妊娠前半期母体性激素的决定因素。
Determinants of maternal sex steroids during the first half of pregnancy.
机构信息
From the Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany; National Institute for Health and Welfare, Oulu, Finland; University of Tampere, Tampere, Finland; Department of Environmental Medicine, New York University School of Medicine, New York; New York University Cancer Institute, New York, New York; Department of Medical Biosciences, University of Umeå, Umeå, Sweden; Public Health and Clinical Medicine, Nutritional Research, University of Umeå, Umeå, Sweden; School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland; Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany; Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland; Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York; Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
出版信息
Obstet Gynecol. 2011 Nov;118(5):1029-1036. doi: 10.1097/AOG.0b013e3182342b7f.
OBJECTIVE
To examine the associations of maternal and child characteristics with early pregnancy maternal concentrations of testosterone, androstenedione, progesterone, 17-hydroxyprogesterone, and estradiol (E2).
METHODS
We analyzed these hormones among 1,343 women with singleton pregnancies who donated serum samples to the Finnish Maternity Cohort from 1986 to 2006 during the first half of pregnancy (median 11 weeks). The associations of maternal and child characteristics with hormone concentrations were investigated by correlation and multivariable regression.
RESULTS
Women older than age 30 years had lower androgen and E2 but higher progesterone concentrations than women younger than that age. Multiparous women had 14% lower testosterone, 11% lower androstenedione and 17-hydroxyprogesterone, 9% lower progesterone, and 16% lower E2 concentrations compared with nulliparous women (all P<.05). Smoking mothers had 11%, 18%, and 8% higher testosterone, androstenedione, and 17-hydroxyprogesterone levels, respectively, but 10% lower progesterone compared with nonsmoking women (all P<.05). E2 concentrations were 9% higher (P<.05) among women with a female fetus compared with those with a male fetus.
CONCLUSION
Parity, smoking, and, to a lesser extent, maternal age and child sex are associated with sex steroid levels during the first half of a singleton pregnancy. The effects of smoking on the maternal hormonal environment and the possible long-term deleterious consequences on the fetus deserve further evaluation.
目的
探讨母体和胎儿特征与早孕母体睾丸酮、雄烯二酮、孕酮、17-羟孕酮和雌二醇（E2）浓度的相关性。
方法
我们分析了 1986 年至 2006 年期间，1343 名单胎妊娠女性在妊娠早期（中位数 11 周）向芬兰母婴队列捐献血清样本时的这些激素。采用相关分析和多元回归分析探讨母体和胎儿特征与激素浓度的相关性。
结果
年龄大于 30 岁的女性比年龄小于该年龄的女性的雄激素和 E2 水平较低，而孕酮水平较高。与初产妇相比，经产妇的睾丸酮、雄烯二酮和 17-羟孕酮分别降低 14%、11%和 17%，孕酮降低 9%，E2 降低 16%（均 P<.05）。吸烟的母亲的睾丸酮、雄烯二酮和 17-羟孕酮水平分别升高 11%、18%和 8%，但孕酮水平降低 10%（均 P<.05）。与怀男胎的女性相比，怀女胎的女性的 E2 浓度升高 9%（P<.05）。
结论
孕次、吸烟以及在一定程度上的母亲年龄和胎儿性别与单胎妊娠早期的性激素水平有关。吸烟对母体激素环境的影响及其对胎儿可能产生的长期不良后果值得进一步评估。
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