Araştırma Makalesi
The importance of second-trimester AFP and preconception TSH levels for predicting the severity of proteinuria in patients with preeclampsia
Öz
Objective: This study aimed to investigate the relationships between preconception thyroid stimulating hormone (TSH) and thyroxine (T4) levels, as well as second-trimester alpha-fetoprotein (AFP) levels, and the severity of proteinuria in 24-hour urine samples from patients with preeclampsia.
Method: This retrospective analysis focused on preeclampsia patients categorized by proteinuria in 24-hour urine. Inclusion criteria involved patients aged 20-44 with singleton pregnancies diagnosed with preeclampsia and delivery after 20 weeks of gestation. Patients were divided into mild (0.3 to <2 g, n = 94), severe (2 to <5 g, n = 38), and massive (≥5 g, n = 11) proteinuria groups. Comparison included second-trimester AFP levels, preconception TSH, and maternal/neonatal outcomes.
Results: Second-trimester AFP levels increased with proteinuria severity (mild: 47.97 ng/ml; severe: 60.52 ng/ml; massive: 65.50 ng/ml [p<0.001]). AFP emerged as a significant independent predictor of severe proteinuria (odds ratio=1.041), while TSH was not predictive (odds ratio=1.098; p=0.463).
Conclusion: AFP proved to be a valuable marker for predicting proteinuria severity in 24-hour urine samples from preeclampsia patients, whereas preconception TSH was a less compelling predictor.
Anahtar Kelimeler
Kaynakça
- Organization WH. The World health report: 2005: make every mother and child count. World Health Organization; 2005.
- Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P, Audibert F, et al. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Canada. 2014;36(5):416–38.
- Tanacan A, Fadiloglu E, Beksac MS. The importance of proteinuria in preeclampsia and its predictive role in maternal and neonatal outcomes. Hypertens pregnancy. 2019;38(2):111–8.
- Speranza RJ, Greiner KS, Rincon M, Beeraka S, Burwick RM. 506: A population-based definition for severe proteinuria and its association with adverse outcomes in preeclampsia. Am J Obstet Gynecol. 2019;220(1):S339–40.
- Newman MG, Robichaux AG, Stedman CM, Jaekle RK, Fontenot MT, Dotson T, et al. Perinatal outcomes in preeclampsia that is complicated by massive proteinuria. Am J Obstet Gynecol. 2003;188(1):264–8.
- Obstetricians A. Gynecologists. Hypertens pregnancy Rep Am Coll Obstet Gynecol task force Hypertens pregnancy Obs Gynecol. 2013;122(5):1122.
- Ingram RS, Scott RW, Tilghman SM. alpha-Fetoprotein and albumin genes are in tandem in the mouse genome. Proc Natl Acad Sci. 1981;78(8):4694–8.
- Yliniemi A, Makikallio K, Korpimaki T, Kouru H, Marttala J, Ryynanen M. Combination of PAPPA, fhCGβ, AFP, PIGF, sTNFR1, and Maternal Characteristics in Prediction of Earlyonset Preeclampsia. Clin Med Insights Reprod Heal. 2015;9:CMRH-S21865.
- Olsen RN, Woelkers D, Dunsmoor-Su R, LaCoursiere DY. Abnormal second-trimester serum analytes are more predictive of preterm preeclampsia. Am J Obstet Gynecol. 2012;207(3):228-e1.
- Yaron Y, Cherry M, Kramer RL, O’Brien JE, Hallak M, Johnson MP, et al. Secondtrimester maternal serum marker screening: maternal serum α-fetoprotein, β-human chorionic gonadotropin, estriol, and their various combinations as predictors of pregnancy outcome. Am J Obstet Gynecol. 1999;181(4):968–74.
- Long W, Zhou Q, Wang H, Lu B, Chen Y, Zhang B, et al. Second-trimester maternal serum screening biomarkers in the risk assessment for preeclampsia. Ann Clin Lab Sci. 2018;48(3):308–13.
- Yefet E, Kuzmin O, Schwartz N, Basson F, Nachum Z. Predictive value of second-trimester biomarkers and maternal features for adverse pregnancy outcomes. Fetal Diagn Ther. 2017;42(4):285–93.
- Başbuğ M, Aygen E, Tayyar M, Tutuş A, Kaya E, Öktem ÖR. Correlation between maternal thyroid function tests and endothelin in preeclampsia-eclampsia. Obstet Gynecol. 1999;94(4):551–5.
