Effects of Parity on Pregnancy Hormonal Profiles Across Ethnic Groups with a Diverse Incidence of Breast Cancer

Arslan, Alan A.; Zeleniuch‐Jacquotte, Anne; Lukanova, Annekatrin; Afanasyeva, Yelena; Katz, Joseph; Levitz, Mortimer; Priore, Giuseppe Del; Toniolo, Paolo

doi:10.1158/1055-9965.epi-06-0470

Cited by 51 publications

(56 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Descriptive data characterising the hormonal profile of the entire pregnancy are lacking with regard to parity. The elevated first trimester oestradiol we observed in first compared with subsequent pregnancies has also been shown for the second (Wuu et al, 2002;Arslan et al, 2006) and early third trimesters (Wuu et al, 2002), but perhaps not at delivery (Troisi et al, 2003). The elevated prolactin concentrations in our data for first pregnancies have also been noted in the second trimester (Xu et al, 2003;Arslan et al, 2006), but not later in the pregnancy (Xu et al, 2003), and the first trimester androgen elevations have not been shown at delivery (Troisi et al, 2003).…”

Section: Discussionsupporting

confidence: 72%

Maternal, prenatal and perinatal characteristics and first trimester maternal serum hormone concentrations

Troisi

Thadhani

et al. 2008

Br J Cancer

View full text Add to dashboard Cite

In uncomplicated pregnancies, first trimester androgen, oestrogen and prolactin concentrations were higher in nulliparous (n ¼ 160) than parous (n ¼ 260) mothers. Androgens and estrogens were higher in younger than older mothers. These data are consistent with elevated hormone concentrations mediating the breast cancer protection from a first pregnancy and pregnancies occurring at younger ages. There are few opportunities to directly evaluate the hypothesis that the pregnancy hormonal milieu influences cancer risk in the mother and offspring. Investigations have instead used proxies to reflect the endocrine environment such as birth weight which is associated with a modestly elevated breast cancer risk in the daughter (Michels and Xue, 2006). Whereas age at first and last pregnancy and parity are established maternal breast cancer risk factors (National Cancer Institute, 2003), associations have been less consistent for other pregnancy characteristics with regard to the mother (Cnattingius et al, 2005) and offspring (Potischman et al, 2004).The few studies on hormone variations by maternal and pregnancy characteristics have focused on maternal measures in mid-or late pregnancy, primarily estrogens. Because the timing of carcinogenic events is unknown, characterising hormones over the entire pregnancy may provide additional insights into the biological mechanisms for maternal and perinatal breast cancer risk factors. MATERIALS AND METHODSData derived from an obstetrical study at the Massachusetts General Hospital (MGH) in Boston, Massachusetts that began in 1998 (Thadhani et al, 2001). Women were recruited at their first prenatal visit (ranging from 6.4 to 19.9 weeks gestation (median 11) with over 90% in the first 13 weeks), interviewed, and asked to provide a blood sample. Participants gave informed consent and the study was approved by the MGH Institutional Review Board. The study sample, described previously (Potischman et al, 2005), includes 109 Hispanic, 56 African American and 255Caucasian women 18 -42 years of age (median 29.6), who delivered a live, singleton birth in an uncomplicated pregnancy. A total of 38% of the women were nulliparous. Laboratory assaysSample handling, storage and assays were described previously (Potischman et al, 2005). Intra-class correlation coefficients from repeated measures of blind quality control samples were 97% for oestradiol, 92% for SHBG, 90% for oestrone, 85% for androstenedione, 76% for prolactin, 76% for testosterone, 60% for progesterone and o50% for DHEAS. Hormone medians and ranges have been published (Potischman et al, 2005). Statistical methodsSpearman correlation coefficients were calculated using continuous data. All pregnancy factors associated with the hormones in unadjusted analyses were entered with gestational age at blood collection (excluding pregnancies with 14 þ weeks' gestation) into linear regression models with logarithm-transformed hormones as dependent variables. Exponentiated b estimates (À1.0) from these models are presented for factors which r...

show abstract

Section: Discussionsupporting

confidence: 72%

Maternal, prenatal and perinatal characteristics and first trimester maternal serum hormone concentrations

