Determination of Urine Protein Levels and Analysis of Differences in Vascular Endothelial Growth Factor Levels between Early Onset and Late Onset Preeclampsia
DOI:
https://doi.org/10.3889/oamjms.2021.6222Keywords:
Preeclampsia, Early onset, Late onset, Urine protein, Vascular endothelial growth factorAbstract
BACKGROUND: Preeclampsia is a disease with the high mortality rate. Data indicate that 23.5% of maternal deaths due to preeclampsia. Urine protein testing is essential for pregnant women to discover the function of kidney during pregnancy and to identify the presence of preeclampsia, both mild and severe, which it can lead to eclampsia. Preeclampsia based on onset can also be detected by examining serum biomarkers of Vascular Endothelial Growth Factor (VEGF).
AIM: The aim of this study was to overview the urine protein levels and analyzed the differences serum VEGF levels between the early and late onset of preeclampsia.
MATERIALS AND METHODS: This study used design of the cross sectional comparative study in RSUP DR. M Djamil Padang, Pariaman Hospital, Aisiyah Pariaman Hospital, and Padang Pariaman Regional Hospital for 2 years. The population in this study consisted of patients with early and late onset preeclampsia who went to the study site during that time and met the inclusion criteria. Sampling with consecutive sampling consisted of 28 people per group.
RESULTS: The results revealed that the number of patients who had urine protein levels with a value of 2+ at the early onset was 14 and at the late onset was 12, meanwhile for patients with a urine protein content value of 3+ at the early onset it was 14 and at the late onset was 10.For the category urine protein with a value of 4+ amounted to 6 people only in the late onset group. The results of the normality test showed that the mean value of VEGF levels at early onset and late onset was 3.91 pg / ml and 4.3 pg / ml, respectively. Thus, the level of VEGF serum had an abnormal distribution and it led to the T test data could not be tested. So then, the testing was done using a non-parametric test, namely the Mann-Whittney test. The mean levels of VEGF, respectively, based on the Mann-Whittney test for early onset preeclampsia and late onset preeclampsia were 29.75 ng / mL and 30.25 ng / mL. VEGF in early onset preeclampsia is lower than late onset preeclampsia.
CONCLUSION: Based on the results obtained, it can be concluded that there was no significant difference in the level of VEGF in early onset preeclampsia and late onset preeclampsia (p = 0.42).
Keywords: Preeclampsia, early onset, late onset, urine protein, VEGF
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Li XL, Chen TT, Dong X, Gou WL, Lau S, Stone P, et al. Early onset preeclampsia in subsequent pregnancies correlates with early onset preeclampsia in first pregnancy. Eur J Obstet Gynecol Reprod Biol. 2014;177:94-9. https://doi.org/10.1016/j.ejogrb.2014.03.043 PMid:24784713
National Research Council. Reducing Maternal and Neonatal Mortality in Indonesia: Saving Lives, Saving the Future. Washington, DC: National Academies Press; 2013. https://doi.org/10.17226/18437
Raghupathy R. Cytokines as key players in the pathophysiology of preeclampsia. Med Princ Pract. 2013;22 Suppl 1:8-19. https://doi.org/10.1159/000354200 PMid:23949305
Wojtowicz A, Zembala-Szczerba M, Babczyk D, Kołodziejczyk-Pietruszka M, Lewaczyńska O, Huras H. Early-and lateonset preeclampsia: A comprehensive cohort study of laboratory and clinical findings according to the new ISHHP criteria. Int J Hypertens. 2019;2019:4108271. https://doi.org/10.1155/2019/4108271 PMid:31637053
Lisonkova S, Joseph KS. Incidence of preeclampsia: Risk factors and outcomes associated with early-versus late-onset disease. Am J Obstet Gynecol 2013;209(6):544.e1-12. https://doi.org/10.1016/j.ajog.2013.08.019 PMid:23973398
Lisonkova S, Sabr Y, Mayer C, Young C, Skoll A, Joseph KS. Maternal morbidity associated with early-onset and lateonset preeclampsia. Obstet Gynecol. 2014;124(4):771-81. https://doi.org/10.1097/aog.0000000000000472 PMid:25198279
Saadat M, Nejad SM, Habibi G, Sheikhvatan M. Maternal and neonatal outcomes in women with preeclampsia. Taiwan J Obstet Gynecol. 2007;46(3):255-9. https://doi.org/10.1016/s1028-4559(08)60029-7 PMid:17962105
