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Gestational Age-specific Reference Intervals for Androgens in Pregnancy.

So Ling Lau1, Lai Yuk Yuen1, Chung Shun Ho2

  • 1Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.

The Journal of Clinical Endocrinology and Metabolism
|June 13, 2024
PubMed
Summary

This study establishes gestational age-specific reference intervals for maternal androgens, total testosterone (TT), androstenedione (A4), and 17-hydroxyprogesterone (17-OHP). Elevated levels of these hormones were observed in women with preeclampsia, even before its clinical onset.

Keywords:
17-hydroxyprogesteroneChineseandrostenedionenomogrampregnancysex hormonetestosterone

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Area of Science:

  • Reproductive Endocrinology
  • Maternal-Fetal Medicine
  • Clinical Chemistry

Background:

  • Maternal androgen levels can influence pregnancy outcomes and cervical remodeling.
  • Establishing gestational age-specific reference intervals for androgens is crucial for diagnosing maternal hyperandrogenism.
  • Previous studies suggest a link between higher androgen levels and adverse pregnancy outcomes.

Purpose of the Study:

  • To establish population-based, gestational age-specific reference intervals for total testosterone (TT), androstenedione (A4), and 17-hydroxyprogesterone (17-OHP) in healthy Chinese women.
  • To investigate the relationship between maternal androgen levels and preeclampsia (PE).

Main Methods:

  • Longitudinal serum samples were collected from 600 healthy pregnant Chinese women.
  • Serum androgen profiles (TT, A4, 17-OHP) were quantified using liquid chromatography-tandem mass spectrometry.
  • Statistical modeling (MedCal, MLwiN) was employed to generate reference intervals and analyze variances.

Main Results:

  • Total testosterone (TT) and androstenedione (A4) levels increased throughout gestation and were highly correlated (R = .90).
  • 17-hydroxyprogesterone (17-OHP) levels showed a decrease from week 5 to 16, followed by an increase towards term.
  • Women with preeclampsia (PE) exhibited significantly higher levels of A4, TT, and 17-OHP compared to non-PE cases (P≤ .01).

Conclusions:

  • The study provides a robust methodology for creating gestational age-specific reference ranges for maternal androgens.
  • Higher maternal TT, A4, and 17-OHP levels were observed prior to the clinical manifestation of preeclampsia.
  • These findings enhance the interpretation of androgen profiles in pregnancy and support their role in PE pathogenesis.