Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India.
Department of Physiology, Uttar Pradesh Autonomous State Medical College, Hardoi, Uttar Pradesh, India.
Ann Afr Med. 2024 Apr 1;23(2):169-175. doi: 10.4103/aam.aam_81_23. Epub 2024 May 1.
Preeclampsia is a life-threatening complication of pregnancy that occurs in approximately 7% of all pregnancies. In India, the incidence of preeclampsia is 8%-10% and the prevalence is 5.4%, whereas the prevalence of hypertensive disorders of pregnancy is 7.8%.
This study was aimed at evaluating the diagnostic accuracy of serum glycosylated fibronectin (S. GlyFn) in the prediction of preeclampsia.
A nested case-control study was carried out for 16 months in the department of obstetrics and gynecology. A total of 240 women were recruited and followed after written consent and ethical clearance. Six were lost to follow-up, 15 had second-trimester abortions (excluded from the study), and 32 women developed hypertensive disorders of pregnancy (cases), out of which 1 woman developed antepartum eclampsia, 10 women developed preeclampsia with severe features, and 21 women developed preeclampsia without severe features. One hundred and eighty-seven women remained normotensive throughout the pregnancy until 6 weeks postpartum. After randomization, out of these samples, 54 were analyzed and considered controls. Levels of S. GlyFn were estimated using an ELISA kit using the ELISA technique.
The mean S. GlyFn level was significantly higher at the time of enrollment among those women who later developed preeclampsia (127.59 ± 27.68 ng/m) as compared to controls (107.79-53.51 ng/mL). GlyFn at a cutoff value of 126.70 ng/mL significantly (P = 0.034) discriminates cases of preeclampsia with severe features from healthy controls with a sensitivity of 90.00%, a specificity of 63.00%, a 31.03% positive predictive value, and 97.14% negative predictive value.
S. GlyFn, at a cutoff value of 126.70 ng/mL, had good sensitivity to discriminate PE from normotensive and was also a good prognostic marker.
子痫前期是一种危及生命的妊娠并发症，约占所有妊娠的 7%。在印度，子痫前期的发病率为 8%-10%，患病率为 5.4%，而妊娠高血压疾病的患病率为 7.8%。
本研究旨在评估血清糖基化纤维连接蛋白（S. GlyFn）在预测子痫前期中的诊断准确性。
在妇产科进行了为期 16 个月的嵌套病例对照研究。共招募了 240 名女性，并在书面同意和伦理批准后进行了随访。有 6 人失访，15 人在妊娠中期流产（排除研究），32 人发生了妊娠高血压疾病（病例），其中 1 人发生产前子痫，10 人发生重度子痫前期，21 人发生无重度子痫前期。187 名女性在整个孕期直至产后 6 周一直保持血压正常。随机分组后，从这些样本中分析了 54 个样本并将其视为对照。使用 ELISA 试剂盒和 ELISA 技术来估计 S. GlyFn 的水平。
与对照组（107.79-53.51ng/mL）相比，后来发生子痫前期的女性在入组时的平均 S. GlyFn 水平显著升高（127.59±27.68ng/m）。GlyFn 在截断值为 126.70ng/mL 时，能显著（P=0.034）区分有严重特征的子痫前期病例与健康对照组，其敏感性为 90.00%，特异性为 63.00%，阳性预测值为 31.03%，阴性预测值为 97.14%。
S. GlyFn 在截断值为 126.70ng/mL 时，具有良好的敏感性，可以区分子痫前期与正常血压，并且也是一个良好的预后标志物。
