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Correlation of Serum Cancer Antigen-125 (CA-125) Levels with Severity of Pre-eclampsia

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Abstract

Background

Pre-eclampsia is often associated with unfavourable feto-maternal outcomes. There is a lacuna in its pathophysiology, which emphasizes the need to research for tests, which can predict or correlate with the severity of pre-eclampsia. Cancer antigen-125 (CA-125) is a simple, readily available biomarker with evidence of its secretion at the choriodecidual unit and may have a possible role. This study compared serum CA-125 levels between normal pregnant and pre-eclamptic women and determined its clinical usefulness in correlating with the severity of pre-eclampsia.

Methods

A case–control study was conducted enrolling 58 women with pre-eclampsia further divided into severe and non-severe groups and 62 gestational age-matched healthy, pregnant controls. Serum CA-125 levels were compared between the two groups.

Results

The mean serum CA-125 in the controls was 16.44 ± 8.28 IU/ml, 13.82 ± 9.18 IU/ml in the non-severe and 23.55 ± 30.55 IU/ml in the severe pre-eclampsia group (p = 0.134). Serum CA-125 had a significant association with systolic blood pressure (SBP) p = 0.002), diastolic blood pressure (DBP) (p = 0.026), foetal growth restriction (p = 0.025), pre-term birth (p = 0.039) and a highly significant association with 24-h urinary protein, liver enzymes, placental abruption, need of maternal intensive care as well as with poor neonatal outcome including stillbirth and neonatal mortality (p < 0.001).

Conclusion

Serum CA-125 levels were found to be higher in the severe pre-eclampsia group as compared to non-severe pre-eclampsia and normotensive group, but the difference was not statistically significant. More studies on a larger scale are required to prove the usefulness of this marker with respect to maternal and perinatal outcome as well as its association with pre-eclampsia and its severity.

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References

  1. American College of Obstetricians and Gynecologists. Committee on practice bulletins—obstetrics. ACOG practice bulletin number 222: gestational hypertension and pre-eclampsia. Obstet Gynecol. 2020;135:237–60.

    Article  Google Scholar 

  2. Duley L. The global impact of pre-eclampsia and eclampsia. InSeminars Perinatol. 2009;33:130–7.

    Article  Google Scholar 

  3. Pre-eclampsia. Pre-eclampsia|National Health Portal of India; 2022. Accessed from: https://www.nhp.gov.in/disease/gynaecology-and-obstetrics/pre-eclampsia. Accessed 1 Nov 2022.

  4. Ghulmiyyah L, Sibai B. Maternal mortality from pre-eclampsia/eclampsia. Semin Perinatol. 2012;36:56–9.

    Article  PubMed  Google Scholar 

  5. Van Lerberghe W. The world health report 2005: make every mother and child count. Geneva: World Health Organization; 2005.

    Google Scholar 

  6. Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller AB, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013;10:1–4.

    Article  Google Scholar 

  7. Cudihy D, Lee RV. The pathophysiology of pre-eclampsia: current clinical concepts. J Obstet Gynaecol. 2009;1(29):576–82.

    Article  Google Scholar 

  8. Hladunewich M, Karumanchi SA, Lafayette R. Pathophysiology of the clinical manifestations of pre-eclampsia. Clin J Am Soc Nephro. 2007;2:543–9.

    Article  Google Scholar 

  9. Jacobs I, Bast RC Jr. The CA 125 tumour-associated antigen: a review of the literature. Human Reprod. 1989;4:1–2.

    Article  CAS  Google Scholar 

  10. Schmidt T, Rein DT, Foth D, Eibach HW, Kurbacher CM, Mallmann P, et al. Prognostic value of repeated serum CA 125 measurements in first trimester pregnancy. Eur J Obstet Gynecol Reprod Biol. 2001;97:168–73.

    Article  CAS  PubMed  Google Scholar 

  11. Jacobs IJ, Fay TN, Stabile I, Bridges JE, Oram DH, Grudzinskas JG. The distribution of CA 125 in the reproductive tract of pregnant and non-pregnant women. BJOG Int J Obstet Gynaecol. 1988;95:1190–4.

    Article  CAS  Google Scholar 

  12. Kobayashi F, Sagawa N, Nakamura K, Nonogaki M, Ban C, Fujii S, et al. Mechanism and clinical significance of elevated CA 125 levels in the sera of pregnant women. Am J Obstet Gynecol. 1989;160:563–6.

    Article  CAS  PubMed  Google Scholar 

  13. Brumsted JR, Nakajima ST, Badger G, Riddick DH, Gibson M. Serum concentration of CA-125 during the first trimester of normal and abnormal pregnancies. J Reprod Med. 1990;35:499–502.

    CAS  PubMed  Google Scholar 

  14. Seki K, Kikuchi Y, Uesato T, Kato K. Increased serum CA 125 levels during the first trimester of pregnancy. Acta Obstet Gynecol Scand. 1986;65:583–5.

    Article  CAS  PubMed  Google Scholar 

  15. El Shahaway AA, Abd Elhady RR, Abdelrhman AA, Yahia S. Role of maternal serum interleukin 17 in preeclampsia: diagnosis and prognosis. J Inflammation Res. 2019;12:175–80.

    Article  Google Scholar 

  16. Garovic VD, Dechend R, Easterling T, Karumanchi SA, McMurtry Baird S, Magee LA, et al. Hypertension in pregnancy: diagnosis, blood pressure goals, and pharmacotherapy: a scientific statement from the american heart association. Hypertension. 2022;79:e21-41.

