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Elevated maternal cortisol leads to relative maternal hyperglycemia and increased stillbirth in ovine pregnancy.
[cushing syndrome]
In
normal
pregnancy
,
cortisol
increases
;
however
,
further
pathological
increases
in
cortisol
are
associated
with
maternal
and
fetal
morbidities
.
These
experiments
were
designed
to
test
the
hypothesis
that
increased
maternal
cortisol
would
increase
maternal
glucose
concentrations
,
suppress
fetal
growth
,
and
impair
neonatal
glucose
homeostasis
.
Ewes
were
infused
with
cortisol
(
1
mg
·
kg
(
-
1
)
·
day
(
-
1
)
)
from
day
115
of
gestation
to
term
;
maternal
glucose
,
insulin
,
ovine
placental
lactogen
,
estrone
,
progesterone
,
nonesterified
free
fatty
acids
(
NEFA
)
,
β-hydroxybutyrate
(
BHB
)
,
and
electrolytes
were
measured
.
Infusion
of
cortisol
increased
maternal
glucose
concentration
and
slowed
the
glucose
disappearance
after
injection
of
glucose
;
maternal
infusion
of
cortisol
also
increased
the
incidence
of
fetal
death
at
or
near
parturition
.
The
design
of
the
study
was
altered
to
terminate
the
study
prior
to
delivery
,
and
post
hoc
analysis
of
the
data
was
performed
to
test
the
hypothesis
that
maternal
metabolic
factors
predict
the
fetal
outcome
.
In
cortisol-infused
ewes
that
had
stillborn
lambs
,
plasma
insulin
was
increased
relative
to
control
ewes
or
cortisol-infused
ewes
with
live
lambs
.
Maternal
cortisol
infusion
did
not
alter
maternal
food
intake
or
plasma
NEFA
,
BHB
,
estrone
,
progesterone
or
placental
lactogen
concentrations
,
and
it
did
not
alter
fetal
body
weight
,
ponderal
index
,
or
fetal
organ
weights
.
Our
study
suggests
that
the
adverse
effect
of
elevated
maternal
cortisol
on
pregnancy
outcome
may
be
related
to
the
effects
of
cortisol
on
maternal
glucose
homeostasis
,
and
that
chronic
maternal
stress
or
adrenal
hypersecretion
of
cortisol
may
create
fetal
pathophysiology
paralleling
some
aspects
of
maternal
gestational
diabetes
.
Diseases
Validation
Diseases presenting
"fetal organ weights"
symptom
cushing syndrome
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