Objectives: Evaluation of serum levels of high-sensitivity cardiac troponin I (cTnI), D-Dimer (D-Di) and Tumor necrosis factor-α (TNF-α) changes during pregnancy in women who developed preeclampsia (PE).
Patients and Methods: 70 PE women were diagnosed according to the American Society of Hypertension and were classified according to guidelines of American College of Obstetricians and Gynecologists. Also, 70 pregnant women free of hypertensive manifestations were enrolled as normotensive group (NT group). Two blood samples were obtained at the start of the 12th GW (S1 sample) and at time of diagnosis of PE (S2 sample) for ELISA estimation of cTnI, D-Di and TNF-α. Study outcomes included the relation between time and severity and change in serum levels of studied biomarkers and the ability of S1 sample levels as early predictors of development of PE and its severity
Results: PE women had significantly higher body mass index and fasting blood glucose levels than in NT women. Serum cTnI levels estimated in both samples of PE women were significantly higher than in NT women with increased levels in S2 than S1 by 1.46 folds and 2.44 folds than in S2 sample of NT women. Serum TNF-α and D-Di levels were significantly higher in both samples of all pregnant women in comparison to control levels and in PE than in NT women, and in S2 than S1 sample of PE women. Regression analysis defined high serum TNF-α and D-Di as significant positive early predictors for the possibility of development of PE especially early-onset, while high S1 sample serum D-Di and cTnI as the most significant early predictors for development of severe PE.
Conclusion: Estimation of serum TNF-α, D-Di and cTnI as an array early during pregnancy could identify women vulnerable to PE development and can be used as early predictors for early and/or severe PE.