Maternal serum unconjugated oestriol and human chorionic gonadotrophin levels in twin pregnancies: implications for screening for Down's syndrome

Wald, Nicholas; Cuckle, Howard; Wu, Tiesheng; George, Lynne M.

doi:10.1111/j.1471-0528.1991.tb13513.x

Cited by 106 publications

(71 citation statements)

References 5 publications

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“…Suppression of embryonic mammary gland development by androgens in males supports this hypothesis (41). In the mouse model, destruction of mammary gland anlagen (the initial clustering of cells destined to become breast tissue) by testosterone occurs in early pregnancy, and this androgen sensitivity is expressed in male as well as female mammary glands (42). Female fetuses are protected from sterilization through rapid placental metabolism of androgens to estrogens (43).…”

Section: Discussionmentioning

confidence: 58%

Cord Serum Estrogens, Androgens, Insulin-Like Growth Factor-I, and Insulin-Like Growth Factor Binding Protein-3 in Chinese and U.S. Caucasian Neonates

Troisi

Λάγιου

Trichopoulos

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Markedly lower breast cancer incidence rates in Asians than Caucasians are not explained by established adult risk factors. Migration studies suggest the importance of early-life exposures, including perhaps the in utero period. Concentrations of steroid hormones and insulin-like growth factors (IGF) were measured in umbilical cord sera from pregnancies in Shanghai, China (n = 121) and Boston, MA (n = 111). Pregnancy characteristics were ascertained by interview and medical records. Means and percent differences in hormone concentrations comparing Chinese with Caucasians and 95% confidence intervals were estimated from linear regression models. Cord concentrations of androstenedione (91.9%), testosterone (257%), estriol (48.6%), and IGF binding protein-3 (21.1%) were significantly higher in the Chinese than U.S. samples, and cord prolactin was lower (À14.9%). Cord estradiol and IGF-I concentrations did not differ by race/ethnicity. With adjustment for gestational length, maternal age, pre-pregnancy weight, and weight gain, androstenedione (60.5%), testosterone (185%), and IGF binding protein-3 (40.4%) remained significantly higher in the Chinese, whereas the higher estriol and lower prolactin concentrations were attenuated. In addition, estradiol levels became lower in the Chinese (À29.8%) but did not reach statistical significance. Results were generally similar when restricted to first full-term pregnancies, with reduced estradiol concentrations in the Chinese reaching statistical significance after adjustment. These data are consistent with the hypothesis that elevated prenatal androgen exposure could mediate reductions in breast cancer risk. The meaning of the change in findings for estrogens after controlling for factors related to the pregnancy is unclear with regard to explaining international breast cancer differences. (Cancer Epidemiol Biomarkers Prev 2008;17(1):224 -31)

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Section: Discussionmentioning

confidence: 58%

Cord Serum Estrogens, Androgens, Insulin-Like Growth Factor-I, and Insulin-Like Growth Factor Binding Protein-3 in Chinese and U.S. Caucasian Neonates

Troisi

Λάγιου

Trichopoulos

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Algorithms for assigning a "pseudorisk" have been published. 12,17,18 Whether or not a program interprets samples from known twin pregnancies is left to the laboratory director. Pseudorisks do not have to be reported.…”

Section: Ds3572 Multiple Gestationmentioning

confidence: 99%

Technical standards and guidelines: Prenatal screening for Down syndrome: This new section on “Prenatal Screening for Down Syndrome,” together with the new section on “Prenatal Screening for Open Neural Tube Defects,” replaces the previous Section H of the American College of Medical Genetics Standards and Guidelines for Clinical Genetics Laboratories

