Coagulation Factors and Natural Anticoagulants as Surrogate Markers of Preeclampsia and Its Subtypes: A Case–Control Study in a Ghanaian Population

Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and i...

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Bibliographic Details
Published in:	Clinical and applied thrombosis/hemostasis Vol. 29; p. 10760296231204604
Main Authors:	Mintaah, Selina, Anto, Enoch Odame, Boadu, Wina Ivy Ofori, Sackey, Benedict, Boateng, Lilian Antwi, Ansah, Ezekiel, Korsah, Emmanuel Ekow, Frimpong, Joseph, Tamakloe, Valentine Christian Kodzo Tsatsu, Selleh, Peter Kuugemah, Afrifa, David Amoah, Saasi, Abdul-Razak, Senu, Ebenezer, Duah, Lawrence Agyemang, Opoku, Stephen, Amoah, John Paul, Adu, Patrick, Boachie, Joseph, Nyamekye, Dorcas Asamoah, Sackey, David Sebbie, Wiafe, Yaw Amo, Addai-Mensah, Otchere
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01-01-2023 SAGE PUBLICATIONS, INC SAGE Publishing
Subjects:	Anticoagulants Biomarkers Original Manuscript Preeclampsia Proteins Scandals Ghana D-dimers antithrombin III (ATIII) activated partial thromboplastin time prothrombin time preeclampsia protein C protein S coagulation
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Summary:	Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and its subtypes. This case–control study included 90 women with PE (cases) and 90 normotensive pregnant women (controls). Blood samples were drawn for the estimation of complete blood count and coagulation tests. The prothrombin time (PT), activated partial thromboplastin time (APTT), and the calculation of the international normalized ratio (INR) were determined by an ACL elite coagulometer while the levels of protein C (PC), protein S (PS), antithrombin III (ATIII), and D-dimers were also measured using the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. All statistical analyses were performed using the R Language for Statistical Computing. Results showed significantly (p < .05) shortened APTT (28.25 s) and higher D-dimer levels (1219.00 ng/mL) among PE women, as well as low levels of PC (1.02 µg/mL), PS (6.58 µg/mL), and ATIII (3.99 ng/mL). No significant difference was found in terms of PT and INR. From the receiver operating characteristic analysis, PC, PS, and ATIII could significantly predict PE and its subtypes at certain cutoffs with high accuracies (area under the curve [AUC] ≥0.70). Most women with PE are in a hypercoagulable state with lower natural anticoagulants. PC, PS, and ATIII are good predictive and diagnostic markers of PE and its subtypes (early-onset PE [EO-PE] and late-onset PE [LO-PE]) and should be explored in future studies.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1076-0296 1938-2723
DOI:	10.1177/10760296231204604