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Serum Allopregnanolone Levels in Pregnant Women: Changes during Pregnancy, at Delivery, and in Hypertensive Patients

Department of Reproductive Medicine and Child Development, Section of Gynecology and Obstetrics (S.L., F.B., A.R.G.), University of Pisa, Pisa; Department of Surgical Sciences, Chair of Obstetrics and Gynecology (F.P., M.F., F.M.R.), University of Udine, 33100 Udine; Department of Obstetrics and Gynecology (C.B.), University of Turin, Turin; Department of Obstetrics and Gynecology (R.E.N.), University of Pavia, Pavia; and Endocrine Research Unit, Consiglio Nazionale delle Ricerche (M.L.), Pisa, Italy

Address correspondence and requests for reprints to: Felice Petraglia, M.D., Department of Surgical Sciences, Chair of Obstetrics and Gynecology, University of Udine, piazzale S. Maria della Misericordia, 33100 Udine, Italy. E-mail: felice.petraglia{at}dsc.uniud.it

Allopregnanolone is a neuroactive steroid measurable in peripheral circulation. The aim of the present study was to investigate the presence and the possible changes in serum allopregnanolone and progesterone levels in pregnant women during gestation, at delivery, and in patients with chronic hypertension, with or without superimposed preeclampsia. We also evaluated allopregnanolone in cord blood. Three groups of pregnant women were studied: 1) healthy controls followed longitudinally throughout gestation (n = 14); 2) at vaginal or cesarean delivery (n = 66); and 3) with chronic hypertension (n = 12), with (n = 7) or without (n = 5) superimposed preeclampsia. Allopregnanolone and progesterone levels were measured in maternal and cord serum by RIA. In healthy pregnant women, serum allopregnanolone and progesterone levels progressively increased throughout gestation. Whereas no changes were found at vaginal delivery, serum allopregnanolone and progesterone levels were significantly lower at delivery by emergency cesarean section (P < 0.01). Umbilical cord serum allopregnanolone and progesterone levels in emergency cesarean were significantly lower than those found at vaginal delivery (P < 0.01). Patients with chronic hypertension, with or without superimposed severe preeclampsia, showed serum allopregnanolone levels significantly higher than those of healthy women at the same gestational age (P < 0.01). In conclusion, maternal serum allopregnanolone levels increased during normal gestation were lower in women who underwent emergency cesarean and higher in patients with chronic hypertension, with or without preeclampsia. Because allopregnanolone is active on the central nervous system and in the control of systemic blood pressure, an involvement of this neurosteroid in the adaptive processes induced by pregnancy is suggested.

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