Biochemical markers of maternal bone turnover are elevated in pre-eclampsia

Objectives To investigate the hypothesis that bone turnover is reduced in p re-eclampsia compared with normal pregnancy. Design A prospective cross-sectional study. Setting Obstetric unit at the Chelsea and Westminster Hospital, London. Methods Third trimester maternal plasma levels of the cross-linked carboxyl -terminal telo-peptide of type I collagen (ICTP!, ja marker of bone resorpt ion) and the carboxyl terminal pro-peptide of type I pro-collagen (PICP), i a marker of bone formation) were compared in 25 women with pre-eclampsia an d in 24 normal pregnant controls. The subjects were matched for maternal ag e, booking body mass index and gestational age. PICP and ICTP levels were m easured by radio-immunoassay. Results ICTP and PICP levels were significantly increased in women with pre -eclampsia compared with the normal pregnant controls (P = 0.0001 and P = 0 .004, for ICTP and PICP respectively, Wilcoxon signed ranked test). There w as no significant correlation between either of the markers and booking bod y mass index, blood pressure. serum uric acid levels or platelet count. Conclusions These data suggest that bone turnover is increased in establish ed pre-eclampsia compared with normal pregnancy. Further studies are requir ed to investigate whether this precedes the onset of the disease.