Abstract
Background:
Progesterone is an important biomarker of early pregnancy failure. However, literature is limited regarding factors that influence progesterone levels in early pregnancy. Maternal obesity has been associated with adverse pregnancy outcomes such as miscarriages.
Materials and methods:
We investigated the association between maternal body mass index (BMI) and serum progesterone level in first trimester singleton pregnancies for 194 women at a tertiary maternity hospital in Singapore, from January 2012 to February 2014. Maternal characteristics and study outcomes were retrieved from clinical records.
Results:
Multivariate analysis demonstrated an inverse relationship between first trimester maternal BMI category and serum progesterone level (p=0.012). Obesity (maternal BMI ≥30 kg/m2), relative to normal weight (BMI 18.5–24.9 kg/m2), conferred an increased risk for serum progesterone <35 nmol/L (adjusted OR: 9.14; 95% CI: 2.12 – 39.5; p=0.003). The overall miscarriage rate in our study population was 13.9%.
Conclusions:
This study indicates that maternal obesity is associated with low first trimester serum progesterone. Pre-pregnancy weight optimization may be beneficial in regulation of serum progesterone level and maintenance of healthy pregnancy.
Acknowledgments
I would like to express my appreciation and acknowledgment to Prof Østbye, Truls for his continuous advice for publication of the original manuscript manuscript.
References
1. Azuma K, Calderon I, Besanko M, MacLachlan V, Healy DL. Is the luteo-placental shift a myth? Analysis of low progesterone levels in successful art pregnancies. J Clin Endocrinol Metab 1993;77:195–8.10.1210/jcem.77.1.7686913Search in Google Scholar
2. Hanita O, Hanisah A. Potential use of single measurement of serum progesterone in detecting early pregnancy failure. Malaysian J Pathol 2012;34:41–6.Search in Google Scholar
3. Troisi R, Hoover RN, Thadhani R, Hsieh C-C, Sluss P, Ballard-Barbash R, Potischman N. Maternal, prenatal and perinatal characteristics and first trimester maternal serum hormone concentrations. Br J Cancer 2008;99:1161–4.10.1038/sj.bjc.6604639Search in Google Scholar
4. Toriola AT, Vääräsmäki M, Lehtinen M, Zeleniuch-Jacquotte A, Lundin E, Rodgers KG, Lakso HA, Chen T, Schock H, Hallsmans G, Pukkala E, Toniolo P, Grankvist K, Surcel HM, Lukanova A. Determinants of maternal sex steroids during the first half of pregnancy. Obstet Gynecol 2011;118:1029–36.10.1097/AOG.0b013e3182342b7fSearch in Google Scholar
5. Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R, Brown TJ, Summerbell CD. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev 2008;9:635–83.10.1111/j.1467-789X.2008.00511.xSearch in Google Scholar
6. Hartwig IR, Pincus MK, Diemert A, Hecher K, Arck PC. Sex-specific effect of first-trimester maternal progesterone on birthweight. Hum Reprod 2013;28:77–86.10.1093/humrep/des367Search in Google Scholar
7. Arck PC, Rücke M, Rose M, Szekeres-Bartho J, Douglas AJ, Pritsch M, Blois SM, Pincus MK, Barenstrauch N, Dudenhausen JW, Nakamura K, Sheps S, Klapp BF. Early risk factors for miscarriage: a prospective cohort study in pregnant women. Reprod Biomed Online 2008;17:101–13.10.1016/S1472-6483(10)60300-8Search in Google Scholar
8. Rasmussen K, Yaktine A. Weight gain during pregnancy. Washington, DC: National Academies Press (US), 2009.Search in Google Scholar
