Fibronectin as an Early Predictor of Gestational Hypertension/Preeclampsia.

Corresponding Author:
Dr. Geeta DG,
H. No. 3-1/72, Dr. Reddys Enclave,
Near Makta, Miyapur, Hyderabad-500049,
Telangana, India.
E-mail: gitagadhiraju@gmail.com

ABSTRACT

BACKGROUND

Hypertensive disorders complicate 2% to 8% of pregnancies globally. They are one of the leading causes of maternal mortality responsible for 16% of maternal deaths. Preeclampsia is a pregnancy specific syndrome whose pathophysiologic features have not been clearly established, but research during past two decades has suggested that maternal endothelial damage and improper placental development are involved in the genesis of preeclampsia. Fibronectin is known to be a marker of endothelial dysfunction, which occurs in early gestation in women who develop preeclampsia in later gestation and hence levels of fibronectin may vary in first trimester itself in such women. We wanted to examine the usefulness of single biomarker ‘plasma fibronectin’ in screening of pregnant women for gestational hypertension/preeclampsia, study the difference in fibronectin levels in early versus late onset gestational hypertension/preeclampsia and evaluate its levels in preeclampsia with severe features.

METHODS

200 antenatal women with singleton pregnancy, who were normotensive were enrolled in the study and plasma fibronectin levels were measured at 10-12 weeks of gestation. Women were followed throughout pregnancy and 12 weeks postpartum. Plasma fibronectin levels were compared between normotensive women and women who developed gestational hypertension/preeclampsia.

RESULTS

The mean values of plasma fibronectin are significantly higher in group who developed gestational hypertension/preeclampsia compared to group who remained normotensive (167+/-81 vs 114+/-58; p<0.05). The mean value in group with early onset disease as well as preeclampsia with severe features is higher than that of group with late onset disease and preeclampsia without severe features respectively. But the difference is not statistically significant.

CONCLUSIONS

Study showed that plasma fibronectin could be used as a marker for early prediction of gestational hypertension/ preeclampsia.

KEY WORDS

HDP, Gestational Hypertension, Preeclampsia, Fibronectin, Endothelial Dysfunction, Predictor