Circulating Fibronectin and Plasminogen Activator Inhibitor-2 Levels as Possible Predictors of Recurrent Placental...

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Biology

Background:

• Placental syndromes (PS) involve endothelial and placental dysfunction.
• Fibronectin and plasminogen activator inhibitor-2 (PAI-2) are potential markers for endothelial dysfunction and trophoblast amount, respectively.

Purpose of the Study:

• To investigate if fibronectin and PAI-2 levels deviate in women with recurrent placental syndromes (rPS).
• To determine if these deviations are influenced by pre-pregnant plasma volume (PV).

Main Methods:

• Blood samples were collected preconceptionally and during early/mid-pregnancy (12-16 weeks) from 36 former PS patients.
• Fibronectin and PAI-2 levels were analyzed, comparing pregnancies with rPS (n=12) to those without (non-rPS, n=24).
• Subanalyses considered normal versus subnormal pre-pregnant PV.

Main Results:

• Higher fibronectin and lower PAI-2 levels were observed in the rPS subgroup during early/mid-pregnancy.
• These differences were more significant in women with subnormal pre-pregnant PV.
• The findings suggest these markers can indicate rPS risk in subsequent pregnancies.

Conclusions:

• Former PS patients who develop rPS exhibit elevated fibronectin and reduced PAI-2 levels early in pregnancy.
• Subnormal pre-pregnant PV exacerbates these marker deviations.
• A two-step screening program could identify high-risk women for closer surveillance.