9. Valley VT, Mateer JR, Aiman EJ, Tkoma ME, Phelan MB. Serum progesterone and endovaginal sonography by emergency physicians in the evaluation of ectopic pregnancy. Acad Emerg Med 1998;5:309–13.10.1111/j.1553-2712.1998.tb02710.xSearch in Google Scholar
10. Ku C, Allen J, Malhotra R, Chong H, Tan NS, Østbye T, Lek SM, Lie D, Tan TC. How can we better predict the risk of spontaneous miscarriage among women experiencing threatened miscarriage? Gynecol Endocrinol 2015:In press.10.3109/09513590.2015.1031103Search in Google Scholar
11. Filicori M, Flamigni C, Meriggiola MC, Ferrari P, Michelacci L, Campaniello E, Valdiserri A, Cognigni G. Endocrine response determines the clinical outcome of pulsatile gonadotropin-releasing hormone ovulation induction in different ovulatory disorders. J Clin Endocrinol Metab 1991;72:965–72.10.1210/jcem-72-5-965Search in Google Scholar
12. Jain A, Polotsky AJ, Rochester D, Berga SL, Loucks T, Zeitlian G, Gibbs K, Polotsky HN, Feng S, Isaac B, Santoro N. Pulsatile luteinizing hormone amplitude and progesterone metabolite excretion are reduced in obese women. J Clin Endocrinol Metab 2007;92:2468–73.10.1210/jc.2006-2274Search in Google Scholar
13. Albano C, Grimbizis G, Smitz J, Riethmüller-Winzen H, Reissmann T, Van Steirteghem A, Devroey P. The luteal phase of nonsupplemented cycles after ovarian superovulation with human menopausal gonadotropin and the gonadotropin-releasing hormone antagonist Cetrorelix. Fertil Steril 1998;70:357–9.10.1016/S0015-0282(98)00135-6Search in Google Scholar
14. Tavaniotou A, Albano C, Smitz J, Devroey P. Impact of ovarian stimulation on corpus luteum function and embryonic implantation. J Reprod Immunol 2002;55:123–30.10.1016/S0165-0378(01)00134-6Search in Google Scholar
15. Rochester D, Jain A, Polotsky AJ, Polotsky H, Gibbs K, Isaac B, Zeitlian G, Hickmon C, Feng S, Santoro N. Partial recovery of luteal function after bariatric surgery in obese women. Fertil Steril 2009;92:1410–5.10.1016/j.fertnstert.2008.08.025Search in Google Scholar
16. Pasquali R, Casimirri F, Cantobelli S, Morselli Labate AM, Venturoli S, Paradisi R, Zannarini L. Insulin and androgen relationships with abdominal body fat distribution in women with and without hyperandrogenism. Horm Res 1993;39:179–87.10.1159/000182732Search in Google Scholar
17. Lykke JA, Dideriksen KL, Lidegaard O, Langhoff-Roos J. First-trimester vaginal bleeding and complications later in pregnancy. Obstet Gynecol 2010;115:935–44.10.1097/AOG.0b013e3181da8d38Search in Google Scholar
18. He S, Allen J, Malhotra R, Østbye T, Tan TC. Association of maternal serum progesterone in early pregnancy with low birth weight and other adverse pregnancy outcomes. J Matern Neonatal Med 2015. http://dx.doi.org/10.3109/14767058.2015.1072159.10.3109/14767058.2015.1072159Search in Google Scholar
19. Allolio B, Hoffmann J, Linton EA, Winkelmann W, Kusche M, Schulte HM. Diurnal salivary cortisol patterns during pregnancy and after delivery: relationship to plasma corticotrophin-releasing-hormone. Clin Endocrinol (Oxf) 1990;33:279–89.10.1111/j.1365-2265.1990.tb00492.xSearch in Google Scholar
20. Darne FJ, McGarrigle HH, Lachelin GC. Diurnal variation of plasma and saliva oestrogen, progesterone, cortisol and plasma dehydroepiandrosterone sulphate in late pregnancy. Eur J Obstet Gynecol Reprod Biol 1989;32:57–66.10.1016/0028-2243(89)90184-6Search in Google Scholar
©2016 Walter de Gruyter GmbH, Berlin/Boston
