Abstract
Matrix Metalloproteinases 14 presumably play for cytotrophoblast migration and invasion of the uterine wall and in the remodeling of the spiral arteries in pregnancy. Inadequate trophoblastic invasion leads to an inappropriate vascular remodeling, which generates conditions of hypoxia and increased oxidative stress in the placenta early onset preeclampsia. Therefore, it is particularly important to investigating whether MMP14 altered and can be used as biomarker of preeclampsia. There have been no studies done to measure MMP14 in serum maternal between early onset preeclampsia and normal pregnancy The purpose of this study was to analyse whether maternal serum matrix metalloproteinases 14 levels differ in early onset preeclampsia and uncomplicated pregnancies. This crosssectional study was carried out in 20 subjects with early onset preeclampsia and 20 subjects of normotensive pregnant women range 24 up to 34 weeks of gestation. The study was conducted in Margono Hospital Purwokerto, Indonesia. Level of MMP 14 was measured in maternal serum using an enzyme-linked immunosorbent assay (ELISA). The mean difference was statically analysed by independent samples T-test and ROC curve to determine sensitivity and specificity of MMP 14.Women age, gestational age, parity and body mass index showed a non significant difference between both groups. In this study level MMP 14 in serum was higher in pregnant women with preeclampsia compared to the normotensive ( 266.41 vs 46.80 pg/dl ; p<0.00). Moreover, the area under curve of serum MMP 14 was 0.936, standard error 0.043, p<0.00. The optimal cut-off value of serum MMP at 110.73 pg/dl showed a high diagnostic value in preeclampsia with a sensitivity of 90 % and a specificity of 90%. Maternal serum MMP 14 was higher in preeclampsia and the important finding is the MMP 14 probably become a marker to predict early onset preeclampsia.
Highlights
Preeclampsia is a major complication in pregnancy and a leading cause of death and maternal and perinatal morbidity
The incidence of preeclampsia is different in each country, it ranges between 2-8% of all pregnancy (Duley, 2009)
The age, parity, gestational age and body mass index, of the subjects were higher in women with early preeclampsia than in women with normal pregnancy
Summary
Preeclampsia is a major complication in pregnancy and a leading cause of death and maternal and perinatal morbidity. 10-15% of maternal deaths are directly related to preeclampsia and eclampsia. The incidence of preeclampsia is different in each country, it ranges between 2-8% of all pregnancy (Duley, 2009). Maternal mortality as reported in East Java as a cause of death by preeclampsia reached 31% and in Central Java 34% (Dinas Kesehatan Jawa Tengah, 2016; Dinas Kesehatan Jawa Timur, 2016). Based on the Indonesian Demographic and Health Survey (IDHS) the tendency of maternal mortality increase from 228 per 100,000 live births (2007) to 359 per 100,000 live births in 2012. The Population Survey (SUPAS) reported maternal mortality rate that declined slightly to 305 per 100,000 live births in 2015 (Kementrian Kesehatan, 2017)
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