Biochemical Indicators as Predictive Markers by Combining Clinical Signs in Pre-eclampsia

Abstract

Abstract AIM: To determine whether previously identified risk factors are associated with the development of a severe form of pre-eclampsia in a heterogeneous cohort of women, and the predictive values of these risk factors when combined with certain biochemical indicators. MATERIALS AND METHODS: Systematic review of data collected for a doctoral case-control study plus an examination of the indicators of pre-eclampsia and maternal IL10 levels. This examination was conducted in 100 women with pregnancies complicated by varying degrees of pre-eclampsia and in 80 normotensive patients hospitalized at the University Clinic of Gynecology and Obstetrics, Skopje, Republic of Macedonia. Patients with preeclampsia were categorized into moderate (m PE) and severe (s PE) pre-eclampsia group according to the degree of pre-eclampsia. The severity of pre-eclampsia was determined according to the definition of the World Health Organization, Handbook for guideline development from 2010. RESULTS: The regression analysis applied in this study showed that elevated systolic blood pressure of 160 mmHg or higher, diastolic blood pressure of 100 mmHg or higher, pregnancy at an older age, nulliparity, persistent proteinuria in pregnancy, the serum lactate dehydrogenase concentration of 450 U/L or higher, and reduced serum concentrations of IL10 as significant predictors of severe pre-eclampsia in pregnant women. While other variables predicted a higher likelihood for the development of severe pre-eclampsia, IL10 decreased such likelihood. IL10 was also found to be negatively correlated with proteinuria and positively correlated with blood platelets. Significantly higher concentration of IL10 was confirmed in patients with a higher number of platelets in the blood and vice versa. On the other hand, the serum concentration of IL10 was significantly lower in patients with a higher amount of proteins in the urine and vice versa. CONCLUSIONS: Examination of clinical risk factors combined with biochemical markers can improve the predictive success of pre-eclampsia and has important clinical values in improving the prognosis of pregnant women and fetuses.