Samal Sunita, Manoharan Kaviya, Jinson Juanna, George Melvin, Rao Aishwarya Anand
Department of Obstetrics & Gynaecology, Apollo Womens' Hospital, Thousand Lights, Chennai, Tamil Nadu, 600006, India.
Department of Clinical Pharmacology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Chengalpet, Tamil Nadu, 603203, India.
Placenta. 2023 Oct;142:12-17. doi: 10.1016/j.placenta.2023.08.062. Epub 2023 Aug 15.
Preeclampsia is one of the major causes of maternal and foetal morbidity and mortality worldwide. Its complications include but are not limited to eclampsia, intracerebral haemorrhage and cardiovascular diseases in the later stages of life. The combination of clinical and risk variables and a panel of multiple biomarkers will help clinicians in risk stratification and prognostication of clinical outcomes among preeclamptic women. We evaluated MMP-9 (matrix metalloproteinase - 9) and ST2 (suppression of tumorigenicity 2) for utility as biomarkers and for predicting maternal and foetal outcomes in women with preeclampsia.
This prospective cohort study involved 49 preeclamptic women and 80 healthy controls. Biomarkers were measured in plasma using ELISA. The patients were followed up to assess maternal and foetal outcomes.
The mean value of MMP-9 was 2.42 ng/mL in the preeclamptic group and 2.67 ng/mL in controls. The mean value of ST2 (1937.4 ± 747.81) in the preeclamptic group was high compared to the control group (1005.7 ± 683.6) and the difference was significant (P = 0.0001). The study population was divided into those with high and low MMP-9 and those with high and low ST2. Lower levels of MMP-9 seemed to be related to both early and late onset preeclampsia. The ROC (Receiver Operating Characteristic) curve did not show the ability to predict maternal and foetal outcomes.
Our study demonstrated that women with preeclampsia had low MMP-9 and high ST2 compared to healthy pregnant women. But neither of the biomarkers could predict complications of preeclampsia.
先兆子痫是全球孕产妇和胎儿发病及死亡的主要原因之一。其并发症包括但不限于子痫、脑出血以及后期的心血管疾病。临床和风险变量与一组多种生物标志物相结合，将有助于临床医生对先兆子痫女性的临床结局进行风险分层和预后评估。我们评估了基质金属蛋白酶-9（MMP-9）和抑瘤素2（ST2）作为生物标志物的效用以及预测先兆子痫女性母婴结局的能力。
这项前瞻性队列研究纳入了49例先兆子痫女性和80例健康对照者。使用酶联免疫吸附测定法（ELISA）检测血浆中的生物标志物。对患者进行随访以评估母婴结局。
先兆子痫组MMP-9的平均值为2.42 ng/mL，对照组为2.67 ng/mL。先兆子痫组ST2的平均值（1937.4±747.81）高于对照组（1005.7±683.6），差异具有统计学意义（P = 0.0001）。研究人群被分为MMP-9高低组和ST2高低组。较低水平的MMP-9似乎与早发型和晚发型先兆子痫均相关。受试者工作特征（ROC）曲线未显示出预测母婴结局的能力。
我们的研究表明，与健康孕妇相比，先兆子痫女性的MMP-9水平较低，ST2水平较高。但这两种生物标志物均无法预测先兆子痫的并发症。
