Barrett Emily S, Mbowe Omar, Thurston Sally W, Butts Samantha, Wang Christina, Nguyen Ruby, Bush Nicole, Redmon J Bruce, Sheshu Sukrita, Swan Shanna H, Sathyanarayana Sheela
Department of Epidemiology, Rutgers School of Public Health, 170 Frelinghuysen Road, Piscataway, NJ, 08854, USA.
Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA.
Matern Child Health J. 2019 Mar;23(3):397-407. doi: 10.1007/s10995-018-02705-0.
Objectives To identify factors predicting maternal sex steroid hormone concentrations in early pregnancy. Methods The Infant Development and the Environment Study recruited healthy pregnant women from academic medical centers in four US cities. Gold standard liquid chromatography-tandem mass spectrometry was used to measure maternal sex steroids concentrations (total testosterone [TT], free testosterone [FT], estrone [E1], estradiol [E2], and estriol [E3] concentrations) in serum samples from 548 women carrying singletons (median = 11.7 weeks gestation). Women completed questionnaires on demographic and lifestyle characteristics. Results In multivariable linear regression analyses, hormone concentrations varied in relation to maternal age, body mass index (BMI), race, and parity. Older mothers had significantly lower levels of most hormones; for every year increase in maternal age, there was a 1-2% decrease in E1, E2, TT, and FT. By contrast, each unit increase in maternal BMI was associated 1-2% lower estrogen (E1, E2, E3) levels, but 1-2% higher androgen (TT, FT) concentrations. Hormone concentrations were 4-18% lower among parous women, and for each year elapsed since last birth, TT and FT were 1-2% higher (no difference in estrogens). Androgen concentrations were 18-30% higher among Black women compared to women of other races. Fetal sex, maternal stress, and lifestyle factors (including alcohol and tobacco use) were not related to maternal steroid concentrations. Conclusions for Practice Maternal demographic factors predict sex steroid hormone concentrations during pregnancy, which is important given increasing evidence that the prenatal endocrine environment shapes future risk of chronic disease for both mother and offspring.
目的 确定预测孕早期母体性类固醇激素浓度的因素。方法 “婴儿发育与环境研究”从美国四个城市的学术医疗中心招募了健康孕妇。采用金标准液相色谱 - 串联质谱法测量548名单胎妊娠妇女（妊娠中位数 = 11.7周）血清样本中的母体性类固醇浓度（总睾酮[TT]、游离睾酮[FT]、雌酮[E1]、雌二醇[E2]和雌三醇[E3]浓度）。妇女完成了关于人口统计学和生活方式特征的问卷调查。结果 在多变量线性回归分析中，激素浓度因母体年龄、体重指数（BMI）、种族和胎次而异。年龄较大的母亲大多数激素水平显著较低；母体年龄每增加一岁，E1、E2、TT和FT水平降低1 - 2%。相比之下，母体BMI每增加一个单位，雌激素（E1、E2、E3）水平降低1 - 2%，但雄激素（TT、FT）浓度升高1 - 2%。经产妇的激素浓度低4 - 18%，自上次分娩后每过一年，TT和FT升高1 - 2%（雌激素无差异）。与其他种族的女性相比，黑人女性的雄激素浓度高18 - 30%。胎儿性别、母体压力和生活方式因素（包括饮酒和吸烟）与母体类固醇浓度无关。实践结论 母体人口统计学因素可预测孕期性类固醇激素浓度，鉴于越来越多的证据表明产前内分泌环境会影响母亲和后代未来患慢性病的风险，这一点很重要。
