Determination of Serum Inhibin-A Levels in Differentiating Pre-Eclampsia and Gestational Hypertension

Article Information

Title: Determination of Serum Inhibin-A Levels in Differentiating Pre-Eclampsia and Gestational Hypertension

Authors: Shahrukh Shah, Muhammad Aamir, Zujaja Hina Haroon, Afshan Bibi, Rabiya Akber, Usama Bin Khalid

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2022

Volume: 72

Issue: 3

Language: English

DOI: 10.51253/pafmj.v72i3.7178

Keywords: Pre-eclampsiaInhibin-AGestational Hypertension

Abstract

Objective: To determine the association of serum Inhibin-A levels in differentiating Pre-eclampsia and gestational hypertension.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) Rawalpindi, in collaboration with the Gynaecology and Obstetrics Department at Combined Military Hospital (CMH), Rawalpindi Pakistan, from Jul 2020 to Jun 2021.
Methodology: Nulliparous women with single pregnancy in the third trimester admitted to evaluate high blood pressure in the Department of Gynaecology and obstetrics CMH Rawalpindi were selected after getting their informed written consent. Forty women with pre-eclampsia, forty with gestational hypertension, and 40 normotensive pregnant healthy women receiving routine antenatal care were matched for parity, age, and gestational age.
Results: The concentration of inhibin A [Median (IQR)] in women having preeclampsia were significantly higher [1745 pg/ ml (1601.2–1821.7)] than subjects with gestational hypertension [895 pg/ml (834.5-977.5)] and normotensive pregnant women [637pg/ml (589-684.7)] with p-value 0.001. Further, Women with severe preeclampsia had a considerably greater serum concentration of inhibin A [Median (IQR)] [1895 pg/ml (1827.2-1955.7)] than those with mild preeclampsia [1686 pg/ml (1537.5-1762.7)].
Conclusion: As per our study, median serum Inhibin A concentrations were higher in pre-eclampsia subjects than in gestational hypertension. In clinical situations, serum Inhibin A levels may be used to differentiate between pre-eclampsia and gestational hypertension.

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Research Objective

To determine the association of serum Inhibin-A levels in differentiating Pre-eclampsia and gestational hypertension.

Methodology

A cross-sectional study was conducted with nulliparous women in their third trimester admitted for evaluation of high blood pressure. Participants were divided into three groups: 40 with pre-eclampsia, 40 with gestational hypertension, and 40 normotensive pregnant healthy women. Serum Inhibin A levels were measured using Enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using SPSS version 23.0, with Kruskal Wallis test for group comparisons and Mann Whitney U test for mild versus severe pre-eclampsia.

Methodology Flowchart

                        graph TD;
    A["Recruit Nulliparous Women in Third Trimester"] --> B["Evaluate High Blood Pressure"];
    B --> C["Categorize into Pre-eclampsia, Gestational Hypertension, or Normotensive"];
    C --> D["Collect Blood Samples"];
    D --> E["Measure Serum Inhibin-A Levels via ELISA"];
    E --> F["Analyze Data using SPSS"];
    F --> G["Compare Inhibin-A Levels Between Groups"];
    G --> H["Draw Conclusions on Differentiation Potential"];

Discussion

The study suggests that elevated serum Inhibin A levels are associated with pre-eclampsia and can potentially differentiate it from gestational hypertension. The findings are consistent with previous research indicating a role for Inhibin A in the development and severity of pre-eclampsia. The use of protein to creatinine ratio for diagnosis of pre-eclampsia is also discussed.

Key Findings

Median serum Inhibin A levels were significantly higher in women with pre-eclampsia (1745 pg/ml) compared to those with gestational hypertension (895 pg/ml) and normotensive pregnant women (637 pg/ml) (p-value 0.001). Women with severe pre-eclampsia had considerably greater serum Inhibin A concentrations (1895 pg/ml) than those with mild pre-eclampsia (1686 pg/ml).

Conclusion

Median serum Inhibin A concentrations were higher in pre-eclamptic subjects than in gestational hypertension. Serum Inhibin A levels may be used in clinical situations to differentiate between pre-eclampsia and gestational hypertension and to predict patients requiring higher levels of medical intervention.

Fact Check

1. Inhibin A levels in pre-eclampsia: The study found median serum Inhibin A levels of 1745 pg/ml in women with pre-eclampsia.
2. Inhibin A levels in gestational hypertension: The study found median serum Inhibin A levels of 895 pg/ml in women with gestational hypertension.
3. Study duration: The study was conducted from July 2020 to June 2021.

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