Altered umbilical sex steroids in preterm infants born small for gestational age

Abstract

Background: Boys born small for gestational age (SGA) are at increased risk of testicular dysgenesis syndrome, and girls born SGA face the risk of polycystic ovary syndrome later in life. Our aim was to study whether neonates born SGA have an altered profile of steroid hormones at birth. Materials and methods: A total of 168 singletons (99 boys, 69 girls) born at 32.0-36.9 gestational weeks were recruited to a population-based, university hospital, single-center study. Of these, 31 infants (17 boys, 14 girls) were born SGA. The concentrations of dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, dihydrotestosterone, estrone, estradiol, cortisone, and cortisol were analyzed in umbilical cord serum with mass spectrometry. Results: Girls born SGA had higher levels of androstenedione than girls born appropriate for gestational age (AGA) (4.0 versus 2.6 nmol/L, p ¼ .002). Boys born SGA had lower levels of estrone than boys born AGA (33 822 versus 62 471 pmol/L, p ¼ .038). Infants born SGA had lower levels of cortisone than infants born AGA, both in girls (340 versus 579 nmol/L, p ¼ .010) and in boys (308 versus 521 nmol/L, p ¼ .045). Furthermore, boys born SGA had a higher cortisol/cortisone ratio than boys born AGA (0.41 versus 0.25, p ¼ .028). Gestational age correlated with DHEAS (boys r ¼ 0.48, p ¼ .000, girls r ¼ 0.35, p ¼ .013), and cortisol (boys r ¼ 0.48, p ¼ .000, girls r ¼ 0.29, p ¼ .039). Conclusions: In moderate-to-late preterm infants born SGA, we observed a different steroid hormone profile in cord serum. Girls born SGA show increased levels of androstenedione and boys born SGA show decreased levels of estrone in cord serum, which could be related to placental aromatase deficiency in intrauterine growth restriction.

Naturally Occurring and Experimentally Induced Rhesus Macaque Models for Polycystic Ovary Syndrome: Translational Gateways to Clinical Application

“…In addition to such evidence for gestational hyperandrogenism contributing to PCOS etiopathogenesis, gestationally diabetic in utero environments [64][65][66][67], as well as poor intrauterine nutrition and fetal growth restriction [67][68][69], contribute developmental, likely epigenetic [37,70,71], programming to women with PCOS. Human placentae readily convey maternal glucose to the fetus engaging a progressively maturing fetal pancreatic beta cell response, but preventing transfer of maternal insulin [72].…”

Men born small for gestational age or with low birth weight do not improve their rate of reproduction over time: a Swedish population-based study

“…Phthalates (33) and bisphenols (34) have been intensively investigated as potential causes of TDS, which has led to their banning by the European Union. However, much of the experimental evidence is on the basis of rodent studies and has been strongly questioned (35), and human studies have had divergent results (36,37). We cannot link the men in the cohorts we studied to any particular environmental exposure, but surely exposure to EDCs was present, to varying degrees, for the entire period of the study.…”

Longitudinal Sex Steroid Data in Relation to Birth Weight in Preterm Boys

“…Umbilical venous blood was collected directly after birth in 85 boys. These are a subgroup of a lager cohort, for whom steroid hormones in umbilical venous blood have already been published ( 18 ). Venous blood was drawn once a week if the infant was admitted to a neonatal ward after birth.…”

“…We have previously shown an altered umbilical sex steroid pattern in preterm neonates born small for gestational age (SGA) ( 18 ), as well as in SGA males as young adults ( 19 ). Based on these findings, we hypothesized that boys born with low birth weight have a disturbed pattern of androgen secretion that begins during infancy.…”