Urine and serum L-type fatty acid-binding protein levels in preeclampsia: a prospective cohort study on maternal deterioration prediction.

Abstract

Background: We aimed to examine the association between maternal urine and serum L-type fatty acid-binding protein (L-FABP) levels and preeclampsia (PE) severity and their potential as predictors of maternal and fetal deterioration following PE diagnosis.

Method: A prospective cohort of women with singleton pregnancies diagnosed with PE was analyzed. Participants were classified into two groups based on the timing of delivery: PE-delivery (delivery within 1 week of sample collection) and PE-non-delivery (no delivery within 1 week). Urine and serum samples were collected at the time of PE diagnosis, and cases were classified based on the presence of maternal or fetal complications.

Results: In total, 53 singleton pregnancies were analyzed and classified into the PE-delivery (n = 32) and PE-non-delivery groups (n = 21). No significant differences in L-FABP levels were observed between severe and non-severe PE cases. However, L-FABP levels were significantly higher in cases of severe PE due to maternal factors. In the PE-delivery group, urine and serum L-FABP levels were significantly elevated in cases requiring delivery within 1 week due to maternal indications compared to the PE-non-delivery group, whereas no such differences were found in cases with fetal indications. Receiver operating characteristic analysis showed strong predictive performance of L-FABP levels for delivery within 1 week due to maternal deterioration, with areas under the curve of 0.892 (urine, cutoff: 12.3 μg/gCr) and 0.795 (serum, cutoff: 1.64 ng/mL).

Conclusion: Maternal urine and serum L-FABP levels are closely associated with PE severity due to maternal complications and may serve as reliable biomarkers for imminent maternal deterioration.