Prognostic role of maternal neutrophil gelatinase-associated lipocalin in women with severe early-onset preeclampsia.

INTRODUCTION

The association between maternal plasma levels of neutrophil gelatinase-associated lipocalin (NGAL) and maternal complications in women admitted with severe early-onset preeclampsia was evaluated.

MATERIAL AND

METHODS

Plasma levels of NGAL were measured at admission in patients with severe early-onset (presenting before 34 weeks) preeclampsia. The maternal outcome of women with elevated plasma levels was compared with those with normal levels. Maternal complications included eclampsia, HELLP syndrome, acute renal failure, subcapsular hepatic hematoma, pulmonary edema and disseminated intravascular disease.

RESULTS

Sixty-seven patients were included. The median NGAL plasma levels in the group of women who subsequently had a complication were significantly higher than in those uncomplicated cases (114.8 vs. 84.2 ng/ml; Mann-Whitney U test p = 0.03). Maternal complications were more common in the elevated (>100 ng/ml) NGAL group (58.3 vs. 25.6%; χ(2) test p = 0.008), with an OR of 4.1 (95% CI 1.4-11.8). After adjustment by gestational age at onset, the association between elevated NGAL plasma levels and maternal complications remained significant (OR 4.2; 95% CI 1.4-12.4).

DISCUSSION: Women with severe early-onset preeclampsia are at higher risk of maternal complications if plasma levels of NGAL are elevated.