Novel prognostic Potential of Early Second Trimester and Mid-pregnancy
8-hydroxy-2-deoxyguanosine/Placental growth factor ratio for
preeclampsia: A Longitudinal Nested-Case Control Study
Abstract
Objective The study used both subjective, Suboptimal Health Status (SHS)
concept along with objective, biomarkers of oxidative stress (OS):
8-OHdG, 8-epi-PGF2α and total antioxidant capacity (TAC); and angiogenic
growth mediators (AGMs): VEGF-A, sFlt-1, PlGF and soluble endoglin
(sEng) for predicting early-onset (EO) and late-onset (LO) preeclampsia
(PE) Design A hospital-based longitudinal nested case-control study
Setting Obstetrics and Gynaecology Department at Komfo Anokye Teaching
Hospital, Ghana Population/Sample Singleton normotensive pregnancies
(NTN-P) at baseline W1 (10-20th week gestation) (n= 593) of which 498
(197 developed PE) completed the study. Methods: The overall health
status of the NTN-P participants was assessed at W1 and categorised as
SHS and optimal health status (OHS) using a validated SHS
questionnaire-25. Participants were followed at W2 (21-31st week,
mid-pregnancy) and 32-42nd week. Samples were collected and analysed for
biomarkers of OS and AGMs at the three-time points. Main Outcome
Measures Receiver operative characteristics curve analysis was performed
for the single and combined W1 and W2 biomarkers of OS and AGMs for
predicting PE and its subtypes (EO-PE and LO-PE) Results Compared to
single biomarkers of OS and AGMs, their combined ratios particularly,
the W2 8-OHdG/PIGF ratio was a potent biomarker for PE [AUC=0.93].
Additionally, 8-OHdG/PIGF ratio best identified SHS-pregnant women who
later developed EO-PE [AUC=0.97] and LO-PE [AUC=0.93]. Moreover,
8-OHdG/PIGF ratio best identified OHS-pregnant women who later developed
EO-PE [AUC=0.94] and LO-PE (AUC=0.94). Conclusion Combination of
biomarkers of OS and AGMs, particularly, mid-pregnancy 8-OHdG/PlGF ratio
is a potent biomarker for PE and its subtypes.