Progesterone and 17β-Estradiol Levels during Normal Pregnancy and the Puerperium among Women Attending a Tertiary Health Facility Clinic in Jos, Plateau State, Nigeria

Abstract

Introduction: Progesterone and Estrogen are the chief pregnancy hormones. Their levels increase during pregnancy to aid successful maintenance of pregnancy, which depends on maternal tolerance of the fetal semi allograft. Aim: To determine levels of progesterone and 17β-estradiol, at different trimesters during normal pregnancy and the puerperium, which may be used as baseline data for Nigerian women. Study Design: Cross-sectional study. Place and Duration of Study: The study was carried out in the antenatal clinic of Bingham University Teaching Hospital Jos, from April, 2011 to August, 2012. Methodology: A total of three hundred and thirty (330) apparently healthy women between the ages of 18 and 42 years (mean age, 27.88±4.9 years) were studied. The study included two hundred and ten (210) women selected at different trimesters of pregnancy, seventy (70) women at six weeks post partum and fifty (50) non pregnant women as controls. Blood pressure measurements were done using the Auscultatory technique with mercury Sphygmomanometer.  Hypertensive subjects were excluded. Serum progesterone and 17β-estradiol concentrations were measured by Electrochemiluminescence immunoassay (ECLIA) on Elecsys 2010, Auto analyzer. Results: Out of the 330 women included from the onset, 260 completed the procedures. The relationship between Age group and Parity versus Serum levels of progesterone and 17β-estradiol were found not to be significant (P > 0.05). However, the hormonal levels increased significantly (P = .000) from the first trimester (49.158±7.97 ng/ml to 142.21±73.194 ng/ml) to the third trimester (3121.24±2076.6 to 11648.58±8325 pg/ml) respectively. These values declined sharply during the 6 weeks post partum period to (0.344±0.213 ng/ml and 39.44±16.23 pg/ml) for both progesterone and 17β-estradiol. The post partum women and the control showed no significant difference (P =.281). Conclusion: The levels of progesterone and 17β-estradiol increased progressively throughout pregnancy and declined sharply to levels lower than the non-pregnant state during the puerperium. The levels recorded in this study are significantly higher than earlier reports among the African - Americans and the Caucasians. Thus the data generated in this study may be used as baseline values for management of pregnant women in Nigeria.