1
|
Jeong U, Yoon S, Park S, Jeon TJ, Kim SM. 3D Artificial Skin Platform for Investigating Pregnancy-Related Skin Pigmentation. MICROMACHINES 2024; 15:511. [PMID: 38675322 PMCID: PMC11052160 DOI: 10.3390/mi15040511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
In this study, we created a 3D Artificial Skin Platform that can be used for the treatment of pigmentation by artificially realizing the skin of pregnant women. For the stable realization of 3D artificial skin, a bilayer hydrogel composed of collagen type I and fibrin was designed and applied to the study to reduce the tension-induced contraction of collagen type I, the extracellular matrix (ECM) of artificial skin, by dynamic culture. Oxygen concentration and 17β-Estradiol (E2) concentration, which are highly related to melanin production, were selected as parameters of the pregnancy environment and applied to cell culture. Oxygen concentration, which is locally reduced in the first trimester (2.5-3%), and E2, which is upregulated in the third trimester, were applied to the cell culture process. We analyzed whether the 3D artificial skin implemented in the 3D Artificial Skin Platform could better represent the tendency of melanin expression in pregnant women than cells cultured under the same conditions in 2D. The expression levels of melanin and melanin-related genes in the 2D cell culture did not show a significant trend that was similar to the melanin expression trend in pregnant women. However, the 3D artificial skin platform showed a significant trend towards a 2-6-fold increase in melanin expression in response to low oxygen concentrations (2.5%) and E2 concentrations (17 ng/mL), which was similar to the trend in pregnant women in vivo. These results suggest that 3D artificial skin cultured on the Artificial Skin Platform has the potential to be used as a substitute for human pregnant skin in various research fields related to the treatment of pigmentation.
Collapse
Affiliation(s)
- Uiechan Jeong
- Department of Mechanical Engineering, Inha University, 100 Inha-ro, Incheon 22212, Republic of Korea;
| | - Sunhee Yoon
- Department of Biological Sciences and Bioengineering, Inha University, 100 Inha-ro, Incheon 22212, Republic of Korea;
| | - Sungjin Park
- Department of Mechanical and System Design Engineering, Hongik University, 94 Wausan-ro, Seoul 04066, Republic of Korea;
| | - Tae-Joon Jeon
- Department of Biological Sciences and Bioengineering, Inha University, 100 Inha-ro, Incheon 22212, Republic of Korea;
- Department of Biological Engineering, Inha University, 100 Inha-ro, Incheon 22212, Republic of Korea
| | - Sun Min Kim
- Department of Mechanical Engineering, Inha University, 100 Inha-ro, Incheon 22212, Republic of Korea;
- Department of Biological Sciences and Bioengineering, Inha University, 100 Inha-ro, Incheon 22212, Republic of Korea;
| |
Collapse
|
2
|
Reference intervals for thyroid hormone, sex hormone, and clinical biochemical tests in cord blood from Taiwanese newborn - TMICS cohort. Clin Chim Acta 2023; 541:117247. [PMID: 36754192 DOI: 10.1016/j.cca.2023.117247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND/PURPOSE This study aims to establish reference intervals for important biochemical parameters in cord blood of newborn male and female infants in Taiwan and to investigate their sex difference. We also examined the correlation of the same markers between maternal blood levels and neonatal cord blood levels. METHODS 2,136 pregnant women receiving regular routine prenatal health assessments in their third trimester (weeks 29-40) were recruited from nine hospitals in Taiwan between 2012 and 2015. After exclusion, we were left with 580 cord blood samples to include in this study. RESULTS Cord blood thyroid-stimulating hormone was higher in males than females (p < 0.05). Males also had significantly higher sex hormone levels (estradiol, follicle-stimulating hormone, and sex hormone-binding globulin), while females had higher levels of luteinizing hormone. Male newborns had higher cord blood immunoglobulin E (IgE), while females had higher insulin-like growth factor-1 (IGF-1) levels. We found a slight positive link between maternal blood and cord blood in thyroid hormones and sex hormones. CONCLUSION This study found sex differences in cord blood thyroid hormone, sex hormone, IGF-1, and IgE levels and a link between maternal blood levels of thyroid and sex hormones and those in the cord blood of their infants.
Collapse
|
3
|
Firestein MR, Romeo RD, Winstead H, Goldman DA, Grobman WA, Haas D, Mercer B, Parker C, Parry S, Reddy U, Silver R, Simhan H, Wapner RJ, Champagne FA. Elevated prenatal maternal sex hormones, but not placental aromatase, are associated with child neurodevelopment. Horm Behav 2022; 140:105125. [PMID: 35131524 DOI: 10.1016/j.yhbeh.2022.105125] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 01/08/2023]
Abstract
Fetal exposure to testosterone may contribute to vulnerability for autism spectrum disorder (ASD). It is hypothesized that placental aromatase prevents fetal exposure to maternal testosterone, however, this pathway and the implications for child neurodevelopment have not been fully explored. We examined the relationships between prenatal maternal testosterone and estradiol at 19.2 ± 1.3 weeks, cord blood testosterone and estradiol at birth, placental aromatase mRNA expression, and neurodevelopment using the Social Communication Questionnaire (SCQ), the Behavioral Assessment System for Children, 3rd Edition (BASC-3), and the Empathizing Quotient for Children (EQ-C) at 4.5-6.5 years of age in a sample of 270 Nulliparous-Mothers-to-be (nuMoM2b) study participants. Maternal testosterone levels were positively associated with SCQ scores, but the association was not significant after adjusting for maternal age at delivery, nor was there a significant interaction with sex. Maternal estradiol levels were negatively associated with BASC-3 Clinical Probability scores among males (n = 139). We report a significant interaction effect of cord blood testosterone and fetal sex on both total SCQ scores and t-scores on the Developmental Social Disorders subscale. Placental aromatase was not associated with any neurodevelopmental or hormone measure, but under conditions of low placental aromatase expression, high maternal testosterone was positively associated with SCQ scores in males (n = 46). No other associations between hormone levels and neurodevelopment were significant. Our findings provide a foundation for further investigation of the mechanisms through which maternal sex hormones and placental steroidogenesis may affect fetal hormone production and neurobehavior.
