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Serum Ceruloplasmin in Pre-eclampsia: A Case-Control Study in a Tertiary Health Centre in Southwest Nigeria
Joy Onyinyechi Chionuma1, Olusegun Cosmos Adebara2, Nosimot Omolola Davies3
1Department of Obstetrics and Gynaecology, College of Medicine, Lagos State University, Lagos State University Teaching Hospital, Ikeja, Nigeria.
Background:
Pre-eclampsia is a pregnancy disorder linked with increased maternal and perinatal complications. An imbalance between free radical-induced lipid peroxidation and the antioxidant system may contribute to its pathogenesis.
Aims:
This study aimed to compare serum ceruloplasmin levels in women with pre-eclampsia and their normotensive counterparts and to assess its predictive value for disease severity.
Subjects And Methods:
A prospective case-control study was conducted involving 100 pregnant women diagnosed with pre-eclampsia, matched for age and parity against 100 healthy controls. Patients with pre-eclampsia were classified into mild (55) and severe (45) pre-eclampsia groups. Data on demographics, obstetric characteristics and outcomes were collected. Ceruloplasmin protein concentration was measured using a competitive enzyme-linked immunosorbent assay kit. Data analysis was performed using Stata Version 17. The reference range of serum ceruloplasmin for determining the risk of pre-eclampsia was from the 2.5 th to the 97.5 th percentile of the controls. The statistical significance level was set at P < 0.05.
Results:
The median interquartile range (IQR) serum ceruloplasmin levels were 21 mg/dL (IQR 17.5-23.8) in normotensive women, 35.5 mg/dl (IQR, 33.8-38.3) in mild pre-eclampsia, and 46.5 mg/dL (IQR, 42.5-49) in severe pre-eclampsia, with significant differences ( P = 0.001). The cut-off point for serum ceruloplasmin using Youden's index was 29 mg/dL. Ceruloplasmin exhibited 90.8% sensitivity, 95.6% specificity and positive and negative predictive values and accuracy of 96.1%, 89.6% and 92.3%, respectively, in pre-eclampsia.
Conclusion:
Serum ceruloplasmin was elevated in pre-eclampsia, and the levels correlate with the severity of pre-eclampsia. The sensitivity and specificity observed in this study suggest that ceruloplasmin may be a potential marker for discriminating between normotensive pregnant women and those with pre-eclampsia. Elevated levels may be an indicator of severe disease.
