Serum protein

marker panel for

predicting
preeclampsia
Introduction
Preeclampsia
“new onset of hypertension and
proteinuria or end-organ dysfunction
after 20 weeks of gestation in previously
normotensive women”
Pathogenesis
placental hypoxia and/or ischemia and
excessive oxidative stress

Release of soluble factors from the ischemic placenta

Coagulation dysfunction, inflammation, and

immunological responses
dysregulated proteins in the
preeclampsia
vascular plasminogen
human pentraxin 3 human endoglin
endothelial growth activator inhibitor-
(PTX3) (Endoglin)
factor (VEGF) 1 (PAI-1)

vascular
human placenta epidermal growth
endothelial growth
growth factor factor receptor human prolactin,
factor receptor 1
(PlGF) (EGFR),
(Flt-1)

neutrophil
gelatinase- human interleukin cyclooxygenase-2
associated lipocalin 27 (IL-27), (COX-2)
(NGAL),
Materials and
methods
Patient
172 Pregnant women
110 Preeclampsia 62 normal

85 PS 25 PNS Control
Exclusion
Multiple gestations
Fetal congenital malformation
Fetal chromosomal disorders
Maternal history of cardiovascular, renal, or other
hypertension-associated diseases
Pregestational diabetes
Treatment with antiplatelet drugs or nonsteroidal
anti-inflammatory agents
Serum Sampling
Peripheral blood samples (3 mL) were obtained from each
subject using SST II tubes
After centrifugation at 3000g for 5 min, the serum samples
were aliquoted and stored at −80 °C until further analysis
Each serum sample was analyzed for the presence of 11
analytes:
(COX-2, VEGF, sEndoglin, IL-27, PTX3, PIGF, PAI-1, NGAL,
human prolactin, sEGFR) or ELISA (sFlt-1)
Statistical Analysis
Chi-square tests  compare the categorical
variables of clinical characteristics
t test  comparison of continuous variables
logistic regression analysis  association of
preeclampsia with severe features
Result
4 proteins including VEGF, sEndoglin, PlGF and
sEGFR were selected as independent predictors
through multivariate analysis. The established
risk model based on these 4 proteins has the
best ability to predict preeclampsia at third
trimester, yielding an AUC of 0.988
We also established a second model to predict
severe features of preeclampsia based on
serum creatinine, platelet count and sEndoglin
with an AUC of 0.92