A Study of the Relationship of Preeclampsia with Total Plasma Fibronectin

Han, Man Sik; Lee, Ki Won; Hwang, Soon Gu; Park, Jeong Don; Park, Soon Woo

Abstract

Of 119 full-term pregnant subjects studied from October, 1995 to March, 1996, 79 hadpreeclampsia(severe; 43, mild; 36) and 40 were normotensive controls. The plasma fibronectinlevels of each subject were assayed by turbidometric immunoassy(Boehringer Mannheim).The objective of this study was to evaluate the relationship of plasma fibronectin withpreeclampsia as a marker for vascular injury.The results were as follows:1. There were significant differences of plasma fibronectin values among the normotensivepregnancy, mild preeclampsia and severe preeclampsia. Within each group of patients,plasm a fibronectin values were 101.7 +/- 59.4 ng/ml and 249.7 +/- 96.3 ng/ml and 329.2 +/- 169.5 ng/ml, respectively (p < 0.001).2. Plasma fibronectin values had positive correlations with severity of preeclampsia,proteinuria, diastlic blood pressure and systolic blood pressure, but negative correlationswith birth weight and platelet count(p < 0.001).3. When the severity of proteinuria on preeclampsia were +1, +2, and +3 or more,plasma fibr onectin values revealed 246.0 +/- 93.3 ng/ml, 342.3 +/- 185.1 ng/ml and 345.0 +/- 168.1ng/ml, respectively and there were significant differences among three groups.4. To verify the variables correlated with plasma fibronectin by using mutiple regressionanalysis, the only variable which was selected significantly was the severity of preeclampsia(r(2) : 0.529).5. With receiver operating characteristic(ROC) curve analysis of the relationship betweenplasma fibronectin values and preeclampsia, if cut off value was selected at the levelof 175ng/ml or more, the sensitivity for diagnosis of preeclampsia was 87.3%, specificity90.0%, positive predictive value 94.5%, and negative predictive value 78.3%, respectively.