[Plasma fibronectin: a marker of arterial hypertension in pregnancy?]

In a study of 40 pregnant women, Lazarchick and al. Have found that plasma fibronectin concentrations are abnormally elevated in normotensive pregnant women destined to become preeclamptic. We tried to confirm this fact in a larger study with intent to establish a predictive value of fibronectin rise as a sensitive indicator for preeclampsia. 285 pregnant women were included in our study: plasma fibronectin and uric acid were both measured between 14 and 39 weeks. Blood pressure and urinary protein were assessed monthly. 35 patients (12%) became hypertensive. Plasma fibronectin level was significantly higher (greater than 0.4 g/l) in the hypertensive gravid women group (chi 2 test: p less than 0.001; good specificity: 90%, bad sensitivity: 31%). There was a relationship between plasma fibronectin (greater than 0.4 g/l) and uric acid rise (greater than 50 mg/l) (chi 2 test: p less than 0.01). We did not find a relationship between fibronectin level and fetal weight. In conclusion, plasma fibronectin level is higher in hypertensive pregnant women but the absolute value is not statistically significant. It looks like a bad screening test, but it is a very specific test. It does not give information about fetal prognosis. It would be interesting to carry out another study in a larger population with repeated samplings to prove or reject the greater predictive value of fibronectin and its concentration as a sensitive indicator for preeclampsia.