Collapse
Affiliation(s)
- Morgan R Firestein
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
| | - Russell D Romeo
- Departments of Psychology and Neuroscience and Behavior, Barnard College of Columbia University, New York, NY, USA
| | | | - Danielle A Goldman
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, USA
| | - William A Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - David Haas
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Brian Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA
| | | | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Uma Reddy
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Robert Silver
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Hyagriv Simhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ronald J Wapner
- Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, NY, USA
| | | |
Collapse
|
4
|
Test of the auricular surface sex estimation method in fetuses and non-adults under 5 years old from the Lisbon and Granada Reference Collections. Int J Legal Med 2020; 135:993-1003. [PMID: 32990776 DOI: 10.1007/s00414-020-02431-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
Non-adult sex estimation is an active field of forensic inquiry as morphological variations between males and females are subtle, but observable, even from intrauterine development. The objectives of this study are threefold: to test the validity of the auricular surface method for sex estimation (Int J Osteoarchaeol 27:898-911, 2017) in fetuses and children under the age of 5 years old; to evaluate if health conditions, reported as the cause of death, influence its accuracy; and to detect possible secular trends in sexual dimorphism. One-hundred and ninety-seven skeletal individuals from the Lisbon and Granada Identified Collections were studied. Individuals were divided according to the hormonal peaks (< 0, 0-2, < 2, and 2.1-5 years old), cause, and year of death (before and after 1960). As in previous studies, two ratios (FI/CF and DE/AD) and two qualitative variables (OM and MRS) showed the highest frequencies of correct estimation (0.81-0.86). The correct sex allocations increased when the discriminant function (0.85) and logistic regression (0.86) were applied. Males of the age groups < 0 and 2.1-5 years were all correctly sexed by both formulae, and the same was observed for the female probabilities of adequate allocation. The cause and year of death were identified as variables without statistical significance. It is proposed that this method can be incorporated with confidence into the multifactorial laboratory protocols for non-adult sex estimation from skeletal remains.
Collapse
|
5
|
Monge Calleja ÁM, Aranda CM, Santos AL, Luna LH. Evaluation of the auricular surface method for non‐adult sex estimation on the Lisbon documented collection. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 172:500-510. [DOI: 10.1002/ajpa.24012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/23/2019] [Accepted: 01/07/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Álvaro M. Monge Calleja
- Centro de Investigação em Antropologia e Saúde (CIAS), Department of Life SciencesUniversity of Coimbra Coimbra Portugal
| | - Claudia M. Aranda
- Faculty of OdontologyUniversity of Buenos Aires Buenos Aires Argentina
| | - Ana Luísa Santos
- Centro de Investigação em Antropologia e Saúde (CIAS), Department of Life SciencesUniversity of Coimbra Coimbra Portugal
| | - Leandro H. Luna
- CONICET‐IMHICIHUMultidisciplinary Institute of History and Human Sciences Buenos Aires Argentina
| |
Collapse
|
6
|
Allvin K, Ankarberg-Lindgren C, Niklasson A, Jacobsson B, Dahlgren J. Altered umbilical sex steroids in preterm infants born small for gestational age. J Matern Fetal Neonatal Med 2019; 33:4164-4170. [PMID: 30895831 DOI: 10.1080/14767058.2019.1598362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Boys born small for gestational age (SGA) are at increased risk of testicular dysgenesis syndrome, and girls born SGA face the risk of polycystic ovary syndrome later in life. Our aim was to study whether neonates born SGA have an altered profile of steroid hormones at birth.Materials and methods: A total of 168 singletons (99 boys, 69 girls) born at 32.0-36.9 gestational weeks were recruited to a population-based, university hospital, single-center study. Of these, 31 infants (17 boys, 14 girls) were born SGA. The concentrations of dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, dihydrotestosterone, estrone, estradiol, cortisone, and cortisol were analyzed in umbilical cord serum with mass spectrometry.Results: Girls born SGA had higher levels of androstenedione than girls born appropriate for gestational age (AGA) (4.0 versus 2.6 nmol/L, p = .002). Boys born SGA had lower levels of estrone than boys born AGA (33 822 versus 62 471 pmol/L, p = .038). Infants born SGA had lower levels of cortisone than infants born AGA, both in girls (340 versus 579 nmol/L, p = .010) and in boys (308 versus 521 nmol/L, p = .045). Furthermore, boys born SGA had a higher cortisol/cortisone ratio than boys born AGA (0.41 versus 0.25, p = .028). Gestational age correlated with DHEAS (boys r = 0.48, p = .000, girls r = 0.35, p = .013), and cortisol (boys r = 0.48, p = .000, girls r = 0.29, p = .039).Conclusions: In moderate-to-late preterm infants born SGA, we observed a different steroid hormone profile in cord serum. Girls born SGA show increased levels of androstenedione and boys born SGA show decreased levels of estrone in cord serum, which could be related to placental aromatase deficiency in intrauterine growth restriction.
