Plasma Level of Umbilical Cord Hemeoxygenase-1 (HO-1)  and Neonatal Outcome in Early Onset and Late Onset  Severe Preeclampsia

Background: Many studies had discovered that early onset severe preeclampsia (EO-PE) has worst maternal and neonatal outcome compared to late-onset type (LO-PE), related to its placental involvement. Severe preeclampsia was defined as newly onset severe hypertension developed after 20 weeks gestation in previously normal blood pressure women, with coexistence of proteinuria, or maternal organ or uteroplacental dysfunction. Hemeoxygenase-1 (HO-1) is an enzyme with multiple effect which is protective to pregnancy.Materials and Methods: The total study subjects were 40 pregnant women consisted of 10 EO-PE, 10 normal early onset pregnancy (EO-NP), 10 LO-PE, and 10 normal late onset pregnancy (LO-NP). As much as 5 cc of plasma from umbilical cord was taken as soon as the baby was born, and the HO-1 level was examined by enzyme-linked immunosorbent assay (ELISA). The primary outcome were umbilical cord HO-1 level and neonatal composite morbidity (low Apgar score, low birthweight, length of stay >5 day, respiratory distress syndrome, jaundice and neonatal death).Results: The plasma level of HO-1 in EO-PE subjects were lower than EO-NP (0.96±0.37 ng/mL vs. 2.43±0.58 ng/mL, p<0.001). There were no significant differences in the level of HO-1 in LO-PE and LO-NP (2.18±1.07 ng/mL vs. 3.02±0.64 ng/mL, p=0.277). Plasma level of umbilical cord HO-1 of EO-PE patients was lower compared to LO-PE (0.96±0.37 ng/mL vs. 2.18±1.07 ng/mL, p=0.034). Neonatal outcome of EO-PE was worse than EO-NP (p=0.033), and LO-PE (p=0.003), while in LO-PE did not different with LO-NP (p=0.211).Conclusion: EO-PE is associated with lower plasma umbilical cord level of HO-1 and worse neonatal outcome compared to LO-PE. This indicating abnormal placental blood vessel development, placental ischemia in EO-PE, lead to reduced uteroplacental perfusion and significantly worse neonatal outcome compared to LO-PE.Keywords: severe preeclampsia, early onset preeclampsia, late onset preeclampsia, hemeoxygenase-1

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Altered Maternal Serum Matrix Metalloproteinases MMP-2, MMP-3, MMP-9, and MMP-13 in Severe Early- and Late-Onset Preeclampsia

BioMed Research International ◽

10.1155/2017/6432426 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 15

Author(s):

Marzena Laskowska

Keyword(s):

Matrix Metalloproteinases ◽

Pregnant Women ◽

Immunosorbent Assay ◽

Early Onset ◽

Late Onset ◽

Maternal Serum ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Controls ◽

Control Subjects ◽

Early Onset Preeclampsia

Objective. The aim of this study was to determine whether maternal serum matrix metalloproteinases 2, 3, 9, and 13 levels differ in early- and late-onset preeclampsia and uncomplicated pregnancies. Patients and Methods. The study was carried out in 125 pregnant women (29 with early-onset preeclampsia; 31 preeclamptic patients with late-onset preeclampsia; and 65 healthy pregnant controls). Levels of MMP-2, MMP-3, MMP-9, and MMP-13 were measured in the maternal serum using an enzyme-linked immunosorbent assay. Results. Maternal serum MMP-2 levels in both the groups of preeclamptic women were significantly higher than those in the controls. Levels of MMP-3 were significantly higher in preeclamptic patients with early-onset disease; however, the MMP-3 levels in patients with late-onset preeclampsia were similar to those observed in the control subjects. MMP-9 levels were lower whereas the levels of MMP-13 were higher in both preeclamptic groups of pregnant women than in the healthy controls, but these differences were statistically insignificant. Conclusions. One important finding of the present study was that MMP-3 appears to be involved solely in early-onset preeclampsia, but not in late-onset preeclampsia. Higher levels of MMP-2 and MMP-13 and lower levels of MMP-9 seem to be related to both early- and late-onset severe preeclampsia.

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Different Profile of Serum Leptin between Early Onset and Late Onset Preeclampsia

Disease Markers ◽

10.1155/2014/628476 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 15

Author(s):

Saeedeh Salimi ◽

Farzaneh Farajian-Mashhadi ◽

Anoosh Naghavi ◽

Mojgan Mokhtari ◽

Mahnaz Shahrakipour ◽

...

