Association of sflt-1 as a maternal serum biomarker in preeclampsia: A case–control tertiary care hospital based study

Abstract

\n\nPreeclampsia (PE) is a multisystemic disorder portrayed by the new beginning of circulatory pressure more noteworthy than 140/90 mmHg and proteinuria with 0.3 g in a 24 h on dip stick emerging after 20 weeks of incubation. The hidden pathophysiology of PE includes endothelial brokenness and vasospasm beginning principally in the placenta. The unusual growth of blood vessels in placenta leads to poor perfusion. This relative hypoxic condition in placenta causes arrival of antiangiogenic factors into the maternal blood dissemination which prompts the modifications in maternal fundamental endothelial functions and causes hypertension. Soluble fms-like tyrosine kinase (sFlt) can form a heterodimer, binding with vascular endothelial growth Factor A and placental growth factor. In preeclamptic subjects, there will be an imbalance in anti-angiogenesis factors and there will be incomplete arterial transformation and cytotrophoblast cell division. Due to imbalance in sFlt levels in preeclamptic women it effects in the blood vessels by constriction and leads to endothelial dysfunction. This study aim is to compare the maternal serum concentration of sFlt levels in normotensive pregnant women to preeclamptic women in early and late gestational weeks.\n\n\n\nOut of 300 participants in the case–control study, 150 were preeclamptic women as cases and 150 as normotensive pregnant women as controls participated in the present study. A 5 ml of maternal venous blood was collected; the serum was separated and stored at –800°C till the analysis. Using commercially available enzyme-linked immunosorbent assay (ELISA) kits from Chongqing Biospes Co., Ltd., (suppliers: Infobio Company, New Delhi) was measured with ELISA microplate reader at 450 nm (Merilyzer Eiaquant Company).\n\n\n\nOut of 300 participants in the study, 46 pregnant women were early gestational weeks and 254 were late gestational weeks. The complications due to severe PE such as intrauterine death are 15%, intrauterine fetal growth retardation 33%, and premature 15%. The statistical analyses were performed by Statistical Packages for the Social Sciences Software 22. The area under the receiver operating characteristic curve is 0.82, with 91% sensitivity, and 79% specificity. The significance in the maternal serum sFlt levels was calculated by the Mann–Whitney U-test. By comparing the cases and controls, it was found that maternal serum sFlt1 were significantly higher in preeclamptic women with Z = 2.96 and U = 9021 with P = 0.005 significance.\n\n\n\nThis is the first South Indian study. If we compare the sFlt1 levels in early and late gestational weeks, in late gestational weeks in controls and PE the levels were highly significant than early gestational weeks of PE and controls. Maternal serum sFlt can be used as a preeclamptic diagnostic marker in South Eastern Kolar population.\n