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Different SNP combinations in the GCH1 gene and use of labor analgesia
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. (Reproduktiv hälsa/Sundström Poromaa)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. (Reproduktiv hälsa/Sundström Poromaa)
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2010 (Engelska)Ingår i: Molecular Pain, E-ISSN 1744-8069, Vol. 6, s. 41-Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: The aim of this study was to investigate if there is an association between different SNP combinations in the guanosine triphosphate cyclohydrolase (GCH1) gene and a number of pain behavior related outcomes during labor. A population-based sample of pregnant women (n = 814) was recruited at gestational week 18. A plasma sample was collected from each subject. Genotyping was performed and three single nucleotide polymorphisms (SNP) previously defined as a pain-protective SNP combination of GCH1 were used. Results: Homozygous carriers of the pain-protective SNP combination of GCH1 arrived to the delivery ward with a more advanced stage of cervical dilation compared to heterozygous carriers and non-carriers. However, homozygous carriers more often used second line labor analgesia compared to the others. Conclusion: The pain-protective SNP combination of GCH1 may be of importance in the limited number of homozygous carriers during the initial dilation of cervix but upon arrival at the delivery unit these women are more inclined to use second line labor analgesia.

Ort, förlag, år, upplaga, sidor
2010. Vol. 6, s. 41-
Nationell ämneskategori
Medicin och hälsovetenskap Farmaceutiska vetenskaper Biologiska vetenskaper
Identifikatorer
URN: urn:nbn:se:uu:diva-134350DOI: 10.1186/1744-8069-6-41ISI: 000282485300002OAI: oai:DiVA.org:uu-134350DiVA, id: diva2:372402
Tillgänglig från: 2010-11-25 Skapad: 2010-11-24 Senast uppdaterad: 2023-09-21Bibliografiskt granskad
Ingår i avhandling
1. Genetics and Labor Pain Behavior
Öppna denna publikation i ny flik eller fönster >>Genetics and Labor Pain Behavior
2011 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Labor may perhaps be the most painful a woman might experience, although characterized by large inter-individual variability. The perceived pain during labor is the result of diverse factors, i.e. her previous pain experiences, the analgesia she receives and maybe also her genes. The overall aim of this thesis was to investigate biological and psychological mechanisms underlying inter-individual differences in labor pain related behaviors.

The mechanisms that characterize endogenous pain relief during labor are not fully understood, though it is known to be partly explained by the effects of β-endorphin (BE). BE plasma levels were followed longitudinally in a cohort of pregnant women and were found to remain unchanged between early and late pregnancy, although with a nadir in the beginning of the third trimester. Furthermore, women with low levels of BE in plasma at the end of the third trimester, required second line labor analgesia to a significantly higher extent than women with normal levels.

In a population-based sample of 814 pregnant women we investigated if inter-individual differences in labor pain related behavior was influenced by the pain-protective single nucleotide polymorphism (SNP) combination of guanosine triphosphate cyclohydrolase (GCH1) and the opioid receptor µ-1 gene (OPRM1) A118G SNP. We identified a possible association between the pain-protective SNP combination of GCH1 and use of second line analgesia. No association was found between the OPRM1 and use of analgesia or labor pain related behavior.

The association between self-rated antenatal depressed mood and anxiety in relation to pain behaviors and self-reported pain during labor was investigated. We found that depressed mood during pregnancy is associated with early arrival to the delivery department, whereas antenatal anxiety is associated with increased self-rated pain prior to labor analgesia. 

In conclusion, although an increasing number of studies strongly suggest that genetic predisposition plays an important role in pain and pain-related mechanisms, GCH1 and OPRM1 has little to offer in terms of individual counseling on labor analgesia. To enable the future use of genetic variability for pre-labor testing and counseling, a number of different genes reflecting pain mediation pathways, involving biological and psychological mechanisms, need to be analyzed in combination.      

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2011. s. 60
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 729
Nyckelord
anxiety, beta-endorphin, depressed mood, GCH1, labor analgesia, labor pain, OPRM1, SNP
Nationell ämneskategori
Reproduktionsmedicin och gynekologi
Forskningsämne
Obstetrik och gynekologi
Identifikatorer
urn:nbn:se:uu:diva-162539 (URN)978-91-554-8237-4 (ISBN)
Disputation
2012-01-20, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 09:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2011-12-21 Skapad: 2011-12-01 Senast uppdaterad: 2012-01-03Bibliografiskt granskad

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Dabo, FatimahSundström Poromaa, IngerÅkerud, Helena

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Dabo, FatimahGrönbladh, AlfhildNyberg, FredSundström Poromaa, IngerÅkerud, Helena
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Institutionen för kvinnors och barns hälsaInstitutionen för farmaceutisk biovetenskap
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Molecular Pain
Medicin och hälsovetenskapFarmaceutiska vetenskaperBiologiska vetenskaper

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