Keyword(s):

Early Onset ◽

Significant Positive Correlation ◽

Late Onset ◽

Maternal Serum ◽

Serum Adiponectin ◽

Enzyme Linked Immunosorbent Assay ◽

Serum Leptin ◽

Positive Correlation ◽

Early Onset Preeclampsia

Aim. This study was designed to clarify the role of leptin and adiponectin in preeclampsia (PE) pathogenesis and different subtypes of preeclampsia.Method. This case control study was performed in 45 PE patients and 45 healthy controls matched for age, BMI, and ethnicity. Serum leptin and adiponectin levels were determined by enzyme linked immunosorbent assay (ELISA).Results. Maternal serum leptin and adiponectin were significantly higher in PE women than controls. Serum leptin was elevated in early onset preeclampsia (EOPE) and late onset preeclampsia (LOPE) compared to controls. Among PE patients, serum leptin was higher in EOPE than LOPE women. However, serum adiponectin was not different between EOPE and LOPE women. The serum leptin was significantly higher in severe PE than mild PE. The serum adiponectin was significantly elevated in severe PE compared to controls. Significant positive correlation was observed between leptin and adiponectin and also between leptin and BMI in controls. Moreover significant positive correlation was observed between adiponectin and BMI in PE patients and controls.Conclusion. The present study showed that serum leptin level may play a significant role as a biomarker to differentiate early and late onset PE and also its relation to BMI and severity of disease.

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Differences in levelFms-Like Tyrosine Kinase-1 (sFlt-1), soluble Endoglin (s-Eng), and Placental Growth Factor (PIGF) between Early Onset Preeclampsia and Late Onset Preeclampsia

Journal of Midwifery ◽

10.25077/jom.3.2.11-18.2018 ◽

2018 ◽

Vol 3 (2) ◽

pp. 11

Author(s):

Lita Nafratilova ◽

Yusrawati Yusrawati ◽

Irza Wahi

Keyword(s):

Early Onset ◽

Late Onset ◽

Serum Levels ◽

Enzyme Linked Immunosorbent Assay ◽

Cross Sectional ◽

Intrinsic Factors ◽

Significant Difference ◽

The Difference ◽

Cross Sectional Design ◽

Early Onset Preeclampsia

Early Onset Preeclampsia (EO-PE) is preeclampsia that develops before 34 weeks 'gestation, caused by intrinsic factors, while Late Onset Preeclampsia (LO-PE) is preeclampsia that develops after 34 weeks' gestation due to extrinsic and maternal factors. There is an increased production of antiangiogenic factors (sFlt-1, s-Eng and PIGF) contribute to pathophysiology of preeclampsia.This study aims to measure the difference of sFlt-1, sEng, PIGF levels between EO-PE and LO-PE. This was an observational study with cross sectional design conducted at Dr. M. Djamil, TK Hospital. III dr. Reksodiwiryo and Biomedical Laboratory FK Unand Padang from August 2017 to August 2018. The sample of this study were 26 severe preeclampsia women : 13 (EO-PE) and 13 (LO-PE), selected using consecutive sampling. Levels of sFlt-1, sEng, PIGF were examined using the enzyme-linked immunosorbent assay (ELISA) method. Statistical analysis was performed using unpaired t test and Mann-Whitney Test. Results shown that serum levels of sFlt-1 and sEng in (EO-PE) were 9.51 ± 0.71 ng / L, 1.44 ± 0.06 ng / mL, 5.79 ± 0.42 ng / mL while in PEAL it was 8, 89 ± 0.78 ng / mL, 1.35 ± 0.14 ng / mL, 6.72 ± 0.76. There were a significant difference with a value of p <0.05. The conclusion of this study is that the levels of sFlt-1 and sEng are higher in (EO-PE) than(LO-PE)and PIGF levels was lower in (EO-PE) compared to (LO-PE)

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Faculty Opinions recommendation of Cardiovascular disease risk factors after early-onset preeclampsia, late-onset preeclampsia, and pregnancy-induced hypertension.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725298358.793542862 ◽

2018 ◽

Author(s):

Andrew Shennan ◽

Kate Duhig

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Early Onset ◽

Disease Risk ◽

Late Onset ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

Early Onset Preeclampsia

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THE RELATIONSHIP BETWEEN THE ONSET OF SEVERE PREECLAMPSIA AND PERINATAL COMPLICATIONS AT RUMKITAL Dr. RAMELAN IN SURABAYA

Indonesian Midwifery and Health Sciences Journal ◽

10.20473/imhsj.v5i2.2021.139-151 ◽

2021 ◽

Vol 5 (2) ◽

pp. 139

Author(s):

