Levels Of Selected Biomarkers In Peripheral Blood Of Hemoglobinopathy Patients Diagnosed With Preeclampsia, Korle Bu Teaching Hospital, Accra,2019.
| dc.contributor.author | Asante, J. | |
| dc.date.accessioned | 2024-04-22T11:51:52Z | |
| dc.date.available | 2024-04-22T11:51:52Z | |
| dc.date.issued | 2020-06 | |
| dc.description | MPhil. Applied Epidemiology And Disease Control | en_US |
| dc.description.abstract | Background: Preeclampsia is a multifactorial progressive disease that is characterized by a persistently high blood pressure above 140/90mmHg and proteinuria 2+ and above. It is known to cause 2-8% of pregnancy complications worldwide and its prevalence in Ghana is between 2-3%. Women with preexisting conditions such as abnormal haemoglobin genotypes are at a higher risk of developing preeclampsia during pregnancy. The shared pathophysiology between hemoglobinopathies and preeclampsia could make early detection of the condition difficult. More so, due to the unknown aetiology of the disease, the only way to solve it is to deliver the placenta. This may lead to obstetric and perinatal complications and also death depending on the severity of the disease. Biomarkers can be used to understand the pathogenesis and better diagnose the disease. This study determined selected circulating biomarkers in women with hemoglobinopathies diagnosed with preeclampsia. Method: This was a cross-sectional study of women between the ages of 18-45 years that was delivered in the Obstetrics and Gynecology Department in KBTH, Accra. The study population was 108. It included hemoglobinopathy patients diagnosed with Preeclampsia and those without preeclampsia and normal haemoglobin patients diagnosed with preeclampsia and those without preeclampsia. Out of the several markers reviewed 4 potential markers were explored, N-Terminal Prohormone-Brain Natriuretic Protein (NTpro-BNP), Pregnancy Associated Plasma Protein -A (PAPP-A), Neuropilin-1(NEU-1) and Plasminogen Activator Inhibitor-1 (PAI-1). Gel electrophoresis was run to confirm the haemoglobin genotypes of the participants. A sandwich ELISA was run to determine the levels of the biomarkers in the study participants. A histogram was used to show the frequency of the genotypes. Fisher’s exact test was done to determine an association. Spearman correlation test was done to assess correlation. A multivariate model was done to assess if the biomarkers can predict preeclampsia. Results: From gel electrophoresis, it was found that the majority 54.6% (49/108) of the patients had normal hemoglobinopathy genotypes. The confirmation tests reclassified 0.08% of the participants with initial HbAA genotypes to different haemoglobin genotypes and 2.8% of participants with initial HbSS genotypes were also reclassified to different genotypes. Preeclampsia complicated pregnancy patients had the highest mean age of study participants was 31±4.5years. Among the women with PE and HbP, the majority (78.9%) of them delivered by caesarean section as well as those with HbP only and PE only. Among the women with HbP, mean serum levels of NTpro-BNP were higher in the preeclamptic group (40.76±21.6pg/ml, p=0.9309) compared to the non-preeclamptic group. Serum levels of PAI- 1 were extremely high among the HbP and PE women (135.18±157.1pg/ml, p= 0.0105). The mean serum levels of PAPP-A, across the comparison groups, the women with HbP diagnosed with PE had a low mean serum level of PAPP-A (0.86±0.7ng/ml, p=0.4563). The highest median serum level of Neuropilin-1 was 1918pg/ml which ranges from 78.5pg/ml to 3134pg/ml in women with PE complicated pregnancy. There was a significant difference between the DBP of mothers at their first prenatal visit and preeclampsia diagnosis though the correlation was weak (r=0.1993, p=0.0456; r=0.4036, p=0.0080). In the multivariate model, it was found that none of the markers showed significance in predicting preeclampsia in pregnant women with hemoglobinopathy. Conclusion: In conclusion, misclassifications of patients' sickling status were detected. The confirmation tests reclassified some participants of HbAA genotype and others of HbSS. There were variations in the concentrations of the selected biomarkers measured in pregnant women with hemoglobinopathies diagnosed with PE. This variation was only significant in the serum levels of PAI-1. All biomarkers investigated did not show any promising ability in predicting preeclampsia in women with HbP and PE and women without HbP and PE. | en_US |
| dc.identifier.uri | http://ugspace.ug.edu.gh:8080/handle/123456789/41650 | |
| dc.language.iso | en | en_US |
| dc.publisher | University Of Ghana | en_US |
| dc.subject | Biomarkers | en_US |
| dc.subject | Hemoglobinopathy | en_US |
| dc.subject | Korle Bu Teaching Hospital | en_US |
| dc.subject | Preeclampsia | en_US |
| dc.title | Levels Of Selected Biomarkers In Peripheral Blood Of Hemoglobinopathy Patients Diagnosed With Preeclampsia, Korle Bu Teaching Hospital, Accra,2019. | en_US |
| dc.type | Thesis | en_US |