Maternal plasma soluble ST2 concentrations are elevated prior to the development of early and late onset preeclampsia – a longitudinal study

Abstract

Objective

The objectives of this study were to determine: 1) the longitudinal profile of plasma-soluble ST2 (sST2) concentrations in patients with preeclampsia and those with uncomplicated pregnancies; 2) whether the changes in sST2 occur prior to the diagnosis of preeclampsia; and 3) the longitudinal sST2 profile of women with early or late preeclampsia.

Materials and Methods

This longitudinal nested case-control study included singleton pregnancies in the following groups: 1) uncomplicated pregnancies (n=160); and 2) those complicated by early (<34 weeks, n=9) and late (≥34 weeks, n=31) preeclampsia. sST2 concentrations were determined by enzyme-linked immunosorbent assays. Mixed-effects models were used for the longitudinal analysis.

Results

1) Plasma sST2 concentration profiles across gestation differed significantly among cases and controls (p<0.0001); 2) women with early preeclampsia had higher mean sST2 concentrations than controls >22 weeks of gestation; cases with late preeclampsia had higher mean concentrations >33 weeks of gestation (both p<0.05); and 3) these changes started approximately six weeks prior to clinical diagnosis.

Conclusions

Maternal plasma sST2 concentrations are elevated six weeks prior to the clinical diagnosis of preeclampsia. An increase in maternal plasma concentration of sST2 may contribute to an exaggerated intravascular inflammatory response and/or the Th1/Th2 imbalance in some cases.