Total Fibronectin in Maternal Plasma as a Predictor for Preeclampsia

Abstract

Objective: To assess the ability of measuring total maternal plasma fibronectin in predicting the risk of developing preeclampsia. Method: In a cohort of 657 initially normotensive pregnant nulliparous women blood samples were collected at 26, 30 and 34 weeks of gestation. After delivery 3 groups were selected for measurement of total plasma fibronectin. The first group comprised 24 women who developed preeclampsia; the second 21 women who developed gestational hypertension, and the third 89 age-matched controls who remained normotensive. Results: In women who developed preeclampsia the fibronectin levels were higher at 26 (p < 0.01), 30 (p < 0.001) and 34 weeks of gestation (p < 0.001) than in pregnant controls. In the general population of pregnant nulliparous women the estimated risk of subsequent preeclampsia correlated with the fibronectin level at each measurement. In women with fibronectin levels within the 25th percentile at the 26th week of gestation, the risk was ≤1.9% and within the 90th percentile ≥6.2%. The change in fibronectin levels between 26 and 34 weeks of gestation was the only variable that remained statistically associated with preeclampsia (p = 0.0002) in multivariate analysis. In this model the risk figures for the corresponding percentiles were ≤1.0 and ≥5.8%, respectively. Conclusion: Longitudinal assessment of the change in total fibronectin levels predicted preeclampsia slightly better than cross-sectional analysis of fibronectin at any gestational age. Nevertheless, measurement of total fibronectin in maternal plasma could not be proven to be a useful clinical predictor for preeclampsia in a general obstetric population of nulliparous women.

Fibronectin, Plasminogen Activator Inhibitor Type 1 (PAI-1) And Uterine Artery Doppler Velocimetry as Markers of Preeclampsia

“…Total fibronectin makes up the majority of fibronectin present in the circulation. In different studies, both total and cellular fibronectin levels were found to be elevated prior to onset of preeclampsia [9][10][11][12]. In the present study increased second trimester plasma levels of fibronectin in patients who later developed preeclampsia has been observed.…”

“…The association of elevated plasma fibronectin in preeclampsia has been documented in previous studies indicating an endothelial cell dysfunction [12]. In the study of Gredmark et al, the positive predictive value in 26th gw was 57%, the specificity 97%, whereas the sensitivity was only 17% [11]. The authors concluded that total fibronectin might be useful to determine relative risks, but is a poor predictor in a low risk population.…”

N-Acetylcysteine improves the disturbed thiol redox balance after methionine loading

“…Since the cFN isoform is localized primarily to the endothelium, it is considered to be a specific marker of endothelial injury [30]. Recently, Powers et al [14] showed that homocysteine-induced oxidative stress might result in endothelial dysfunction, as measured by plasma cFN levels.…”

Maternal Plasma Fibronectin and Advanced Oxidative Protein Products for the Prediction of Preeclampsia in High Risk Pregnancies: A Prospective Cohort Study

“…Early detection and timely assessments of the disease are essential to reduce the risks associated with the development of preeclampsia [1][2][3] . Uterine artery Doppler at 22-24 weeks was found to identify women at higher risk for the development of subsequent complications of placental insufficiency.…”