从怀孕到产后的雌二醇和孕酮:纵向潜类分析。

IF 2.3 Q2 OBSTETRICS & GYNECOLOGY
Frontiers in global women's health Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI:10.3389/fgwh.2024.1428494
Jelena Dukic, Alexandra Johann, Mirka Henninger, Ulrike Ehlert
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引用次数: 0

摘要

简介在围产期,妇女体内的荷尔蒙会发生显著变化,这对胎儿的发育以及母婴健康的孕期和产后生活至关重要。虽然多项研究已确定了雌二醇和孕酮的健康标准范围,但这些报告之间存在差异,因此尚不清楚哪些激素水平与不良健康后果有关。为了说明性类固醇模式对母婴健康结果的影响,需要对不同参数进行纵向评估:我们对 130 名妇女在怀孕和产后五个月内的情况进行了纵向评估。这些妇女提供了唾液样本并填写了社会心理问卷。激素分析采用酶联免疫吸附试验(ELISA)进行。分析和评估了雌二醇和孕酮的不同参数与心理测量变量的关系。为了研究围产期是否存在异质性激素轨迹,我们应用了基于群体的轨迹模型,作为潜类群体分析的一种特殊情况:结果:雌二醇和孕酮水平在妊娠末期上升,分娩后急剧下降,个体差异很大,尤其是在妊娠期间。不过,它们的比例保持稳定。我们发现了三个雌二醇轨迹亚组和两个孕酮亚组。年龄影响孕酮水平,高龄孕妇的孕酮水平高于年轻孕妇。焦虑和抑郁症状对特定亚组妇女的轨迹具有预测价值。研究还发现,在雌二醇和孕酮的波动过程及其比例方面,有两个不同的亚组:这项研究深入揭示了围产期健康妇女唾液中雌二醇和孕酮水平的变化过程和波动情况,凸显了这一时期激素水平的显著变化及其比率的稳定性。在围产期发现不同的性激素变化过程是一项新发现,这表明有必要进一步研究它们对健康结果的影响。我们的初步研究结果表明,妊娠末期的荷尔蒙波动似乎是一种正常现象,甚至可能是妇女出现相关心理症状和睡眠障碍的保护因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Estradiol and progesterone from pregnancy to postpartum: a longitudinal latent class analysis.

Introduction: During the peripartum, women undergo significant hormonal changes that are crucial for fetal development and a healthy pregnancy and postpartum period for mother and infant. Although several studies have determined healthy norm ranges of estradiol and progesterone, there are discrepancies among the reports, rendering it unclear which hormone levels are linked to adverse health outcomes. To account for the impact of sex steroid patterns on health outcomes in mothers and children, a longitudinal assessment of different parameters is needed.

Materials and methods: We longitudinally assessed a cohort of 130 women over five months during pregnancy and postpartum. The women provided saliva samples and completed psychosocial questionnaires. Hormone analyses were conducted using enzyme-linked immunosorbent assay (ELISA). Different parameters of estradiol and progesterone were analyzed and evaluated in relation to psychometric variables. To examine the presence of heterogenous hormonal trajectories in the peripartum, we applied group-based trajectory modelling as a special case of latent-class group analysis.

Results: Estradiol and progesterone levels rose towards the end of pregnancy and dropped sharply after birth, with considerable individual variation, particularly during pregnancy. However, their ratio remained stable. We identified three estradiol trajectory subgroups and two progesterone subgroups. Age influenced progesterone levels, with older pregnant women having higher levels than younger women. Anxiety and depressive symptoms had a predictive value for trajectories of specific subgroups of women. The study also revealed two distinct subgroups regarding the course of estradiol and progesterone fluctuations as well as their ratio.

Conclusion: This study provides insights into the course and fluctuation of salivary estradiol and progesterone levels among healthy women during the peripartum period, highlighting significant variations in hormone levels but stability in their ratio during this time. The finding of distinct sex steroid courses in the peripartum is new and suggests the need for further research to explore their impact on health outcomes. Our preliminary results suggest that hormonal fluctuations at the end of pregnancy appear to be a normal occurrence and might even be a protective factor for associated psychological symptoms and sleep disturbances in women.

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