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Title: Evaluation of endothelial dysfunction and pregnancy outcomes in preeclampsia
Authors: Tashie, Worlanyo
Fondjo, Linda Ahenkorah
Keywords: Endothelial Dysfunction
Issue Date: 28-Jul-2021
Abstract: Preeclampsia is a major cause of maternal and neonatal morbidity and mortality in sub-Saharan Africa. Evidence indicates that endothelial dysfunction is central to the pathogenesis of this disorder. Altered bioavailability of nitric oxide (NO∙) has been implicated in the pathogenesis of endothelial dysfunction. This study, therefore, assessed the levels and correlations between markers of endothelial dysfunction and adverse pregnancy outcomes in preeclampsia to investigate the roles of these factors in preeclampsia. This case-control study was conducted among pregnant women, with gestational age of 20-40 weeks, visiting Comboni Hospital from January 2017 to May 2018. A total of 180 pregnant women comprising 88 preeclamptic women (PE) and 92 healthy normotensive pregnant women (NP) were recruited. Socio-demographic, clinical and obstetric data were obtained. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of NO∙, Larginine, asymmetric dimethylarginine (ADMA), 3-nitrotyrosine and 25-hydroxyvitamin D (25[OH]D) using enzyme-linked immunosorbent assay technique. Mean levels of NO∙, L-arginine/ADMA ratio and 25 (OH)D were significantly lower in PE compared to NP (p<0.05), while mean levels of L-arginine, ADMA and 3-nirotyrosine were significantly higher in PE compared to NP (p<0.05). In the women with severe preeclampsia, ADMA showed a significant positive correlation with systolic blood pressure (β= 0.454, p=0.009) and diastolic blood pressure (β= 0.469, p=0.007). Increased proportion of adverse maternal and foetal outcomes such as intrauterine growth restriction (IUGR), low birth weight neonates and preterm delivery were significantly associated with preeclamptic pregnancies compared to normotensive pregnancy (p<0.05). Preeclampsia was significantly associated with vitamin D deficiency compared to the control group (p=0.021). 81.7% of the study participants had vitamin D deficiency; 88.6% in PE compared to 75.0% in NP. 93.8% of the participants with severe preeclampsia had vitamin D deficiency compared to 85.7% in mild preeclampsia. A significant proportion of women with vitamin D deficiency had low birth weight neonates (p=0.011) and preterm delivery (p=0.015). Vitamin D status showed a positive inverse correlation with 3- nirotyrosine in the preeclamptic women (β= -0.211, p=0.049). Preeclampsia is associated with endothelial dysfunction, as evidenced by reduced levels of NO∙, L-arginine/ADMA ratio, 25(OH)D and an elevated concentration of ADMA and 3-nitrotyrosine. Combined measurements of these markers of endothelial dysfunction during pregnancy, as well as L-arginine supplementation to increase the L-arginine/ADMA ratio of preeclamptic women and women at risk of developing preeclampsia could serve as generic biomarkers for early diagnosis and management of preeclampsia.
Description: A thesis submitted in fulfillment of the requirements for the Degree of Master of Philosophy in the Department of Molecular Medicine,School of Medical Sciences Kwame Nkrumah University of Science & Technology, Kumasi. June, 2019
URI: http://hdl.handle.net/123456789/14510
Appears in Collections:College of Health Sciences

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