Relevance of maternal sodium level for preeclampsia-associated adverse pregnancy outcomes

Dröge, Lisa Antonia; Eidmann, J; Aigner, Annette; Frank, Luca; Perschel, F. H.; Henrich, Wolfgang; Verlohren, Stefan

doi:10.1016/j.preghy.2021.05.021

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…Multi-marker regression models, including the combination of risk factors, assessment of the sFlt-1/PlGF ratio, and other clinical tests to predict PE-related AOs, have been investigated in a multitude of studies [22][23][24][25][26][27][28][29][30][31][32]. In a prospective study of n = 616 women, Rana et al reported that a cutoff value of the sFlt-1/PlGF ratio of 85 shows an AUC of 89% when predicting maternal and perinatal AOs within 2 weeks.…”

Section: Results In Context Of the Literaturementioning

confidence: 99%

Comparison of the Soluble fms-Like Tyrosine Kinase 1/Placental Growth Factor Ratio Alone versus a Multi-Marker Regression Model for the Prediction of Preeclampsia-Related Adverse Outcomes after 34 Weeks of Gestation

Sroka¹,

Lorenz-Meyer²,

Scherfeld³

et al. 2023

Fetal Diagn Ther

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Introduction: The objective of this retrospective study was to compare the predictive performance of the soluble fms-like tyrosine kinase 1 (sFlt-1) / placental growth factor (PlGF)-ratio alone or in a multi-marker regression model for preeclampsia-related maternal and/or fetal adverse outcomes in women >34 weeks of gestation. Methods: We analyzed the data collected from 655 women with suspected preeclampsia. Adverse outcomes were predicted by multivariable and univariable logistic regression models. The outcome of patients was evaluated within 14 days after presentation with signs and symptoms of preeclampsia or diagnosed preeclampsia. Results: The full model integrating available, standard clinical information and the sFlt-1/PlGF-ratio had the best predictive performance for adverse outcomes with an AUC of 72.6%, which corresponds to a sensitivity of 73.3% and specificity of 66.0%. The positive predictive value of the full model was 51.4% and the negative predictive value was 83.5%. 24.5% of patients, who did not experience adverse outcomes but were classified as high risk by sFlt-1/PlGF-ratio (≥38), were correctly classified by the regression model. The sFlt-1/PlGF-ratio alone had a significantly lower AUC of 65.6%. Conclusions: Integrating angiogenic biomarkers in a regression model improved the prediction of preeclampsia-related adverse outcomes in women at risk after 34 weeks of gestation.

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Section: Results In Context Of the Literaturementioning

confidence: 99%

Comparison of the Soluble fms-Like Tyrosine Kinase 1/Placental Growth Factor Ratio Alone versus a Multi-Marker Regression Model for the Prediction of Preeclampsia-Related Adverse Outcomes after 34 Weeks of Gestation

Sroka¹,

Lorenz-Meyer²,

Scherfeld³

et al. 2023

Fetal Diagn Ther

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“…Na concentration in the umbilical cord showed a positive linear correlation with the duration of the pregnancy. A low level of Na (hyponatremia) is the most common electrolyte abnormality that may pose a risk to pregnancy [ 60 ] and contribute to pre-eclampsia, which can result in a shorter pregnancy [ 61 , 62 , 63 ]. Hsu et al [ 64 ] showed that hyponatremia in pre-eclampsia can lead to maternal respiratory and circulatory arrest.…”

Section: Discussionmentioning

confidence: 99%

Calcium, Potassium, Sodium, and Magnesium Concentrations in the Placenta, Umbilical Cord, and Fetal Membrane from Women with Multiple Pregnancies

