Longitudinal Course of Sex Steroids From Pregnancy to Postpartum

Abstract

Context Sex steroids (SS) typically rise during pregnancy and decline after birth, but no consistent reference values exist for these hormonal courses. We aimed to establish an overview of SS secretion patterns during the peripartum and to better understand how SS contribute to maternal and fetal pathologies. Evidence acquisition A systematic literature search was conducted in accordance with the PRISMA guidelines using PubMed, Cochrane Library, and PsycINFO. Additionally, we conducted a supplementary manual search of references. Observational studies published in English and assessing estradiol, progesterone, and testosterone over the course of the peripartum in physically healthy female subjects were included, without restrictions on year of publication. Extracted data were analyzed descriptively and visually. Evidence synthesis SS increase progressively during pregnancy, with an extremely wide range of reported concentrations, especially in the third trimester. In fact, reported concentrations varied up to 5000-fold at comparable measurement time points. Conclusions A comprehensive understanding of the influence of SS levels on associated maternal and fetal pathologies is currently hindered by two main factors. First, reported SS levels vary widely during the peripartum period. Second, the current state of knowledge on how SS are associated with pathologies in mothers and babies is largely based on correlational studies, and causality thus remains unclear. Consequently, we recommend the development of a systematic reference framework that follows the suggestions presented in this review. This would enable the establishment of SS reference values for a healthy population, resulting in the possibility to draw conclusions about deviations and related pathologies.

Immunogenicity of 2-Dose HPV Vaccine Series for Postpartum Women

“…A possible explanation for the higher GMTs among postpartum women could be elevated sex steroid hormone concentrations at the time of the first vaccine dose. In the gravid state, progesterone levels increase 100-fold relative to levels in the nongravid state, and estrogen undergoes a 50-fold increase . These levels remain elevated after delivery but rapidly decrease in the 5 days after delivery to pregravid levels .…”

“…In the gravid state, progesterone levels increase 100-fold relative to levels in the nongravid state, and estrogen undergoes a 50-fold increase. 30,31 These levels remain elevated after delivery but rapidly decrease in the 5 days after delivery to pregravid levels. 31,32 There are well-documented sex-based differences in immune response after viral vaccines (eg, yellow fever, influenza, measles, mumps, and rubella), with female sex being associated with superior antibody responses.…”

Second trimester maternal serum progesterone and estradiol concentrations with live and demised fetuses: Secondary analysis results from a randomized controlled trial

“…However, as the gamma distribution with an identity link was the best-fitting model using Pregibon link test and we did not obtain any negative predictions we proceeded with these models. The nonlinear associations of gestation in weeks (as a continuous variable) with estradiol and progesterone was accounted for using a [3,3] fractional polynomial transformation. This technique allows us to include flexibility in the trends of biomarker levels with gestation.…”

“…The knowledge of progesterone and estradiol levels in pregnancy has several clinical applications, including as a potential biomarker for adverse pregnancy outcomes in an otherwise uncomplicated pregnancy (e.g., the later development of hypertension or pre-eclampsia 1 ), a reflection of in vivo endometrial hormone receptor status, which may impact the efficacy of drugs used in pregnancy, including abortifacients 2 and as a marker of adaptive changes to optimise a healthy pregnancy and postnatal period. 3 Progesterone and estradiol are necessary for ongoing pregnancy, and the ranges of both vary during pregnancy. There are limited published data on sex steroid hormone levels during pregnancy.…”

Association between Salivary Hormones, Dental Caries, and Cariogenic Microorganisms during Pregnancy

“…Another limitation in analyzing factors associated with hormone levels in saliva is the exclusion of body mass index (BMI) from our study. It could be justified by the following: (1) the potential effect of BMI on salivary hormone levels is unclear and unconfirmed with limited available data [39],…”