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Diagnostic ability of hepcidin in predicting fetal outcome in preeclampsia
S G Nila1, Zachariah Bobby1, Gowri Dorairajan2
1Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India.
Insights
Maternal hepcidin levels can predict poor fetal outcomes in preeclampsia. Elevated hepcidin at 34 weeks gestation indicates risks like low birth weight, preterm birth, and NICU admission.
Area of Science:
- Reproductive Medicine
- Maternal-Fetal Medicine
- Biomarker Discovery
Background:
- Low birth weight and prematurity are leading causes of neonatal mortality and morbidity.
- Preeclampsia significantly contributes to adverse maternal and fetal outcomes.
- Hepcidin, an acute phase peptide, elevates in inflammation and cytotoxicity, conditions linked to poor fetal outcomes.
Purpose of the Study:
- To investigate hepcidin as a diagnostic marker for predicting poor fetal outcomes in pregnancies.
- To assess the correlation between maternal serum hepcidin levels and adverse neonatal outcomes.
Main Methods:
- A prospective follow-up study involving 80 pregnant women (40 healthy, 40 preeclampsia) in South India.
- Serum hepcidin levels were measured and compared between groups.
- Receiver Operating Characteristic (ROC) curves were used to evaluate hepcidin's predictive ability for poor fetal outcomes.
Main Results:
- Hepcidin levels were significantly higher in preeclampsia patients and mothers with poor fetal outcomes (p < .001).
- Hepcidin demonstrated predictive value for low birth weight (AUC 0.686), preterm delivery (AUC 0.788), and NICU admission (AUC 0.749).
- A maternal hepcidin cutoff of 615 pg/ml predicted overall poor fetal outcomes in preeclampsia.
Conclusions:
- Maternal serum hepcidin levels at 34 ± 4 weeks gestation can predict poor fetal outcomes.
- Elevated hepcidin above 615 pg/ml is associated with increased risk of low birth weight, preterm delivery, and NICU admission.
Background:
Low birth weight and prematurity are the major contributors to neonatal mortality and morbidity. Preeclampsia which is associated with both maternal and fetal mortality and morbidity is a major contributor to such poor fetal outcomes. Hepcidin an acute phase peptide hormone gets elevated in conditions of iron overload, inflammation, infections, and cytotoxicity. Hepcidin levels can get elevated in pregnancies with such pathologies which invariably will be having a poor fetal outcome.
Objective:
To study the role of hepcidin as a diagnostic marker in predicting a poor fetal outcome.
Materials And Methods:
A cross-sectional study with follow up was carried out in a South Indian Tamil population. Forty healthy pregnant women and forty preeclampsia patients were recruited between the gestational age of 34 ± 4 weeks and followed up till delivery. Serum levels of hepcidin were analyzed for all the participants and comparisons were done between preeclampsia and healthy pregnancies as well as between pregnancies with good and poor fetal outcomes. Fetal outcome variables such as birth weight, gestational age at the time of delivery and NICU admission status of the newborn were collected during the follow-up period. ROC curves were constructed to determine the ability of maternal serum hepcidin levels in predicting poor fetal outcomes with good sensitivity, specificity and likelihood ratios.
Results:
Maternal hepcidin levels were found to be significantly elevated in preeclampsia patients (p < .001) as well as in mothers with the poor fetal outcome (p < .001). On ROC curve analysis, AUC were 0.686, 0.788, 0.749 and LR + were 2.18, 2.44, 2.14, respectively for predicting low birth weight, preterm delivery and NICU admission status of the newborn. Hepcidin was able to predict the overall poor fetal outcome in our preeclampsia patients above a cut off level of 615 pg/ml.
Conclusion:
Above a cut off level of 615 pg/ml and at the gestational age of 34 ± 4 weeks, maternal hepcidin levels were able to predict poor fetal outcomes such as low birth weight, preterm delivery, and NICU admission.
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