Plasma P-selectin is elevated in the first trimester in women who subsequently develop pre-eclampsia.
OBJECTIVE
To report plasma concentrations of the adhesion cell molecule P-selectin during pregnancy to determine the effect of subsequent development of hypertension and pre-eclampsia.


METHODS
A longitudinal study.


METHODS
A longitudinal study involving 70 women followed up from early pregnancy; 20 who subsequently developed pre-eclampsia were compared with 24 who developed gestational hypertension and 26 normotensive women with normal obstetric outcome. The determination of citrate plasma soluble P-selectin levels throughout pregnancy was performed using a commercial quantitative sandwich immunoassay kit. The temporal course of plasma P-selectin in the three groups of subjects was analysed.


RESULTS
There was no significant difference in mean plasma P-selectin concentration between normotensive and gestational hypertensive subjects at any stage of pregnancy. Using a cutoff level of 60 ng/mL, P-selectin concentration at 10-14 weeks had a negative predictive value for pre-eclampsia of almost 99%. Mean plasma P-selectin concentrations were significantly elevated by 10-14 weeks in women who later developed pre-eclampsia (P < 0.001).


CONCLUSIONS
Our data support an inflammatory model for pre-eclampsia whereby endothelial cell activation may be secondary to a primary inflammatory response. Plasma P-selectin has significant potential as a first trimester clinical marker of pre-eclampsia.
Bosio
P M
PM
Rotunda Hospital, Dublin, Ireland.
Cannon
S
S
McKenna
P J
PJ
O'Herlihy
C
C
Conroy
R
R
Brady
H
H
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D008137:Longitudinal Studies; D019007:P-Selectin / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis; D011261:Pregnancy Trimester, First
D015415:Biomarkers; D019007:P-Selectin