Androgen levels in the third trimester of pregnancy in patients with preeclampsia Emanouel Salamalekis * , Panagiotis Bakas, Nikolaos Vitoratos, Makarios Eleptheriadis, Georgios Creatsas 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens, Vas. Sofias Avenue 76, Athens, Greece Received 5 September 2004; received in revised form 19 April 2005; accepted 13 July 2005 Abstract Objective(s): To investigate if testosterone levels are higher in patients with preeclampsia compared to normotensive pregnant patients. Study design: The levels of serum total and free testosterone, dehydroepiandrosterone sulfate, androstenedione and sex hormone binding globulin were estimated in 28 patients during the third trimester of pregnancy with established preeclampsia and 25 normotensive women. Results: No statistically significant differences were noted between the two groups regarding the maternal age, gestational age, body mass index (BMI) haematocrit and neonatal sex. The mean Æ S.D. total testosterone and free testosterone levels were significantly higher ( p < 0.01) in the group with preeclapsia compared to the control group. The values of DHEA-S, androstenedione and sex hormone binding globulin were lower in the group with preeclampsia but the difference did not reach statistical significance. Conclusion(s): The levels of total and free testosterone appear to be higher in patients with preeclampsia compared to normotensive pregnant women during the third trimester of pregnancy. This difference could indicate an involvement of testosterone in the pathophysiology of preeclampsia and stimulates research in the potential role of anti-androgens in the management of preeclampsia. # 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Preeclampsia; Androgens; Testosterone; Pregnancy; Hypertension 1. Introduction Hypertension in pregnancy including gestational hyper- tension and preeclampsia, is associated with significant morbidity and mortality [1]. Although the pathophysiology of preeclampsia remains unclear, several mechanisms have been investigated and implicated for the development of preeclampsia such as the rennin–angiotensin system, platelets [2], endothelial function [3], the role of carbon monoxide, nitric oxide and prostacyclines [4], the role of androgens [5,6]. The presence of polycystic ovarian syndrome, which is characterized by elevated levels of circulating androgens, has been associated with significantly increased risk of pregnancy-induced hypertension [7]. Also, women with prior preeclampsia have been found to have elevated testosterone levels even 17 years later [8]. In the present study, we aimed to investigate any possible link between androgens and preeclampsia in the period between 28 and 34 weeks of gestation (first half of third trimester). 2. Material and methods We studied 53 women with singleton pregnancies during the third trimester at the 2nd Department of Obstetrics and Gynecology of Athens University. All women included in the study were taking iron and multivitamin supplementa- tion and none of them were taking antihypertensive or hormonal treatment. There was no history of hypertension, hyperandrogenism or polycystic ovarian syndrome. Patient recruitment was done from the outpatient clinic and all patients gave their informed consent for the study, www.elsevier.com/locate/ejogrb European Journal of Obstetrics & Gynecology and Reproductive Biology 126 (2006) 16–19 * Corresponding author at: University of Athens, Alexandras avenue 108, 11472 Athens, Greece. Fax: +30 210 7473204. E-mail address: eurotas@panafonet.gr (E. Salamalekis). 0301-2115/$ – see front matter # 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ejogrb.2005.07.007