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Early second-trimester maternal hyperandrogenemia and subsequent preeclampsia: a prospective study
Sven Magnus Carlsen1, Pål Romundstad, Geir Jacobsen
1Section of Endocrinology, Department of Medicine, St Olavs Hospital, University Hospital of Trondheim, Gudruns gate 9, NO 7006 Trondheim, Norway. sven.carlsen@medisin.ntnu.no
Acta Obstetricia Et Gynecologica Scandinavica
|February 3, 2005
Summary
Maternal androgen levels, including testosterone, are elevated early in pregnancy for women who later develop preeclampsia. This suggests hyperandrogenism could be an early risk marker for preeclampsia.
Area of Science:
- Reproductive Endocrinology
- Maternal-Fetal Medicine
- Endocrinology
Background:
- Preeclampsia is a serious pregnancy complication.
- Early identification of risk factors for preeclampsia is crucial for timely intervention.
- The role of maternal androgens in preeclampsia pathogenesis is not fully understood.
Purpose of the Study:
- To investigate whether maternal androgen levels are elevated prior to the clinical onset of preeclampsia.
- To explore the potential of hyperandrogenism as an early risk marker for preeclampsia.
Main Methods:
- A case-control study involving 29 women with mild preeclampsia and 142 controls across three university hospitals in Norway and Sweden.
- Maternal serum levels of dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, and sex hormone-binding globulin (SHBG) were measured at 17 and 33 weeks of gestation.
- The free testosterone index (FTI) was calculated to assess bioavailable testosterone.
Main Results:
- Elevated levels of androstenedione, testosterone, and FTI were observed at both 17 and 33 weeks of gestation in women who developed preeclampsia.
- Dehydroepiandrosterone sulfate (DHEAS) was elevated at 17 weeks gestation only.
- Higher FTI at 17 weeks gestation was associated with an increased odds ratio (3.7) for developing preeclampsia.
Conclusions:
- Maternal androgen levels are significantly elevated in the early second trimester among women who subsequently develop preeclampsia.
- Hyperandrogenism may serve as an early predictive marker for preeclampsia.
- These findings suggest that androgens might play a role in the underlying mechanisms (pathogenesis) of preeclampsia.