Estimation of asymmetric dimethylarginine (ADMA), placental growth factor (PLGF) and pentraxin 3 (PTX 3) in women with preeclampsia.

OBJECTIVE

To evaluate the sequential trend of asymmetric dimethylarginine (ADMA), placental growth factor (PLGF) and pentraxin 3 (PTX 3) in pregnancies developing preeclampsia (PE) as compared to healthy pregnancy (HP) and to estimate their predictive value for development of PE later in pregnancy.

STUDY DESIGN

Nested case control design, sampling was done in 13 women with PE and 21 age matched healthy pregnant women at 11-13 weeks, 20-22 weeks and 30-32 weeks of gestation.

MAIN OUTCOME MEASURE

PLGF, ADMA, and PTX 3 were estimated temporally.

RESULTS

Serum ADMA and PTX 3 levels were higher in PE than HP even at 11-13 weeks and remained elevated throughout the gestation. PTX 3 concentration increased in both the groups with advancing gestation however significant rise was observed only in HP group. PLGF levels also increased with advancing gestation in HP group while in PE, there was a rise till 20-22 weeks of gestation followed by fall at 30-32 weeks. PLGF levels were lower in PE at 30-32 weeks than healthy pregnancy. Area under curve (AUC) for ADMA and PTX 3 were: at 11-13 weeks; 95.95% and 83.33% and 20-22 weeks; 89.88% and 90.06% respectively. At 30-32 weeks, PLGF and ADMA demonstrated an AUC of 86.51% and 86.51% respectively.

CONCLUSION

Abnormally elevated ADMA and PTX 3 levels precede the manifestation of PE and suggest endothelial dysfunction with exaggerated inflammatory response in PE. Both ADMA and PTX 3 can be used to segregate high risk women for development of PE than others in early pregnancy.