61 - Urinary Biomarkers for Preeclampsia: Marinobufagenin and Angiogenic Factor Dynamics

Publication Number: 2058.61

raza Bajwa, Baylor Scott and White, Temple, TX, United States; Niraj Vora, Baylor Scott White McLane Children's Medical Center, Leander, TX, United States; Ram R.. Kalagiri, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States

Background: Preeclampsia occurs in 3–10% of pregnancies and remains a leading cause of maternal and fetal morbidity and mortality. It is characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. The etiology is multifactorial, involving abnormal angiogenic balance, but no single biomarker reliably detects the syndrome.

Objective: To measure angiogenic, anti-angiogenic factors, and marinobufagenin (MBG) in pregnant patients with and without preeclampsia.

Design/Methods: A prospective cohort study of normotensive and preeclamptic patients recruited from the Obstetric Service at Baylor Scott & White Hospital. Urine samples were collected for biomarker assays. Levels of soluble fms-like tyrosine kinase-1 (sFlt-1), soluble endoglin (sEng), placental growth factor (PlGF), transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), and MBG were measured by ELISA and normalized to urinary creatinine. Serum MBG was analyzed at four time points during pregnancy. Group comparisons used Chi-square, Student’s t-test, and Mann-Whitney U test; p < 0.05 was considered significant. Gestational age effects were evaluated by correlation and regression.

Results: Forty-four normotensive and 32 preeclamptic patients (22–39 and 28–39 weeks gestation) were included. Groups differed in blood pressure, gestational age at delivery, and age (p < 0.02) but not in weight, height, or creatinine (p > 0.28). Preeclampsia showed increased sEng (p = 0.016), sFlt-1 (p = 0.00066), and MBG (p < 0.0001) and decreased PlGF (p = 0.018); TGF-β1 and VEGF were unchanged (p > 0.14). Only urinary MBG varied with gestational age in normal pregnancies (p = 0.0009). ROC analysis showed significant AUCs for MBG, sFlt-1, PlGF, and sFlt-1/PlGF ratio (p < 0.02) with sensitivities 65–88% and specificities 74–96%. Serum MBG was highest in the second trimester in preeclampsia and at delivery in normal pregnancies.

Conclusion(s): Urinary angiogenic and anti-angiogenic factors differ significantly between preeclamptic and normotensive pregnancies. Urine-based assays, particularly MBG, may provide a less invasive and practical approach for early detection and monitoring of pre-eclampsia.

Table 1. Plasma Marinobufagenin (MBG) (pg/mL)
MBG Table.pdfPreeclampsia: The Plasma MBG significantly increased in second trimester (p < 0.05); N= 32
Normal Pregnancy: Significant difference observed at delivery; N=44