Gestation-specific reference intervals for comprehensive spot urinary steroid hormone metabolite analysis in normal singleton pregnancy and 6 weeks postpartum.
BACKGROUND
Normal pregnancy depends on pronounced adaptations in steroid hormone concentrations. Although in recent years, the understanding of these hormones in pregnancy has improved, the interpretation is hampered by insufficient reference values. Our aim was to establish gestation-specific reference intervals for spot urinary steroid hormone levels in normal singleton pregnancies and 6 weeks postpartum.


METHODS
Cross-sectional multicentre observational study. Women recruited between 2008 and 2013 at 3 University Hospitals in Switzerland (Bern), Scotland (Glasgow) and Austria (Graz). Spot urine was collected from healthy women undergoing a normal pregnancy (age, 16-45 years; mean, 31 years) attending routine antenatal clinics at gestation weeks 11, 20, and 28 and approximately 6 weeks postpartum. Urine steroid hormone levels were analysed using gas-chromatography mass spectrometry. Creatinine was also measured by routine analysis and used for normalisation.


RESULTS
From the results, a reference interval was calculated for each hormone metabolite at each trimester and 6 weeks postpartum. Changes in these concentrations between trimesters and postpartum were also observed for several steroid hormones and followed changes proposed for index steroid hormones.


CONCLUSIONS
Normal gestation-specific reference values for spot urinary steroid hormones throughout pregnancy and early postpartum are now available to facilitate clinical management and research approaches to steroid hormone metabolism in pregnancy and the early postpartum period.
Department of Nephrology, Hypertension, Clinical Pharmacology and Clinical Research, University of Bern, 3010, Berne, Switzerland.
Hiten D
HD
Mistry
Department of Nephrology, Hypertension, Clinical Pharmacology and Clinical Research, University of Bern, 3010, Berne, Switzerland.
Nicole
N
Eisele
Department of Nephrology, Hypertension, Clinical Pharmacology and Clinical Research, University of Bern, 3010, Berne, Switzerland.
Geneviève
G
Escher
Department of Nephrology, Hypertension, Clinical Pharmacology and Clinical Research, University of Bern, 3010, Berne, Switzerland.
Bernhard
B
Dick
Department of Obstetrics and Gynecology, University Hospital Bern, 3010, Berne, Switzerland.
Daniel
D
Surbek
University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, UK.
Christian
C
Delles
University of Glasgow, Institute of Cardiovascular and Medical Sciences, Glasgow, UK.
Gemma
G
Currie
Vivantes Clinic Berlin-Neukölln, Department of Obstetrics, Berlin, Germany.
Dietmar
D
Schlembach
Department of Nephrology, Hypertension, Clinical Pharmacology and Clinical Research, University of Bern, 3010, Berne, Switzerland. markus.mohaupt@insel.ch.|Division of Hypertension, Department of Nephrology, Hypertension, Clinical Pharmacology and Clinical Research, University of Bern, CH-3010, Berne, Switzerland. markus.mohaupt@insel.ch.
Markus G
MG
Mohaupt
Department of Nephrology, Hypertension, Clinical Pharmacology and Clinical Research, University of Bern, 3010, Berne, Switzerland.
Carine
C
Gennari-Moser
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D012739:Gonadal Steroid Hormones / Q000378:metabolism / Q000652:urine*; D006801:Humans; D008875:Middle Aged; D049590:Postpartum Period / Q000378:metabolism / Q000652:urine*; D011247:Pregnancy / Q000378:metabolism / Q000652:urine*; D012016:Reference Values; D016482:Urinalysis / Q000592:standards; D055815:Young Adult
D012739:Gonadal Steroid Hormones