THE CAUSES OF LOW OESTROGEN EXCRETION IN PREGNANCY: ASSESSMENT OF THE FETAL CONTRIBUTION BY STEROID MEASUREMENTS POST PARTUM

Abstract

Estrogen levels in urine from 21 normotensive and 13 hypertensive pregnant women were moderately correlated (r = 0.48) with levels of 3.beta.-hydroxy-5-ene steroids (estrogen precursors) in urine from their infants. In 5 infants from otherwise normal pregnancies in which estrogen excretion was very low, levels of 3.beta.-hydroxy-5-ene steroids were significantly lower than normal while there was no difference between hypertensives and normals. Levels of urinary cortisol metabolites in the infants were moderately correlated with 3.beta.-hydroxy-5-ene steroids (r = 0.55) and were especially low in 2 out of 5 infants in the series suffering from distress during delivery. Subnormal fetal steroidogenesis rather than reduced placental metabolism is the most common cause of low estrogen excretion of unknown etiology. A factor in the increased perinatal risk in this group may be an associated insufficient cortisol synthesis by the fetus.