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International Journal of Pediatrics & Neonatal Care Volume 5 (2019), Article ID 5:IJPNC-148, 6 pages
https://doi.org/10.15344/2455-2364/2019/148
Research Article
Improving the Predictive Accuracy for Pre-eclampsia by Combining Demographic and Socio-economic Risk Factors with Biochemical Indicators

Ana Daneva Markova*, Goran Dimitrov, Gligor Tofoski, Jadranka Georgievska, Elena Dzikova, Vesna Livrinova, Ivo Kjaev and Marijana Filipovska

University clinic of obstetrics and gynecology, Skopje, Macedonia
Prof. Ana Daneva Markova, University clinic of obstetrics and gynecology, Skopje, Macedonia; E-mail: anadaneva@yahoo.com
02 December 2018; 02 March 2019; 04 March 2019
Markova AD, Dimitrov G, Tofoski G, Georgievska J, Dzikova E, et al. (2019) Improving the Predictive Accuracy for Pre-eclampsia by Combining Demographic and Socio-economic Risk Factors with Biochemical Indicators. Int J Pediatr Neonat Care 5: 148. doi: https://doi.org/10.15344/2455-2364/2019/148

Abstract

Objective: Since prevention of pre-eclampsia is not possible, the target should be to estimate the severity of the disease that will provide intensive supervision during the further course of pregnancy. So, the aim of this study is to improve the predictive accuracy for pre-aclampsia by defining the demographic and socio-economic characteristics of pregnant women with pre-eclampsia in Macedonia combined with certain biochemical indicators.
Methods and materials: The data used in this study are collected from a case control study which was conductedat the University Clinic of Gynecology and Obstetrics, University "Ss. Cyril and Methodius" in Skopje, Macedonia. The study included 50 pregnant women with singleton pregnancies between 28 and 40 gestational weeks hospitalized with symptoms of pre-eclampsia, determined by standard clinical laboratory analysis. The control group consisted of 50 normotensive pregnant women of the same gestational age.
After obtaining consent for participation in the examination of every pregnant woman, a detailed history was taken, cardiotocography and ultrasound biometry were preformed. Also a blood sample was drawn to determine serum concentrations of appropriate markers and clinical laboratory testing to assess the severity of pre-eclampsia (moderate or severe). Inflammatory cytokines IL-10 was analyzed from peripheral blood 1-1,5ml by enzymatic amplification chemiluminescence on the device Immulite 1000, Siemens Healthcare Diagnostics, USA.
The data were digitized and all statistical tests were performed using SPSS version 13.0. Logistic regression analysis (Binary Logistic Regression) was used to determine the predictive value of the different parameters for the occurrence of severe preeclampsia. Rates of probability - odds ratios (OR) and 95% Confidence Intervals (CI) were calculated in order to quantify independent associations.
Results: Analysis applied in this study for several of the demographic and clinical risk factors for pre-eclapsia showed that elevated systolic blood pressure of 160 mmHg or higher, diastolic blood pressure of 100 mmHg or higher, pregnancy at older age than 35 years as is nulliparity are associated with highly significant risk for developing severe form of pre-eclampsia. Other risk factors examined in this survey such as duration of gestation, BMI, number of pregnancies, previous pregnancy with pre-eclampsia, diabetes and smoking status according to the results of this study, are risk factors that insignificantly increase the risk for severe form of pre-eclapmsia. As for the biochemical indicators, reduced serum concentrations of IL10 are statistically significantly associated with the development of severe form of preeclampsia in pregnant women. IL10 was also found to be negatively correlated with proteinuria, and positively correlated with blood platelets. Significantly higher concentration of IL10 was confirmed in patients with higher number of platelets in the blood, and vice versa. On the other hand, the serum concentration of IL10 was significantly lower in patients with higher amount of proteins in the urine, and vice versa.
Conclusions: Examination of clinical risk factors combined with biochemical markers can improve the predictive success of pre-eclampsia and has important clinical values in improving the prognosis of pregnant women and fetuses.