Corticotrophin-releasing hormone production by the placenta and fetal membranes

Maturation of the fetal hypothalamic-pituitary-axis may be an important factor in the stimulation of the onset of parturition. Recent studies have found that corticotrophin-releasing hormone (CRH), the hypothalamic component of this axis is also present in the placenta and the fetal membranes. We review the evidence demonstrating that glucocorticoids stimulate the production of CRH by these tissues towards term, and this is manifest by increases in CRH concentrations in maternal and fetal plasma and in placental extracts, and by increased abundance of CRH mRNA in the placenta. We discuss how CRH secretion by the placenta and fetal membranes is controlled. We hypothesize that CRH may be an important signal in initiating of the onset and maintenance of term labour and may also be a factor in the etiology of premature labour, through stimulation of the fetal HPA axis, and through paracrine/autocrine interactions within the placenta, fetal membranes and decidua.