Collapse
Affiliation(s)
- Kerstin Allvin
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Carina Ankarberg-Lindgren
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Aimon Niklasson
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
7
|
Constantinescu M, Moore DS, Johnson SP, Hines M. Early contributions to infants’ mental rotation abilities. Dev Sci 2017; 21:e12613. [DOI: 10.1111/desc.12613] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 07/21/2017] [Indexed: 01/16/2023]
Affiliation(s)
| | - David S. Moore
- Psychology Field Group; Pitzer College and Claremont Graduate University; Claremont CA USA
| | - Scott P. Johnson
- Department of Psychology; University of California; Los Angeles CA USA
| | - Melissa Hines
- Department of Psychology; University of Cambridge; Cambridge UK
| |
Collapse
|
8
|
Whitehouse AJO, Gilani SZ, Shafait F, Mian A, Tan DW, Maybery MT, Keelan JA, Hart R, Handelsman DJ, Goonawardene M, Eastwood P. Prenatal testosterone exposure is related to sexually dimorphic facial morphology in adulthood. Proc Biol Sci 2016; 282:20151351. [PMID: 26400740 DOI: 10.1098/rspb.2015.1351] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Prenatal testosterone may have a powerful masculinizing effect on postnatal physical characteristics. However, no study has directly tested this hypothesis. Here, we report a 20-year follow-up study that measured testosterone concentrations from the umbilical cord blood of 97 male and 86 female newborns, and procured three-dimensional facial images on these participants in adulthood (range: 21-24 years). Twenty-three Euclidean and geodesic distances were measured from the facial images and an algorithm identified a set of six distances that most effectively distinguished adult males from females. From these distances, a 'gender score' was calculated for each face, indicating the degree of masculinity or femininity. Higher cord testosterone levels were associated with masculinized facial features when males and females were analysed together (n = 183; r = -0.59), as well as when males (n = 86; r = -0.55) and females (n = 97; r = -0.48) were examined separately (p-values < 0.001). The relationships remained significant and substantial after adjusting for potentially confounding variables. Adult circulating testosterone concentrations were available for males but showed no statistically significant relationship with gendered facial morphology (n = 85, r = 0.01, p = 0.93). This study provides the first direct evidence of a link between prenatal testosterone exposure and human facial structure.
Collapse
Affiliation(s)
- Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia
| | - Syed Zulqarnain Gilani
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Faisal Shafait
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia School of Electrical Engineering and Computer Science, National University of Science and Technology, Islamabad, Pakistan
| | - Ajmal Mian
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Diana Weiting Tan
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia Neurocognitive Development Unit, School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Murray T Maybery
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Jeffrey A Keelan
- School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Roger Hart
- School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney, Concord Hospital, New South Wales 2139, Australia
| | - Mithran Goonawardene
- School of Dentistry/Oral Health Centre of Western Australia, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| |
Collapse
|
9
|
Whitehouse AJO, Gilani SZ, Shafait F, Mian A, Tan DW, Maybery MT, Keelan JA, Hart R, Handelsman DJ, Goonawardene M, Eastwood P. Prenatal testosterone exposure is related to sexually dimorphic facial morphology in adulthood. Proc Biol Sci 2015. [PMID: 26400740 DOI: 10.1098/rspb.2015.1351.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Prenatal testosterone may have a powerful masculinizing effect on postnatal physical characteristics. However, no study has directly tested this hypothesis. Here, we report a 20-year follow-up study that measured testosterone concentrations from the umbilical cord blood of 97 male and 86 female newborns, and procured three-dimensional facial images on these participants in adulthood (range: 21-24 years). Twenty-three Euclidean and geodesic distances were measured from the facial images and an algorithm identified a set of six distances that most effectively distinguished adult males from females. From these distances, a 'gender score' was calculated for each face, indicating the degree of masculinity or femininity. Higher cord testosterone levels were associated with masculinized facial features when males and females were analysed together (n = 183; r = -0.59), as well as when males (n = 86; r = -0.55) and females (n = 97; r = -0.48) were examined separately (p-values < 0.001). The relationships remained significant and substantial after adjusting for potentially confounding variables. Adult circulating testosterone concentrations were available for males but showed no statistically significant relationship with gendered facial morphology (n = 85, r = 0.01, p = 0.93). This study provides the first direct evidence of a link between prenatal testosterone exposure and human facial structure.
Collapse
Affiliation(s)
- Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia
| | - Syed Zulqarnain Gilani
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Faisal Shafait
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia School of Electrical Engineering and Computer Science, National University of Science and Technology, Islamabad, Pakistan
| | - Ajmal Mian
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Diana Weiting Tan
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia Neurocognitive Development Unit, School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Murray T Maybery
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Jeffrey A Keelan
- School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Roger Hart
- School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney, Concord Hospital, New South Wales 2139, Australia
| | - Mithran Goonawardene
- School of Dentistry/Oral Health Centre of Western Australia, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| |
Collapse
|
10
|
Hollier LP, Keelan JA, Jamnadass ESL, Maybery MT, Hickey M, Whitehouse AJO. Adult digit ratio (2D:4D) is not related to umbilical cord androgen or estrogen concentrations, their ratios or net bioactivity. Early Hum Dev 2015; 91:111-7. [PMID: 25594498 DOI: 10.1016/j.earlhumdev.2014.12.011] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/17/2014] [Accepted: 12/28/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ratio of second digit length to fourth digit length (2D:4D) has been extensively used in human and experimental research as a marker of fetal sex steroid exposure. However, very few human studies have measured the direct relationship between fetal androgen or estrogen concentrations and digit ratio. AIMS We investigated the relationships between both androgen and estrogen concentrations in umbilical cord blood and digit ratio in young adulthood. In addition we calculated measures of total serum androgen and total estrogen bioactivity and investigated their relationship to digit ratio. STUDY DESIGN Prospective cohort study. SUBJECTS An unselected subset of the Western Australian Pregnancy Cohort (Raine) Study (159 female; 182 male). OUTCOME MEASURES Cord serum samples were collected immediately after delivery. Samples were assayed for androgen (testosterone, Δ4-androstenedione, dehydroepiandrosterone) and estrogen (estrone, estradiol, estriol, estetrol) concentrations using liquid-chromatography mass-spectrometry. Digit ratio measurements were taken from hand photocopies at age 19-22years. RESULTS For both males and females, there were no significant correlations between digit ratio and any androgen or estrogen concentrations considered individually, the testosterone to estradiol ratio, total androgen bioactivity measure or ratio of androgen to estrogen bioactivity (all p>.05). In males, but not females, total estrogen bioactivity was negatively correlated with left hand digit ratio (r=-.172, p=.02), but this relationship was no longer significant when adjusted for variables known to affect sex steroid concentrations in cord blood. CONCLUSIONS Our findings indicate that digit ratio is not related to fetal androgens or estrogens at late gestation.
