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Meta-Analysis
. 2025 Jan;27(1):e14977.
doi: 10.1111/jch.14977.

Association Between SHBG Levels and Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis

Ajay Malvi  1 , Muhammed Shabil  2   3 , Mahalaqua Nazli Khatib  4 , Roopashree R  5 , Mandeep Kaur  6 , Manish Srivastava  7 , Amit Barwal  8 , G V Siva Prasad  9 , Pranchal Rajput  10 , Rukshar Syed  11 , Kamal Kundra  12 , Vinamra Mittal  13 , Amit Kumar  14 , Pancham Cajla  15 , Ganesh Bushi  16 , Rachana Mehta  17 , Zaid Khan  18 , Prakasini Satapathy  19   20 , Shilpa Gaidhane  21 , Renu Sah  22   23   24
Affiliations
Meta-Analysis

Association Between SHBG Levels and Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis

Ajay Malvi et al. J Clin Hypertens (Greenwich). 2025 Jan.

Abstract

Sex hormone-binding globulin (SHBG) regulates sex hormone availability and is influenced by metabolic factors. Variations in SHBG levels during pregnancy may affect the development of hypertensive disorders such as gestational hypertension (GH) and preeclampsia (PE). This systematic review and meta-analysis explores the potential of SHBG as a biomarker for predicting GH and PE. A search of PubMed, Embase, and Web of Science was conducted to identify studies evaluating the association between SHBG levels and the risk of HDP, including GH and PE. Inclusion criteria encompassed observational studies reporting quantitative risk estimates (risk ratios, odds ratios, or hazard ratios) for SHBG levels. Results were pooled using a random-effects meta-analysis in R software (V 4.4), with the I2 statistic assessing heterogeneity. Eight studies were included in the systematic review from a total of 592 screened records. The association between SHBG levels and the risk of any HDP showed a pooled OR of 0.875 (95% CI: 0.772-0.993), for PE 0.890 (95% CI: 0.767-1.032), and for GH 0.729 (95% CI: 0.442-1.205), suggesting significant association between SHBG and HDP. Sensitivity analysis validated the robustness of the findings. This meta-analysis found potential significant association between higher SHBG levels and risk of HDP. Further high-quality research is required to better understand the role of SHBG in pregnancy-related hypertensive disorders. Future studies should consider larger sample sizes, more precise measurement techniques, and explore potential confounding factors to clarify the potential utility of SHBG as a biomarker for predicting GH and PE.

Keywords: gestational hypertension; hypertensive disorders of pregnancy; preeclampsia; pregnancy biomarker; sex hormone binding globulin.

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Conflict of interest statement

The authors declare no conflicts of interest.

The author declares no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flowchart depicting article selection and screening process. PRISMA indicates preferred reporting items for systematic reviews and meta‐analyses.
FIGURE 2
FIGURE 2
Pooled OR for risk of HDP among individuals with high SHBG levels. HDP indicates hypertensive disorders of pregnancy; OR, odds ratios; SHBG, sex hormone‐binding globulin.
FIGURE 3
FIGURE 3
Pooled OR for risk of PE among individuals with high SHBG levels. OR indicates odds ratios; PE, preeclampsia; SHBG, sex hormone‐binding globulin.
FIGURE 4
FIGURE 4
Pooled OR for risk of GH among individuals with high SHBG levels. GH indicates gestational hypertension; OR, odds ration; SHBG, sex hormone‐binding globulin.
FIGURE 5
FIGURE 5
Subgroup analysis of pooled OR for risk of HDP among individuals with high SHBG levels. HDP indicates hypertensive disorders of pregnancy; OR, odds ratio; SHBG, sex hormone‐binding globulin.
See this image and copyright information in PMC

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