Estimation of Glycosylated Fibronectin as a Predictor of Hypertensive Disorder and Its Severity in Primigravida: A Prospective Observational Cohort Study

Abstract

Purpose of the study: Glycosylated fibronectin as a predictor of hypertensive disorder and its severity in primigravida.

Materials and methods: It is a prospective observational cohort study done in 100 primigravida into two groups at 28-38 weeks. Group A consists of 24 patients with risk factors of hypertension but not clinically hypertensive. Group B consists of 76 patients who were already hypertensive. GlyFn levels were determined in maternal serum sample by Lumella test kit, and the ability of GlyFn to assess PE status was analyzed.

Results: In Group A, 19 cases were GlyFN positive out of which 14 (73%) developed PE later. In Group B, 100% cases of severe PE showed GlyFN positive (p < 0.001), 80% of non-severe PE were GlyFN positive (p < 0.44) and 95.2% of hypertension cases (on admission) showed GlyFn positive (p < 0.001), and all developed PE later. In Group B, 63 deliveries were within 7 days from testing, out of whom, 62 were GlyFn positive (p < 0.0447).In total of 100 cases, GlyFn was positive in 92 cases out of which 87 had PE, and remaining eight cases had normal GlyFn out of which three had PE (p value < 0.0001). This gives rise to GlyFN test sensitivity of 96.6%, specificity of 50%, PPV of 94.5% and NPV of 62.5%.

Conclusion: Our study results demonstrate that test has high sensitivity and PPV for preeclampsia that can be a useful adjunct in risk assessment and prediction of preeclampsia.

Keywords: Glycosylated fibronectin (GlyFn); Preeclampsia (PE).