Collapse
Affiliation(s)
- Lauren P Hollier
- Telethon Kids Institute, University of Western Australia, Australia; Neurocognitive Development Unit, School of Psychology, University of Western Australia, Australia.
| | - Jeffrey A Keelan
- School of Women's and Infant's Health, University of Western Australia, Australia
| | - Esha S L Jamnadass
- Telethon Kids Institute, University of Western Australia, Australia; Neurocognitive Development Unit, School of Psychology, University of Western Australia, Australia
| | - Murray T Maybery
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Victoria, Australia
| | | |
Collapse
|
11
|
Hollier LP, Maybery MT, Keelan JA, Hickey M, Whitehouse AJO. Perinatal testosterone exposure and cerebral lateralisation in adult males: evidence for the callosal hypothesis. Biol Psychol 2014; 103:48-53. [PMID: 25148786 DOI: 10.1016/j.biopsycho.2014.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 08/13/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
Abstract
Two competing theories address the influence of foetal testosterone on cerebral laterality: one proposing exposure to high foetal testosterone concentrations is related to atypical lateralisation (Geschwind-Galaburda hypothesis), the other that high foetal testosterone concentrations exaggerate typical lateralisation (callosal hypothesis). The current study examined the relationship between cord testosterone concentrations and cerebral laterality for language and spatial memory in adulthood. Male participants with high (>0.15nmol) and low (<0.10nmol) cord testosterone levels were invited to take part in the study (n=18 in each group). Cerebral laterality was measured using functional Transcranial Doppler ultrasonography, while participants completed word generation and visual short-term memory tasks. Typical left lateralisation of language was more common in the high-testosterone group than in the low-testosterone group, χ(2)=4.50, df=1, p=034. Spatial memory laterality was unrelated to cord testosterone level. Our findings indicate that foetal testosterone exposure is related to language laterality in a direction that supports the callosal hypothesis.
Collapse
Affiliation(s)
- Lauren P Hollier
- Telethon Kids Institute, University of Western Australia, Australia; Neurocognitive Development Unit, School of Psychology, University of Western Australia, Australia.
| | - Murray T Maybery
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, Australia
| | - Jeffrey A Keelan
- School of Women's and Infant's Health, University of Western Australia, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Victoria, Australia
| | | |
Collapse
|
12
|
Hollier LP, Keelan JA, Hickey M, Maybery MT, Whitehouse AJO. Measurement of androgen and estrogen concentrations in cord blood: accuracy, biological interpretation, and applications to understanding human behavioral development. Front Endocrinol (Lausanne) 2014; 5:64. [PMID: 24829559 PMCID: PMC4014673 DOI: 10.3389/fendo.2014.00064] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/14/2014] [Indexed: 01/12/2023] Open
Abstract
Accurately measuring hormone exposure during prenatal life presents a methodological challenge and there is currently no "gold standard" approach. Ideally, circulating fetal hormone levels would be measured at repeated time points during pregnancy. However, it is not currently possible to obtain fetal blood samples without significant risk to the fetus, and therefore surrogate markers of fetal hormone levels must be utilized. Umbilical cord blood can be readily obtained at birth and largely reflects fetal circulation in late gestation. This review examines the accuracy and biological interpretation of the measurement of androgens and estrogens in cord blood. The use of cord blood hormones to understand and investigate human development is then discussed.
Collapse
Affiliation(s)
- Lauren P. Hollier
- Telethon Kids Institute, University of Western Australia, Subiaco, WA, Australia
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, Crawley, WA, Australia
| | - Jeffrey A. Keelan
- School of Women’s and Infants’ Health, University of Western Australia, Crawley, WA, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia
| | - Murray T. Maybery
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, Crawley, WA, Australia
| | | |
Collapse
|
13
|
Hickey M, Hart R, Keelan JA. The relationship between umbilical cord estrogens and perinatal characteristics. Cancer Epidemiol Biomarkers Prev 2014; 23:946-52. [PMID: 24636976 DOI: 10.1158/1055-9965.epi-13-1321] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prenatal estrogen exposure is thought to contribute to later life diseases such as breast cancer. However, few studies have directly measured prenatal estrogens and most have relied on proposed "markers" of estrogen exposure. We used a large population-based birth cohort to directly measure the relationship between prenatal estrogens and perinatal characteristics, including putative markers of estrogen exposure. METHODS Total estrone (E1), estradiol (E2), estriol (E3), and estetrol (E4) were assayed by liquid chromatography/tandem mass spectrometry from archived mixed arterial and venous serum from 860 umbilical cord blood samples. RESULTS Values for all estrogens were strongly intercorrelated. Cord estrogen concentrations did not differ between males and females. Levels of all estrogens were reduced in twins and concentrations increased with gestational age. Neither E1 nor E2 was correlated with birth weight, but E3 and E4 levels correlated weakly, whereas onset of labor was associated with higher estrogen concentrations. E1 and E2 concentrations were not associated with preeclampsia in the current pregnancy, but E3 and E4 concentrations were lower in pregnancies complicated by preeclampsia and antepartum hemorrhage. CONCLUSIONS Umbilical cord estrogen concentrations vary with gestational age, mode of delivery, pregnancy complications, and twinning, but not with infant sex. Putative markers of prenatal estrogen exposure, preeclampsia, and birth weight did not correlate with direct fetal measures of the most potent estrogen (E2) but were associated with weaker estrogens (E3 and E4). Twins had lower concentrations of all estrogens. IMPACT This is the largest and best characterized dataset of prenatal estrogen concentrations, measured using highly accurate mass spectrometry/spectroscopy. These observations represent the new "gold standard" for umbilical cord estrogens, and will inform the interpretation of other datasets and the early life origins of health and disease. Cancer Epidemiol Biomarkers Prev; 23(6); 946-52. ©2014 AACR.
