PP071. suPAR levels in normal- and preeclamptic pregnancies

Preeclampsia (PE) has been considered to be a maternal inflammatory response to pregnancy and may be hazardous for mother and child. Soluble urokinase Plasminogen Activator receptor (suPAR) is a non-specific marker that reflects overall systemic inflammation and immune activation.

We examined the levels of suPAR in first and third trimesters of normal- and preeclamptic pregnancies.

Two clinical studies were conducted. The first study included 43 women who subsequently developed PE and 86 control women not developing PE. Blood samples were collected during the first trimester. The two groups were matched with respect to gestational age. In the second study, 13 cases of PE and 8 controls were enrolled and blood samples were collected during the third trimester. Serum suPAR were analyzed by the commercially availably suPARnostic® assay kit (ELISA, Virogates, Copenhagen, Denmark).

There were no significant differences in first trimester suPAR level between women who subsequently developed PE and those who completed a normal pregnancy (4.5 [3.7-5.4] ng/mL versus 4.3 [3.8-5.0] ng/mL, p=0.49, median [interquartile range]). In the third trimester, suPAR levels were significantly elevated in the preeclamptic group compared to the control group (2.5 [2.2-3.5] ng/mL versus 1.9 [1.5-2.1] ng/mL, p=0.008). After adjustment for gestational age (38.6 (0.7) and 31 (3.1) weeks in the control- and the PE-group respectively, p<0.001, mean (SD)), the group difference did not remain statistically significant (p=0.064).

suPAR is not a suitable marker for detecting the systemic maternal inflammatory response in women with established PE nor a useful pre-clinical marker of the disorder. The observation of the higher suPAR level in first trimester of pregnancy compared to third trimester suPAR level alludes to a possible physiological function that needs to be clarified.