Evaluating circulating soluble markers of endothelial dysfunction and risk factors associated with PE: A multicentre longitudinal case control study in northern Ghana
Benjamin Ahenkorah,
Samuel Asamoah Sakyi,
Linda Ahenkorah Fondjo,
Gideon Helegbe,
Eddie-Williams Owiredu,
Edmund Muonir Der,
Linda Eva Amoah,
Kwadwo Asamoah Kusi,
Dorotheah Obiri,
Benjamin Amoani,
Samuel Bimpong,
Winfred Ofosu,
Christian Obirikorang,
Enoch Odame,
Christopher Larbie,
Priscilla Arthur-Johnson,
Isaac Quaye,
Emmanuel Mawuli Ametefe,
Bernard Kwaku Okai,
Rasheed Anormah,
Emmanuel Akorli,
Ana Maria Simono Charadan,
Robilu Mikdad Aboubacar,
Emmanuel Amesewu,
Ben Gyan
Affiliations
Benjamin Ahenkorah
Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Medical Laboratory Science, Bolgatanga Technical University, Bolgatanga, Upper East Region, Ghana; Corresponding author. Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Samuel Asamoah Sakyi
Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Linda Ahenkorah Fondjo
Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Gideon Helegbe
School of Medicine and Health Science, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Eddie-Williams Owiredu
Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Edmund Muonir Der
School of Medicine and Health Science, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Linda Eva Amoah
Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana
Kwadwo Asamoah Kusi
Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana
Dorotheah Obiri
Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana
Benjamin Amoani
Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
Samuel Bimpong
School of Medicine and Health Science, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Winfred Ofosu
Ghana Health Service, Upper East Region, Ghana
Christian Obirikorang
Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Enoch Odame
Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Christopher Larbie
Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Priscilla Arthur-Johnson
School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
Isaac Quaye
Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana
Emmanuel Mawuli Ametefe
Department of Pathology, Korle-Bu Teaching Hospital, Ghana
Bernard Kwaku Okai
Ghana Health Service, Upper East Region, Ghana
Rasheed Anormah
School of Medicine and Health Science, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Emmanuel Akorli
School of Medicine and Health Science, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Ana Maria Simono Charadan
School of Medicine and Health Science, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Robilu Mikdad Aboubacar
School of Medicine and Health Science, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Emmanuel Amesewu
School of Medicine and Health Science, Tamale Teaching Hospital, University for Development Studies, Tamale, Ghana
Ben Gyan
Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana; Department of Pharmaceutics and Microbiology, School of Pharmacy, University of Ghana, Ghana
Serpin E1/PAI-1, N-terminal pro-brain natriuretic peptide (NTpro-BNP) and neuropilin-1 are markers which have been associated with endothelial dysfunction. However, data on the levels of these markers in PE is limited. The limited data on the pathophysiology of PE in relation to these markers necessitated the study.This was a multicentre case-control study conducted at the Obstetrics and Gynaecology Department of the Tamale Teaching Hospital, the Bawku Presbyterian Hospital and the Bolgatanga Regional Hospital. Out of 520 consenting pregnant women, 127 pregnant women met the inclusion criteria (53 with PE and 74 controls) and were included in this study. Venous, placental, cord and peripheral blood were collected for biomarker assay, haematological parameters and placental parasite determination. Placental tissue sections were obtained for placental malaria and histopathological lesions associated with hypoperfusion. Maternal heart rate and foetal umbilical artery Doppler impedance indices; resistance index (RI) and systolic diastolic (SD) ratio were determined to confirm utero-placental hypoperfusion.Significantly higher proportions of foeto-maternal complications; eclampsia, low birth weight (LBW), neonatal intensive care unit admissions (NICU), intrauterine growth restriction (IUGR), caesarian deliveries and early gestational age at delivery were associated with PE. Women with PE had lower concentrations of platelet (p = 0.02) whereas red cell distribution width (RDW) was markedly elevated (p = 0.01). NTPro-BNP concentration was markedly elevated (p = 0.01) in women with PE whereas neuropilin-1 concentration was lower (p = 0.03) compared to the non-PE group. Maternal heart rate was elevated in women with PE and Doppler resistance indices (RI and SD) were significantly elevated in foetuses of PE women than foetuses of the controls. Placental mal-perfusion lesions were higher in women with PE compared to the non-PE group.Women with PE had increased risk of adverse foeto-maternal complications, significantly associated with placental mal-perfusion lesions, had reduced platelet concentration and elevated RDW-CV levels. NTPro-BNP, RI and SD are elevated in women with PE whereas neuropilin-1 concentration is reduced. Significant changes in these pathological variables in PE women is indicative of significant derangement in endothelial function culminating in adverse maternal and perinatal outcomes of pregnancy.