Collapse
Affiliation(s)
- Martha Hickey
- Authors' Affiliations: Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
| | - Roger Hart
- Authors' Affiliations: Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
| | - Jeffrey A Keelan
- Authors' Affiliations: Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
| |
Collapse
|
14
|
Whitehouse AJO, Mattes E, Maybery MT, Dissanayake C, Sawyer M, Jones RM, Pennell CE, Keelan JA, Hickey M. Perinatal testosterone exposure and autistic-like traits in the general population: a longitudinal pregnancy-cohort study. J Neurodev Disord 2012; 4:25. [PMID: 23110806 PMCID: PMC3500651 DOI: 10.1186/1866-1955-4-25] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 10/01/2012] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED BACKGROUND Increased prenatal testosterone exposure has been hypothesized as a mechanism underlying autism spectrum disorders (ASD). However, no studies have prospectively measured prenatal testosterone exposure and ASD. The current study sought to determine whether testosterone concentrations in umbilical cord blood are associated with a clinical diagnosis of ASD in a small number of children and with autistic-like traits in the general population. METHODS Umbilical cord blood was collected from 707 children. Samples were analyzed for total (TT) and bioavailable (BioT) testosterone concentrations. Parent report indicated that five individuals had a clinical diagnosis of ASD. Those participants without a diagnosis were approached in early adulthood to complete the Autism-Spectrum Quotient (AQ), a self-report measure of autistic-like traits, with 184 males (M = 20.10 years; SD= 0.65 years) and 190 females (M = 19.92 years; SD=0.68 years) providing data. RESULTS The BioT and TT concentrations of the five children diagnosed with ASD were within one standard-deviation of the sex-specific means. Spearman's rank-order coefficients revealed no significant correlations between TT levels and scores on any AQ scale among males (rho range: -.01 to .06) or females (rho value range: -.07 to .01). There was also no significant association between BioT or TT concentrations and AQ scores among males (rho value range: -.07 to .08) or females (rho value range: -.06 to .12). Males were more likely than females to have 'high' scores (upper decile) on the AQ scale relating pattern and detail processing. However, the likelihood of a high score on this scale was unrelated to BioT and TT concentrations in both males and females. CONCLUSIONS These findings indicate that testosterone concentrations from umbilical cord blood are unrelated to autistic-like traits in the general population. However, the findings do not exclude an association between testosterone exposure in early intrauterine life and ASD.
Collapse
Affiliation(s)
- Andrew JO Whitehouse
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008, Australia
| | - Eugen Mattes
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008, Australia
| | - Murray T Maybery
- School of Psychology, University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia, 6009, Australia
| | - Cheryl Dissanayake
- School of Psychological Science, La Trobe University, Melbourne, Victoria, 3086, Australia
| | - Michael Sawyer
- Discipline of Paediatrics, University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Rachel M Jones
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008, Australia
| | - Craig E Pennell
- School of Women’s and Infants’ Health, University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia, 6009, Australia
| | - Jeffrey A Keelan
- School of Women’s and Infants’ Health, University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia, 6009, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Royal Women’s Hospital, Cnr of Flemington Road and Grattan Street, Parkville, Victoria, 3052, Australia
| |
Collapse
|
15
|
Zlotnik A, Tsesis S, Gruenbaum BF, Ohayon S, Gruenbaum SE, Boyko M, Sheiner E, Brotfain E, Shapira Y, Teichberg VI. Relationship between glutamate, GOT and GPT levels in maternal and fetal blood: a potential mechanism for fetal neuroprotection. Early Hum Dev 2012; 88:773-8. [PMID: 22633534 DOI: 10.1016/j.earlhumdev.2012.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 04/11/2012] [Accepted: 05/04/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Excess glutamate in the brain is thought to be implicated in the pathophysiology of fetal anoxic brain injury, yet little is known about the mechanisms by which glutamate is regulated in the fetal brain. This study examines whether there are differences between maternal and fetal glutamate concentrations, and whether a correlation between them exists. METHODS 10 ml of venous blood was extracted from 87 full-term (>37 weeks gestation) pregnant women in active labor. Immediately after delivery of the neonate, 10 ml of blood from the umbilical artery and vein was extracted. Samples were analyzed for levels of glutamate, glutamate-oxaloacetate transaminase (GOT), and glutamate pyruvate transaminase (GPT). RESULTS Fetal blood glutamate concentrations in both the umbilical artery and vein were found to be significantly higher than maternal blood (p<0.001). Similarly, fetal serum GOT levels in the umbilical artery and vein were found to be significantly higher than maternal GOT levels (p<0.001). The difference in GPT levels between maternal and fetal serum was not statistically significant. There was no difference in fetal glutamate, GOT or GPT between the umbilical artery and vein. There was an association observed between glutamate levels in maternal blood and glutamate levels in both venous (R=0.32, p<0.01) and arterial (R=0.33, p<0.05) fetal blood. CONCLUSIONS This study demonstrated that higher baseline concentrations of blood glutamate are present in fetal blood compared with maternal blood, and this was associated with elevated GOT, but not GPT levels. An association was observed between maternal and fetal blood glutamate levels.
Collapse
Affiliation(s)
- Alexander Zlotnik
- Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben Gurion University of the Negev, Faculty of Health Sciences, Beer Sheva, Israel.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Whitehouse AJO, Mattes E, Maybery MT, Sawyer MG, Jacoby P, Keelan JA, Hickey M. Sex-specific associations between umbilical cord blood testosterone levels and language delay in early childhood. J Child Psychol Psychiatry 2012; 53:726-34. [PMID: 22276678 DOI: 10.1111/j.1469-7610.2011.02523.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Preliminary evidence suggests that prenatal testosterone exposure may be associated with language delay. However, no study has examined a large sample of children at multiple time-points. METHODS Umbilical cord blood samples were obtained at 861 births and analysed for bioavailable testosterone (BioT) concentrations. When participating offspring were 1, 2 and 3 years of age, parents of 767 children (males = 395; females = 372) completed the Infant Monitoring Questionnaire (IMQ), which measures Communication, Gross Motor, Fine Motor, Adaptive and Personal-Social development. Cut-off scores are available for each scale at each age to identify children with 'clinically significant' developmental delays. Chi-square analyses and generalized estimating equations examined longitudinal associations between sex-specific quartiles of BioT concentrations and the rate of developmental delay. RESULTS Significantly more males than females had language delay (Communication scale) at age 1, 2 and 3 years (p-values ≤. 01). Males were also more likely to be classified as delayed on the Fine-Motor (p = .04) and Personal-Social (p < .01) scales at age 3 years. Chi-square analyses found a significant difference between BioT quartiles in the rate of language delay (but not Fine-Motor and Personal-Social delay) for males (age 3) and females (age 1 and 3). Generalized estimating equations, incorporating a range of sociodemographic and obstetric variables, found that males in the highest BioT quartile were at increased risk for a clinically significant language delay during the first 3 years of life, with an odds ratio (OR) of 2.47 (95% CI: 1.12, 5.47). By contrast, increasing levels of BioT reduced the risk of language delay among females (Quartile 2: OR = 0.23, 95% CI: 0.09, 0.59; Quartile 4: 0.46, 95% CI: 0.21, 0.99). CONCLUSION These data suggest that high prenatal testosterone levels are a risk factor for language delay in males, but may be a protective factor for females.
