Predictive Value Of Maternal Serum Biomarkers On Preeclampsia And Neonatal Birth Weight

Background:In clinical practice,abnormal biochemical changes often occur in women who eventually developed preeclampsia.The study aims to investigate whether maternal serum biochemical markers in the early third-trimester can predict preeclampsia and neonatal birth weight.Study design:A retrospective case-control study was performed on 287 women who subsequently developed preeclampsia(mild=139;severe=148)and 143 healthy women.Limosis vein blood sample of all gravidas were drawn for routine biochemical markers screening in the early third-trimester(28.49±1.63 weeks).Appropriate statistical methods were selected for analysis with SPSS software.Results:(1)The concentrations of plasma triglyceride,total cholesterol,low-density lipoprotein cholesterol,uric acid and the ratio of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the severe and mild subgroups of the preeclampsia group were significantly higher compared with the respective levels in the normal pregnancy groups(3.90 vs.4.03 vs.3.14 mmol/L;6.91 vs.6.88 vs.6.50 mmol/L;3.41 vs.3.33 vs.2.89 mmol/L;2.02 vs.2.01 vs.1.79;365.42 vs.318.91 vs.284.69 μmol/L;P<0.05).An almost perfectly converse behavior was indicated in levels of serum total calcium(2.10 vs.2.18 vs.2.22 mmol/L;P<0.0001).In particular,homocysteine levels of severe preeclampsia group were distinctly higher than that of mild preeclampsia and normal pregnancy(7.11 vs.6.49 μmol/L;7.11 vs.6.33 μmol/L;P=0.022).(2)By using the ROC curve to estimate the diagnosis rate of screening for PE of each marker,the highest sensitivity appeared by the combination of TG,TC,LDL,HDL,LDL/HDL,UA,Ca2+and HCY(79%).The AUC of UA was 0.70,which was the highest among these eight markers,but the AUC of an eight-marker combination model(0.85)had a better diagnostic indication.(3)In preeclampsia,the maximum systolic/diastolic blood pressure was significantly positively correlated with serum uric acid(r=0.212/0.205,P<0.0001),and inversely correlated with serum total calcium(r=-0.193/-0.196,P=0.001);the highest diastolic blood pressure was also correlated positively with homocysteine(r=-0.193/-0.196,P=0.045).Neonatal birth weight had a positive correlation with serum triglyceride and serum total calcium,and a negative correlation with uric acid(r=0.141,0.221 and-0.265,P=0.017,P<0.0001,P<0.0001).Conclusion:The individual markers really perform terrible in predicting preeclampsia.Joint monitoring and evaluation of these parameters may help to detect preeclampsia and poor fetal growth early.