Email this article Extended combined screening for preeclampsia prediction in women with diabetes mellitus
- Authors: Kapustin R.V.1,2, Tcybuk E.M.2, Kopteeva E.V.1, Alekseenkova E.N.1, Chepanov S.V.1, Shelaeva E.V.1, Arzhanova O.N.1,2, Korenevsky A.V.3, Kogan I.Y.1,2
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Affiliations:
- The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
- St. Petersburg State University
- The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Issue: Vol 72, No 2 (2023)
- Pages: 39-50
- Section: Original Research
- Submitted: 13.03.2023
- Accepted: 04.04.2023
- Published: 18.05.2023
- URL: https://journals.eco-vector.com/jowd/article/view/321321
- DOI: https://doi.org/10.17816/JOWD321321
- ID: 321321
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Abstract
BACKGROUND: Early screening for preeclampsia has shown high efficiency for low-risk groups, however, the presence of systemic vascular disease in patients with diabetes mellitus complicates their use and requires the development of additional approaches to predicting preeclampsia in this group of patients.
AIM: The aim of this study was to evaluate the effectiveness of early prediction of preeclampsia with extended combined screening in patients with pregestational types of diabetes mellitus.
MATERIALS AND METHODS: This study included 75 pregnant women: 40 patients with type 1 diabetes mellitus, and 35 patients with type 2 diabetes mellitus. To determine the risk of further preeclampsia development, we evaluated biochemical, biophysical and anamnestic factors, along with the serum levels of placental growth factor, soluble fms-like tyrosine kinase 1, and soluble endoglin at 11+0 to 13+6 gestational weeks. The main outcome assessed was the development of preeclampsia.
RESULTS: In patients with further development of preeclampsia (35% in type 1 and 40 % in type 2 diabetic women), we observed higher soluble fms-like tyrosine kinase 1 / placental growth factor ratios, as well as elevated serum soluble endoglin (type 1 diabetes mellitus) and soluble fms-like tyrosine kinase 1 (type 2 diabetes mellitus) levels. Isolated determination of placental growth factor showed no significant differences in the levels of this angiogenic factor in preeclampsia. A multivariate predictive model for preeclampsia demonstrated high prognostic parameters: for patients with type 1 diabetes mellitus, area under the curve was 0.96 (95% confidence interval 0.93–1.00), with positive predictive value 76.7% and negative predictive value 90.1%; for patients with type 2 diabetes mellitus, area under the curve was 0.94 (95% confidence interval 0.86–1.00), with positive predictive value 88.5% and negative predictive value 97.1%.
CONCLUSIONS: Specific biochemical and biophysical markers of preeclampsia combined with maternal risk factors and assessment of carbohydrate metabolism can increase the predictive value of early screening studies for preeclampsia in women with pregestational diabetes mellitus.
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About the authors
Roman V. Kapustin
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; St. Petersburg State University
Author for correspondence.
Email: kapustinroman@gmail.com
ORCID iD: 0000-0002-2783-3032
SPIN-code: 7300-6260
Scopus Author ID: 57191964826
ResearcherId: G-3759-2015
MD, Dr. Sci. (Med.)
Russian Federation, Saint Petersburg; Saint PetersburgElizaveta M. Tcybuk
St. Petersburg State University
Email: elizavetatcybuk@gmail.com
ORCID iD: 0000-0001-5803-1668
SPIN-code: 3466-7910
ResearcherId: ABB-6930-2020
Russian Federation, Saint Petersburg
Ekaterina V. Kopteeva
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: ekaterina_kopteeva@bk.ru
ORCID iD: 0000-0002-9328-8909
SPIN-code: 9421-6407
Scopus Author ID: 57219285002
Russian Federation, Saint Petersburg
Elena N. Alekseenkova
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: ealekseva@gmail.com
ORCID iD: 0000-0002-0642-7924
SPIN-code: 3976-2540
Scopus Author ID: 57212242446
ResearcherId: W-3735-2017
Russian Federation, Saint Petersburg
Sergey V. Chepanov
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: chepanovsv@gmail.com
ORCID iD: 0000-0001-6087-7152
SPIN-code: 6642-6837
Scopus Author ID: 56399329700
ResearcherId: M-3471-2015
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgElizaveta V. Shelaeva
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott
Email: eshelaeva@yandex.ru
ORCID iD: 0000-0002-9608-467X
SPIN-code: 7440-0555
ResearcherId: K-2755-2018
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgOlga N. Arzhanova
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; St. Petersburg State University
Email: arjanova_olga@mail.ru
ORCID iD: 0000-0003-3059-9811
SPIN-code: 7910-6039
ResearcherId: G-6895-2015
MD, Dr. Sci. (Med.), Professor
Russian Federation, Saint Petersburg; Saint PetersburgAndrey V. Korenevsky
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: a.korenevsky@yandex.ru
ORCID iD: 0000-0002-0365-8532
SPIN-code: 7942-6016
Scopus Author ID: 16037015200
ResearcherId: K-3444-2013
Dr. Sci. (Biol.)
Russian Federation, Saint PetersburgIgor Yu. Kogan
The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; St. Petersburg State University
Email: ikogan@mail.ru
ORCID iD: 0000-0002-7351-6900
SPIN-code: 6572-6450
Scopus Author ID: 56895765600
ResearcherId: P-4357-2017
MD, Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences
Russian Federation, Saint Petersburg; Saint PetersburgReferences
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