A physiologic model of the dehydroepiandrosterone to estrogen conversion system in the fetoplacental unit. II. Preliminary clinical application--the dehydroepiandrosterone loading test.

A dehydroepiandrosterone (DHEA) loading test (DLT) is described. The results of 19 DHEA loading tests in as many third-trimester obstetric patients are presented. Analysis involves inspection of the raw data and the application of the physiologic model of the DHEA to estrogen conversion system described in the preceding paper (Part I). The DLT results show that within the population studied, the conversion rate of DHEA to estrogens is lower in patients with placental insufficiency than in normal patients (N = 5, p = 0.002) or in patients with various complications of pregnancy who deliver normally grown, undistressed infants (N = 6, p = 0.001). Routine clinical application must await more extensive evaluation to preclude the existence of forms of placental insufficiency not detected by this means, or normal states resulting in "false-positive" tests. These initial clinical results are intended primarily to demonstrate the potential clinical applicability of the physiologic model described in Part I.