Gestational hormone trajectories and early pregnancy failure: a reassessment

Whittaker, Paul; Schreiber, Courtney A.; Sammel, Mary D.

doi:10.1186/s12958-018-0415-1

Cited by 18 publications

(16 citation statements)

References 13 publications

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“…However, spontaneous abortions represent a heterogeneous group of unhealthy pregnancies in contrast with induced abortions and births, which primarily are healthy pregnancies. In addition, studies report that pregnancies resulting in spontaneous abortion have low levels of gestational hormones (including progesterone), 27 28 which could explain the weaker association between spontaneous abortions and risk of endometrial cancer.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy duration and endometrial cancer risk: nationwide cohort study

Husby

Wohlfahrt

Melbye

2019

BMJ

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ObjectiveTo explore the association between pregnancy duration and risk of endometrial cancer.DesignNationwide register based cohort study.SettingDenmark.ParticipantsAll Danish women born from 1935 to 2002.Main outcome measuresRelative risk (incidence rate ratio) of endometrial cancer by pregnancy number, type, and duration, estimated using log-linear Poisson regression.ResultsAmong 2 311 332 Danish women with 3 947 650 pregnancies, 6743 women developed endometrial cancer during 57 347 622 person years of follow-up. After adjustment for age, period, and socioeconomic factors, a first pregnancy was associated with a noticeably reduced risk of endometrial cancer, whether it ended in induced abortion (adjusted relative risk 0.53 (95% confidence interval 0.45 to 0.64) or childbirth (0.66, 0.61 to 0.72). Each subsequent pregnancy was associated with an additional reduction in risk, whether it ended in induced abortion (0.81, 0.77 to 0.86) or childbirth (0.86, 0.84 to 0.89). Duration of pregnancy, age at pregnancy, spontaneous abortions, obesity, maternal birth cohort, fecundity, and socioeconomic factors did not modify the results.ConclusionsThe risk of endometrial cancer is reduced regardless of whether a pregnancy ends shortly after conception or at 40 weeks of gestation. This reduction in risk could be explained by a biological process occurring within the first weeks of pregnancy, as pregnancies ending in induced abortions were associated with similar reductions in risk as pregnancies ending in childbirth.

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Section: Discussionmentioning

confidence: 99%

Pregnancy duration and endometrial cancer risk: nationwide cohort study

Husby

Wohlfahrt

Melbye

2019

BMJ

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“…Appropriate clinical treatment for these three outcomes is drastically different making early, accurate diagnosis imperative. Currently, progesterone and human chorionic gonadotrophin (hCG) are the most commonly used serum biomarkers for evaluating pregnancy prognosis when ultrasound is inconclusive [ 4 , 5 ]. Similarly, serial hCG levels and pelvic ultrasound are the standard methods of diagnosing an EP.…”

Section: Introductionmentioning

confidence: 99%

Proteome-defined changes in cellular pathways for decidua and trophoblast tissues associated with location and viability of early-stage pregnancy

Beer

Senapati

Sammel

et al. 2022

Reprod Biol Endocrinol

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Background In early pregnancy, differentiating between a normal intrauterine pregnancy (IUP) and abnormal gestations including early pregnancy loss (EPL) or ectopic pregnancy (EP) is a major clinical challenge when ultrasound is not yet diagnostic. Clinical treatments for these outcomes are drastically different making early, accurate diagnosis imperative. Hence, a greater understanding of the biological mechanisms involved in these early pregnancy complications could lead to new molecular diagnostics. Methods Trophoblast and endometrial tissue was collected from consenting women having an IUP (n = 4), EPL (n = 4), or EP (n = 2). Samples were analyzed by LC–MS/MS followed by a label-free proteomics analysis in an exploratory study. For each tissue type, pairwise comparisons of different pregnancy outcomes (EPL vs. IUP and EP vs. IUP) were performed, and protein changes having a fold change ≥ 3 and a Student’s t-test p-value ≤ 0.05 were defined as significant. Pathway and network classification tools were used to group significantly changing proteins based on their functional similarities. Results A total of 4792 and 4757 proteins were identified in decidua and trophoblast proteomes. For decidua, 125 protein levels (2.6% of the proteome) were significantly different between EP and IUP, whereas EPL and IUP decidua were more similar with only 68 (1.4%) differences. For trophoblasts, there were 66 (1.4%) differences between EPL and IUP. However, the largest group of 344 differences (7.2%) was observed between EP and IUP trophoblasts. In both tissues, proteins associated with ECM remodeling, cell adhesion and metabolic pathways showed decreases in EP specimens compared with IUP and EPL. In trophoblasts, EP showed elevation of inflammatory and immune response pathways. Conclusions Overall, differences between an EP and IUP are greater than the changes observed when comparing ongoing IUP and nonviable intrauterine pregnancies (EPL) in both decidua and trophoblast proteomes. Furthermore, differences between EP and IUP were much higher in the trophoblast than in the decidua. This observation is true for the total number of protein changes as well as the extent of changes in upstream regulators and related pathways. This suggests that biomarkers and mechanisms of trophoblast function may be the best predictors of early pregnancy location and viability.

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“…Progesterone, which is produced by the corpus luteum, is vital for maintaining early pregnancy. HCG from the villous trophoblast supports the production of lutein progesterone and promotes the onset of progesterone and estradiol production by the placenta at about 8–9 weeks of pregnancy [ 13 ]. In order to be able to assess the development of pregnancy, it is important to know not the absolute value of the hormone concentration, which is determined at a certain period of pregnancy, but the change in its concentration (increase or decrease) with the course of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Changes in the level of fetoplacental complex hormones in pregnant women with miscarriage

et al. 2021

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The purpose of the study was TO analyze the fetoplacental complex hormone levels and changes in their dynamics in pregnant women with miscarriage and the impact of these features on the subsequent course of pregnancy. Hormone levels were determined at different stages of gestation in 50 healthy women with a physiological course of pregnancy (control group) and 50 pregnant women with a history of miscarriage (main group). The women of the main group had a significantly slower rate of increase in hormones and a lag in quantitative indicators than the control group. The estradiol level indicators were 4.1 times (76.0%) and 2.89 times (65.5%) lower in women with miscarriage in the embryonic and late fetal period, respectively, compared to healthy women. Indicators of the level of placental lactogen and chorionic gonadotropin in the embryonic period in women with miscarriage were lower by 39.1% and 50.9%, respectively, compared to healthy women. In the late fetal period, the level of these hormones was lower by 72.9% and 35.4%, respectively. In the embryonic and late fetal periods, progesterone levels were lower by 67.4% and 68.4%, respectively, compared to the control group. The data obtained are evidence of a pronounced hormonal abnormality of the placenta, and hence a marker of fetoplacental dysfunction, which on the background of miscarriage develops at the early stages and continues to progress with the course of pregnancy.

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Gestational hormone trajectories and early pregnancy failure: a reassessment

Cited by 18 publications

References 13 publications

Pregnancy duration and endometrial cancer risk: nationwide cohort study

Pregnancy duration and endometrial cancer risk: nationwide cohort study

Proteome-defined changes in cellular pathways for decidua and trophoblast tissues associated with location and viability of early-stage pregnancy

Changes in the level of fetoplacental complex hormones in pregnant women with miscarriage

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