR positive mothers. Perinatal transmission of the oncogenic type infection of the virus in humans is primarily of the ascending type or occurs during the perinatal period if the delivery was a traditional one.

[Risk factors and frequency of occurrence of HPV DNA of high oncogenic types in paraepidermal epithelium cells of the uterine cervix, in the trophoblast, and in the peripheral blood of pregnant patients]. / Ocena czynników ryzyka i czestosci wystepowania DNA HPV typów onkogennych w komórkach nablonka paraepidermalnego szyjki macicy, w trofoblascie oraz we krwi zylnej kobiet ciezarnych.

INTRODUCTION: During pregnancy viruses of high oncogenic potential--types 16, 18, 31, 33, 35, which had so far remained in the state of chronic infection, undergo reactivation. Among the potential ways of HPV transmission to foetus, the direct perinatal infection is mentioned. In the antenatal period of pregnancy, a descending way of infection through blood is analyzed. OBJECTIVES: The purpose of this study is to evaluate the risk factors and frequency of occurrence of HPV DNA of high oncogenic types in paraepidermal epithelium cells of the uterine cervix, in the trophoblast, and in the peripheral blood of pregnant patients. MATERIAL AND METHODS: The research included 185 pregnant women hospitalized in the Delivery Room, of the Gynecological and Obstetric Clinic of the Poznan Medical University, in years 2005-2006. All patients who took part in the research had been interviewed prior to delivery with the help of a pre-designed questionnaire. Samples of cellular material from the cervix were collected before the delivery (185 specimens). 4-5 ml of peripheral blood (103 specimens) were collected as well. The collection of the cellular material was performed with the use of Cervex-Brush. Samples of tissue from placenta (138 specimens, including 5 pairs of twins) were collected after delivery. RESULTS: The research concludes, that incidental or chronic infection evoked by HPV HR presence in paraepidermal epithelium cells of the uterine cervix has been observed in nearly 30% of pregnant women. The presence of HPV HR DNA in the placenta cells of the HPV HR positive mothers applies to less than 6,5% of the researched women. Identification of the genetic material of Papillomavirus in peripheral blood of pregnant women indicates that this occurrence is incidental. The analysis of the risk factor of the development of HPV infection has exerted that the positive result of molecular tests on the presence of HPV HR DNA concerns the population of young women from 18 to 30 years of age. CONCLUSIONS: Incidental or persistent infection with highly oncogenic types of HPV present in cervix paraepidermal epithelium cells is observed in approximately 30% of pregnant women. The presence of DNA HPV HR in trophoblast cells of HPV HR positive mothers is diagnosed rarely, in less than 7% of pregnant women. Human Papilloma Virus is present in the peripheral blood of pregnant women sporadically. None of the currently known risk factors of HPV infection may be correlated with DNA HPV HR presence in pregnant women.