Widya Retno ◽

Ivon Diah Wittiarika ◽

Muhammad Aldika Akbar

Keyword(s):

Preterm Delivery ◽

Early Onset ◽

Late Onset ◽

Previous History ◽

Severe Preeclampsia ◽

P Value ◽

Chronic Hypertension ◽

Perinatal Complications ◽

Exact Test ◽

The Relationship

Abstract Background: Preeclampsia is one of the biggest causes of maternal-fetal morbidity and mortality. Based on the prognosis, the classification of Preeclampsia is early onset (<34 weeks) and late onset (> 34 weeks). Purpose: to investigate the relationship between the onset of severe Preeclampsia and perinatal complications. Method: This research is a quantitative study with a retrospective observational analytic study type and collected medical record data. The study population was severe Preeclampsia patients who gave birth at RUMKITAL Dr. Ramelan Surabaya for the period January 2018 - June 2020 and has no previous history of chronic hypertension. The research sample was 79 subjects with 44 subjects early onset, and 35 subjects late onset. Perinatal complications examined are preterm delivery, asphyxia, LBW, IUGR, stillbirth. The chi-square test or Fisher’s Exact Test was used to analyze relationships. Result: From the results of the study, the comparison of the percentage from early onset and late onset that experienced complications was 93.2% vs 48.6%, p-value = 0.000, OR = 14.5, CI = 3,764–55,635. At preterm delivery, it was found that 75% vs 28.6%, p-value = 0.000, OR = 7.5, CI = 2,754-20,422. . In asphyxia, it was found 41.7% vs 31.4%, p-value = 0.46. At LBW, it was found 72.7% vs 17.1%, p-value = 0,000, OR = 12.9, CI = 4,285-38,771. In IUGR, it was found that 15.9% vs 2.9%, p-value = 0.000. In stillbirth, it was found 18.2% vs 0% and p-value = 0.008. Conclusion: the onset of severe Preeclampsia is related with perinatal complications. Complications associated with the onset severe Preeclampsia are preterm, LBW, stillbirth. Meanwhile, complications that are not related with the onset severe Preeclampsia are asphyxia and IUGR

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Maternofetal outcomes in early versus late onset pre-eclampsia: a comparative study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190282 ◽

2019 ◽

Vol 8 (2) ◽

pp. 548

Author(s):

Poornima Shankar ◽

Kavitha Karthikeyan ◽

Amrita Priscilla Nalini ◽

Sindhura M. ◽

Gowtham Kim

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Early Onset ◽

Age Of Onset ◽

Late Onset ◽

Fetal Outcomes ◽

Chi Square ◽

Onset Type ◽

Significant Difference ◽

Early Onset Preeclampsia

Background: Preeclampsia is being increasingly recognized as two different entities: early-onset preeclampsia occurring at less than 34 weeks of gestation, and late-onset disease occurring at 34 or more weeks of gestation. Early-onset and late-onset pre-eclampsia are found to have different implications for the mother and neonate. The aim of this study is to compare the risk factors, maternal and fetal outcomes in early (<34 weeks) versus late (≥34weeks) onset preeclampsia.Methods: 208 patients diagnosed with pre-eclampsia in Chettinad Academy of Research and Education over a period of three years (From January 2014 to December 2016) were retrospectively studied. Patients were classified as early onset and late onset pre-eclampsia based on the gestational age of onset. Data on risk factors, maternal and fetal outcomes were collected and analyzed using Chi Square and Fisher’s test and compared.Results: The overall preeclampsia rate was 6.3%. Early onset and late onset were 34.6% and 65.3% respectively and the rate increased with increasing gestational age.35.3% of patients with late onset preeclampsia and 55.6% patients of early onset type required more than one drug which is a statistically significant difference. Proteinuria more than 3gm/l/day was significantly more in late onset preeclampsia than in early onset preeclampsia. 55.5% of patients with early onset pre-eclampsia required MgSO4 when compared to 17.4%. There was no statistically significant difference in the rate of caesarean section (61.1% vs 73.5%). Altered coagulation profile was significantly more in early onset preeclampsia (11.1%). The incidence of oligohydramnios, SGA and low APGAR at 5 minutes of birth were significantly high in early onset pre-eclampsia when compared to late onset type.Conclusions: Patients with early onset pre-eclampsia are found to have significantly higher rates of specific maternal and fetal morbidity when compared to the late onset type.

