Reproductive BioMedicine Online ( IF 3.7 ) Pub Date : 2020-05-25 , DOI: 10.1016/j.rbmo.2020.05.009 María L Sánchez-Ferrer 1 , Julian J Arense-Gonzalo 2 , María T Prieto-Sánchez 1 , Emilia Alfosea-Marhuenda 3 , Inmaculada Gómez-Carrascosa 3 , Miguel A Iniesta 3 , Jaime Mendiola 2 , Alberto M Torres-Cantero 4
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Research question
Does the length of the anogenital distance (AGD), an anthropometric biomarker of fetal androgen exposure, change across pregnancy? It has been suggested that AGD remains stable during adulthood with no changes across the menstrual cycle. No studies, however, have been carried out during pregnancy, during which women are exposed to important hormonal and anthropometric variations.
Design
A cohort study of 186 singleton pregnant women recruited in the first trimester of pregnancy. Measurements from the anterior clitoral surface to the upper verge of the anus (AGDAC), and from the posterior fourchette to the upper verge of the anus (AGDAF) and body mass index (BMI) were obtained in each trimester. Generalized linear model for repeated measures was carried out to assess differences in AGDs and BMI across the three trimesters of the pregnancy.
Results
In crude analyses, AGDAC was progressively and significantly longer as the pregnancy developed (first trimester: 87.69 ± 13.14mm; second trimester: 89.69 ± 13.47mm; third trimester: 91.95 ± 13.25 mm; P < 0.001), whereas AGDAF did not significantly change throughout pregnancy (first trimester: 28.37 ± 6.94 mm; second trimester: 28.09 ± 7.66 mm; third trimester: 28.94 ± 6.7 mm). In the multivariable mixed-effect models for fixed effect (trimester) and time-covariate (BMI), AGDs did not show significant associations with trimesters of pregnancy when BMI was included in the model.
Conclusions
Our results suggest that AGDAF and AGDAC, when adjusted by BMI, do not change throughout gestation despite maternal anthropometric variations during pregnancy. AGDAF may be a meaningful measurement at any time during pregnancy without considering BMI. Therefore, maternal AGDAF may be used as a prenatal biomarker of the mother's in-uteru hormonal exposure even during pregnancy.
中文翻译：
怀孕期间肛门生殖器距离会改变吗？
研究问题
肛门生殖器距离 (AGD) 的长度（胎儿雄激素暴露的人体测量生物标志物）是否会随着怀孕而变化？有人提出，AGD 在成年期保持稳定，整个月经周期没有变化。然而，没有在怀孕期间进行研究，在此期间妇女会暴露于重要的荷尔蒙和人体测量变化。
设计
一项对 186 名在怀孕前三个月招募的单身孕妇的队列研究。在每个孕期获得从阴蒂前表面到肛门上缘 (AGD AC ) 以及从后毛囊到肛门上缘 (AGD AF ) 和体重指数 (BMI) 的测量值。进行了重复测量的广义线性模型，以评估妊娠三个三个月内 AGD 和 BMI 的差异。
结果
在粗略分析中，随着妊娠的发展，AGD AC逐渐显着变长（妊娠早期：87.69 ± 13.14 毫米；妊娠中期：89.69 ± 13.47 毫米；妊娠晚期：91.95 ± 13.25 毫米；P < 0.001），而 AGD AF没有整个孕期发生显着变化（孕早期：28.37 ± 6.94 毫米；孕中期：28.09 ± 7.66 毫米；孕晚期：28.94 ± 6.7 毫米）。在固定效应（妊娠期）和时间协变量（BMI）的多变量混合效应模型中，当模型中包含 BMI 时，AGD 与妊娠期没有显着关联。
结论
我们的结果表明 AGD AF和 AGD AC在通过 BMI 调整后在整个妊娠期间不会发生变化，尽管妊娠期间母亲的人体测量有所不同。在不考虑 BMI 的情况下，AGD AF在怀孕期间的任何时候都可能是一项有意义的测量。因此，即使在怀孕期间，母亲 AGD AF也可以用作母亲子宫内激素暴露的产前生物标志物。
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