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However, a better predictive model of PE remains to be explored. A total of 15 severe preeclampsia (sPE) and 75 healthy control patients were included in this study. Patient data was obtained from September 2019 to September 2021. Nuchal translucency (NT) and crown\u2010rump length (CRL) of the fetus were acquired by ultrasound. Maternal blood samples were collected at 11<jats:sup>+0<\/jats:sup> to 13<jats:sup>+6<\/jats:sup>\u00a0weeks of gestation. Chemiluminescent immunoassays were used to detect serum testosterone (T) and estradiol (E2) levels. Time\u2010resolved fluorescence analysis was used to examine the levels of serum pregnancy\u2010associated plasma protein A (PAPPA) and \u03b2\u2010human chorionic gonadotrophin (\u03b2\u2010HCG) protein. The sPE group exhibited increased T levels, and decreased E2 levels and E2\/T ratios from 11 to 14\u00a0weeks of gestation, compared with the control group. E2 and the E2\/T ratio showed positive linear correlation with CRL in pregnant women. Body\u2010mass\u2010index (BMI), T, and E2 were determined to be the main factors that affected the occurrence of sPE at the 12\u2010week gestation period time point. The receiver operating characteristic (ROC) curve revealed that the AUC of the E2\/T ratio was .717. The imbalanced T and E2 levels in the patients had a specific intrinsic relevance with sPE, which suggests them as novel predictors of the sPE.<\/jats:p>","DOI":"10.1111\/jch.14601","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T18:53:43Z","timestamp":1670439223000},"page":"53-60","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Serum estradiol to testosterone ratio as a novel predictor of severe preeclampsia in the first trimester"],"prefix":"10.1111","volume":"25","author":[{"given":"Yongmei","family":"Shen","sequence":"first","affiliation":[{"name":"Tianjin Key Laboratory of Human Development and Reproductive Regulation Tianjin Central Hospital of Obstetrics and Gynecology  Tianjin China"},{"name":"Institute of Obstetrics and Gynecology Affiliated Maternal Hospital of Nankai University  Tianjin 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