Critical Care and Shock

Clinical features, biochemical markers, and acute phase reagents of inflammation in hypertensive crises of pregnancy

Abstract

Introduction: Preeclampsia is a major cause of maternal and fetal morbidity and mortality, accounting for approximately 25% of maternal deaths in Latin America. Preeclampsia is a state of systemic inflammation due to an immunologic imbalance between proinflammatory and regulatory T cells, leading to multiorgan damage.

Objective: To describe the clinical features, biochemical markers, and acute phase reactants of inflammation in hypertensive disorders of pregnancy.

Materials and methods: An observational, cross-sectional, prospective study was conducted in hypertensive pregnant patients hospitalized at the Women’s Hospital of Culiacan, Mexico, from March 2021 to January 2022. These patients were classified according to the type of hypertension based on 24-hour urine protein determination. A toxicologic profile including uric acid, lactate dehydrogenase (LDH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum lipids, and total leukocytes was obtained to calculate the neutrophil-lymphocyte ratio of patients in each of the study groups. The body mass index (BMI) was also calculated. Data were analyzed using Stata Intercooled 13.1.

Results: The mean age of the included patients was 25.43±6.5 years, gestational age was 37.35±2.73, 35.9% were primigravida, and 16.07% were adolescents. Among the 397 cases, 23.17% had severe preeclampsia, 24.69% had non-severe pre-eclampsia, 27.2% had gestational hypertension, and 24.94% were healthy controls. Neutrophil-lymphocyte ratio, uric acid, urea, LDH, and CRP were higher in the most severe cases of hypertensive disease. Changes in serum magnesium levels were mainly observed in severe preeclampsia.

Conclusions: In this study, biochemical and inflammatory markers were higher in severe forms of hypertensive disorders of pregnancy.