Steroid hormone levels in pregnancy and 1 year postpartum using isotope dilution tandem mass spectrometry

Fertil Steril. 2005 Sep;84(3):701-10. doi: 10.1016/j.fertnstert.2005.02.045.


Objective: To establish normal, trimester-specific reference intervals for serum 17beta-estradiol, progesterone (P), 17alpha-hydroxyprogesterone, cortisol, 11-deoxycortisol, androstenedione, DHEA, and DHEAS, measured simultaneously using isotope dilution tandem mass spectrometry.

Design: Sequential cohort study.

Patient(s): Healthy women undergoing a normal pregnancy (age, 25-38 years; mean, 30 years) attending a prenatal well clinic at gestation weeks 12, 22, and 32 and approximately 1 year postpartum.

Main outcome measure(s): Trimester-specific reference intervals of endogenous steroid hormones analyzed using an isotope dilution tandem mass spectrometer equipped with an atmospheric pressure photoionization source with deuterium-labeled internal standards.

Result(s): Serum estradiol, P, 17alpha-hydroxyprogesterone, and 11-deoxycortisol increased throughout pregnancy; cortisol increased up to the second trimester and then remained steady, while androstenedione increased by 80 percent by gestation week 12, then remained constant. Serum DHEA-S decreased by 50% by the third trimester.

Conclusion(s): Trimester-specific reference intervals are reported for eight serum steroids. The ratios of individual serum hormone concentrations during pregnancy relative to their 1-year postpartum concentrations illustrate the expected normal trends of changes in hormone concentrations during pregnancy.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Gonadal Steroid Hormones / analysis
  • Gonadal Steroid Hormones / blood*
  • Gonadal Steroid Hormones / metabolism
  • Humans
  • Isotopes
  • Postpartum Period / blood*
  • Postpartum Period / metabolism
  • Pregnancy / blood*
  • Pregnancy / metabolism
  • Spectrometry, Mass, Electrospray Ionization / methods*


  • Gonadal Steroid Hormones
  • Isotopes