Espinoza J, Romero R, Kim YM, Kusanovic JP, Hassan S, Erez O, et al. Normal and abnormal transformation of the spiral arteries during pregnancy. J Perinat Med. 2006;34(6):447-58. https://doi.org/10.1515/jpm.2006.089 PMid:17140293
Huppertz B. Placental origins of preeclampsia: Challenging the current hypothesis. Hypertension. 2008;51(4):970-5. https://doi.org/10.1161/hypertensionaha.107.107607 PMid:18259009
Stubert J, Ullmann S, Dieterich M, Diedrich D, Reimer T. Clinical differences between early-and late-onset severe preeclampsia and analysis of predictors for perinatal outcome. J Perinat Med. 2014;42(5):617-27. https://doi.org/10.1515/jpm-2013-0285 PMid:24778345
Herzog EM, Eggink AJ, Reijnierse A, Kerkhof MA, de Krijger RR, Roks AJ, et al. Impact of early-and late-onset preeclampsia on features of placental and newborn vascular health. Placenta. 2017;49:72-9. https://doi.org/10.1016/j.placenta.2016.11.014 PMid:28012458
Foo FL, Mahendru AA, Masini G, Fraser A, Cacciatore S, MacIntyre DA, et al. Association between prepregnancy cardiovascular function and subsequent preeclampsia or fetal growth restriction. Hypertension. 2018;72(2):442-50. https://doi.org/10.1161/hypertensionaha.118.11092 PMid:29967040
Parra M, Rodrigo R, Barja P, Bosco C, Fernández V, Muñoz H, et al. Screening test for preeclampsia through assessment of uteroplacental blood flow and biochemical markers of oxidative stress and endothelial dysfunction. Am J Obstet Gynecol. 2005;193(4):1486-91. https://doi.org/10.1016/j.ajog.2005.02.109 PMid:16202744
Al RA, Baykal C, Karacay O, Geyik PO, Altun S, Dolen I. Random urine protein-creatinine ratio to predict proteinuria in new-onset mild hypertension in late pregnancy. Obstet Gynecol. 2004;104(2):367-71. https://doi.org/10.1097/01.aog.0000134788.01016.2a PMid:15292013
Berks D, Steegers EA, Molas M, Visser W. Resolution of hypertension and proteinuria after preeclampsia. Obstet Gynecol. 2009;114(6):1307-14. https://doi.org/10.1097/aog.0b013e3181c14e3e PMid:19935034
George EM, Granger JP. Recent insights into the pathophysiology of preeclampsia. Expert Rev Obstet Gynecol. 2010;5(5):557-66. PMid:21170149
Kaufmann P, Mayhew TM, Charnock-Jones DS. Aspects of human fetoplacental vasculogenesis and angiogenesis. II. Changes during normal pregnancy. Placenta. 2004;25(2-3):114-26. https://doi.org/10.1016/j.placenta.2003.10.009 PMid:14972444
Mashreghi M, Azarpara H, Bazaz MR, Jafari A, Masoudifar A, Mirzaei H, et al. Angiogenesis biomarkers and their targeting ligands as potential targets for tumor angiogenesis. J Cell Physiol. 2018;233(4):2949-65. https://doi.org/10.1002/jcp.26049 PMid:28608549
Byrne AM, Bouchier-Hayes DJ, Harmey JH. Angiogenic and cell survival functions of vascular endothelial growth factor (VEGF). J Cell Mol Med. 2005;9(4):777-94. https://doi.org/10.1111/j.1582-4934.2005.tb00379.x PMid:16364190
Harry LE, Paleolog EM. From the cradle to the clinic: VEGF in developmental, physiological, and pathological angiogenesis. Birth Defects Res C Embryo Today. 2003;69(4):363-74. https://doi.org/10.1002/bdrc.10024 PMid:14745976
Demir R, Kayisli UA, Seval Y, Celik-Ozenci C, Korgun ET, Demir-Weusten AY, et al. Sequential expression of VEGF and its receptors in human placental villi during very early pregnancy: Differences between placental vasculogenesis and angiogenesis. Placenta. 2004;25(6):560-72. https://doi.org/10.1016/j.placenta.2003.11.011 PMid:15135240
Ackerman C, Locke AE, Feingold E, Reshey B, Espana K, Thusberg J, et al. An excess of deleterious variants in VEGF-a pathway genes in down-syndrome-associated atrioventricular septal defects. Am J Hum Genet. 2012;91(4):646-59. https://doi.org/10.1016/j.ajhg.2012.08.017 PMid:23040494
Escudero C, Celis C, Saez T, San Martin S, Valenzuela FJ, Aguayo C, et al. Increased placental angiogenesis in late and early onset pre-eclampsia is associated with differential activation of vascular endothelial growth factor receptor 2. Placenta. 2014;35(3):207-15. https://doi.org/10.1016/j.placenta.2014.01.007 PMid:24508097
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Copyright (c) 2020 Engga Lift Irwanto, Eryati Darwin, Donel S, Djong Hon Tjong Tjong (Author)

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