Markers may predict severe preeclampsia.

FROM THE ANNUAL MEETING OF THE SOCIETY FOR MATERNAL-FETAL MEDICINE

SAN FRANCISCO--Levels of serum markers measured early in the second trimester of pregnancy may help identify women who are likely to develop severe preeclampsia, the results of a nested case-control study indicated.

There was no association between the levels of vitamin D and of two angiogenic factors that have been previously implicated in the development of preeclampsia, soluble FMS-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF).

But both the level of vitamin D and the ratio of sFlt-1 to PlGF predicted the development of severe preedampsia after other risk factors were taken into account. And in ROC (receiver operating characteristic) curve analysis, the combination outperformed either measure individually lead investigator Dr. Padmashree Chaudhury Woodham said at the meeting.

A low 25-hydroxyvitamin D level has previously been shown to be a risk factor for severe preeclampsia, said Dr. Woodham, who is a fellow in ob.gyn, at the University of North Carolina at Chapel Hill. But its association with angiogenic factors is unclear.

The investigators drew their study patients from a large cohort of pregnant women who gave blood for routine prenatal screening at a gestational age of 1520 weeks. Each of the 43 woman in the study who developed severe preeclampsia was matched by race / ethnicity with three control women in a group of 123 women who had uncomplicated births at term.

Relative to controls, the women who developed preeclampsia had lower levels of vitamin D, vascular endothelial growth factor, and PlGF, and a higher sFlt-1:PlGF ratio; all of the differences were significant. Levels of vitamin D were not correlated with levels of VEGF, PlGE or the sFlt-I:PlGF ratio. However, each 1nmol/L increase in total vitamin D was associated with a 5% reduction in the odds of preedampsia, while each 1-unit increase in the sFlt-1 :PlGF ratio was associated with an 11% increase in the odds.

VITALS

Major Finding: The combination of 25-hydroxyvitamin D level and sFlt-1:PIGF ratio early in the second trimester had an area under the ROC curve of 0.834 for predicting severe preeclampsia.

Data Source: A nested, case-control study of 164 pregnant women, one-fourth of whom had developed severe preeclampsia.

Disclosures: Dr. Woodham did not report any relevant conflicts of interest.