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Title: Amniotic fluid endocrinology and its association with maternal stress
Author: Sarkar, Pampa
ISNI:       0000 0001 3553 1184
Awarding Body: Imperial College London (University of London)
Current Institution: Imperial College London
Date of Award: 2007
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The ability of the early intrauterine environment to program fetal neurodevelopment has been documented in several species, and there is evidence to suggest that a similar process may occur in humans. Glucocorticoids are the primary candidates for fetal hypothalamic-pituitary-adrenal (HPA) programming, but testosterone and DHEAS may also be involved. This thesis examines the relationship between these amniotic fluid honnones, particularly in the context of prenatal stress. Human studies lack the precision of animal experimental paradigms, and most stress protocols in humans have involved laboratory stressors poorly standardised for duration and nature of exposure. I aimed to use a standardised clinical stressor to examine the endocrine response in maternal plasma and amniotic fluid. I hypothesised that amniocentesis in a clinical setting elicits a maternal stress response associated with alterations in amniotic fluid steroidal hormones. I found amniocentesis to be associated with raised Spielberger state anxiety scores, validating the use of this procedure as a clinical model of psychological stress. Despite high state scores, only a modest rise of maternal cortisol (variance of 4%) was noted suggesting the response of an attenuated maternal HPA axis. I observed a positive correlation between maternal plasma cortisol and amniotic fluid cortisol that increased with gestational age. The magnitude of the correlation between maternal and amniotic fluid cortisol increased markedly with maternal state anxiety. A significant, positive correlation was observed between amniotic fluid cortisol and amniotic fluid testosterone. Amniotic fluid DHEAS correlated negatively with state anxiety scores but positively with maternal cortisol. This thesis characterises the relationships between the steroidal hormones cortisol, testosterone and DHEAS in amniotic fluid and in maternal plasma, especially in the context of prenatal stress generated by imminence of amniocentesis. The observations of a positive correlation between maternal and amniotic fluid cortisols, the magnitude increasing with gestation and maternal state anxiety scores, together with positive correlations between amniotic fluid cortisol and testosterone suggest more then one mechanism by which prenatal stress may influence fetal development.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available