Fibronectin is a marker for organ involvement and may reflect the severityof preeclampsia

Objective. We have studied whether plasma fibronectin is related to a rise in blood pressure during normal pregnancy, whether it can be used for the e arly prediction of preeclampsia, and whether plasma fibronectin is a marker for organ involvement in preeclampsia. Study design. Two hundred twenty-eight healthy pregnant nullipara women wer e examined prospectively during pregnancy. Analyses of fibronectin in plasm a were performed in pregnancy weeks 16, 24, 28, 32, and 36. During the same period, 177 patients with suspected preeclampsia and/or intrauterine growt h retardation (IUGR) were tested for plasma fibronectin, mainly in the thir d trimester. Results. In the normal population of pregnant women (n=222/228), fibronecti n levels were 0.35 +/- 0.06 gn in pregnancy week 16 and 0.43 +/- 0.12 gn in week 36. These levels showed a positive correlation to blood pressure elev ation during pregnancy (r=0.21, p=0.006). The six patients in this group (n =6/228) who later developed preeclampsia had higher fibronectin values 0.42 +/-: 0.07 g/L already in week 16 (p=0.023). In the population of women wit h suspected preeclampsia (preeclampsia, n=129, IUGR alone, n=17; hypertensi on or proteinuria during pregnancy, n=31), fibronectin values were signific antly higher, 0.75 +/- 0.27 gn than in the normal population. Patients with preeclampsia and laboratory signs of organ involvement (n=56) showed signi ficantly higher fibronectin values (0.85 +/- 0.27 g/L) compared to preeclam psia without organ involvement (n=73) [0.76 +/- 0.22 g/L (p=0.03)]. Conclusion. Our data show that fibronectin is related to blood pressure in pregnancy. Fibronectin values in women who develop preeclampsia are elevate d already in pregnancy week 16 and were higher in those with laboratory sig ns of organ involvement.