title: Amniotic fluid testosterone: relationship with cortisol and gestational age.
abstract: BACKGROUND
  Foetal exposure to testosterone is increasingly implicated in the programming of future reproductive and non-reproductive behaviour. Some outcomes associated with prenatal exposure to testosterone may be predicted from exposure to prenatal stress, suggesting a link between them. The peak serum levels of testosterone in the foetus are thought to be around 14-18 weeks' gestation, and we explored testosterone levels at different gestations. Although best investigated in foetal plasma, this is now difficult because of the decline in frequency of foetal blood sampling; in this study, we used amniotic fluid as a biomarker to investigate foetal exposure.
  
  
  OBJECTIVE
  To investigate the relationship between amniotic fluid testosterone, amniotic fluid cortisol, foetal gender, and gestational age.
  
  
  METHODS
  Paired amniotic fluid and maternal plasma samples were collected from 264 pregnant women undergoing amniocentesis between 15 and 37 weeks' gestation (median 17 weeks [119 days]). Total testosterone and cortisol in amniotic fluid, and total plasma testosterone (maternal) were measured by radioimmunoassay.
  
  
  RESULTS
  Amniotic fluid testosterone levels were higher in male than in female foetuses, with a median (interquartile range) of 0.85 nmol/l (0.60-1.17 nmol/l) and 0.28 nmol/l (0.175-0.45 nmol/l), respectively. No relationship between amniotic fluid testosterone and gestational age was detected in either sex. Amniotic fluid testosterone correlated positively with amniotic fluid cortisol in both sexes (r = 0.30 male foetuses, r = 0.33 female foetuses, P < 0.001 for both), and remained significant in multivariate analysis.
  
  
  CONCLUSIONS
  Testosterone in amniotic fluid did not change with gestation in the second and third trimester, raising questions about the timing of the reported early peak in the male foetus. The positive correlation between cortisol and testosterone in amniotic fluid suggests that increased foetal exposure to cortisol may also be associated with increased exposure to testosterone.
authors.affiliation: Institute of Reproductive and Developmental Biology, Imperial College London, Hammersmith Campus, London, UK. pampasarkar@aol.com
authors.forename: P
authors.initials: P
authors.lastname: Sarkar
authors.forename: K
authors.initials: K
authors.lastname: Bergman
authors.forename: N M
authors.initials: NM
authors.lastname: Fisk
authors.forename: T G
authors.initials: TG
authors.lastname: O'Connor
authors.forename: V
authors.initials: V
authors.lastname: Glover
mesh_terms: D000293:Adolescent; D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors; D013739:Testosterone / Q000032:analysis* / Q000097:blood
chemical_list: D015415:Biomarkers; D013739:Testosterone; D006854:Hydrocortisone