Comparison of Glucocorticoid Conjugates with Other Indexes of Fetal Maturation

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Abstract
Controversy exists as to whether cortisol acts physiologically to accelerate human fetal lung maturation. Recent data show that cortisol and corticosterone conjugates (GCS) rise 5-fold in amniotic fluid late in pregnancy and correlate well with the palmitic/steric (P/S) ratio (r = 0.79). GCS was compared with various tests of fetal maturation. Cases (38) compared with the lecithin/sphingomyelin (L/S) ratio, the GCS and palmitic acid had the highest concurrence (84% agreement), followed by the shake test (82%), cortisol (74%), cytology (64%), gestational age determined by ultrasound (63%) and creatinine (47%). The GCS correlate better than cortisol alone, probably because cortisol in amniotic fluid is derived from the chorionic membrane as well as from fetal urine. Convincing evidence was provided of a physiologic link between fetal lung maturation and alteration in fetal steroid production.