title: Assessing new terminal body and facial hair growth during pregnancy: toward developing a simplified visual scoring system for hirsutism.
abstract: OBJECTIVE
  To study the distribution and progression of terminal hair growth in pregnant women and to determine the feasibility of a simplified scoring system for assessing hirsutism.
  
  
  METHODS
  Prospective follow-up observational study.
  
  
  METHODS
  Academic hospital.
  
  
  METHODS
  A total of 115 pregnant women (discovery cohort) and 1,159 women with polycystic ovary syndrome (PCOS) (validation cohort).
  
  
  METHODS
  Facial and body terminal hair growth assessed by modified Ferriman and Gallwey score system (mFG score), and total testosterone (TT) level detected by liquid chromatography with tandem mass spectrometry.
  
  
  METHODS
  Degree of facial and body terminal hair growth.
  
  
  RESULTS
  The serum TT level and mFG score increased as pregnancy progressed. Both the prospective study and receiver operating characteristics curve indicated that the body areas with the greatest contribution to hirsutism (defined as an mFG score ≥5) with new terminal hair growth were the upper lip, lower back, lower abdomen, and thigh. A simplified mFG scoring system (sFG) was developed, and a cutoff value of ≥3 was defined as hirsutism. Pregnant hirsute women were distinguished from nonhirsute women with an accuracy of 95.2%, sensitivity of 96.8%, and specificity of 94.3% for detecting hirsutism. This was further validated in the PCOS population with a sensitivity, specificity, and positive predictive value of 97.6%, 96.4%, and 96.4%, respectively.
  
  
  CONCLUSIONS
  This study suggests that the upper lip, lower back, lower abdomen, and thigh may be an effective simplified combination of the mFG system for the evaluation of excess hair growth in Chinese women.
  
  
  BACKGROUND
  ChiCTR-OCH-14005012.
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong, People's Republic of China.
authors.forename: Yabo
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, Guangdong, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong, People's Republic of China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Du
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong, People's Republic of China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong, People's Republic of China.
authors.forename: Dongzi
authors.initials: D
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong, People's Republic of China. Electronic address: zhaoxmiao@163.com.
authors.forename: Xiaomiao
authors.initials: X
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002853:Chromatography, Liquid; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D006197:Hair / Q000254:growth & development*; D006628:Hirsutism / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006785:Hospitals, University; D006801:Humans; D008137:Longitudinal Studies; D011085:Polycystic Ovary Syndrome; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D021241:Spectrometry, Mass, Electrospray Ionization; D053719:Tandem Mass Spectrometry; D013739:Testosterone / Q000097:blood; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D015415:Biomarkers; D013739:Testosterone
keywords: Androgen excess; hair growth; hirsutism; modified Ferriman-Gallwey score; polycystic ovary syndrome; pregnancy