    Article  CAS  PubMed  Google Scholar 

  17. Tyler C, Kapur A, Felder M, Belisle JA, Trautman C, Gubbels JA, et al. The mucin MUC 16 (CA 125) binds to NK cells and monocytes from peripheral blood of women with healthy pregnancy and preeclampsia. Am J Reprod Immunol. 2012;68:28–37.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Ibrahem WW, Al-Assaly RK, Al-Haddad NS. CA-125, plasma fibrinogen and C-reactive protein in correlation with severity of preeclampsia. J Fac Med Baghdad. 2017;59:31–5.

    Article  Google Scholar 

  19. Karaman E, Karaman Y, Alkış İ, Han A, Yıldırım G, Ark HC. Maternal serum CA-125 level is elevated in severe preeclampsia pregnancy hypertension. Int J Women’s Cardiovasc Health. 2014;4:29–33.

    Google Scholar 

  20. Mukherjee B, Das A. Association between serum CA-125 levels and severity of pre-eclampsia: a case-control study conducted in a tertiary care centre, West Bengal. Int J Reprod Contracept Obstet Gynecol. 2020;9:4176.

    Article  Google Scholar 

  21. Schröcksnadel H, Daxenbichler G, Artner E, Steckel-Berger G, Dapunt O. Tumor markers in hypertensive disorders of pregnancy. Gynecol Obstet Investig. 1993;35:204–8.

    Article  Google Scholar 

  22. de Groot CJ, O’Brien TJ, Taylor RN. Biochemical evidence of impaired trophoblastic invasion of decidual stroma in women destined to have preeclampsia. Am J Obstet Gynecol. 1996;175:24–9.

    Article  PubMed  Google Scholar 

  23. Bon GG, Kenemans P, Verstraeten AA, Go S, Philipi PA, Van Kamp GJ, et al. Maternal serum Ca125 and Ca15-3 antigen levels in normal and pathological pregnancy. Fetal Diagn Ther. 2001;16:166–72.

    Article  CAS  PubMed  Google Scholar 

  24. Cebesoy FB, Balat O, Dikensoy E, Kalayci H, Ibar Y. CA-125 and CRP are elevated in preeclampsia. Hypertens Pregnancy. 2009;28:201–11.

    Article  CAS  PubMed  Google Scholar 

  25. Mahdi Kamel W, Hadi Hameed B, Abdul-Hassan-Ali D. The association of serum cancer antigen 125 and c-reactive protein level with the severity of preeclampsia. Kerbala J Med. 2012;5:1322–7.

    Google Scholar 

  26. Karrar AA, Elzein AO, Elzein HO. Determination of cancer antigen-125 level and its association with pre-eclampsia among Sudanese women. Ann Clin Anal Med. 2020;11:1–5.

    Google Scholar 

  27. Bhattacharya A, Saha R. Serum concentrations of CA-125 in normal and preeclamptic pregnancies. Iosrphr Org. 2014;4:14–7.

    Article  CAS  Google Scholar 

  28. Ozat M, Kanat-Pektas M, Yenicesu O, Gungor T, Danisman N, Mollamahmutoglu L. Serum concentrations of CA-125 in normal and preeclamptic pregnancies. Arch Gynecol Obstet. 2011;284:607–12.

    Article  CAS  PubMed  Google Scholar 

  29. Gottipati G, Supriya K. Maternal serum cancer antigen 125: a marker of severity of preeclampsia. J South Asian Fed Obstet Gynaecol. 2019;11:154.

    Google Scholar 

  30. Sayyadi B, Takai I, Ibrahim S, Abdulsalam K, Ibrahim U. CA125 levels in pregnancy: a case-control study amongst pregnant women in Aminu Kano teaching hospital. North-West Niger Niger Postgrad Med J. 2020;27:325–30.

    Article  PubMed  Google Scholar 

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Acknowledgements

Authors would like to thank the Department of Obstetrics and Gynaecology and the Department of Biochemistry, Government Medical College and Hospital, Chandigarh, for giving support in conducting this study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Chandigarh, India

    Pooja Bhatia, Poonam Goel, Reeti Mehra & Sunita Dubey

  2. Department of Biochemistry, Government Medical College and Hospital, Chandigarh, India

    Seema Gupta

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  1. Pooja Bhatia
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Correspondence to Pooja Bhatia.

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Conflict of interest

The authors have no conflict of interest to declare.

Ethical Approval

Approved by the Institutional Ethics Core Committee. The study was conducted among the patients diagnosed with pre-eclampsia at any period of gestation visiting the outpatient department, admitted in antenatal ward or referred to the emergency ward of Department of Obstetrics and Gynaecology of Government Medical College and Hospital, Chandigarh. It was conducted on ethical guidelines for biomedical research on human subjects as given in the Declaration of Helsinki and the Central Ethics Committee on Human Research (CEHER) of ICMR, New Delhi.

Informed Consent

The purpose of the study was explained to all the potential participants, and a written and informed consent was taken from all the patients. Samples were collected from subjects who gave their consent for inclusion in the study at no cost to the participants. They were given the right to opt out of the study at any time with no impact on the treatment to be given. All information including history, physical and laboratory findings obtained from the participants was kept strictly confidential.

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Dr. Pooja Bhatia is a Senior Resident; Dr. Poonam Goel is a Professor and Head; Dr. Reeti Mehra is a Professor; Dr. Sunita Dubey is an Associate Professor; Dr. Seema Gupta is an Associate Professor.

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Bhatia, P., Goel, P., Mehra, R. et al. Correlation of Serum Cancer Antigen-125 (CA-125) Levels with Severity of Pre-eclampsia. J Obstet Gynecol India 73 (Suppl 2), 240–246 (2023). https://doi.org/10.1007/s13224-023-01869-2

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  • DOI: https://doi.org/10.1007/s13224-023-01869-2

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