Troisi

Thadhani

et al. 2008

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…In mid-pregnancy, maternal estriol is elevated in Asian-Americans compared with Caucasians, African-Americans, and Hispanic-American women (53), although no differences were observed for the more biologically active estrogen estradiol in a study of Asian-Americans (mainly second generation) and Caucasians (54). Results for cord hormone concentrations are consistent with higher estriol in Asian-Canadians than Caucasians (55), and no significant differences in estradiol and estrone (44), although the latter data derive from a study of Asian-Americans that were likely to be highly acculturated.…”

Section: Prominent Hypotheses To Explain Prenatal Risk Factorsmentioning

confidence: 99%

Exploring the Underlying Hormonal Mechanisms of Prenatal Risk Factors for Breast Cancer: A Review and Commentary

Troisi

Potischman

Hoover

2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

Prenatal factors have been hypothesized to influence subsequent breast cancer development. Directly evaluating the associations of in utero exposures with risk, however, presents several methodologic and theoretical challenges, including the long induction period between exposure and disease and the lack of certainty regarding the critical timing of exposure. Indirect evaluation of these associations has been achieved by use of proxies such as gestational and neonatal characteristics. Evidence suggests that preeclampsia is associated with a reduced breast cancer risk, whereas high birth weight and dizygotic twinning seem associated with an increased risk. Asians born in Asia have substantially lower breast cancer risks than women born in the West. Although data thus far are few, what exists is not consistent with a unifying hypothesis for a particular biological exposure (such as estrogens or androgens) during pregnancy as mediating the observed associations between pregnancy factors and breast cancer risk. This suggests that additional studies of prenatal factors should seek to broaden the range of hormones, growth, and other endocrine factors that are evaluated in utero. Once candidate biomarkers are identified, assessing them with respect to breast cancer and with intermediate end points in carcinogenesis should be a priority. In addition, investigations should explore the possibility that in utero exposures may not act directly on the breast, but may alter other physiologic pathways such as hormone metabolism that have their effect on risk later in life. (Cancer Epidemiol Biomarkers Prev 2007;16(9):1700 -12)

show abstract

“…However it is also possible that lower testosterone levels among parous women are indicative of a more general suppression of ovarian function, which could include modulation of estradiol and progesterone as well. Only a handful of studies have examined these hormones in relation to parity, and most, but not all, reported that estrogen is lower in parous than nulliparous women, adjusting for age and other covariates (26, 28, 32-34). …”

Section: Introductionmentioning

confidence: 99%

Differences in ovarian hormones in relation to parity and time since last birth

Barrett

Parlett

Windham

et al. 2014

Fertility and Sterility

View full text Add to dashboard Cite

Objective To examine ovarian function in relation to parity and time since last birth. Design Women collected daily urine samples for up to 8 menstrual cycles. Urinary estradiol and progesterone metabolite concentrations (E1C and PdG) were measured using enzyme-linked immunoassay. Cycle phase lengths were calculated from hormone profiles and daily diaries. Setting California, U.S.A. Patients Three hundred forty-six naturally cycling women, age 18-39. Intervention(s) None. Main Outcome Measure(s) Mean follicular E1C (cycle days −8 to −1), mean luteal PdG (days 0 to +10), and cycle phase lengths in ovulatory cycles. Results Women who had given birth within the previous three years had lower E1C than nulliparas (β=−0.22, 95% CI: −0.33, −0.11) and women who last gave birth >3 years earlier (β=−0.13, 95% CI: −0.23, −0.03). Among parous women, E1C was positively associated with time since last birth (β=0.02, 95% CI: 0.01, 0.04). Women who last gave birth >3 years earlier had longer follicular phases than nulliparas (β=1.18, 95% CI: 0.02, 2.34). There were no associations between parity and PdG or luteal phase length. Conclusions Our cross-sectional data suggest that ovarian function differs in nulliparous and parous women and is positively associated with time since last birth. Longitudinal research is needed to explore within-woman changes in ovarian function pre- and post-partum.

show abstract

Effects of Parity on Pregnancy Hormonal Profiles Across Ethnic Groups with a Diverse Incidence of Breast Cancer

Cited by 51 publications

References 45 publications

Maternal, prenatal and perinatal characteristics and first trimester maternal serum hormone concentrations

Maternal, prenatal and perinatal characteristics and first trimester maternal serum hormone concentrations

Exploring the Underlying Hormonal Mechanisms of Prenatal Risk Factors for Breast Cancer: A Review and Commentary

Differences in ovarian hormones in relation to parity and time since last birth

Contact Info

Product

Resources

About