Concentration of 14 Steroid Hormones in Human Amniotic Fluid of Midpregnancy*

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Abstract
Amniotic fluid (AF) levels of all steroids leading from pregnenolone (.DELTA.5Preg) to androgens and estrogens of both the .DELTA.5 and the .DELTA.4 pathways and those of cortisol and cortisone were determined in 63 normal pregnancies (12-19 wk gestation). The 12 unconjugated steroids [.DELTA.5Preg, 17.alpha.-hydroxypregnenolone, progesterone, 17.alpha.-hydroxyprogesterone, dehydroepiandrosterone (DHA), .DELTA.4-androstenedione, .DELTA.5-androstene-3.beta.,17.beta.-diol (.DELTA.5Adiol), testosterone (T), estrone, 17.beta.-estradiol (E2), cortisol and cortisone] were measured by specific radioimmunoassays after appropriate purification by Celite or LH-20 column chromatography, while the sulfates of DHA and .DELTA.5Preg were assayed directly on diluted samples. There were distinct sex differences; T and .DELTA.4-androstenedione levels were higher (P < 0.001) in males than in females, while AF levels of .DELTA.5Preg, 17.alpha.-hydroxypregnenolone, 17-hydroxyprogesterone, DHA and .DELTA.5Adiol were higher (P < 0.05) in females than in males. AF levels of E2 were significantly higher in females only between 15 and 19 wk gestation. There was no difference between sexes in AF levels of progesterone, estrone, cortisone and cortisol. AF levels of T, .DELTA.4-androstenedione and E2 decreased with age in males and AF levels of DHA increased in females during the period examined. These observed sex differences suggest that T and .DELTA.4-androstenedione may reflect fetal testicular activity, while E2 and 17-hydroxyprogesterone might reflect fetal ovarian activity. Determination of AF levels of T would appear to be a valuable screening test for antenatal diagnosis of sex (predictive error, .ltoreq. 15%), but not in the presence of steroidogenic enzyme defects. Elevated levels of 17-hydroxyprogesterone were found in the AF of 2 fetuses with either a 17-20 desmolase defect or 21-hydroxylase deficiency; AF levels of androgens were low in the former and high in the latter.

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