Apelin 13 and Blood Pressure, Is there any Association in Pre-eclampsia? - A Case-control Study
Introduction: Pre-eclampsia is a pregnancy specific disorder, characterised by the onset of hypertension and proteinuria. Preeclampsia is the leading cause of maternal, perinatal morbidity and mortality. The exact cause of pre-eclampsia is not known clearly and needs to be explored. Aim: To eval...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/14403/46243_CE[Ra]_F(Sh)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdf |
| Summary: | Introduction: Pre-eclampsia is a pregnancy specific disorder,
characterised by the onset of hypertension and proteinuria. Preeclampsia is the leading cause of maternal, perinatal morbidity
and mortality. The exact cause of pre-eclampsia is not known
clearly and needs to be explored.
Aim: To evaluate the maternal serum apelin 13 levels among
pre-eclampsia and healthy pregnant women and also, to find
the association between apelin 13 and blood pressure.
Materials and Methods: A case-control study was conducted
between Department of Biochemistry and Department of
Obstetrics and Gynaecology, RL Jalappa Hospital and Research
Centre, Kolar, Karnataka, India. After approval from the
Institutional Ethics Committee and written informed consent from
study subjects, a total of 270 pregnant women were recruited
for this study. Among them, 135 pre-eclamptic women were
considered as cases and 135 normotensive healthy pregnant
women served as controls. According to the pre-eclampsia
severity, cases were grouped into mild (n=47) and severe preeclampsia (n=88). Blood samples were collected from all the
study subjects and was analysed for apelin 13 by Enzyme Linked
Immunosorbent Assay (ELISA) method. Maternal and foetal
adverse outcomes were recorded. Results were expressed
as mean±Standard Deviation (SD). Categorical variables were
expressed in percentages. Spearman’s correlation was applied
and p<0.05 was considered significant.
Results: The mean gestational age was 36.66±3.69 weeks
which was, significantly low in pre-eclamptic women compared
with healthy pregnant women. BMI (26.94±3.81 kg/m2
), systolic
(157.82±15.14 mmHg), diastolic (101.68±11.02 mmHg) and
Mean Arterial Pressure (MAP) (120.20±11.12 mmHg), pulse rate
(88.14±5.82 bpm), Aspartate Transaminase (AST) (25.25±12.49
IU/L) and Alanine Transaminase (ALT) (19.01±10.95 IU/L) were
significantly increased in pre-eclamptic women when compared
with control group. Mean maternal serum apelin 13 (341.44±218.63
pg/mL) concentrations were significantly lower in pre-eclampsia
compared with healthy pregnant women. Maternal serum apelin
13 concentrations were negatively correlated with Systolic Blood
Pressure (SBP) (r = -0.196), Diastolic Blood Pressure (DBP) (r
= -0.172) and MAP (r =-0.204). Adverse maternal outcomes
such as epigastric pain 75 (55.55%), oedema 62 (45.92%) and
persistent headache 35 (25.92%) were higher in pre-eclamptic
group. Additionally, adverse foetal outcomes were more in preeclamptic cases including significantly decreased birth weight
(2.40±0.65), babies requiring Neonatal Intensive Care Unit
(NICU) admission were 54 (40%), preterm birth (≤37 wks) in 50
(37.03%), Respiratory Distress Syndrome (RDS) 31 (22.96%),
Small for Gestational Age (SGA) in 4 (2.96%) and Intra Uterine
Death (IUD) in 11 (8.14%) babies.
Conclusion: It was concluded from the present study that there
was low maternal serum apelin 13 concentrations in pre-eclampsia
and had negative correlation with blood pressure, suggesting its
potential role in the pathophysiology of pre-eclampsia. |
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| ISSN: | 2249-782X 0973-709X |