Exploring Maternal Biomarkers and Risk Factors in Preeclampsia: Insights from a Ghanaian Case-control Study
Martin Awe Akilla
Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana.
Ignatius Abowini Awinibuno Nchor
Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana.
Moses Banyeh *
Department of Biomedical Laboratory Science, University for Development Studies, Tamale, Ghana.
Nafiu Amidu
Department of Clinical Chemistry, University for Development Studies, Tamale, Ghana.
*Author to whom correspondence should be addressed.
Abstract
Aims: The involvement of maternal sociodemographic, obstetric, clinical, anthropometric and biochemical variables in preeclampsia has been demonstrated in previous studies. However, there are intra- and inter-population variabilities in study findings due to differences in genetic and environmental factors. This requires population-specific studies to aid the formulation of local protocols for the early detection and management of preeclampsia.
Study Design: This was a case-control study
Place and Duration of Study: The study was conducted at the Bolgatanga Regional Hospital between January and December 2022. The women were aged between 16 and 41 years and were receiving antenatal care at the hospital.
Aim of Work: The current study sought to determine variations in maternal sociodemographic, clinical, obstetric and biochemical characteristics in preeclampsia. To achieve this, women with and without preeclampsia were recruited and compared.
Methodology: The study included 100 and 150 pregnant women with and without preeclampsia respectively. Sociodemographic, birth outcomes and obstetric data were collected from participants’ medical records. Venous and placental blood samples were collected at delivery and analyzed for biochemical variables and malaria parasites.
Results: The results showed that the maternal and gestational ages did not differ between the pregnant women with and without preeclampsia. However, caesarean delivery (ꭓ2=14.275, P<0.001), preterm birth (ꭓ2=12.209, P=0.001) and .placental malaria (ꭓ2=5.335, P=0.032) were associated with preeclampsia. In addition, maternal body mass index and lipid variables such as total cholesterol, and LDL cholesterol were significantly higher in preeclampsia. The study also observed higher serum levels of aspartate and alanine aminotransferases in preeclampsia. Moreover, serum creatinine, blood urea nitrogen, urea and uric acid levels were also higher in preeclampsia. However, preeclampsia was characterized by lower serum HDL cholesterol as well as a lower estimated glomerular filtration rate.
Conclusion: Maternal anthropometric, obstetric and clinical variables are associated with preeclampsia. In addition, there are variations in serum lipids and renal and hepatic variables between preeclampsia and normotensive pregnancy. These findings are useful for assessing the risk of preeclampsia in the local population.
Keywords: Preeclampsia, body mass index, cholesterol, caesarean section, placental malaria, Ghana
How to Cite
References
Adam I, Elhassan EM, Mohmmed AA, Salih MM, Elbashir MI. Malaria and pre-eclampsia in an area with unstable malaria transmission in Central Sudan. Malaria Journal. 2011;10:258.
Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: A systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2013;170:1-7.
Cho GJ, Kim LY, Min KJ, Sung YN, Hong SC, Oh MJ, Seo HS, Kim HJ. Prior cesarean section is associated with increased preeclampsia risk in a subsequent pregnancy. BMC Pregnancy and Childbirth. 2015;15:1-6.
DA Silva WA, Pinheiro AM, Lima PH, Malbouisson LMS. Renal and cardiovascular repercussions in preeclampsia and their impact on fluid management: A literature review. Braz J Anesthesiol. 2021;71:421-428.
Moran P, Lindheimer MD, Davison JM. The renal response to preeclampsia. Seminars in Nephrology, 2004. Elsevier:588-595.
Mrema D, Lie RT, Østbye T, Mahande MJ, Daltveit AK. The association between pre pregnancy body mass index and risk of preeclampsia: A registry based study from Tanzania. BMC Pregnancy and Childbirth. 2018;18:56.
Kockx M, Roberts L, Wang J, Tran C, Brown MA, Kritharides L. Effects of pre-eclampsia on HDL-mediated cholesterol efflux capacity after pregnancy. Atherosclerosis Plus. 2022;48:12-19.
Tesfa E, Nibret E, Munshea A. Maternal lipid profile and risk of pre-eclampsia in African pregnant women: A systematic review and meta-analysis. Plos One. 2020;15:e0243538.
Lee SM, Moon JY, Lim BY, Kim SM, Park CW, Kim BJ, Jun JK, Norwit ER, Choi MH, Park JS. Increased biosynthesis and accumulation of cholesterol in maternal plasma, but not amniotic fluid in pre-eclampsia. Scientific Reports. 2019;9:1550.
Spracklen CN, Smith CJ, Saftlas AF, Robinson JG, Ryckman KK. Maternal hyperlipidemia and the risk of preeclampsia: A meta-analysis. Am J Epidemiol. 2014;180:346-58.
Dacaj R, Izetbegovic S, Stojkanovic G, Dreshaj S. Elevated liver enzymes in cases of preeclampsia and intrauterine growth restriction. Medical Archives. 2016;70:44.
Müller-Deile J, Schiffer M. Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy. World Journal of Nephrology. 2014;3:169.
Moussa HN, Rajapreyar I. ACOG Practice Bulletin No. 212: Pregnancy and heart disease. Obstetrics & Gynecology. 2019;134:881-882.
Ahenkorah B, Sakyi SA, Fondjo LA, Helegbe G, Owiredu EW, Der EM, Amoah LE, Kusi KA, Obiri D, Amoani B. Evaluating circulating soluble markers of endothelial dysfunction and risk factors associated with PE: A multicentre longitudinal case control study in northern Ghana. Heliyon. 2023;9.
Davies EL, Bell JS, Bhattacharya S. Preeclampsia and preterm delivery: A population-based case-control study. Hypertens Pregnancy. 2016;35:510-519.