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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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The Relationship between Umbilical Cord Estrogens and Perinatal Characteristics

Martha Hickey, Roger Hart and Jeffrey A. Keelan
Martha Hickey
1Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and 2School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
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Roger Hart
1Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and 2School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
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Jeffrey A. Keelan
1Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and 2School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
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DOI: 10.1158/1055-9965.EPI-13-1321 Published June 2014
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    Figure 1.

    Influence of gestational age at delivery on umbilical cord estrogen concentrations. A, concentrations of estrogens (mean ± SD) in the entire cohort (singletons and twins) are shown in six gestational age categories. B, scatter plot comparing cord estetrol (E4) levels in singletons and twins from 26 to 42 weeks of gestation. The difference between twins and singletons remained significant after controlling for gestational age. Similar relationships existed in the other three estrogens.

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    Figure 2.

    Comparison of umbilical cord blood estrogen concentrations (mean ± SD) in male and female infants. There were no significant differences.

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    Figure 3.

    Comparison of umbilical cord blood estrogen concentrations (mean ± SD) in singletons delivered following spontaneous onset of labor versus elective Caesarean section before the onset of labor (A) or with or without preeclampsia (B). *, P < 0.05; **, P < 0.005; ***, P < 0.0001 by the Mann–Whitney U test.

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    Figure 4.

    Comparison of umbilical cord blood estrogen concentrations (mean ± SD) in singletons versus twins (A) and in male versus female twins (B). ***, P < 0.0001 by the Mann–Whitney test. The significant difference was maintained after controlling for gestational age at delivery.

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  • Table 1.

    Demographic and obstetric characteristics of the study cohort

    Singletons (n = 805)Twins (n = 54)P
    Maternal age, ya28.3 ± 5.929.3 ± 5.5NSf
    Caucasian ethnicity, %82.087.0NS
    Smokerb, %25.133.3NS
    Gestational age at delivery, wksa39.0 ± 2.635.0 ± 3.0<0.0001
    Birth weight, females, kga3.32 ± 0.592.09 ± 0.58<0.0001
    Birth weight, males, kg3.31 ± 0.602.43 ± 0.65<0.0001
    Placental weight, g587 ± 124862 ± 228<0.0001
    Caesarean sectionc, %10.942.6<0.0001
    Delivery following labord, %89.456.6NS
    Labor duration, ha,e6.86 ± 4.35.38 ± 2.9NS
    Prelabor rupture of membranes, %19.122.6NS
    Induction of labor, %26.443.40.01
    APH, %8.53.8NS
    Antenatal steroids administered, %2.7520.8<0.0001
    Preterm birth, %7.267.9<0.0001
    IUGR, %3.024.1<0.0001

    Abbreviation: NS, not significant.

    • ↵aMean ± SD.

    • ↵bSmoking defined as one or more cigarettes per day.

    • ↵cIncludes both elective and in-labor sections.

    • ↵dAll deliveries excluding elective Caesarean-section deliveries.

    • ↵eStage I and II of labor combined.

    • ↵fP > 0.05 by the Mann–Whitney U test for group median comparisons or Fisher's exact test for categorical variables.

Additional Files

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    Files in this Data Supplement:

    • Supplementary Figure Legend - PDF file - 61KB
    • Supplementary Figure 1 - PDF file - 652KB, Linear (Pearson) correlation analysis of umbilical cord concentrations of all four estrogens in singleton and twin pregnancies (n=860).
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Cancer Epidemiology Biomarkers & Prevention: 23 (6)
June 2014
Volume 23, Issue 6
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The Relationship between Umbilical Cord Estrogens and Perinatal Characteristics
Martha Hickey, Roger Hart and Jeffrey A. Keelan
Cancer Epidemiol Biomarkers Prev June 1 2014 (23) (6) 946-952; DOI: 10.1158/1055-9965.EPI-13-1321

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The Relationship between Umbilical Cord Estrogens and Perinatal Characteristics
Martha Hickey, Roger Hart and Jeffrey A. Keelan
Cancer Epidemiol Biomarkers Prev June 1 2014 (23) (6) 946-952; DOI: 10.1158/1055-9965.EPI-13-1321
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