Document Detail


The association of maternal factors with delayed implantation and the initial rise of urinary human chorionic gonadotrophin.
MedLine Citation:
PMID:  21292636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND Late implantation and the pattern of early rise in hCG have been associated with early pregnancy loss. We explored factors that might be predictive of these markers of poor embryonic health in spontaneously conceived pregnancies. METHODS Participants in the North Carolina Early Pregnancy Study collected daily first-morning urine specimens while attempting to conceive. Samples were assayed for estrogen and progesterone metabolites (to identify day of ovulation) and hCG (to detect conception). Data were available for 190 pregnancies, 48 of which ended in early loss (within 6 weeks of the last menstrual period). We used logistic regression to identify characteristics associated with late implantation (≥10 days post-ovulation). For pregnancies surviving at least 6 weeks (n= 142), we used linear mixed models to identify factors associated with variations in hCG rise in the first 7 days from detection. RESULTS Later implantation was associated with current maternal smoking [odds ratio (OR): 5.7; 95% confidence interval (CI): 1.1-30] and with oocytes that were likely to have been fertilized late in their post-ovulatory lifespan (OR: 5.1; CI: 1.9-16). Older women had a faster rise in hCG (P= 0.01), as did women who had relatively late menarche (P for trend = 0.02). Women exposed in utero to diethylstilbestrol showed an unusual pattern of slow initial hCG rise followed by a fast increase, a pattern significantly different from that of unexposed women (P= 0.002). CONCLUSIONS Although limited by small numbers and infrequent exposures, our analyses suggest that a woman's exposures both early in life and at the time of pregnancy may influence early development of the conceptus.
Authors:
A M Z Jukic; C R Weinberg; D D Baird; A J Wilcox
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural     Date:  2011-02-02
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  26     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-16     Completed Date:  2011-07-15     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  920-6     Citation Subset:  IM    
Affiliation:
Epidemiology Branch, National Institute of Environmental Health Sciences, PO Box 12233, MD A3-05, Durham, NC 27709, USA. jukica@niehs.nih.gov
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / urine
Adult
Chorionic Gonadotropin / urine*
Diethylstilbestrol / pharmacology
Embryo Implantation*
Female
Fertilization
Humans
North Carolina
Odds Ratio
Oocytes / cytology
Pregnancy
Pregnancy Rate
Smoking
Time Factors
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 56-53-1/Diethylstilbestrol
Comments/Corrections

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