title: Urinary prolactin as a reliable marker for preeclampsia, its severity, and the occurrence of adverse pregnancy outcomes.
abstract: 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.
authors.affiliation: Research Unit in Reproductive Medicine, Don Luis no. 111, Col. Nativitas, México, D.F., México. alfredolm@yahoo.com
authors.forename: Alfredo
authors.initials: A
authors.lastname: Leaños-Miranda
authors.forename: Janeth
authors.initials: J
authors.lastname: Márquez-Acosta
authors.forename: Guadalupe María
authors.initials: GM
authors.lastname: Cárdenas-Mondragón
authors.forename: Zarela Lizbeth
authors.initials: ZL
authors.lastname: Chinolla-Arellano
authors.forename: Roxana
authors.initials: R
authors.lastname: Rivera-Leaños
authors.forename: Sara
authors.initials: S
authors.lastname: Bermejo-Huerta
authors.forename: Juan Fernando
authors.initials: JF
authors.lastname: Romero-Arauz
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Alvarez-Jiménez
authors.forename: Julio César
authors.initials: JC
authors.lastname: Ramos-León
authors.forename: Alfredo
authors.initials: A
authors.lastname: Ulloa-Aguirre
mesh_terms: 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
chemical_list: D015415:Biomarkers; D020033:Protein Isoforms; D011388:Prolactin; D003404:Creatinine