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

Malvi A 1 , Shabil M 2 , Khatib MN 3 , R R 4 , Kaur M 5 , Srivastava M 6 Show all authors , Barwal A 7 , Prasad GVS 8 , Rajput P 9 , Syed R 10 , Kundra K 11 , Mittal V 12 , Kumar A 13 , Cajla P 14 , Bushi G 15 , Mehta R 16 , Khan Z 17 , Satapathy P 18 , Gaidhane S 19 , Sah R 20

Affiliations 

  • 1 Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Guwahati, India
  • 2 Noida Institute of Engineering and Technology (Pharmacy Institute), Greater Noida, India
  • 3 Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
  • 4 Department of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, Karnataka, India
  • 5 Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, Rajasthan, India
  • 6 Department of Endocrinology, NIMS University, Jaipur, India
  • 7 Chandigarh Pharmacy College, Chandigarh Group of College, Jhanjeri, Mohali, Punjab, India
  • 8 Department of Chemistry, Raghu Engineering College, Visakhapatnam, Andhra Pradesh, India
  • 9 School of Applied and Life Sciences, Division of Research and Innovation, Uttaranchal University, Dehradun, India
  • 10 IES Institute of Pharmacy, IES University, Bhopal, Madhya Pradesh, India
  • 11 New Delhi Institute of Management, Tughlakabad Institutional Area, New Delhi, India
  • 12 Graphic Era Institute of Medical Sciences, Graphic Era (Deemed to be University), Clement Town, Dehradun, India
  • 13 Centre of Research Impact and Outcome, Chitkara University, Rajpura, Punjab, India
  • 14 Chitkara Centre for Research and Development, Chitkara University, Pinjore, Himachal Pradesh, India
  • 15 School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
  • 16 Clinical Microbiology, RDC, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
  • 17 Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
  • 18 University Center for Research and Development, Chandigarh University, Mohali, Punjab, India
  • 19 One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
  • 20 SR Sanjeevani Hospital, Siraha, Kalyanpur, Nepal
J Clin Hypertens (Greenwich), 2025 Jan;27(1):e14977.
PMID: 39835844 DOI: 10.1111/jch.14977

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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