Dukic Jelena, Johann Alexandra, Henninger Mirka, Ehlert Ulrike
Clinical Psychology and Psychotherapy, Psychological Department, University of Zurich, Zurich, Switzerland.
Center for Statistics & Data Science, Faculty of Psychology, University of Basel, Basel, Switzerland.
Front Glob Womens Health. 2024 Oct 9;5:1428494. doi: 10.3389/fgwh.2024.1428494. eCollection 2024.
During the peripartum, women undergo significant hormonal changes that are crucial for fetal development and a healthy pregnancy and postpartum period for mother and infant. Although several studies have determined healthy norm ranges of estradiol and progesterone, there are discrepancies among the reports, rendering it unclear which hormone levels are linked to adverse health outcomes. To account for the impact of sex steroid patterns on health outcomes in mothers and children, a longitudinal assessment of different parameters is needed.
We longitudinally assessed a cohort of 130 women over five months during pregnancy and postpartum. The women provided saliva samples and completed psychosocial questionnaires. Hormone analyses were conducted using enzyme-linked immunosorbent assay (ELISA). Different parameters of estradiol and progesterone were analyzed and evaluated in relation to psychometric variables. To examine the presence of heterogenous hormonal trajectories in the peripartum, we applied group-based trajectory modelling as a special case of latent-class group analysis.
Estradiol and progesterone levels rose towards the end of pregnancy and dropped sharply after birth, with considerable individual variation, particularly during pregnancy. However, their ratio remained stable. We identified three estradiol trajectory subgroups and two progesterone subgroups. Age influenced progesterone levels, with older pregnant women having higher levels than younger women. Anxiety and depressive symptoms had a predictive value for trajectories of specific subgroups of women. The study also revealed two distinct subgroups regarding the course of estradiol and progesterone fluctuations as well as their ratio.
This study provides insights into the course and fluctuation of salivary estradiol and progesterone levels among healthy women during the peripartum period, highlighting significant variations in hormone levels but stability in their ratio during this time. The finding of distinct sex steroid courses in the peripartum is new and suggests the need for further research to explore their impact on health outcomes. Our preliminary results suggest that hormonal fluctuations at the end of pregnancy appear to be a normal occurrence and might even be a protective factor for associated psychological symptoms and sleep disturbances in women.
在围产期，女性会经历显著的激素变化，这些变化对胎儿发育以及母婴健康的孕期和产后阶段至关重要。尽管多项研究已确定雌二醇和孕酮的健康正常范围，但报告之间存在差异，这使得尚不清楚哪些激素水平与不良健康结果相关。为了说明性类固醇模式对母婴健康结果的影响，需要对不同参数进行纵向评估。
我们在孕期和产后五个月对130名女性进行了纵向评估。这些女性提供了唾液样本并完成了心理社会问卷。使用酶联免疫吸附测定（ELISA）进行激素分析。分析并评估了雌二醇和孕酮的不同参数与心理测量变量的关系。为了检查围产期激素轨迹的异质性，我们应用基于组的轨迹模型作为潜在类别组分析的一个特例。
雌二醇和孕酮水平在妊娠末期上升，产后急剧下降，个体差异较大，尤其是在孕期。然而，它们的比值保持稳定。我们确定了三个雌二醇轨迹亚组和两个孕酮亚组。年龄影响孕酮水平，年龄较大的孕妇孕酮水平高于年轻女性。焦虑和抑郁症状对特定亚组女性的轨迹具有预测价值。该研究还揭示了关于雌二醇和孕酮波动过程及其比值的两个不同亚组。
本研究深入了解了围产期健康女性唾液中雌二醇和孕酮水平的变化过程及波动情况，突出了激素水平在此期间的显著差异，但它们的比值保持稳定。围产期不同性类固醇变化过程的发现是新的，表明需要进一步研究以探讨它们对健康结果的影响。我们的初步结果表明，妊娠末期的激素波动似乎是正常现象，甚至可能是女性相关心理症状和睡眠障碍的保护因素。
