Evaluation of serum testosterone levels in pre-eclampsia

Abstract

Background: Pre-eclampsia (PE) is a multi-system disorder that affects 3%–6% of human pregnancies and causes substantial maternal and foetal mortality and morbidity. Various studies have implicated testosterone as a causative factor in the pathogenesis of PE. The present study evaluated the association of serum testosterone levels with PE and maternal and foetal outcomes. Aim: The objectives of the study were to assess serum testosterone levels in PE compared to normotensive pregnant mothers, to look for its association with PE and to identify its utility as a biomarker for PE. Materials and Methods: A prospective cohort study was conducted in the 2nd trimester pregnant mothers (n = 110) attending the outpatient department at Vinayaka Mission’s Kirupananda Variyar Medical College Hospital, Salem. Serum testosterone, uric acid, high-sensitivity C-reactive protein (hsCRP) and creatinine were evaluated and compared amongst the pre-eclamptic and normal pregnant women. Results: The mean serum testosterone level was higher in PE women (2.625 ± 1.40 ng/dL) when compared to normal pregnant women (1.217 ± 0.258 ng/dL) (P < 0.001). Serum testosterone was found to be positively correlated with uric acid (r = 0.517, P < 0.001), hsCRP (r = 0.307, P < 0.001), systolic blood pressure (BP) (r = 0.480, P < 0.000) and diastolic BP (r = 0.544 P < 0.001). Receiver operating characteristic curve analysis for serum testosterone levels was done (area under the curve = 0.815), with sensitivity and specificity of 78.18% and 78.18%, respectively. Conclusion: This study attempted to identify the association between serum testosterone levels, PE and pregnancy outcomes in a small South Indian population. Serum testosterone levels were found to be significantly elevated in pre-eclamptic women compared to normal pregnancies and could be used as a predictive biomarker. Serum uric acid and hsCRP also showed a significant positive association with PE.

Keywords

• high-sensitivity c-reactive protein
• pre-eclampsia
• pregnancy
• testosterone