Grzeszczak

Kapczuk

Kupnicka

et al. 2023

Life

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Calcium (Ca), potassium (K), sodium (Na), and magnesium (Mg) are the elements responsible for the fundamental metabolic and biochemical processes in the cells of the body. The demand for these elements increases significantly during pregnancy, where an adequate supply protects women from the hypertension common in pre-eclampsia and preterm labor. This study aimed to evaluate the association between macro-elements (Ca, Mg, Na, and K) in the placenta, fetal membrane, and umbilical cord and the morphometric parameters of newborns from multiple pregnancies. The study involved 57 pregnant European women with healthy uncomplicated twin pregnancies (n = 52) and triple pregnancies (n = 5); 40 pairs of dichorionic diamniotic twins, 11 pairs of monochorionic diamniotic twins, 1 pair of monochorionic monoamniotic twins, 3 trichorionic triamniotic triplets, and 2 dichorionic triamniotic triplets. Placentas (n = 107), umbilical cords (n = 114), and fetal membranes (n = 112) were collected immediately following delivery, and then weighed and measured. The levels of Ca, K, Na, and Mg were determined using inductively coupled plasma atomic emission spectroscopy (ICP-OES) in a Thermo Scientific ICAP 7400 Duo (Waltham, MA, USA). The respective mean concentrations of Ca, K, Na, and Mg (mg/kg−1 dry mass) were: 2466, 8873, 9323, and 436 in the placenta; 957, 6173, 26,757, and 326 in the umbilical cord, and 1252, 7460, 13,562, and 370 in the fetal membrane. In the studied materials from northwestern Poland, we found strong positive correlations between Ca and Mg concentrations in both the umbilical cord (r = 0.81, p = 0.00) and the fetal membrane (r = 0.73, p = 0.00); between K and Mg concentrations in the umbilical cord (r = 0.73, p = 0.00); between Ca and K concentrations in the fetal membrane (r = 0.73, p = 0.00), and we found moderately positive correlations between placental Ca concentration and placental weight (ρ = 0.42, p = 0.00) and between umbilical cord Mg concentrations and the length of the pregnancy (ρ = 0.42, p = 0.00). Negative correlations were found between Na and Ca concentrations in the fetal membrane (r = −0.40, p = 0.00) and Na concentrations in the fetal membrane and Mg concentrations in the placenta (r = −0.16, p = 0.02). Negative correlations were confirmed between the length of pregnancy and head circumference (ρ = −0.42; p = 0.00), infant weight (ρ = −0.42; p = 0.00), infant length (ρ = −0.49; p = 0.00), shoulder width (ρ = −0.49; p = 0.00); and between the infant weight and head circumference (ρ = −0.62; p = 0.00), weight before delivery (ρ = −0.36; p = 0.00), infant length (ρ = −0.45; p = 0.00), shoulder width (ρ = −0.63; p = 0.00), and weight gain during pregnancy (ρ = −0.31; p = 0.01). We found statistically significant correlations between cigarette smoking before pregnancy and the women’s weight before delivery (ρ = 0.32, p = 0.00), and a negative correlation between the women’s ages and infant head circumference (ρ = −0.20, p = 0.02). This is probably the first study to evaluate Ca, Na, K, and Mg concentrations in the afterbirth tissues of multiple pregnancies. It adds to the knowledge of elemental concentrations in multiple pregnancies and their possible effects on fetal morphometric parameters.

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A machine-learning–based algorithm improves prediction of preeclampsia-associated adverse outcomes

Schmidt

Rieger

Neznansky

et al. 2022

American Journal of Obstetrics and Gynecology

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Relevance of maternal sodium level for preeclampsia-associated adverse pregnancy outcomes

Cited by 5 publications

References 26 publications

Comparison of the Soluble fms-Like Tyrosine Kinase 1/Placental Growth Factor Ratio Alone versus a Multi-Marker Regression Model for the Prediction of Preeclampsia-Related Adverse Outcomes after 34 Weeks of Gestation

Comparison of the Soluble fms-Like Tyrosine Kinase 1/Placental Growth Factor Ratio Alone versus a Multi-Marker Regression Model for the Prediction of Preeclampsia-Related Adverse Outcomes after 34 Weeks of Gestation

Calcium, Potassium, Sodium, and Magnesium Concentrations in the Placenta, Umbilical Cord, and Fetal Membrane from Women with Multiple Pregnancies

A machine-learning–based algorithm improves prediction of preeclampsia-associated adverse outcomes

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