Association Between Serum Free Testosterone Levels and Preeclampsia from 20 to 40 Weeks of Gestation

Author(s): Dr. Tanzina Iveen Chowdhury, Prof. Dr. Tripti Rani Das, Farah Noor, Dr. Sabiha Islam, Dr. Jinat Fatema, Dr. Shah Noor Sharmin, Dr. Dipika Majumder, Dr. Bidisha Chakma*

Background: Preeclampsia remains a leading global cause of maternal and perinatal morbidity, disproportionately affecting low-and middleincome countries like Bangladesh where its rising prevalence necessitates identifying hormonal risk factors such as elevated serum free testosterone for improved early detection and prevention.

Aim: To determine the relationship between serum free testosterone levels and the occurrence of preeclampsia in pregnant women between 20 and 40 weeks of gestation.

Materials and Methods: This case-control study was conducted at the Bangladesh Medical University (BMU), Dhaka, from September 2021 to August 2022. It included 39 primigravid women with preeclampsia and 39 gestational age-matched normotensive controls (20-40 weeks), selected via purposive sampling. Data was collected through interviews and clinical assessments. Proteinuria was measured from midstream urine, and serum free testosterone was analyzed using the Diagnosis Related Group (DRG) Enzyme-Linked Immunosorbent Assay (ELISA) kit at BMU. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 26.

Results: Among 78 pregnant women, high serum free testosterone levels were more prevalent in the preeclampsia group 48.7% than in controls 41.0%, with a significant association observed p = 0.030. Preeclampsia cases had higher rates of obesity 56.4%, moderate to severe edema 41.0%, and primigravida status 79.5%. Educational level, income, and employment diversity were lower in the case group. Proteinuria was more severe among cases, with 48.7% showing ++ or +++ levels compared to 35.9% in controls.

Conclusion: Elevated serum free testosterone levels were significantly associated with preeclampsia, suggesting a potential role for androgens in its pathogenesis and utility as an early biomarker in pregnancy risk assessment.