Maternal serum endocan concentrations are elevated in patients with preterm premature rupture of membranes

Abstract

Objectives To evaluate the maternal serum endocan levels in pregnant women complicated by preterm premature rupture of membranes (PPROM) and to compare the results with healthy pregnancies. Methods This cohort study included 31 pregnant women with PPROM and 34 gestational age-matched healthy subjects in the third trimester of pregnancy. The blood for analysis was obtained on the day of diagnosis and serum endocan levels were measured using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. The pregnant women were observed until the delivery and perinatal data were noted. Results No significant differences regarding maternal age, body mass index, gravidity, parity and gestational age at sampling were observed (P > 0.05). Mean serum endocan level was significantly higher in the PPROM group than in healthy controls (1490 ± 632 pg/mL vs. 972 ± 586 pg/mL, respectively; P: 0.001). Serum endocan concentration was positively correlated with C-reactive protein (CRP) (r = 0.754, P < 0.001) and white blood cells count (WBC) (r = 0.712, P:0.001). The receiver operating characteristic (ROC) curve analysis showed that endocan with a cut-off point of 1198 ng/dL indicated women with PPROM with sensitivity of 64.5% and specificity of 35.1% (area under curve 0.731, confidence interval 0.61–0.85). Conclusion Serum endocan level was significantly elevated in the PPROM patients than in healthy controls. The endocan level may be a useful indicator of endothelial dysfunction/inflammation in PPROM cases.

Comparison of the maternal serum endocan levels in preterm premature rupture of membrane and normal pregnancy

“…In the same study, the average WBC count and CRP of pregnant women with PPROM were higher than in the control group. 18 Similarly, in our study, the mean WBC count and endocan levels were significantly higher in pregnant with PPROM than in the control group. Our study evaluated whether endocan could be an independent predictive factor with multivariate logistic regression analysis.…”

“…[15][16][17] During the planning and approval phase of the present study, a similar study was published showing that endocan levels were significantly increased in women with PPROM. 18 However, the number of patients in the study was small and the relationship between endocan levels and the latent period was not specified. Besides, no correlation analysis was performed regarding endocan status and age, white blood cells (WBC), hemoglobin (Hgb), birth weight, and body mass index (BMI).…”

Prior placental bed disorders and later dementia: a retrospective Swedish register‐based cohort study

“…34 Endothelial dysfunction is a key factor in preeclampsia, 35 and markers for endothelial dysfunction are associated with preterm birth, 36 as well as PPROM. 37 Endothelial dysfunction is impaired in women during the pre-eclamptic episode and several years afterwards. 38 Levels of circulating angiogenic factors, 39 as well as failure of physiological transformation of the spiral arteries, 40,41 have been linked to spontaneous preterm birth and PPROM.…”

“…Small vessel disease in the brain is linked to cognitive impairment, 33 and is also associated with endothelial function 34 . Endothelial dysfunction is a key factor in pre‐eclampsia, 35 and markers for endothelial dysfunction are associated with preterm birth, 36 as well as PPROM 37 . Endothelial dysfunction is impaired in women during the pre‐eclamptic episode and several years afterwards 38 …”

Preterm premature rupture of membranes (PPROM)

“…This issue of the Journal of Perinatal Medicine (JPM) shows discoveries in the amniotic cavity that have direct bearing on the diagnosis of intra-amniotic inflammation and infection (IAI/I), the prediction of morbidity, and the management of PPROM. The four articles in this edition of the JPM are markedly different in their design, approach and ability to help elucidate the course of events in the setting of PPROM, although all are retrospective [1][2][3][4]. These articles, as well as others over the course of the last decades, show us that there is a differential response of the maternal immune system in the various bodily compartments -fetal, amniotic fluid, chorio-amniotic membranes, decidua, myometrium and maternal serum.…”