DHEA-S-loading test in cases of intrauterine growth retardation: relationship between the pattern of the maternal plasma metabolites and the fetoplacental dysfunction.

Dehydroepiandrosterone sulfate loading tests (DLT) have been performed in 17 cases of clinically suspected intrauterine fetal growth retardation. At birth, 9 babies had adequate birth weights for gestational age (AGA) and 8 infants were small for gestational age (SGA). In both groups, plasma levels of dehydroepiandrosterone sulfate (DHEA-S), unconjugated DHEA, delta4-adrostenedione (delta4-A), testosterone (T), unconjugated estrone (E1) and estradiol (E2) were measured seven times from 15 min to 4 h after the intravenous injection of 50 mg DHEA-S. Several differences appear between the AGA group and the SGA group: (1) in the latter group, the rate of disappearance of the injected DHEA-S is decreased; (2) plasma levels of delta4-A and T are significantly increased and remain elevated for 2-3 h, whereas in the AGA group these values are increased only for a short period of time just after the injection. E1 and E2 patterns are similar in both groups. It has previously been demonstrated that an impaired response to DLT reflects a reduced uteroplacental blood flow. In addition, our results suggests a concomitant impairment of the aromatizing activity which reduces the placental metabolization of neutral steroids to estrogens.