Maternal serum dehydroepiandrosterone sulfate levels and the efficiency of labor in young nulliparas

OBJECTIVE: To evaluate the maternal serum dehydroepiandrosterone (DHEA) sulfate level as a factor influencing labor "efficiency" at term. METHODS: On admission to the labor and delivery unit, blood was collected from 55 term nulliparous women up to 25 years of age in active labor. Following delivery, umbilical venous cord blood was also collected. Pregnancies complicated by diabetes mellitus, hypertension, fetal growth restriction, tobacco use, corticosteroid use, or chorioamnionitis were excluded. Serum DHEA sulfate levels were measured by radioimmunoassay. Dehydroepiandrosterone sulfate levels and other obstetric variables were correlated retrospectively with the clinically determined requirement for oxytocin augmentation of labor. The unpaired Student t test, Mann-Whitney test, and linear correlation were used for statistical analysis. P < .05 was considered statistically significant. RESULTS: Oxytocin augmentation followed standard indications in 29 of the 55 patients. The mean (+/- standard error) maternal serum DHEA sulfate level was significantly lower in these patients than in the remaining 26 who progressed spontaneously through labor (99.31 +/- 8.92 versus 135.05 +/- 12.30 micrograms/dL, respectively; P = .02). With the exception of cervical dilation on admission, no significant demographic differences were identified between the two groups. The maternal serum DHEA sulfate level did not correlate significantly with cervical dilation on admission (r = 0.03, P = .81). CONCLUSION: Among term nulliparous women, maternal serum levels of DHEA sulfate are significantly lower in those clinically requiring pharmacologic augmentation than in those progressing spontaneously through labor. Dehydroepiandrosterone sulfate may be an important factor in efficient labor.