Soluble endoglin in urine as an early-pregnancy preeclampsia marker: antenatal longitudinal feasibility study

Abstract

This study aimed to evaluate soluble endoglin (sEng) in urine as a preeclampsia predictor. Ninety-three pregnant women at risk for preeclampsia were followed. Spot urine sample ELISA analysis before 20 weeks of gestation was done to assess protein levels. Logistic regression analysis evaluated associations between preeclampsia with sEng/creatinine ratio, pg/mg, adjusted for risk factors. Preeclampsia incidence was 22.8% (20/92). Urinary sEng/creatinine (pg/mg) 0.001 (95% CI 0.001–0.136) was associated, adjusted for body mass index > 28 kg/m² OR 6.44 (95% CI 1.11–37.47) and mean arterial pressure OR 1.20 (1.07–1.35). During the first half of gestation sEng urinary excretion was lower in pregnant women developing preeclampsia.

Impact statement

• What is already known on this subject? The angiogenesis factors present in the plasma of pregnant women have shown good preclinical predictors of preeclampsia. Studies on urinary markers in pregnancy are infrequent, despite the ease of obtaining urine specimens.

• What do the results of this study add? Values of the sEng/creatinine ratio during the first half of pregnancy were related to a higher chance of preeclampsia occurring when it was evaluated alone or adjusted by body mass index and mean arterial pressure values.

• What are the implications of these findings for clinical practice and/or further research? The potential benefits of a urinary test compared to one of the blood levels include its non-invasive nature and ease of performing the test, even during prenatal care. Future research is expected to evaluate the sEng/creatinine ratio relevance to improve clinical scores of preeclampsia prediction for the identification of women at risk for this disease.

Keywords:

• Angiogenesis
• prediction
• preeclampsia
• pregnant women

Acknowledgements

The authors thank the Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, for the support during the urinary concentration of sEng measurement.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the FAPEMIG (Fundação de Amparo à Pesquisa do Estado de Minas Gerais) [APQ-01112-09] and CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) PVE [APQ-01112-09], Brazil.