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Corticotrophin-releasing hormone and CRH-binding protein. Differences between patients at risk for preterm birth and

C J Hobel1, C P Arora, L M Korst

  • 1Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, Burns and Allen Research Institute, Los Angeles, California 90048, USA. HobelC@CSHS.org

Annals of the New York Academy of Sciences
|February 17, 2000
PubMed

Insights

Elevated corticotropin-releasing hormone (CRH) and lower CRH-binding protein (CRH-BP) are linked to preterm birth (PTB). These hormonal differences suggest excessive CRH may contribute to the timing of delivery in at-risk pregnancies.

Area of Science:

  • Reproductive endocrinology
  • Maternal-fetal medicine
  • Biochemistry

Background:

  • Plasma corticotropin-releasing hormone (CRH) rises during pregnancy, primarily from the placenta.
  • CRH-binding protein (CRH-BP) inactivates CRH, potentially limiting its peripheral effects.
  • Decreased CRH-BP in late pregnancy increases free CRH, possibly initiating parturition.

Purpose of the Study:

  • To investigate if CRH, CRH-BP, or CRH/CRH-BP complexes differ in patients at risk for preterm birth (PTB) or hypertension (HYP).
  • To determine if these hormonal differences explain variations in parturition timing.

Main Methods:

  • Maternal plasma samples were collected from 18 PTB, 23 HYP, and control patients at 18-20, 28-30, and 35-36 weeks of gestation.
  • CRH and CRH-BP levels were quantified using radioimmunoassay and immunoradiometric techniques, respectively.
  • A CRH-BP/CRH dimer complex index was calculated, and data analyzed using the Kruskal-Wallis test.

Main Results:

  • Significantly elevated maternal CRH levels were observed in PTB cases compared to HYP and control groups at all time points.
  • Maternal CRH-BP levels were significantly lower in PTB cases versus HYP and control groups throughout gestation.
  • The CRH-BP/CRH dimer complex index was significantly reduced in PTB cases, indicating excessive free CRH.

Conclusions:

  • Patients at risk for PTB exhibit elevated CRH and reduced CRH-BP levels.
  • A lower CRH-BP/CRH dimer complex index in PTB patients suggests an imbalance favoring free CRH.
  • These hormonal profiles may be critical factors in the onset of preterm labor.
Abstract

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