How accurate are placental growth factor, urate, lactate dehydrogenase and proteinuria in diagnosing preeclampsia and its severity?

Khalil, M. I.; Sagr, Emad; Bahyan, Rawda; Elrifaei, Rabab M.; Alzahrani, Mohammed; Tamimi, Waleed

doi:10.1016/j.preghy.2014.02.002

Cited by 6 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Through prospective and longitudinal analyses we have demonstrated that with the exception of very early in pregnancy, there is moderate correlation between urine and serum PlGF levels and that urinary PlGF follows a trend similar to that of serum levels as pregnancy progresses. These results are in keeping with the limited published data available from case-control cross-sectional studies in women without diabetes (16)(17)(18). Although we found significantly lower levels of urinary PlGF from 24 weeks onward in women who subsequently developed preeclampsia, a large proportion had urinary PlGF levels below the minimal detectable level in early and late pregnancy.…”

Section: Discussionsupporting

confidence: 90%

Urinary and Serum Angiogenic Markers in Women With Preexisting Diabetes During Pregnancy and Their Role in Preeclampsia Prediction

et al. 2019

View full text Add to dashboard Cite

To determine the correlation between urinary and serum placental growth factor (PlGF) and investigate the predictive value as pregnancy progresses of urinary PlGF compared with serum PlGF, soluble fms-like tyrosine kinase 1 (sFLT-1), and the sFLT-1-to-PlGF ratio for the outcome of preeclampsia in women with preexisting diabetes. RESEARCH DESIGN AND METHODS A multicenter prospective cohort study was conducted of 158 women with preexisting insulin-requiring diabetes (41 with type 1 and 117 with type 2). Urinary PlGF and serum PlGF, sFLT-1, and the sFLT-1-to-PlGF ratio were assessed four times (14, 24, 30, and 36 weeks' gestation), and the association with the outcome of preeclampsia was investigated. RESULTS A correlation between urinary and serum PlGF was demonstrated from 24 weeks' gestation onward (P < 0.001). At all time points, those who developed preeclampsia had lower serum PlGF levels (P < 0.05), and receiver operating characteristic curves demonstrated that serum PlGF in this cohort performed better than the serum sFLT-1-to-PlGF ratio as a predictive test for preeclampsia. Preconception HbA 1c ‡6.5% (48 mmol/mol) was an important discriminative predictor for preeclampsia (P 5 0.01). CONCLUSIONS This study prospectively describes the longitudinal changes in urinary PlGF alongside serum angiogenic markers throughout pregnancy in women with preexisting diabetes. We demonstrate correlation between urinary and serum PlGF and that in women with preexisting diabetes in pregnancy, serum PlGF is a better predictor of preeclampsia than the sFLT-1-to-PlGF ratio. Compared with the general population, patients with preexisting diabetes represent a high-risk cohort of women, having almost four times the risk of preeclampsia during pregnancy (1). Preeclampsia is associated with serious maternal and neonatal morbidity and mortality (2); thus, it would be of great clinical benefit to be able to identify women with preexisting diabetes who are at higher risk of developing this

show abstract

Section: Discussionsupporting

confidence: 90%

Urinary and Serum Angiogenic Markers in Women With Preexisting Diabetes During Pregnancy and Their Role in Preeclampsia Prediction

et al. 2019

View full text Add to dashboard Cite

show abstract

“…On the contrary, a study done by Khalil et al in Saudi Arabia reported sensitivity of LDH to identify severe preeclampsia as 100%. Another research conducted by Duan et al in China stated the specificity of LDH to be 92.5% both of which had higher finding than our study did (28,29). This discrepancy might arise from genetic variation of study participants involved and different techniques used for determining serum LDH cut-off values.…”

Section: Discussioncontrasting

confidence: 81%

Diagnostic performance of lactate dehydrogenase as a potential biomarker in predicting preeclampsia and associated factors

Teklemariam,

Abebe,

Agidew

et al. 2024

Front. Med.

