목적 : 임상적으로 흔하지만 산부인과 영역에서 체계적으로 다루어지지 않은 분만시 공포와 이와 연관된 세로토닌 농도를 측정하여 상호 연관관계를 알아보고자 하였다. 연구 방법 : 2004년 1월부터 5월까지 가톨릭의과대학교 부속 성가병원 산부인과에서 분만한 348명 산모중 내외과적 합병증이 없는 초산부 179명 중 37-42주 사이의 30명을 대상으로 하였다. 분만 과정 중 세로토닌 농도는 자궁 경부 개대의 정도에 따라 측정하였다. 분만이 시작되기 전 잠복기 (S1), 자궁경부가 3-5 cm 개대된 활성기 (S2), 자궁경부가 완전 개대되어 분만 직전까지의 2단계 (S3), 태반 만출 후 24시간 이내의 3단계 (S4), 태아로 넘어가는 세로토닌 농도를 측정하기 위해 분만 후 탯줄 동맥 (S5)에서 3 cc 혈액을 채취하여 보관후 세로토닌 농도를 측정하였다. 분만이 시작되기 전 잠복기 (S1) 세로토닌 농도를 측정하여 초기 세로토닌 농도가 정상 (1.5-7.5 ng/mL)인 군 (G1)과 비정상적으로 높은 군 (G2)으로 나누어 임상양상과 세로토닌 변화 양상을 분석, 고찰하였다. 결과 : 세로토닌 농도는 분만이 시작되기 전 잠복기 (S1)에서 G1은 5.8±0.8 ng/mL, G2는 10.1±2.7 ng/mL, 자궁경부가 3-5 cm 개대된 활성기 (S2)에서 G1은 7.2±2.5 ng/mL, G2는 11.2±5.2 ng/mL, 자궁경부가 완전 개대되어 분만 직전까지의 2단계 (S3)에서 G1은 8.5±3.7 ng/mL, G2는 10.3±3.9 ng/mL, 태반 만출 후 24시간 이내의 3단계 (S4)에서는 G1은 6.5±1.5 ng/mL, G2는 11.8±8.6 ng/mL이었고, 탯줄 동맥 (S5)에서 측정한 세로토닌 농도는 G1은 4.9±1.2 ng/mL, G2는 5.0±1.0 ng/mL 이었다. 결론 : 세로토닌과 분만 진통의 상관관계를 알아보고자 하였으며, 초기 세로토닌 농도에 따라 분만 과정중 세로토닌 농도 변화가 다르다는 사실을 알 수 있었으며, 이러한 차이는 산모에 따른 유전학적 다형성과 관련 인자 등이 분자 생물학적으로 연구되어져야 할 것이다.

Objective : Although a common clinical problem, no uniform definition for fear of childbirth has been settled. The purpose of this study was to identify the association of serotonin in labor. Methods : A prospective study of serotonin and review of the medical records from the department of obstetrics and gynecology, Catholic University of Korea Holy Family Hospital from January 2004 to May confirmed 30 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. Blood sampling of serotonin was done during labor according to cervix dilatation. Sample collection series on patients latent phase (before labor begins S1), active phase (cervix dilatation 3-5 cm S2), second stage (cervix dilatation full S3), third stage (at delivery of placenta within 24 hours S4), cord artery blood (S5) could be administered. Patient were divided into two groups. From this group 17 patients (G1) who were initial serotonin normal concentration (1.5-7.5 ng/mL), and 13 patients (G2) who were initial serotonin high concentration. Results : The concentration of serotonin of G1 were S1-5.8±0.8 ng/mL, S2-7.2±2.5 ng/mL, S3-8.5±3.7 ng/mL, S4-6.5±1.5 ng/mL, S5-4.9±1.2 ng/mL. The serotonin concentration of G2 were S1-10.1±2.7 ng/ mL, S2-11.2±5.2 ng/mL, S3-10.3±3.9 ng/mL, S4-11.8±8.6 ng/mL, S5-5.0±1.0 ng/mL. Conclusion : The association of serotonin in labor was studied that the change of serotonin concentration was determined according to initial serotonin concentration. This difference of initial serotonin concentration will be studied about genetic polymorphism and factor by molecular biology.

Objective : Although a common clinical problem, no uniform definition for fear of childbirth has been settled. The purpose of this study was to identify the association of serotonin in labor. Methods : A prospective study of serotonin and review of the medical records from the department of obstetrics and gynecology, Catholic University of Korea Holy Family Hospital from January 2004 to May confirmed 30 patients with the diagnosis of singleton pregnancy without medical or obstetrical complications, being in 37-42 weeks. Blood sampling of serotonin was done during labor according to cervix dilatation. Sample collection series on patients latent phase (before labor begins S1), active phase (cervix dilatation 3-5 cm S2), second stage (cervix dilatation full S3), third stage (at delivery of placenta within 24 hours S4), cord artery blood (S5) could be administered. Patient were divided into two groups. From this group 17 patients (G1) who were initial serotonin normal concentration (1.5-7.5 ng/mL), and 13 patients (G2) who were initial serotonin high concentration. Results : The concentration of serotonin of G1 were S1-5.8±0.8 ng/mL, S2-7.2±2.5 ng/mL, S3-8.5±3.7 ng/mL, S4-6.5±1.5 ng/mL, S5-4.9±1.2 ng/mL. The serotonin concentration of G2 were S1-10.1±2.7 ng/ mL, S2-11.2±5.2 ng/mL, S3-10.3±3.9 ng/mL, S4-11.8±8.6 ng/mL, S5-5.0±1.0 ng/mL. Conclusion : The association of serotonin in labor was studied that the change of serotonin concentration was determined according to initial serotonin concentration. This difference of initial serotonin concentration will be studied about genetic polymorphism and factor by molecular biology.

Labor, Serotonin, Fear