DHEA-S — Pregnancy Reference Values

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Dehydroepiandrosterone sulfate (DHEA-S)

DHEA-S is an adrenal androgen precursor. Levels vary widely in pregnancy due to changes in adrenal activity and placental metabolism.

Units Nonpregnant (premenopausal) 1st Trimester 2nd Trimester 3rd Trimester
µg/dL 48 – 252 * 74 – 611 33 – 289 30 – 241
µmol/L 1.3 – 6.8 * 2 – 16.5 0.9 – 7.8 0.8 – 6.5

*Nonpregnant reference range shown is for premenopausal females.

Physiology in pregnancy
  • DHEA-S is produced almost exclusively by the adrenal cortex (fetal and maternal).
  • DHEA-S decreases during pregnancy because the placenta rapidly converts circulating DHEA-S into estrogens (estradiol and estriol).
  • Values are highest in early pregnancy, then decline as placental metabolism increases.
Causes of elevated DHEA-S
  • Adrenal hyperplasia or adrenal tumors
  • Polycystic ovary syndrome (PCOS) — mild elevation
  • Maternal or fetal adrenal disease
  • Medications increasing adrenal output (rare)
Causes of low DHEA-S
  • Normal pregnancy (expected physiologic decline)
  • Adrenal insufficiency (primary or secondary)
  • Chronic glucocorticoid exposure
  • Hypopituitarism

References

  1. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009;114:1326–1331. PMID: 19935037.
  2. Wallach J. Interpretation of Diagnostic Tests. 8th ed. Lippincott Williams & Wilkins; 2007.