View full text Add to dashboard Cite

BackgroundPreeclampsia (PE), a pregnancy specific syndrome, is defined as new-onset hypertension (≥140/90 mmHg) and proteinuria diagnosed after gestational week 20 or new-onset pre-eclampsia associated signs in the absence of proteinuria, and it may tend to present as late as 4–6 weeks’ postpartum period. It is a leading cause of maternal mortality in both developed and developing countries. In order to prevent PE, the disease must be diagnosed at its earliest stage, however, the triads of high blood pressure, edema and albuminuria is neither specific nor sensitive enough for diagnosing the disease. Lactate dehydrogenase (LDH) is useful biochemical marker reflecting the occurrence of complications associated with preeclampsia. Besides, it has been suggested as potential biomarker to predict the severity of preeclampsia and as indicator of multi-organ involvement. The aim of this study was to investigate the diagnostic accuracy of LDH, which is affordable and easy to test, as a potential clinical biomarker to predict onset of preeclampsia.MethodsA hospital based cross-sectional study was conducted as of September 9 to December 24, 2022 at Debre Birhan Comprehensive Specialized Hospital (DBCSH). A total of 132 study subjects (66 preeclamptic and 66 normotensive controls) were enrolled in the study. A receiver operating characteristics (ROC) curve was used to calculate the area under the curve (AUC) and determine diagnostic accuracy of LDH. Youden’s index was used to identify an optimal cut-off point for LDH in detecting preeclampsia associated complications.ResultAUC for LDH was found to be 0.963 (95% CI, 0.91, 1.0; p = 0.000) from ROC curve analysis. An optimal cut-off point for LDH was 376.5 U/L having a sensitivity and specificity of 87.5 and 90.8%, respectively.ConclusionSerum LDH had an AUC of greater than 0.8 and showed good diagnostic accuracy in predicting development of preeclampsia. Disease duration, gestational age, systolic and diastolic blood pressure among enormous number of predictor variables had association with serum level of LDH.

show abstract

“…Specifically, Duan et al reported an area under the curve (AUC) that reached 0.899 and a sensitivity of 92.5% using a cut-off value of 183.5 U/L [20]. Similarly, Khalil observed that LDH could help differentiate severe preeclampsia from healthy controls as well as patients with proteinuria, gestational hypertension and mild preeclampsia using a cut-off value of 208 U/L (sensitivity 100%, AUC 71.2%) [21]. On the other hand, Fazal et al reported that the accuracy of LDH in detecting preeclampsia was limited (sensitivity 50% at an optimal cut-off of 525 U/L) [22]; however, their sample size was particularly small to establish definitive conclusions.…”

Section: Qualitative Analysismentioning

confidence: 99%

Serum LDH values in hypertensive disorders of pregnancy and their association with maternal and neonatal morbidity: a meta-analysis

Pergialiotis

Panagiotopoulos

Bellos

et al. 2021

Preprint

View full text Add to dashboard Cite

Objectives: Serum lactate dehydrogenase has been extensively studied in hypertensive disorders of pregnancy. However, to date, its clinical usefulness in the field remains unknown. The present meta-analysis has been designed to evaluate differences in serum LDH values among patients with hypertensive disorders of pregnancy and to help determine its diagnostic accuracy as well its predictive accuracy in determining adverse pregnancy outcomes. Methods: We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar databases from their inception till March 18, 2021. Meta-analysis was performed using the meta and metafor functions in Rstudio. Pooled mean differences (MD) were calculated with the Hartung-Knapp-Sidik-Jonkman. Meta-regression analyses, publication bias assessment and Trim and Fill function were also performed. The adequacy of the sample size was evaluated with Trial Sequential Analysis. Results: Fifty-two articles were included that comprised 5,340 women with hypertensive disorders of pregnancy and 2,890 healthy controls. The meta-analysis revealed significant differences among patients with preeclampsia (either mild or severe) compared to controls, as well as among patients with mild and severe preeclampsia. Significant asymmetry was noted after examining funnel plots, however, and the trim and fill analysis revealed that differences were significant only among cases with severe preeclampsia and healthy controls. Morbidity outcomes increased with LDH levels > 600 IU/L and particularly when these exceeded 800 IU/L. However, confidence and prediction intervals indicated an underpowered sample size for the accurate determination of the odds of developing maternal morbidity. Conclusions: Despite the extensive research in the field of hypertensive disorders of pregnancy, there is still lack of evidence concerning the diagnostic performance of serum LDH in clinical practice; hence, research should expand in this direction to evaluate its clinical utility.

show abstract

How accurate are placental growth factor, urate, lactate dehydrogenase and proteinuria in diagnosing preeclampsia and its severity?

Cited by 6 publications

References 15 publications

Urinary and Serum Angiogenic Markers in Women With Preexisting Diabetes During Pregnancy and Their Role in Preeclampsia Prediction

Urinary and Serum Angiogenic Markers in Women With Preexisting Diabetes During Pregnancy and Their Role in Preeclampsia Prediction

Diagnostic performance of lactate dehydrogenase as a potential biomarker in predicting preeclampsia and associated factors

Serum LDH values in hypertensive disorders of pregnancy and their association with maternal and neonatal morbidity: a meta-analysis

Contact Info

Product

Resources

About