Collapse
Affiliation(s)
- Andrew J O Whitehouse
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, WA 6008, Australia.
| | | | | | | | | | | | | |
Collapse
|
17
|
Barry JA, Hardiman PJ, Siddiqui MR, Thomas M. Meta-analysis of sex difference in testosterone levels in umbilical cord blood. J OBSTET GYNAECOL 2012; 31:697-702. [PMID: 22085057 DOI: 10.3109/01443615.2011.614971] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This meta-analysis reviewed published literature comparing human male and female umbilical cord total testosterone (T) levels. A total of 18 studies using 1,229 samples from 602 male and 627 female newborns were analysed using the RevMan 5 statistical package. Analysis using the inverse variance method based on a random-effects model revealed significantly higher cord T in boys than girls at a moderate effect size (Hedges' g = 0.57). There was significant heterogeneity between the 18 studies, although the five studies using direct assays showed no heterogeneity. For studies using extraction and chromatography, those that combined T from arterial and venous cord blood found a larger sex difference than those using only cord venous samples (Hedges' g = 0.94 vs 0.32); this suggests umbilical cord venous T is of maternal/placental origin and arterial T is of fetal origin. The wide range of T values between studies suggests high cross-reactivity in the assay methods reviewed.
Collapse
Affiliation(s)
- J A Barry
- Department of Psychology, City University, University, London EC1V 0HB, UK.
| | | | | | | |
Collapse
|
18
|
Carlsen S, Vanky E. Metformin influence on hormone levels at birth, in PCOS mothers and their newborns. Hum Reprod 2009; 25:786-90. [DOI: 10.1093/humrep/dep444] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
19
|
van Leeuwen P, Schiermeier S, Lange S, Klein A, Geue D, Hatzmann W, Grönemeyer DHW. Gender-related changes in magnetocardiographically determined fetal cardiac time intervals in intrauterine growth retardation. Pediatr Res 2006; 59:820-4. [PMID: 16641208 DOI: 10.1203/01.pdr.0000219300.95218.bb] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Prenatal growth deficiencies as well as gender have been associated with cardiovascular disease in later life. It is also known that the duration of fetal cardiac time intervals (CTI) are dependent on fetal development. The aim of this work was to examine the relationship between fetal CTI in healthy and intrauterine growth retardation (IUGR) fetuses, taking gender into account. A total of 269 magnetocardiograms (MCG) were obtained in 47 healthy and 27 IUGR pregnancies. In each signal-averaged MCG, durations of CTI were determined. Age- and heart rate-corrected values were compared between normal and IUGR fetuses separately with respect to gender. Overall, there was an association between atrial and ventricular conduction times and estimated fetal body weight. In female fetuses, IUGR was associated with shorter P WAVE, PQ segment, PR interval, and QRS complex and longer STT and QT intervals. For males, this was so only for P wave, QRS complex, and STT interval. The shortening of conduction times in IUGR may be explained by reduced cardiac muscle mass associated with lower body weight. On the other hand, the gender-specific differences, particularly in the IUGR fetuses may be due to hormonal factors.
Collapse
Affiliation(s)
- Peter van Leeuwen
- Department of Biomagnetism, Grönemeyer Institute of Microtherapy, University Witten/Herdecke, 44799 Bochum, Germany.
| | | | | | | | | | | | | |
Collapse
|
20
|
Muttukrishna S, Jauniaux E, McGarrigle H, Groome N, Rodeck CH. In-vivo concentrations of inhibins, activin A and follistatin in human early pregnancy. Reprod Biomed Online 2004; 8:712-9. [PMID: 15169590 DOI: 10.1016/s1472-6483(10)61653-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aims of this study were to investigate the relationship between inhibins, activin A and follistatin in first trimester fetal fluids, maternal serum, placenta and decidua, and to investigate if these hormones are present in the circulation of the early second trimester human fetus. Amniotic and coelomic fluid, maternal serum, placental villi and decidual tissue were obtained from normal pregnancies at 8-12 weeks. Fetal blood by cardiocentesis and maternal blood were collected at 14-16 weeks gestation. Placental extracts had higher concentrations of inhibins, activin A and follistatin compared with decidual extracts. In the second trimester, inhibins and follistatin were detectable in fetal blood at 14-16 weeks gestation. Maternal serum concentrations of inhibin A (P < 0.001) and follistatin (P < 0.05) were significantly higher than fetal serum whereas inhibin B (P < 0.01) and pro-alpha C concentrations (P < 0.001) were higher in fetal serum. Inhibin B concentrations were also higher in male fetal serum samples that had higher concentrations of testosterone. The presence of all molecular forms of inhibins, activin A and follistatin in the first trimester fetal fluids, placental and decidual extracts in the first trimester confirms other reports. In the second trimester, high concentrations of inhibin B with testosterone in the fetal circulation indicate that these hormones may interact in the development of the male fetal gonads.
