Urinary prolactin as a reliable marker for preeclampsia, its severity, and the occurrence of adverse pregnancy outcomes.
BACKGROUND
It has been proposed that preeclampsia may result from of an imbalance in angiogenic factors. Although prolactin (PRL) is mainly related to lactation, it is also involved in other biological functions, including angiogenesis.


OBJECTIVE
Our objective was to determine the relationship among preeclampsia, serum and urinary PRL (uPRL) levels, and excretion of antiangiogenic PRL fragments in urine.


METHODS
Using a cross-sectional design, uPRL and serum PRL levels, and the presence of PRL isoforms were determined in 546 pregnant women: 207 healthy pregnant, 124 with gestational hypertension, 48 with mild preeclampsia, and 167 with severe preeclampsia (sPE).


RESULTS
uPRL concentrations were significantly (P < 0.001) higher in preeclampsia (11.99 ng/mg creatinine) than in healthy pregnancy (0.20 ng/mg creatinine) and gestational hypertension (0.19 ng/mg creatinine), and were even higher in sPE compared with mild preeclampsia (21.20 vs. 2.77 ng/mg creatinine, respectively; P < 0.001). Antiangiogenic PRL fragments (14-16 kDa) were detected in 21.6% of urine samples from women with sPE but in none from other groups. Patients with hemolysis, elevated liver enzymes, low platelet count syndrome, and/or eclampsia, placental abruption, acute renal failure, and pulmonary edema exhibited highest uPRL concentrations (P < or = 0.028) and frequency of antiangiogenic PRL fragments in urine (P < or = 0.036). High-serum PRL levels were associated with sPE independently of gestational age, proteinuria, and prolactinuria (P = 0.032).


CONCLUSIONS
Preeclampsia is characterized by increased uPRL excretion. uPRL concentrations and their isoforms appear to be suitable markers to assess the severity of preeclampsia and occurrence of adverse outcomes. PRL and and/or its isoforms might be involved in the pathophysiology of preeclampsia.
Leaños-Miranda
Alfredo
A
Research Unit in Reproductive Medicine, Don Luis no. 111, Col. Nativitas, México, D.F., México. alfredolm@yahoo.com
Márquez-Acosta
Janeth
J
Cárdenas-Mondragón
Guadalupe María
GM
Chinolla-Arellano
Zarela Lizbeth
ZL
Rivera-Leaños
Roxana
R
Bermejo-Huerta
Sara
S
Romero-Arauz
Juan Fernando
JF
Alvarez-Jiménez
Guadalupe
G
Ramos-León
Julio César
JC
Ulloa-Aguirre
Alfredo
A
D000328:Adult; D015415:Biomarkers; D015153:Blotting, Western; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016015:Logistic Models; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011388:Prolactin / Q000097:blood / Q000652:urine*; D020033:Protein Isoforms
D015415:Biomarkers; D020033:Protein Isoforms; D011388:Prolactin; D003404:Creatinine