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Pregnancy‐Associated Plasma Protein Levels at Term in Normal Pregnancy, Preeclampsia and Essential Hypertension
Author(s) -
Griffin J. F. T.
Publication year - 1983
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1983.tb00150.x
Subject(s) - ceruloplasmin , preeclampsia , pregnancy , medicine , acute phase protein , endocrinology , pathological , gestation , inflammation , biology , genetics
Summary: The levels of protein associated with pregnancy (placental specific β 1 glycoprotein, SP 1 and pregnancy associated ‐α2‐ globulin, α2‐PAG), immune function (complement, C3c) and inflammation (ceruloplasmin, C), were studied at term in groups of patients with normal and complicated primigravid and multigravid pregnancy. The levels of SP, and C3c were similar in all the groups studied. In patients matched for parity, the levels of α2‐PAG were significantly lower than normal in preeclamptic primigravidas and in multigravidas with a history of preeclampsia in their first pregnancy. Ceruloplasmin levels were significantly elevated in preeclampsia patients and in patients with essential hypertension. It is suggested that reduced plasma α2‐PAG may be of prognostic value and have a role in the aetiology of preeclampsia whereas increased ceruloplasmin levels may be no more than an acute phase reactant resulting from pathological changes due to hypertension. The dramatic changes in the mother during pregnancy are reflected in marked alterations in maternal plasma proteins from early postconception until after parturition. Considerable research has been carried out to establish the role of these proteins in normal pregnancy and to determine their relevance in pregnancy associated pathology. The present work was designed to assess the role of pregnancy specific β‐globulin (SP 1 ) (Bohn, 1971) which is produced by trophoblastic tissue (Home et al., 1976), and pregnancy associated α2 globulin (α2‐PAG) which has been found in the plasma of pregnant women (MacLaren et al., 1959; Bohn, 1971; Stimson and Eubank‐Scott, 1972) and in malignancy (Stimson, 1974). In addition to these proteins, ceruloplasmin, an acute phase reactant (Goldstein et al., 1979) has been found to be elevated in pregnancy (Markowitz et al., 1955) and in autoimmune conditions (Scudder et. al., 1978). Elevated levels of ceruloplasmin have been found in severe preeclampsia by comparison with normal pregnancy (Fattah et al., 1976). To test the hypothesis that preeclampsia has an immune aetiology, the by‐product of complement activation (C3c), known to be elevated in immune complex disease (Scudder et al., 1978) was also studied in normal and complicated pregnancy. In an attempt to determine whether any of these proteins could be of relevance in pregnancy hypertension, a comparative study involving normal pregnant women, preeclampsia patients and pregnant women with essential hypertension was carried out. An additional comparison was made between plasma protein levels in primigravid preeclampsia patients. and compromised multigravidas who had a history of preeclampsia as primigravidas, to determine if any of these proteins could give an insight into a genetic predisposition of women to develop this disease.