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Maternal ABO Blood Type and Factors Associated With Preeclampsia Subtype

Biological Research For Nursing ◽

10.1177/1099800419833782 ◽

2019 ◽

Vol 21 (3) ◽

pp. 264-271 ◽

Cited By ~ 1

Author(s):

Adriane Burgess ◽

Teresa S. Johnson ◽

Amanda Simanek ◽

Theodore Bell ◽

Sandra Founds

Keyword(s):

Early Onset ◽

Late Onset ◽

Risk Identification ◽

Blood Type ◽

Tertiary Referral Center ◽

South Central ◽

Central Pennsylvania ◽

Subtype Identification ◽

Abo Blood Type ◽

Early Onset Preeclampsia

Background: The pathophysiology of preeclampsia remains unclear. The disorder is heterogeneous, and the pathophysiology may vary by subtype. Identification of relevant biomarkers will help to better elucidate the pathophysiologic basis of each preeclampsia subtype. Blood type may be a biomarker that allows risk identification for preeclampsia. Objective: The purpose of this study was to investigate the associations among maternal ABO blood type and preeclampsia subtype and fetal growth restriction (FGR). Method: Medical records of 126 women with early-onset preeclampsia (≤33 6/7 weeks’ gestation), 126 women with late-onset preeclampsia (≥34 0/7 weeks’ gestation), and 259 controls who gave birth between January 2012 and June 2016 were retrospectively abstracted from a large suburban tertiary referral center in South Central Pennsylvania for this hospital-based case–control study. Results: Women with AB blood type had >3 times the odds of late-onset preeclampsia (odds ratio [ OR] = 3.35, 95% confidence interval (CI) = [1.02, 11.05]) compared to those with O blood type. Among women with early-onset preeclampsia, those with B blood type had 5 times the odds of having a growth-restricted fetus than did women with O blood type ( OR = 5.44, 95% CI [1.65, 17.94]). Discussion: Our findings suggest that AB blood type may be an important risk factor for late-onset preeclampsia and that among women with early-onset preeclampsia, those with B blood type have increased odds of FGR. These findings warrant further study in women and their offspring to identify the pathophysiologic processes that may link ABO blood type, preeclampsia subtype, and FGR.

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Ketanserin versus dihydralazine in the management of early-onset preeclampsia: Maternal and neonatal outcome

American Journal of Obstetrics and Gynecology ◽

10.1016/s0002-9378(97)80104-4 ◽

1997 ◽

Vol 176 (1) ◽

pp. S15 ◽

Cited By ~ 3

Author(s):

AC Bolte ◽

J van Eyck ◽

HW Bruinse ◽

HHH Kanhai ◽

A de Vries ◽

...

Keyword(s):

Early Onset ◽

Neonatal Outcome ◽

Early Onset Preeclampsia

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HtrA3 Isoform–Specific ELISAs for Early Detection of Preeclampsia

SLAS DISCOVERY Advancing Life Sciences ◽

10.1177/1087057116682425 ◽

2016 ◽

Vol 23 (10) ◽

pp. 1092-1099 ◽

Cited By ~ 2

Author(s):

Yao Wang ◽

Ying Li ◽

Jonathan Hyett ◽

Fabricio da Silva Costa ◽

Guiying Nie

Keyword(s):

Early Detection ◽

Early Onset ◽

Late Onset ◽

Pdz Domain ◽

First Trimester ◽

Potential Utility ◽

Third Trimester ◽

The Third ◽

Early Onset Preeclampsia ◽

Singleton Pregnancies

Preeclampsia is a serious disorder of human pregnancy occurring after 20 weeks of gestation. It can be divided into subtypes of early onset (<34 weeks of gestation) and late onset (>34 weeks). Presymptomatic detection to identify those at high risk is important for managing this disease. HtrA3, a serine protease with high expression in the developing placenta, exists in long (HtrA3-L) and short (HtrA3-S) isoforms. They are identical, except HtrA3-S lacks the C-terminal PDZ domain. We have previously shown by Western blot analysis that serum HtrA3 levels at the end of the first trimester are significantly higher in women who later develop preeclampsia than in controls. In this study, using highly specific HtrA3 monoclonal antibodies, we established and fully validated two enzyme-linked immunosorbent assays to detect both HtrA3 isoforms together (HtrA3-T) and HtrA3-L alone in the human serum. We then determined serum HtrA3 at 11 to 13 weeks of gestation in a cohort of singleton pregnancies that proceeded without complications or developed preeclampsia in the third trimester. Compared with controls, those who developed late-onset preeclampsia had significantly higher levels of HtrA3-L, whereas those who developed early-onset preeclampsia had significantly lower ratios of HtrA3-L/HtrA3-T. These data support a potential utility of these HtrA3 ELISAs for early detection of preeclampsia.

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