Collapse
Affiliation(s)
- S Muttukrishna
- Department of Obstetrics and Gynaecology, RFUC Medical School, 86-96 Chenies Mews, London WC1E 6HX, UK.
| | | | | | | | | |
Collapse
|
21
|
Hrabovszky Z, Hutson JM. Androgen imprinting of the brain in animal models and humans with intersex disorders: review and recommendations. J Urol 2002; 168:2142-8. [PMID: 12394744 DOI: 10.1016/s0022-5347(05)64338-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Psychosexual development, gender assignment and surgical treatment in patients with intersex are controversial issues in the medical literature. Some groups are of the opinion that gender identity and sexual orientation are determined prenatally secondary to the fetal hormonal environment causing irreversible development of the nervous system. We reviewed the evidence in animal and human studies to determine the possible role of early postnatal androgen production in gender development. MATERIALS AND METHODS An extensive literature review was performed of data from animal experiments and human studies. RESULTS Many animal studies show that adding or removing hormonal stimulus in early postnatal life can profoundly alter gender behavior of the adult animal. Human case studies show that late intervention is unable to reverse gender orientation from male to female. Most studies have not permitted testing of whether early gender assignment and treatment as female with suppression/ablation of postnatal androgen production leads to improved concordance of the gender identity and sex of rearing. CONCLUSIONS Animal studies support a role for postnatal androgens in brain/behavior development with human studies neither completely supportive nor antagonistic. Therefore, gender assignment in infants with intersex should be made with the possibility in mind that postnatal testicular hormones at ages 1 to 6 months may affect gender identity. A case-control study is required to test the hypothesis that postnatal androgen exposure may convert ambisexual brain functions to committed male behavior patterns.
Collapse
Affiliation(s)
- Zoltan Hrabovszky
- Surgical Department, Royal Children's Hospital, Melbourne, Victoria, Australia
| | | |
Collapse
|
22
|
Androgen Imprinting of the Brain in Animal Models and Humans With Intersex Disorders: Review and Recommendations. J Urol 2002. [DOI: 10.1097/00005392-200211000-00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
|
23
|
Trotter A, Maier L, Pohlandt F. Management of the extremely preterm infant: is the replacement of estradiol and progesterone beneficial? Paediatr Drugs 2002; 3:629-37. [PMID: 11688594 DOI: 10.2165/00128072-200103090-00001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This review presents data to suggest that postnatal estradiol and progesterone replacement therapy may be beneficial in preterm infants. During pregnancy, maternal plasma levels of estradiol and progesterone increase up to 100-fold compared to the nonpregnant status. The fetus is also exposed to these increasing hormone levels. After delivery, estradiol and progesterone levels drop by a factor of 100 within 1 day. Whereas this is a physiological condition for an infant born at term, preterm delivery means withdrawal from the placental supply of these hormones at an earlier developmental stage. Seventy years ago, the idea was raised that preterm infants may benefit from the replacement of estrogens. Studies in which estrogen was injected subcutaneously showed only a slightly better bodyweight gain compared to placebo-treated controls and therefore routine use was not established. The effective treatment of postmenopausal osteoporosis with hormone replacement therapy led to a pilot study of estradiol and progesterone therapy to prevent osteopenia of prematurity. The highest median bone mineral accretion rate was found in the replacement group when the supplementation with calcium and phosphorus was also sufficient. None of the previous studies dealing with estrogen replacement controlled for achieved plasma levels of estradiol in the infants. In our controlled randomised pilot study with 30 preterm infants (15 in each group), we aimed to maintain intra-uterine plasma levels of estradiol and progesterone. Preterm infants with replacement of estradiol and progesterone for 6 weeks postnatally showed trends to higher bone mineral accumulation. In addition, a trend towards a lower incidence of chronic lung disease was found. Neurodevelopmental follow-up showed normal psychomotor development in infants given estradiol and progesterone, whereas the untreated infants (controls) showed a trend towards delayed development. Recent research emphasises that estradiol and progesterone may be important for brain development. Thus, while there is data indicating that postnatal estradiol and progesterone replacement therapy may be beneficial in preterm infants, experience with this new therapy is limited and extensive research is needed to address the potential benefits and to rule out adverse effects.
Collapse
Affiliation(s)
- A Trotter
- Section of Neonatology and Paediatric Critical Care Medicine, Children's Hospital, University of Ulm, Germany.
| | | | | |
Collapse
|
24
|
Trotter A, Maier L, Kohn T, Böhm W, Pohlandt F. Growth of the uterus and mammary glands and vaginal cytologic features in extremely premature infants with postnatal replacement of estradiol and progesterone. Am J Obstet Gynecol 2002; 186:184-8. [PMID: 11854632 DOI: 10.1067/mob.2002.119641] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Growth of the uterus and the mammary glands and changes in vaginal cytologic features are known to be estrogen dependent and were evaluated to proof the biologic effectiveness of a postnatal replacement of estradiol and progesterone in extremely premature infants. STUDY DESIGN Thirty female infants with a mean gestational age of 26.4 weeks (24.1-28.7 weeks) and a mean birth weight of 708 g (370-990 g) were investigated. Fifteen infants received postnatal replacement of estradiol and progesterone for 6 weeks to maintain intrauterine plasma levels of estradiol and progesterone. Uterine size and the diameter of mammary glands were assessed repeatedly by ultrasound scans and palpation. Vaginal smears were also obtained. RESULTS The uterus and mammary glands showed significant growth during the hormone replacement, but growth was not observed in nontreated infants. Vaginal smears showed high karyopyknotic and eosinophilic indices in both groups at birth; the indices remained significantly higher at 3 and 6 weeks in the hormone-treated infants. CONCLUSION The biologic effectiveness of postnatal estradiol and progesterone replacement in extremely premature infants was proved.
