Predictive markers of pre-eclampsia in hypertensive disorders of pregnancy

Objective: The aim of this work is to assess the most widespread methods cu rrently proposed and two new markers for predicting the development of pre- eclampsia in pregnant women with hypertension. Methods: The study involved 212 pregnant Caucasian women: 104 normotensive, 68 pregnancy-induced hypert ensive and 40 chronic hypertensive. Blood and urine were sampled between 28 and 30 weeks gestation. All 108 hypertensive pregnant women, at the time o f sampling, demonstrated proteinuria below 0.3 g/24 h. The following labora tory tests were performed: fibronectin, antithrombin-III, alpha-1-microglob ulin, U-N-acetyl-beta-glucosaminidase, uric acid and albumin excretion rate . Student's t-test, discriminant analysis and chi(2) (chi-square) test were used as statistical methods. A P value less than 0.05 was considered signi ficant. Results: After discriminating analysis, only three of the six varia bles analyzed were able to discriminate patients who would develop pre-ecla mpsia from the remaining hypertensive pregnant women: microalbuminuria, uri c acid and fibronectin (chi(2) = 29.122, P < 0.01). Conclusions: In agreeme nt with previous studies, albumin excretion rate appeared to be the best pr edictive test for pre-eclampsia in hypertensive pregnant women: giving a hi gher positive predictive value and specificity (87.5 and 98.9%, respectivel y). (C) 1999 International Federation of Gynceology and Obstetrics.