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Glycosylated fibronectin positivity in the spectrum of hypertensive disorders of pregnancy in relation to the severity and adverse outcomes

Background: The aim of the study was to estimate the levels of glycosylated fibronectin (GlyFn) in preeclampsia (PE), and hypertensive disorders of pregnancy (HDP) and to correlate with the severity of the disease, adverse outcomes and complications. The study included 77 cases of HDP that were managed in the Institute of Obstetrics and Gynaecology, Modern Government Maternity Hospital (MGMH), Osmania Medical College, Hyderabad.Methods: This study was a prospective non-interventional analytical investigative study. To ascertain the performance of this biomarker, GlyFn, we evaluated the LumellaTM GlyFn POC test.Results: GlyFn positivity percentage was found to be highest in eclampsia (78.57%), next in PE with severe features 74.07%, in HELLP syndrome and gestational hypertension (HTN) (71.42%). In PE without severe features (66.66%) and in chronic HTN with PE superimposed (55.55%). Maternal complications include: abruption 5 (6.57%), thrombocytopenia 3 (3.94%), acute kidney injury (AKI) 3 (3.94%), post-partum hemorrhage (PPH) 3 (3.94%), and ascites 3 (3.94%). Perinatal outcome in 77 cases include: fetal growth restriction in 18 (23.37%) and total perinatal mortality was 14 (18.18%).Conclusions: GlyFn positivity was found to be highest in eclampsia and the severe forms of PE. The positivity declined in the less severe disease. The birth weight in the severe forms of PE group was significantly lower (p<0.0006). The differences in the birth weight among the GlyFn positive and normal groups was not significant for this population size (p=0.38). 