Accuracy of fetal growth indicators as surrogate measures of steroid hormone levels during pregnancy
Accuracy of fetal growth indicators as surrogate measures of steroid hormone levels during pregnancy
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DOI：
10.1093/aje/kwf183
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发表时间：
2003-02-01
影响因子：
5
通讯作者：
Richardson, BE
中科院分区：
文献类型：
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作者：
Peck, JD;Hulka, BS;Richardson, BE
本研究评估使用胎儿生长特征作为妊娠期间类固醇激素暴露的替代指标。使用出生体重、出生身长、体重指数和胎盘重量作为妊娠激素暴露指标的有效性通过参加加州伯克利儿童健康与发展研究（1959-1966）的 568 名孕妇的妊娠晚期血清样本进行评估。使用几何平均值、皮尔逊相关性以及线性和逻辑回归来评估出生特征和激素浓度之间的关联程度。使用敏感性、特异性和受试者工作特征曲线分析来评估准确性。观察到的最强且最一致的关联是出生体重和雌三醇水平之间。尽管与高雌三醇水平呈正相关（r = 0.32）并且与高雌三醇水平有很强的相关性（最高与最低出生体重四分位相比的比值比 = 6.63，95% 置信区间：3.20、12.5），但出生体重作为雌三醇水平代理的预测性能很差（受试者工作特征曲线下面积 = 0.66，95% 置信区间：0.61， 0.71）。同样，所有胎儿生长测量结果显示，作为雌三醇、雌酮、雌二醇或黄体酮水平的指标，几乎没有区分能力。因此，观察到的与这些替代指标的关联可能并不反映妊娠激素暴露，应谨慎解释。
This study evaluates the use of fetal growth characteristics as surrogate measures for steroid hormone exposures during pregnancy. The validity of using birth weight, birth length, ponderal index, and placental weight as indicators of pregnancy hormone exposures was assessed using third-trimester serum samples from 568 pregnant women who participated in the Child Health and Development Studies, Berkeley, California (1959-1966). The magnitude of the associations between birth characteristics and hormone concentrations was assessed using geometric means, Pearson's correlations, and linear and logistic regression. Accuracy was evaluated using sensitivity, specificity, and receiver operating characteristic curve analyses. The strongest and most consistent association observed was between birth weight and estriol levels. Despite a positive correlation (r = 0.32) and strong associations with high estriol levels (odds ratio for highest compared with lowest birth weight quartile = 6.63, 95% confidence interval: 3.20, 12.5), the predictive performance of birth weight as a proxy for estriol levels was poor (area under the receiver operating characteristic curve = 0.66, 95% confidence interval: 0.61, 0.71). Likewise, all fetal growth measures revealed little discriminatory ability as indicators of estriol, estrone, estradiol, or progesterone levels. Thus, observed associations with these surrogate measures may not be a reflection of pregnancy hormone exposure and should be interpreted with caution.