Collapse
Affiliation(s)
- Andreas Trotter
- Section of Neonatology and Pediatric Critical Care Medicine, Children's Hospital, University of Ulm, Germany.
| | | | | | | | | |
Collapse
|
25
|
Abstract
The idea of replacing 17beta-oestradiol (E2) and progesterone (P) in preterm infants is based on the observation that during pregnancy E2 and P plasma concentrations rise in the mother and the fetus by a factor of 100. Disruption of the placental supply of these hormones is a physiological event for an infant delivered at term. A preterm infant is deprived from this supply at an earlier developmental stage. In vitro and in vivo data are discussed, and they highlights the potential benefit of E2 and P on the development of different organ systems. The postnatal replacement of E2 and P has the aim of maintaining in utero plasma concentrations. In the first randomized clinical study in 30 extremely preterm infants, E2 and P were replaced postnatally for a total of 6 weeks. With a median intravenous replacement of 8.4 micromol/kg/day of E2 (4.2-22.9) and 67.4 micromol/kg/day of P (35.7-87.0), plasma levels of E2 and P were maintained within the intrauterine reference values of 7.3-22.0 nmol/L and 0.95-1.9 micromol/L, respectively. Three- to sixfold higher dosages were needed via the transepidermal route. Trends towards an improved postnatal bone mineral accretion and a reduced incidence of chronic lung disease were found. Further studies are warranted to clarify the potentially important role of E2 and P for the postnatal development of an extremely preterm infant.
Collapse
Affiliation(s)
- A Trotter
- Section of Neonatology and Pediatric Critical Care Medicine, Children's Hospital, University of Ulm, Germany.
| | | |
Collapse
|
26
|
Trotter A, Maier L, Grill HJ, Kohn T, Heckmann M, Pohlandt F. Effects of postnatal estradiol and progesterone replacement in extremely preterm infants. J Clin Endocrinol Metab 1999; 84:4531-5. [PMID: 10599713 DOI: 10.1210/jcem.84.12.6180] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The fetus is supplied from the placenta with estradiol (E2) and progesterone (P) in increasing amounts during gestation. After delivery of a premature infant, placental supply is disrupted, resulting in a rapid decrease in E2 and P. Replacement of these placental hormones may restore intrauterine conditions and may be beneficial for bone mineral accretion, clinical course, and outcome. Thirty female infants with a median gestational age of 26.6 weeks (between 24.1-28.7) and a birth weight of 675 g (370-990) were randomized to receive E2 and P replacement, aiming to maintain plasma levels equaling the intrauterine levels, or no replacement. The E2 and P replacement was started iv and was followed by transepidermal administration for a total duration of 6 weeks. Repeated measurements included plasma levels of E2, P, FSH, and LH; uterine volume; calcium and phosphorus in spot urine specimens; and bone mineral accretion by single photon absorption densitometry. Further, the incidence of chronic lung disease and various clinical outcome data were recorded. The plasma levels of E2 and P were within the intrauterine range with median replacements of 2.30 mg/kg x day E2 (1.13-6.23) and 21.20 mg/kg x day P (11.23-27.36), iv. Three- and 6-fold higher doses of E2 and P were needed via the transepidermal route. The uterine volumes increased, and FSH and LH as indicators for biological effectiveness were significantly lowered with replacement. The bone mineral accretion rates tended to be higher, and the incidence of chronic lung disease tended to be lower (0% vs. 29%; P = 0.097). E2 and P replacement via iv and transepidermal routes is capable of maintaining plasma levels as high as those in utero with biological effectiveness. Trends toward improved postnatal bone mineral accretion and less chronic lung disease were found with the hormone replacement. Further and more extensive studies are warranted to address the role of this new approach in the care of extremely premature infants.
Collapse
Affiliation(s)
- A Trotter
- Section of Neonatology and Pediatric Critical Care Medicine, Children's Hospital, University of Ulm, Germany.
| | | | | | | | | | | |
Collapse
|
27
|
Trotter A, Maier L, Grill HJ, Wudy SA, Pohlandt F. 17Beta-estradiol and progesterone supplementation in extremely low-birth-weight infants. Pediatr Res 1999; 45:489-93. [PMID: 10203139 DOI: 10.1203/00006450-199904010-00006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
During pregnancy, 17beta-estradiol (E2) and progesterone (P) plasma concentrations increase up to 100-fold. The fetus is exposed to these increasing amounts of E2 and P. Within 1 d after delivery, E2 and P concentrations fall to nonpregnancy concentrations in the mother and the infant. Extremely premature infants are cut off from the placental supply of E2 and P at a very early developmental stage, and therefore they suffer from this deprivation for a longer period than infants born at term. Nothing is known about the consequences of this deprivation. The purpose of this study was to investigate how intrauterine concentrations of E2 and P could be maintained after birth. In 13 infants with a median gestational age of 26.4 wk (24.1-28.7), a phospholipid-stabilized soybean oil emulsion available for parenteral nutrition that contains different amounts of E2 and P was continuously administered, starting within the first postnatal hours. The supplementation was continued as long as venous access was indicated but not longer than 6 wk (median 20 d, 12-44). To maintain intrauterine plasma concentrations of 2000-6000 pg/mL E2 and 300-600 ng/mL P, 2.30 mg x kg(-1) x d(-1) E2 (1.13-3.42 mg x kg(-1) x d(-1)) and 21.20 mg x kg(-1) x d(-1) P (11.23-27.36 mg x kg(-1) x d(-1)) were needed. We conclude that supplementation of E2 and P to maintain intrauterine concentrations in extremely premature infants is possible intravenously. The infants in this study are enrolled in a randomized, controlled pilot study to evaluate the potential benefits of E2 and P supplementation.
Collapse
Affiliation(s)
- A Trotter
- Section of Neonatology and Pediatric Critical Care Medicine, Children's Hospital, University of Ulm, Germany.
| | | | | | | | | |
Collapse
|
28
|
Gemer O, Sevillia J, Zalis J, Segal S. Umbilical cord androgens in infants of diabetic mothers. Arch Gynecol Obstet 1997; 259:139-41. [PMID: 9187466 DOI: 10.1007/bf02505322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The aim was to measure umbilical cord testosterone and androstenedione and to explore possible relationships with fetal weight and insulin levels. Testosterone, androstenedione and insulin were measured at birth in venous umbilical blood in 12 infants of gestational diabetic mothers and in 12 control subjects. The mean concentrations of umbilical testosterone and androstenedione were not significantly different between the infants of the diabetic and control mothers. No significant correlation was found between maternal weight, fetal weight or insulin concentrations and androgen levels.
Collapse
Affiliation(s)
- O Gemer
- Department of Obstetrics and Gynecology, Barzilai Medical Center, Ashkelon, Israel
| | | | | | | |
Collapse
|