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Adhesion molecules, activin and inhibin—candidates for the biochemical prediction of hypertensive diseases in pregnancy?

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Abstract

Background

The aim of the prospective study was to compare standard parameters as Doppler ultrasound and 24-h blood pressure measurement with possible maternal serological markers regarding their prognostic value in predicting hypertensive diseases in pregnancy.

Materials

Twenty-four-hour blood pressure measurement was performed before and after 32+0 gestational week in 57 pregnant women with either chronic hypertension (n=13), preeclampsia (n=21), pregnancy-induced hypertension (PIH; n=12) or normotension (n=11). Blood samples were taken and the concentrations of soluble intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), activin A and inhibin A were determined as well as serum uric acid, creatinine, total serum protein and serum albumin. Doppler ultrasound of the uterine arteries was examined before 32+0 gestational week in the same patients. For the statistical evaluation Kruskal-Wallis-Test and Mann-Whitney-U-Test were performed. Differences in the predictive value were evaluated by receiver-operating characteristics.

Results

VCAM-1 was significantly elevated in women developing hypertensive diseases as compared to normotensive women (preeclampsia: p<0.001; PIH: p<0.05; chronic hypertension: p<0.001). In early pregnancy activin A and inhibin A were significantly higher in preeclamptic patients than in the other groups (activin A: normotension: p<0.005; PIH: p<0.001; chronic hypertension: p<0.005) (inhibin A: normotension: p<0.005; PIH: p<0.001; chronic hypertension: p<0.01), thus suggesting them to be specific markers for the development of preeclampsia. Mean arterial pressure was significantly elevated in preeclampsia (p<0.001) and chronic hypertension (p<0.005) as compared to normotensives.

Conclusion

Twenty-four-hour blood pressure monitoring with determination of mean arterial pressure and measurement of VCAM-1, activin A and inhibin A as serum parameters can be suggested as useful tests in the specific prediction of different types of hypertensive diseases in pregnancy.

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Abbreviations

AUC:

Area under the curve

ELISA:

Enzyme-linked immunosorbent assay

ICAM-1:

Intercellular adhesion molecule-1

MAP:

Mean arterial pressure

PI:

Pulsatility index

PIH:

Pregnancy-induced hypertension

ROC:

Receiver-operating characteristic

s:

Soluble

SD:

Standard deviation

VCAM-1:

Vascular cell adhesion molecule-1

g.w.:

Gestational week

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Acknowledgement

We thank Iris Paffenholz for her technical assistance in the determination of the adhesion molecules and of activin A and inhibin A.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Hospital, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany

    Claudia G. Hanisch

  2. Department of Obstetrics and Gynecology, University Hospital, Hufelandstrasse 55, 44122, Essen, Germany

    Kerstin A. Pfeiffer

  3. Department of Obstetrics and Gynecology, University Hospital, Schleichstrasse 4, 72076, Tübingen, Germany

    Harald Schlebusch

  4. Department of Obstetrics and Gynecology, KH der Augustinerinnen, Jakobstrasse 27–31, 50678, Cologne, Germany

    Jan Schmolling

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  1. Claudia G. Hanisch
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  2. Kerstin A. Pfeiffer
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  4. Jan Schmolling
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Correspondence to Jan Schmolling.

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Hanisch, C.G., Pfeiffer, K.A., Schlebusch, H. et al. Adhesion molecules, activin and inhibin—candidates for the biochemical prediction of hypertensive diseases in pregnancy?. Arch Gynecol Obstet 270, 110–115 (2004). https://doi.org/10.1007/s00404-003-0514-9

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  • DOI: https://doi.org/10.1007/s00404-003-0514-9

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