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Predictors of Steroid Hormone Concentrations in Early Pregnancy: Results from a Multi-Center Cohort

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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.

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We wish to acknowledge the contributions of the TIDES Study Team: Coordinating Center: Fan Liu, Erica Scher; UCSF: Marina Stasenko, Erin Ayash, Melissa Schirmer, Jason Farrell, Mari-Paule Thiet, Laurence Baskin; UMN: Heather L. Gray, Chelsea Georgesen, Brooke J. Rody, Carrie A. Terrell, Kapilmeet Kaur; URMC: Erin Brantley, Heather Fiore, Lynda Kochman, Lauren Parlett, Jessica Marino, William Hulbert, Robert Mevorach, Eva Pressman; UW/SCH: Kristy Ivicek, Bobbie Salveson, Garry Alcedo and the families who participated in the study. We thank the TIDES families for their participation and the residents at URMC and UCSF who assisted with birth exams. This analysis was supported by the following NIH Grants: R21ES023883, R01ES016863, R01ES06863-02S4. Additional support for the current analyses was provided by: T32ES007271, P30ES001247, P30ES005002, and UL1TR000124.

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Correspondence to Emily S. Barrett.

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TIDES was approved by institutional review boards at all participating institutions, and all subjects signed informed consent prior to starting any study activities.

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Barrett, E.S., Mbowe, O., Thurston, S.W. et al. Predictors of Steroid Hormone Concentrations in Early Pregnancy: Results from a Multi-Center Cohort. Matern Child Health J 23, 397–407 (2019).

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