Nature Medicine
1, 460 - 463 (1995)
doi:10.1038/nm0595-460
A placental clock controlling the length of human pregnancyMark McLean1, Andrew Bisits1, Joanne Davies1, Russell Woods2, Philip Lowry2
& Roger Smith1, 3
1Maternal Health Research Centre, John Hunter Hospital, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia
2School of Animal and Microbial Sciences, University of Reading, Reading, UK
3Correspondence should be addressed to R.S. We report the existence of a 'placental clock', which is active from an early stage in human pregnancy and determines the length of gestation and the timing of parturition and delivery. Using a prospective, longitudinal cohort study of 485 pregnant women we have demonstrated that placental secretion of corticotropin-releasing hormone (CRH) is a marker of this process and that measurement of the maternal plasma CRH concentration as early as 16−20 weeks of gestation identifies groups of women who are destined to experience normal term, preterm or post-term delivery. Further, we report that the exponential rise in maternal plasma CRH concentrations with advancing pregnancy is associated with a concomitant fall in concentrations of the specific CRH binding protein in late pregnancy, leading to a rapid increase in circulating levels of bioavailable CRH at a time that coincides with the onset of parturition, suggesting that CRH may act directly as a trigger for parturition in humans.
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