Association between preeclampsia and cancer antigen 125 in women attending antenatal clinic in Usmanu, Danfodiyo University Teaching Hospital, Sokoto

Abstract

Background: Preeclampsia is a hypertensive disorder of pregnancy that is characterized by the development of elevated blood pressure and proteinuria after 20 weeks of conception in a previously normotensive and non-proteinuric patient. It is one of the leading and most important causes of maternal and perinatal morbidity and mortality and it occurred in about 6% of human pregnancies. In Usmanu Danfodiyo Teaching Hospital Sokoto, preeclampsia and its complications were the leading causes of death in the year 2016. Preeclampsia has many suggested biomarkers, some of which are not well-defined. It has been assumed that failure in trophoblastic invasion and induction of an inflammatory process within the placenta in patients with preeclampsia may trigger the expression of CA-125 antigen. This study established a definite association between CA-125 and preeclampsia. Aims: This study was conducted to determine the relationship between cancer antigen 125 and preeclampsia and its correlation with severity. Settings and Design: Hospital-based study, comparative cross-sectional study. Methods and Materials: Ninety-seven pregnant women with preeclampsia were recruited as cases while 97 pregnant women without preeclampsia were similarly recruited as controls. In both groups (cases and controls), only women with singleton pregnancies at ≥32 weeks' gestational ages were recruited. Sociodemographic characteristics, obstetric history, family history, and clinical data were obtained using a standard interviewer-administered questionnaire. Anthropometric measurements were taken. Blood samples were taken for measurement of serum cancer antigen 125. Mean arterial pressure (MAP) was used as an indicator of the severity of the disease. Statistical Analysis Used: SPSS computer statistical software version 22, percentages, Chi-square, mean, Pearson correlation test. Results: The age range of the respondents was between 16 and 45 years. The mean age for the control was 28.6 ± 5.9 years, 27.9 ± 7.5 and 28.7 ± 7.2 years, for the control and severe preeclampsia groups, respectively. The mean level of CA-125 in the preeclampsia group was significantly higher than the control (36.13 ± 23.02 vs 24.53 ± 9.42). The mean levels of CA-125 in severe preeclampsia were significantly higher than mild preeclampsia (45.68 ± 23.38 vs 21.94 ± 13.18), P = 0.001. The MAP in mild and severe preeclampsia was 112.82 ± 3.55 mmHg and 130.63 ± 12.87 mmHg respectively. A negligible positive correlation was observed between the MAP and CA-125 in the mild preeclampsia group (r = 0.01, P = 0.48), while a positive correlation, that was statistically significant was observed between the MAP and CA-125 in the severe preeclampsia group (r = 0.62, P = 0.001). Conclusions: This study found a significant association between preeclampsia and CA-125. In addition, a positive relationship between the level of CA-125 and the severity of preeclampsia was established.