title: Plasma P-selectin is elevated in the first trimester in women who subsequently develop pre-eclampsia.
abstract: 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.
authors.affiliation: Rotunda Hospital, Dublin, Ireland.
authors.forename: P M
authors.initials: PM
authors.lastname: Bosio
authors.forename: S
authors.initials: S
authors.lastname: Cannon
authors.forename: P J
authors.initials: PJ
authors.lastname: McKenna
authors.forename: C
authors.initials: C
authors.lastname: O'Herlihy
authors.forename: R
authors.initials: R
authors.lastname: Conroy
authors.forename: H
authors.initials: H
authors.lastname: Brady
mesh_terms: 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
chemical_list: D015415:Biomarkers; D019007:P-Selectin