Work

Glycosylated fibronectin as a biomarker for preeclampsia and preeclampsia-related complications

Year: 2024

Type: article

Abstract: • What’s already known about this topic? • Glycosylated fibronectin (GlyFn) emerges as a biomarker for preeclampsia, particularly in early pregnancy (11–13 weeks). After 20 weeks of gestation, the predictive performance of GlyFn is similar to that of the sFlt-1/PlGF ratio. • What does this study add? • In women with suspected or confirmed preeclampsia after 20 weeks of gestation, GlyFn can be used as a biomarker for both maternal and fetal preeclampsia-related complications, particularly in patients below 37 weeks of gestation. To evaluate glycosylated fibronectin (GlyFn) as a novel biomarker for preeclampsia and preeclampsia-related complications, and to compare GlyFn to traditional biomarkers, including soluble Fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF). Secondary analysis of a prospective cohort study (n = 524) with suspected preeclampsia (control), gestational hypertension (GH), or confirmed preeclampsia/hemolysis, elevated liver enzymes and low platelets syndrome (PE/HELLP). GlyFn levels in PE/HELLP versus control and GH. Its association with preeclampsia-related complications, and its added value on top of a traditional model incorporating gestational age, proteinuria, parity, and blood pressure. A comparison of all GlyFn-related performances versus those of sFlt-1 and PlGF. A significant elevation in GlyFn levels in patients with GH and PE/HELLP was observed versus control. Notably, GlyFn displayed positive correlations with sFlt-1 and the sFlt-1/PlGF ratio, and a negative correlation with PlGF. GlyFn alone outperformed the traditional model in predicting maternal but not fetal complications. This pattern was also observed for sFlt-1, PlGF and their ratio. Combining GlyFn with the traditional model, enhanced the C-index for maternal complications. However, the GlyFn/PlGF ratio, when added to the traditional model, yielded the best results for predicting fetal complications in the overall cohort. In women with a GA < 37 weeks, the latter combination also showed the best predictive value for predicting maternal complications. GlyFn is a novel biomarker for PE diagnosis and its complications, particularly at GA < 37 weeks. Prospective studies should evaluate to what degree it outperforms traditional biomarkers.

Source: Pregnancy Hypertension

DOI: 10.1016/j.preghy.2024.101177