Potential new biomarkers and a risk assessment tool have been identified.
An in-vivo study has identified 345 human placental proteins unique to preeclampsia pregnancies, with several of them showing promising biomarker potential, researchers say.
Placental dysfunction is a hallmark of preeclampsia and has been linked to altered release of proteins into the maternal circulation.
As the placenta cannot be easily accessed during pregnancy, placenta-derived proteins have been difficult to study directly.
More than 1000 women were included in the study. Blood was collected from the ingoing and outgoing vessels of the placenta during caesarean section birth at Oslo University Hospital in Norway.
A total of 620 placenta-derived proteins were identified, including 229 released in both healthy pregnancies and in preeclampsia and 46 released in healthy controls only.
Peripheral venous and arterial blood, along with blood from the uterine vein, was collected immediately prior to uterine incision.
Maternal samples were also taken during pregnancy, at gestational weeks 12–19, 20–26 and 28–34.
Researchers were able to identify biomarker candidates among these placenta-derived proteins at least three weeks and, on average, more than seven weeks before delivery.
“These proteins not only enhance our understanding of the disease mechanism but also pave the way for early diagnosis, facilitating timely interventions,” the authors wrote.
Elevated atherogenic index of plasma (AIP) was identified as a potential preeclampsia biomarker in another recent study.
Researchers evaluated more than 6000 singleton pregnant women in Northwest China, all under 14 weeks gestation and with no history of hypertension. The mean participant age was 29 years.
They were categorised into three groups based on AIP values: less than 0.20, between 0.20 and 0.35, and greater than 0.35.
Pregnant women in the highest tertile of AIP had a 42% increased risk of developing preeclampsia compared with those in the lowest tertile.
A significant interaction was also observed between AIP and uric acid levels, with the greatest preeclampsia risk observed in those with higher levels of both AIP and uric acid.
When uric acid levels exceeded 198 μmol/L (3.33 mg/dL), those in the higher AIP tertile had a 32% greater risk of preeclampsia than those with lower uric acid levels.
While not directly measurable, AIP can be calculated from a standard lipid blood panel using log10 (triglycerides/high-density lipoprotein cholesterol).
AIP was identified as the strongest predictor of preeclampsia among all variables in the prediction model, which included maternal age, educational level, BMI, primiparity, drinking, smoking or passive smoking, a history of pregnancy complications and uric acid, fasting plasma glucose and albumin levels.
