Maternal serum dehydroepiandrosterone sulfate levels and successful labor induction

OBJECTIVE: To evaluate the maternal serum dehydroepiandrosterone (DHEA) sulfate level as a factor affecting the outcome of labor induction. STUDY DESIGN: After obtaining consent, venous blood was collected at the initiation of labor induction from 139 women. Pregnancies complicated by chronic maternal corticosteroid use, antepartum chorioamnionitis, or intrapartum fetal distress resulting in cesarean delivery were excluded from analysis. In those 133 women meeting inclusion criteria, induction methods included intravenous oxytocin and/or intravaginal prostaglandin gel following established protocols. Serum DHEA sulfate levels were measured by radioimmunoassay. DHEA sulfate levels were correlated with the success or failure of each attempt. A success was defined as progression to vaginal delivery prior to discharge from the labor and delivery unit. Linear correlation, the Welch approximate t-test, and Fisher's exact test were utilized for statistical analysis, with P < 0.05 considered statistically significant. RESULTS: Serum DHEA sulfate levels correlated significantly with the length of time from initiation of induction to deliver)- (r = -0.19, P = 0.03). The mean (± standard error) DHEA sulfate level approached significance in women who progressed successfully to vaginal delivery compared to those with unsuccessful attempts (112.27 ±6.37 vs 87.53 ± 10.67 (JLg/dl, respectively; P = 0.06). As compared with women having DHEA sulfate levels >70 μg/dl, women with levels ≤70 μg/dl had a relative risk = 2.05 (95% confidence interval of 0.92-4.54) for unsuccessful induction (P = 0.11). CONCLUSION: Higher maternal serum DHEA sulfate levels correlate significantly with a shorter length of labor. Among women undergoing induction of labor, maternal serum DHEA sulfate levels are higher in those who progress successfully to vaginal delivery than in those with unsuccessful attempts; however, this difference does not reach statistical significance with the current sample si/e. DHEA sulfate may be an important factor in successful labor induction.