Prediction of preeclampsia based on maternal serum endoglin level in women with pregestational diabetes mellitus

ABSTRACT

Purpose

To evaluate the level of soluble endoglin (sEng) in pregnant women with pregestational diabetes mellitus (DM) and to assess its predictive value for preeclampsia development.

Methods

Ninety pregnant women were enrolled in the study forming five comparison groups: type 1 DM (not planned, n = 20; planned, n = 20), type 2 DM (diet, n = 15; insulin therapy, n = 20), and the control group (n = 15). The primary outcome was clinically confirmed preeclampsia. Maternal serum concentrations of sEng were measured at 11+0–13+6 and 30+0–33+6 weeks.

Results

sEng level was elevated in all patients with pregestational DM compared to the control group. Its plasma concentration increased with gestational age and in case of preeclampsia development. In patients with type 1 DM, serum sEng level did not depend on the presence of preeclampsia. This is evidence of severe metabolic disorder and endothelial dysfunction in these patients. The addition of sEng level to logistic models considering established risk factors (body mass index + age + HbA1c level) in the first and third trimesters significantly improved their performance for preeclampsia prediction.

Conclusions

Eng level may become an important marker for early prediction of preeclampsia in women with pregestational DM.     

KEYWORDS:

• Endoglin
• diabetes mellitus
• pregestational diabetes
• pregnancy
• preeclampsia

Disclosure statement

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

Author contributions

Conceptualization, R.V.K., methodology, I.V.S.; software, R.V.K.; validation, R.V.K. and E.V.K.; formal analysis, R.V.K.; investigation, R.V.K.; data curation, E.N.A.; writing, original draft preparation, E.V.K.; writing, review and editing, E.N.A, A.V.K.; visualization, R.V.K.; supervision, O.N.A.; project administration, R.V.K.

All authors have read and agreed to the published version of the manuscript.

Institutional review board statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of D.O. Ott Institute of Obstetrics, Gynecology, and Reproductive Medicine (St. Petersburg, Russia) (protocol code 83 and date of approval: 21 April 2017).

Informed consent statement

Informed consent was obtained from all subjects involved in the study.

Additional information

Funding

The study was supported by grant [АААА-А20-120041390024-2] from the Ministry of Science and Higher Education, Russian Federation.