Umbilical Artery Erythropoietin Levels in Preeclamptic Pregnancies

Abstract

Objective: The aim of this study was to determine the levels of umbilical artery erythropoietin (EPO) levels and to evaluate its relation with clinical findings. Material and Methods: In this prospective study, 26 normal (Group I), 25 mild preeclamptic (Group II) and 17 severe preeclamptic (Group III) pregnant women whose gestational ages were between 37-42 weeks were enrolled. After the delivery, blood samples were taken from the umbilical artery of double clamped umbilical cord and umbilical artery EPO levels and blood gas parameters were analyzed. Sociodemographic findings, labor properties and physical examination of neonates were recorded. The blood gas parameters, EPO levels, their relationships with clinical findings of the groups were evaluated. Statistical analyses were performed by SPSS 9.05 statistical package program. Results: There were no statistical differences between gravidity, parity and gestational ages of the groups (p> 0.05). Maternal ages were significantly higher in the second group when compared with the others (p< 0.05). Systolic and diastolic blood pressures were statistically different in the groups (p< 0.05), and the highest levels were found in the third group. Birth weights were; 3480.76 +/- 431.75, 3373.20 +/- 846.83 and 2497.05 +/- 859.83 grams in group I, group II and group III, respectively (p< 0.05). First minute Apgar scores were 8 (ranges between 7-10) in the first group, 8 (ranges between 3-9) in the second group and 6 (ranges between 3-9) in the third group (p< 0.05). Umbilical cord pH levels were 7.35 +/- 0.06, 7.25 +/- 0.11 and 7.19 +/- 0.09; base excess (BE) levels were -4,71 +/- 2,02, -6.53 +/- 3.98 and -9.29 +/- 3.82 mmol/L; EPO levels were 30.0 (9.2-122), 62.5 (11.0-549) and 167.4 (10.1-908) mU/ml, respectively, and the differences between the groups were statistically significant (p< 0.05). In the Spearman bivariate correlation analysis, there was no significant relation between maternal age and EPO levels. There was significant positive correlation between EPO levels and systolic, diastolic blood pressures, pCO2 levels, and, significant negative correlation between first, fifth minute Apgar scores, birth weight, umbilical cord blood pH and BE levels. Conclusions: After delivery umbilical artery EPO levels showed significant correlation with severity of preeclampsia and, clinical and biochemical determinants of perinatal hypoxia. Our results support that erythropoietin can be used as a biochemical determinant of chronic fetal hypoxia that is caused by preeclampsia.