Palomaki

Bradley²,

McDowell

2005

Genetics in Medicine

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21) is one of the most common genetic causes of moderate to severe mental retardation. Virtually all individuals with Down syndrome are hypotonic and have minor dysmorphic features, which can include up-slanting palpebral fissures, epicanthal folds, flat nasal bridge, Brushfield spots of the iris, shortened fifth finger, and transverse palmar crease. Congenital heart disease is present in 40%, and 5% have gastrointestinal anomalies such as duodenal atresia or Hirschsprung disease. The incidence of childhood leukemia is increased up to 20 times over that of the general population. Adults with Down syndrome experience neuronal degeneration identical to that present in Alzheimer's disease. Down syndrome individuals without congenital heart disease can live beyond 60 years of age.DS2.3 ETIOLOGY. Down syndrome is caused by the presence of an extra copy of chromosome 21, either as a free chromosome, a Robertsonian translocation, or a reciprocal translocation involving chromosome 21. Approximately 95% of cases result from sporadic nondisjunction during parental meiosis. The nondisjunction is maternal in 95% of cases, and 77% of the maternal nondisjunction occurs during meiosis I. The risk of having a child with Down syndrome increases with advancing maternal age. Down syndrome can be inherited when one parent carries a translocation involving chromosome 21. If a parent carries a Robertsonian translocation, the risk to the offspring is dependent on the sex of the carrier parent. DS2.4 LABORATORY DIRECTOR.Although the prenatal screening laboratory utilizes clinical chemistry methods such as enzyme immunoassays, its function differs, because the results require a unique kind of interpretation. This interpretation puts the results of the test into the appropriate context of a priori risks as determined by maternal age, gestational age, and family history. The laboratory director is often called upon to provide consultation regarding these risks and options for further action. To address these unique requirements, the laboratory director should meet the standards set out in Section B3 of the ACMG guidelines. When prenatal screening for Down syndrome is performed in a clinical chemistry laboratory in which the director does not meet these standards, the laboratory should have a demonstrated relationship with an individual Women and Infants Hospital, Providence, Rhode Island. From the G.E. Palomaki's present address is

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“…Higher levels of a-fetoprotein (122), human placental lactogen (123,124), and progesterone have been observed in mothers pregnant with twins compared with those pregnant with singletons (123). Maternal (122,125) and cord hCG may be higher in twins compared with singletons (125), but may be similar in like and unlike sex twin pairs (125). Compared with singletons, leptin levels measured a day after birth were lower in a study of dichorionic twins (126), but were elevated in amniotic fluid of twins (127).…”

Section: Prominent Hypotheses To Explain Prenatal Risk Factorsmentioning

confidence: 99%

Exploring the Underlying Hormonal Mechanisms of Prenatal Risk Factors for Breast Cancer: A Review and Commentary

Troisi

Potischman

Hoover

2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Prenatal factors have been hypothesized to influence subsequent breast cancer development. Directly evaluating the associations of in utero exposures with risk, however, presents several methodologic and theoretical challenges, including the long induction period between exposure and disease and the lack of certainty regarding the critical timing of exposure. Indirect evaluation of these associations has been achieved by use of proxies such as gestational and neonatal characteristics. Evidence suggests that preeclampsia is associated with a reduced breast cancer risk, whereas high birth weight and dizygotic twinning seem associated with an increased risk. Asians born in Asia have substantially lower breast cancer risks than women born in the West. Although data thus far are few, what exists is not consistent with a unifying hypothesis for a particular biological exposure (such as estrogens or androgens) during pregnancy as mediating the observed associations between pregnancy factors and breast cancer risk. This suggests that additional studies of prenatal factors should seek to broaden the range of hormones, growth, and other endocrine factors that are evaluated in utero. Once candidate biomarkers are identified, assessing them with respect to breast cancer and with intermediate end points in carcinogenesis should be a priority. In addition, investigations should explore the possibility that in utero exposures may not act directly on the breast, but may alter other physiologic pathways such as hormone metabolism that have their effect on risk later in life. (Cancer Epidemiol Biomarkers Prev 2007;16(9):1700 -12)

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Maternal serum unconjugated oestriol and human chorionic gonadotrophin levels in twin pregnancies: implications for screening for Down's syndrome

Cited by 106 publications

References 5 publications

Cord Serum Estrogens, Androgens, Insulin-Like Growth Factor-I, and Insulin-Like Growth Factor Binding Protein-3 in Chinese and U.S. Caucasian Neonates

Cord Serum Estrogens, Androgens, Insulin-Like Growth Factor-I, and Insulin-Like Growth Factor Binding Protein-3 in Chinese and U.S. Caucasian Neonates

Exploring the Underlying Hormonal Mechanisms of Prenatal Risk Factors for Breast Cancer: A Review and Commentary

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