Serum estradiol to testosterone ratio as a novel predictor of severe preeclampsia in the first trimester

Shen, Yongmei; Cao, Jiasong; Yao, Lei; Li, Shanshan; Zhao, Xuefei; Li, Wen; Zhuo, Wei; Zhang, Lei; Wang, Jianxi; Chang, Ying

doi:10.1111/jch.14601

Cited by 5 publications

(1 citation statement)

References 39 publications

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“…More recently, in 2022, in China, Shen et al measured serum T levels in pregnant women in the first semester to evaluate whether the serum estradiol-to-T ratio is a biomarker of pre-eclampsia severity. T levels alone showed no significant difference between the groups, although the severe pre-eclamptic group exhibited higher levels [ 96 ].…”

Section: Effects Of Testosterone In Pre-eclampsiamentioning

confidence: 99%

Relationship between Androgens and Vascular and Placental Function during Pre-eclampsia

Fernandes,

Lorigo,

Cairrao

2024

CIMB

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Hypertensive disorders of pregnancy (HDP) represent a substantial risk to maternal and fetal health. Emerging evidence suggests an association between testosterone and pre-eclampsia (PE), potentially mediated through androgen receptors (AR). Nevertheless, the mechanism driving this association is yet to be elucidated. On the other hand, reports of transgender men’s pregnancies offer a limited and insightful opportunity to understand the role of high androgen levels in the development of HDP. In this sense, a literature review was performed from a little over 2 decades (1998–2022) to address the association of testosterone levels with the development of HDP. Furthermore, this review addresses the case of transgender men for the first time. The main in vitro outcomes reveal placenta samples with greater AR mRNA expression. Moreover, ex vivo studies show that testosterone-induced vasorelaxation impairment promotes hypertension. Epidemiological data point to greater testosterone levels in blood samples during PE. Studies with transgender men allow us to infer that exogenous testosterone administration can be considered a risk factor for PE and that the administration of testosterone does not affect fetal development. Overall, all studies analyzed suggested that high testosterone levels are associated with PE.

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Section: Effects Of Testosterone In Pre-eclampsiamentioning

confidence: 99%

Relationship between Androgens and Vascular and Placental Function during Pre-eclampsia

Fernandes,

Lorigo,

Cairrao

2024

CIMB

View full text Add to dashboard Cite

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The Relationship Between the Average Decreased Times of Estradiol and Early Miscarriage: An Observational Study

Mu,

Wang,

et al. 2024

Reprod. Sci.

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Decreased estradiol (E2) levels are associated with early miscarriage (EM), but the relationship between decreased times of E2 and EM has not been reported. We aimed to investigate the relationship between the average decreased times of E2 (ADTE) and EM. Women with a history of miscarriage were retrospectively recruited from the Reproductive Center of Lanzhou University Second Hospital (Lanzhou, China) between September 2019 and February 2022. Based on pregnancy outcome, they were divided into ongoing pregnancy group (n = 359) and EM group (n = 104). In addition, subgroup analyses were performed for the number of previous miscarriages and whether E2 levels decreased continuously. The exposure and outcome variables were ADTE and miscarriage before 12 weeks of gestation, respectively. Totally, 1171 patients were recruited and 463 patients were finally analyzed. ADTE was associated with EM (odds ratio [OR] = 1.346, 95% confidence interval [CI]1.154-1.571, P < 0.001). When ADTE ≥ 2.5, the EM risk increased 1.17-fold compared to patients with 0-1.249 times (OR = 2.170, 95% CI 1.144-4.117, P = 0.018). Moreover, a threshold effect existed in the ADTE and the risk of EM with a value of 4.9 times. When exceeding 4.9 times, the EM risk increased 4.713-fold for each increased unit (OR = 5.713, 95% CI 1.255-23.170, P = 0.024). Subgroup analysis showed that ADTE had a greater effect on the occurrence of EM in women with a history of 1-2 miscarriages than in women with 3 miscarriages. Decreased E2 was a risk factor for EM regardless of whether it dropped continuously or not. In conclusion, our study identifies a potential link between ADTE and early miscarriage risk in women with prior miscarriages, yet cautious interpretation is necessary due to inherent design limitations. Further research with prospective designs and large population samples is essential to validate ADTE's utility as a predictive indicator for early miscarriage in clinical settings.

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Serum estradiol to testosterone ratio as a novel predictor of severe preeclampsia in the first trimester

Shen

Cao

Yao

et al. 2022

J of Clinical Hypertension

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Preeclampsia (PE) is the most common medical complication during pregnancy and the second leading cause of maternal death worldwide. However, a better predictive model of PE remains to be explored. A total of 15 severe preeclampsia (sPE) and 75 healthy control patients were included in this study. Patient data was obtained from September 2019 to September 2021. Nuchal translucency (NT) and crown-rump length (CRL) of the fetus were acquired by ultrasound. Maternal blood samples were collected at 11 +0 to 13 +6 weeks of gestation. Chemiluminescent immunoassays were used to detect serum testosterone (T) and estradiol (E2) levels. Time-resolved fluorescence analysis was used to examine the levels of serum pregnancy-associated plasma protein A (PAPPA) and β-human chorionic gonadotrophin (β-HCG) protein. The sPE group exhibited increased T levels, and decreased E2 levels and E2/T ratios from 11 to 14 weeks of gestation, compared with the control group. E2 and the E2/T ratio showed positive linear correlation with CRL in pregnant women. Body-mass-index (BMI), T, and E2 were determined to be the main factors that affected the occurrence of sPE at the 12week gestation period time point. The receiver operating characteristic (ROC) curve revealed that the AUC of the E2/T ratio was .717. The imbalanced T and E2 levels in the patients had a specific intrinsic relevance with sPE, which suggests them as novel predictors of the sPE.

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Serum estradiol to testosterone ratio as a novel predictor of severe preeclampsia in the first trimester

Cited by 5 publications

References 39 publications

Relationship between Androgens and Vascular and Placental Function during Pre-eclampsia

Relationship between Androgens and Vascular and Placental Function during Pre-eclampsia

The Relationship Between the Average Decreased Times of Estradiol and Early Miscarriage: An Observational Study

Serum estradiol to testosterone ratio as a novel predictor of severe preeclampsia in the first trimester

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