Low Serum Pregnancy Protein 13 Early in Pregnancy might predict the oncoming Gestational Hypertensive Disorders, especially Early-onset Preeclampsia

Abstract

Background: Gestational hypertensive disorders (GHD) are associated with maternal and neonatal complications. However, the prediction of GHD stills a dilemma especially in high-risk women. Objectives: Evaluation of the role of estimated serum levels of pregnancy protein 13 (PP13) for the prediction of GHD in newly pregnant women. Patients and methods: the attendants of the clinic with a one-missed period (T0) underwent determination of baseline blood pressure (BP) measures and gave blood samples for estimation of levels of PP13, placental growth factor (PLGF) and soluble fms-like tyrosine kinase-1 (sFlt-1). The same evaluations were repeated on the 6th, 24th, 32nd, and 36th gestational week (GW). Twenty non-pregnant women gave samples as control group for estimated biomarkers. Results: PP13 was undetectable in sera of non-pregnant women but was detected in all T0 samples of pregnant women, but were significantly lower in PE women and continued to increase during pregnancy with significantly lower levels in PE women. The sFlt-1/PLGF ratio was significantly higher in PE women than in other women. Low serum PP13 levels and high sFlt-1/PLGF in T0 samples are significant predictors for high BP measures at the 24th GW and low serum PP13 at the cutoff point of 122 ng/ml can predict early-onset PE. Conclusion: Low serum PP13 levels in T0 sample could predict women liable to develop GHD especially early-onset PE and low PP13 levels and high sFlt-1/PLGF ratio in the 6th GW samples will assure this suspicion.

Keywords

• gestational hypertensive disorders; pregnancy protein 13; placental growth factor; early predictors; early-onset preeclampsia