Abstract
Background:
Norepinephrine (NE) and epinephrine (EPI) levels are higher in cord arterial blood relative to venous blood, consistent with active mechanisms of placental-maternal clearance. There are no contemporary studies of cord arteriovenous blood levels of sulfated and non-sulfated catechols.
Aim:
To assess the arteriovenous differences in cord blood levels of dopamine (DA), the sulfated catecholamines and their sulfated and non-sulfated metabolites. To correlate levels of oxygen, H+/CO2, and glucose with cord catecholamine levels.
Methods:
Fifty-seven term infants, delivered by elective cesarean section, were recruited. Cord arterial and venous blood was sampled; levels of glucose, lactate, blood gases, six catechols and their sulfated conjugates were measured.
Results:
With one exception (DOPA sulfate), mean cord arterial levels of sulfated and non-sulfated catechols were significantly higher than venous levels. Arterial lactate and glucose levels were independently associated with NE levels, but only lactate was associated with levels of EPI and DA.
Conclusion:
This study establishes that in vivo metabolic parameters of hypoxia, respiratory and metabolic acidosis are associated with catecholamine levels, a key relationship for perinatal adaptation and homeostasis, and findings that are consistent with in vitro studies of the regulators of catecholamine secretion.
Contributions to the study: Dr. Williams conceptualized and designed the study, carried out the initial analyses, drafted the initial manuscript, revised the manuscript and approved the final manuscript as submitted. Professor Hume conceptualized and designed the study, revised the manuscript and approved the final manuscript as submitted. Ms. Watson carried out the initial analyses, designed the data collection forms, critically reviewed the manuscript and approved the final manuscript as submitted. Dr. Koh undertook the recruitment and data collection, critically reviewed the manuscript and approved the final manuscript as submitted. Professor Eisenhofer supervised the analysis of catechols, critically reviewed the manuscript, and approved the final manuscript as submitted.
Funding: Anonymous Trust (Dundee), NHS Tayside Acute Division Grant Scheme, NHS Scotland Programme Support Grant.
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The authors stated that there are no conflicts of interest regarding the publication of this article.
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