- Dhananjaya BS Venkatesh G, Murthy Niranjan SH. Thyroid Stimulating Hormone (TSH) Level as a Possible Indicator of Pre-eclampsia. Vol. 5, jf. p. 1542–3.
- Guida JP, Parpinelli MA, Surita FG, Costa ML. The impact of proteinuria on maternal and perinatal outcomes among women with pre-*eclampsia. Int J Gynecol Obstet. 2018;143(1):101–7.
- Ayres-de-Campos D, Spong CY, Chandraharan E. FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography. Int J Gynaecol Obstet Off organ Int Fed Gynaecol Obstet. 2015 Oct;131(1):13–24.
- Li B, Lin L, Yang H, Zhu Y, Wei Y, Li X, et al. The value of the 24-h proteinuria in evaluating the severity of preeclampsia and predicting its adverse maternal outcomes. Hypertens pregnancy. 2018;37(3):118–25.
- Kayem G, Lorthe E, Doret M. [Management of preterm labor]. J Gynecol Obstet Biol Reprod (Paris). 2016 Dec;45(10):1364–73.
- Mateus J, Newman R, Sibai BM, Li Q, Barton JR, Combs CA, et al. Massive urinary protein excretion associated with greater neonatal risk in preeclampsia. AJP Rep. 2017;7(1):e49.
- Kim MJ, Kim YN, Jung EJ, Jang HR, Byun JM, Jeong DH, et al. Is massive proteinuria associated with maternal and fetal morbidities in preeclampsia? Obstet Gynecol Sci. 2017;60(3):260–5.
- Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM, Hofmeyr GJ. Preeclampsia. Lancet (London, England). 2016 Mar;387(10022):999–1011.
- Yadav V, Verma AK, Soni N, Kaushik GG, Broca JS. Role of Alphafeto Protein, Beta Human Chorionic Gonadotropin and Unconjugated Estriol as Predictor of Preeclampsia. 2016
- Rahul R. Chaudhary, M.G. Muddeshwar. A STUDY OF THYROID PROFILE AND SERUM ALBUMIN IN PREECLAMPSIA WOMEN. Int J Curr Res Rev. 2016;08(23):11-5.
- Deshpande S, Yelikar K, Patil S, Andurkar S. Maternal thyroid hormone status in preeclampsia: a tertiary care hospital based study. Int J Reprod Contraception, Obstet Gynecol Vol 4,No6.
- Arbib N, Hadar E, Sneh-Arbib O, Chen R, Wiznitzer A, Gabbay-Benziv R. First trimester thyroid stimulating hormone as an independent risk factor for adverse pregnancy outcome. J Matern Neonatal Med. 2017;30(18):2174–8.
Yıl 2024,
Cilt: 2 Sayı: 1, 11 - 19, 29.01.2024
Öz
Kaynakça
- Organization WH. The World health report: 2005: make every mother and child count. World Health Organization; 2005.
- Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P, Audibert F, et al. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Canada. 2014;36(5):416–38.
- Tanacan A, Fadiloglu E, Beksac MS. The importance of proteinuria in preeclampsia and its predictive role in maternal and neonatal outcomes. Hypertens pregnancy. 2019;38(2):111–8.
- Speranza RJ, Greiner KS, Rincon M, Beeraka S, Burwick RM. 506: A population-based definition for severe proteinuria and its association with adverse outcomes in preeclampsia. Am J Obstet Gynecol. 2019;220(1):S339–40.
- Newman MG, Robichaux AG, Stedman CM, Jaekle RK, Fontenot MT, Dotson T, et al. Perinatal outcomes in preeclampsia that is complicated by massive proteinuria. Am J Obstet Gynecol. 2003;188(1):264–8.
- Obstetricians A. Gynecologists. Hypertens pregnancy Rep Am Coll Obstet Gynecol task force Hypertens pregnancy Obs Gynecol. 2013;122(5):1122.
- Ingram RS, Scott RW, Tilghman SM. alpha-Fetoprotein and albumin genes are in tandem in the mouse genome. Proc Natl Acad Sci. 1981;78(8):4694–8.
- Yliniemi A, Makikallio K, Korpimaki T, Kouru H, Marttala J, Ryynanen M. Combination of PAPPA, fhCGβ, AFP, PIGF, sTNFR1, and Maternal Characteristics in Prediction of Earlyonset Preeclampsia. Clin Med Insights Reprod Heal. 2015;9:CMRH-S21865.
