Quantification of Polar Glucocorticosteroids in the Urine of Pregnant and Nonpregnant Women: A Comparison with 6α-Hydroxylated Metabolites of Cortisol in Neonatal Urine and Amniotic Fluid

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Abstract
6.alpha.-Hydroxy metabolites of cortisol were determined in the urine of pregnant (36-40 wk of gestation) and nonpregnant women and in amniotic fluid from nearly full-term pregnant women because relatively large amounts of these compounds are excreted in the urine of 2 day old infants (> 200 .mu.g/day). The corticosteroids analyzed by high pressure liquid chromatography and gas chromatography-mass spectrometry were 6.alpha.-hydroxy derivatives of (allo)tetrahydrocortisone (3.alpha.,17.alpha.,21-trihydroxy-5.zeta.-pregnan-11,20-dione), (allo)tetrahydrocortisol (3.alpha.,11.beta.,17.alpha.,21-tetrahydroxy-5.zeta.-pregnan-20-one), and .alpha.- and .beta.-cortolone (3.alpha.,17.alpha.,20.zeta.,21-tetrahydroxy-5.beta.-pregnan-11-one). All of these compounds were found in the urine samples from both groups of women and in the amniotic fluid samples in contrast to those found in the urine samples from the neonates were 6.alpha.-hydroxy compounds of (allo)tetrahydrocortisol and allotetrahydrocortisone were not positively identified because of insufficient yields. The pregnant women excreted significantly larger amounts of 6.alpha.-hydroxy metabolites of cortisol (.apprx. 600 .mu.g/day) than the control women (.apprx. 90 .mu.g/day), and the rate of urinary excretion of these 6.alpha.-hydroxy compounds was 7.82 and 1.30 .mu.g/kg per day, respectively, for these groups of women, compared to 54.3 .mu.g/kg per day for the neonates. The precursors of these metabolites within the fetal body originated largely from the maternal circulation, and, therefore, the 6.alpha.-hydroxy metabolites of cortisol excreted by the mother refer mainly to fetal metabolism and, to a lesser extent, to the fetal secretion of cortisol.