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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
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  • Enoch Anto,
  • David Coall,
  • Yaw Wiafe,
  • Otchere Addai-Mensah,
  • Cornelius Turpin,
  • Augustine Tawiah,
  • WKBA Owiredu,
  • Christian Obirikorang,
  • Eric Adua,
  • Max Annani-Akollor,
  • Samuel Sakyi,
  • Linda Fondjo,
  • Emmanuel Acheampong,
  • Evans Adu,
  • Ebenezer Afrifa-Yamoah,
  • Xueqing Wang,
  • youxin Wang,
  • wei Wang
Enoch Anto
Kwame Nkrumah University of Science and Technology

Corresponding Author:[email protected]

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David Coall
Edith Cowan University
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Yaw Wiafe
Kwame Nkrumah University of Science and Technology
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Otchere Addai-Mensah
Kwame Nkrumah University of Science and Technology
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Cornelius Turpin
Komfo Anokye Teaching Hospital
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Augustine Tawiah
Komfo Anokye Teaching Hospital
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WKBA Owiredu
Kwame Nkrumah University of Science and Technology
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Christian Obirikorang
Kwame Nkrumah University of Science and Technology
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Eric Adua
Edith Cowan University
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Max Annani-Akollor
Kwame Nkrumah University of Science and Technology
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Samuel Sakyi
Kwame Nkrumah University of Science and Technology
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Linda Fondjo
Kwame Nkrumah University of Science and Technology
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Emmanuel Acheampong
Edith Cowan University
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Evans Adu
Kwame Nkrumah University of Science and Technology
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Ebenezer Afrifa-Yamoah
Edith Cowan University School of Science
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Xueqing Wang
Edith Cowan University
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youxin Wang
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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.