Laskowska Marzena, Dymara-Konopka Weronika, Szmit Elżbieta, Ledwich-Kibicka Dominika, Wróbel Andrzej
Department of Obstetrics and Perinatology, Medical University of Lublin, Jaczewskiego 8, 20-095, Lublin, Poland.
Neonatology Division of Clinical Public Hospital, No 4 in Lublin, Jaczewskiego 8, 20-095, Lublin, Poland.
Heliyon. 2023 Jul 7;9(7):e18105. doi: 10.1016/j.heliyon.2023.e18105. eCollection 2023 Jul.
The aim of the present study was to assess the interrelationships between the level of matrix metalloproteinase-3 in the blood serum of pregnant women and the occurrence of pregnancy complications in the form of foetal growth restriction, idiopathic or in the course of preeclampsia.
A total of 245 patients were included in the study. 65 of them are normotensive patients with idiopathic foetal growth restriction (FGR group). 115 women were diagnosed with severe preeclampsia. In the group of women with preeclampsia, there were 51 patients with adequate for gestational age foetal growth and 64 patients with the foetal growth restriction in the course of severe preeclampsia. The control group consisted of 65 healthy patients with normal pregnancy course, with no cardiovascular disorders at the present and in the history, normal blood pressure and normal intrauterine foetal growth. Matrix metalloproteinase-3 (MMP-3) in maternal circulation were determined by ELISA method.
In our studies, we observed elevated levels of matrix metalloproteinase-3 in preeclamptic women with pregnancies complicated by FGR and significantly lower in the group of normotensive women with idiopathic FGR. The mean values of MMP-3 were 33.50 ± 65.74 ng/mL [Median (min-max) 19.19 (2.05-454.53)] in the Control group, 21.22 ± 23.28 ng/mL [Median (min-max) 16.39 (3.45-156.29)] in the FGR group, 35.96 ± 46.14 ng/mL [Median (min-max) 25.21 (4.16-253.05)] in the P group and 52.81 ± 61.61 ng/mL [Median (min-max) 32.83 (5.06-314.14)] in preeclamptic women with FGR (group PI) respectively.The assessment of MMP-3 in the serum of women with pregnancies complicated by intrauterine foetal growth restriction with normal values of blood pressure and in the group of preeclamptic patients in relation to healthy pregnant women with uncomplicated pregnancies and in relation to preeclamptic patients with normal intrauterine foetal growth is the novelty of this study. Such a strict definition of each research group seems to allow for the assessment of each pregnancy complication separately.
It seems that higher levels of MMP-3 in preeclamptic women may suggest the need for observation towards the risk of lower birth weight of newborns. This necessitates further research and a better integration in the clinical practice.
本研究的目的是评估孕妇血清中基质金属蛋白酶-3水平与胎儿生长受限、特发性或子痫前期过程中妊娠并发症发生之间的相互关系。
本研究共纳入245例患者。其中65例为患有特发性胎儿生长受限的血压正常患者（FGR组）。115名女性被诊断为重度子痫前期。在子痫前期女性组中，有51例胎儿生长符合孕周，64例在重度子痫前期过程中出现胎儿生长受限。对照组由65例妊娠过程正常的健康患者组成，目前及既往无心血管疾病，血压正常，宫内胎儿生长正常。采用ELISA法测定母血循环中的基质金属蛋白酶-3（MMP-3）。
在我们的研究中，我们观察到子痫前期合并胎儿生长受限的孕妇血清中基质金属蛋白酶-3水平升高，而特发性胎儿生长受限的血压正常女性组中该水平显著降低。对照组MMP-3的平均值为33.50±65.74 ng/mL[中位数（最小值-最大值）19.19（2.05-454.53）]，FGR组为21.22±23.28 ng/mL[中位数（最小值-最大值）16.39（3.45-156.29）]，P组为35.96±46.14 ng/mL[中位数（最小值-最大值）25.21（4.16-253.05）]，子痫前期合并胎儿生长受限的女性（PI组）为52.81±61.61 ng/mL[中位数（最小值-最大值）32.83（5.06-314.14）]。本研究的新颖之处在于评估血压正常但合并宫内胎儿生长受限的孕妇血清中的MMP-3，以及子痫前期患者与妊娠未合并并发症的健康孕妇以及胎儿生长正常的子痫前期患者相比的情况。每个研究组如此严格的定义似乎允许分别评估每种妊娠并发症。
子痫前期女性中较高水平的MMP-3似乎提示需要关注新生儿低出生体重的风险。这需要进一步的研究并更好地融入临床实践。