- Olsen RN, Woelkers D, Dunsmoor-Su R, LaCoursiere DY. Abnormal second-trimester serum analytes are more predictive of preterm preeclampsia. Am J Obstet Gynecol. 2012;207(3):228-e1.
- Yaron Y, Cherry M, Kramer RL, O’Brien JE, Hallak M, Johnson MP, et al. Secondtrimester maternal serum marker screening: maternal serum α-fetoprotein, β-human chorionic gonadotropin, estriol, and their various combinations as predictors of pregnancy outcome. Am J Obstet Gynecol. 1999;181(4):968–74.
- Long W, Zhou Q, Wang H, Lu B, Chen Y, Zhang B, et al. Second-trimester maternal serum screening biomarkers in the risk assessment for preeclampsia. Ann Clin Lab Sci. 2018;48(3):308–13.
- Yefet E, Kuzmin O, Schwartz N, Basson F, Nachum Z. Predictive value of second-trimester biomarkers and maternal features for adverse pregnancy outcomes. Fetal Diagn Ther. 2017;42(4):285–93.
- Başbuğ M, Aygen E, Tayyar M, Tutuş A, Kaya E, Öktem ÖR. Correlation between maternal thyroid function tests and endothelin in preeclampsia-eclampsia. Obstet Gynecol. 1999;94(4):551–5.
- Dhananjaya BS Venkatesh G, Murthy Niranjan SH. Thyroid Stimulating Hormone (TSH) Level as a Possible Indicator of Pre-eclampsia. Vol. 5, jf. p. 1542–3.
- Guida JP, Parpinelli MA, Surita FG, Costa ML. The impact of proteinuria on maternal and perinatal outcomes among women with pre-*eclampsia. Int J Gynecol Obstet. 2018;143(1):101–7.
- Ayres-de-Campos D, Spong CY, Chandraharan E. FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography. Int J Gynaecol Obstet Off organ Int Fed Gynaecol Obstet. 2015 Oct;131(1):13–24.
- Li B, Lin L, Yang H, Zhu Y, Wei Y, Li X, et al. The value of the 24-h proteinuria in evaluating the severity of preeclampsia and predicting its adverse maternal outcomes. Hypertens pregnancy. 2018;37(3):118–25.
- Kayem G, Lorthe E, Doret M. [Management of preterm labor]. J Gynecol Obstet Biol Reprod (Paris). 2016 Dec;45(10):1364–73.
- Mateus J, Newman R, Sibai BM, Li Q, Barton JR, Combs CA, et al. Massive urinary protein excretion associated with greater neonatal risk in preeclampsia. AJP Rep. 2017;7(1):e49.
- Kim MJ, Kim YN, Jung EJ, Jang HR, Byun JM, Jeong DH, et al. Is massive proteinuria associated with maternal and fetal morbidities in preeclampsia? Obstet Gynecol Sci. 2017;60(3):260–5.
- Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM, Hofmeyr GJ. Preeclampsia. Lancet (London, England). 2016 Mar;387(10022):999–1011.
- Yadav V, Verma AK, Soni N, Kaushik GG, Broca JS. Role of Alphafeto Protein, Beta Human Chorionic Gonadotropin and Unconjugated Estriol as Predictor of Preeclampsia. 2016
- Rahul R. Chaudhary, M.G. Muddeshwar. A STUDY OF THYROID PROFILE AND SERUM ALBUMIN IN PREECLAMPSIA WOMEN. Int J Curr Res Rev. 2016;08(23):11-5.
- Deshpande S, Yelikar K, Patil S, Andurkar S. Maternal thyroid hormone status in preeclampsia: a tertiary care hospital based study. Int J Reprod Contraception, Obstet Gynecol Vol 4,No6.
- Arbib N, Hadar E, Sneh-Arbib O, Chen R, Wiznitzer A, Gabbay-Benziv R. First trimester thyroid stimulating hormone as an independent risk factor for adverse pregnancy outcome. J Matern Neonatal Med. 2017;30(18):2174–8.
Toplam 25 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Research Articles |
| Yazarlar | |
| Yayımlanma Tarihi | 29 Ocak 2024 |
| Gönderilme Tarihi | 22 Kasım 2023 |
| Kabul Tarihi | 21 Ocak 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 2 Sayı: 1 |
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2023