Early pregnancy plasminogen activator inhibitor-1 levels in Nigerian women and its relationship with preeclampsia
Aim: This study compared early plasma levels of plasminogen activator inhibitor‑1 (PAI‑1) in normal pregnancy and preeclampsia and determined its relationship with disease severity.
Subjects and Methods: This was a prospective cohort study of 195 normotensive, aproteinuric pregnant women without prior history of gestational hypertension. The women were attending the Antenatal Clinic at The Lagos University Teaching Hospital and were within 24 weeks gestation at recruitment. The outcome measures were PAI‑1, systolic blood pressure (SBP), diastolic blood pressure (DBP), and significant proteinuria. The endpoint of the study was the development of preeclampsia. The diagnosis of preeclampsia was made by the attending Obstetrician. The data were analyzed using the IBM SPSS statistical software. Statistical significance was set at P < 0.05.
Results: First trimester PAI‑1 levels were significantly higher in the women who later developed preeclampsia compared to those who had a normal pregnancy (P < 0.0001). In these group of women who later developed preeclampsia, PAI‑1 had an inverse relationship with gestational age (r = 0.878) whereas in normal pregnancy, PAI‑1 and gestational age had a direct relationship (r = 0.017). Second trimester systolic and DBP values were also significantly higher in the women who later developed preeclampsia compared to normal pregnancy, P = 0.007 and 0.004, respectively. There was, however, no correlation between PAI‑1 values and SBP, DBP and proteinuria in the women who developed preeclampsia.
Conclusion: Plasma levels of PAI‑1 are increased early in pregnancies complicated by preeclampsia, but the lack of correlation of this marker with disease severity may limit its clinical utility.
Keywords: Disease severity, plasminogen activator inhibitor‑1, preeclampsia, pregnancy