This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Leaños-Miranda, A. Articles by Ulloa-Aguirre, A. Search for Related Content PubMed PubMed Citation Articles by Leaños-Miranda, A. Articles by Ulloa-Aguirre, A. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information High Risk Pregnancy Related Collections Neuroendocrinology and Pituitary Female Endocrinology

Urinary Prolactin as a Reliable Marker for Preeclampsia, Its Severity, and the Occurrence of Adverse Pregnancy Outcomes

Research Unit in Reproductive Medicine (A.L.-M., J.M.-A., G.M.C.-M., Z.L.C.-A., R.R.-L., S.B.-H., A.U.-A.) and Hypertensive Diseases of Pregnancy Clinic (J.F.R.-A., G.A.-J., J.C.R.-L.), Unidad Medica de Alta Especialidad-Hospital de Ginecología y Obstetricia "Luis Castelazo Ayala," Instituto Mexicano del Seguro Social, México 03500 D.F., Mexico

Address all correspondence and requests for reprints to: Dr. Alfredo Leaños-Miranda, Research Unit in Reproductive Medicine, Don Luis no. 111, Col. Nativitas, México 03500, D.F., México. E-mail: alfredolm{at}yahoo.com.

Context: It has been proposed that preeclampsia may result from of an imbalance in angiogenic factors. Although prolactin (PRL) is mainly related to lactation, it is also involved in other biological functions, including angiogenesis.

Objective: Our objective was to determine the relationship among preeclampsia, serum and urinary PRL (uPRL) levels, and excretion of antiangiogenic PRL fragments in urine.

Study design: Using a cross-sectional design, uPRL and serum PRL levels, and the presence of PRL isoforms were determined in 546 pregnant women: 207 healthy pregnant, 124 with gestational hypertension, 48 with mild preeclampsia, and 167 with severe preeclampsia (sPE).

Results: uPRL concentrations were significantly (P < 0.001) higher in preeclampsia (11.99 ng/mg creatinine) than in healthy pregnancy (0.20 ng/mg creatinine) and gestational hypertension (0.19 ng/mg creatinine), and were even higher in sPE compared with mild preeclampsia (21.20 vs. 2.77 ng/mg creatinine, respectively; P < 0.001). Antiangiogenic PRL fragments (14–16 kDa) were detected in 21.6% of urine samples from women with sPE but in none from other groups. Patients with hemolysis, elevated liver enzymes, low platelet count syndrome, and/or eclampsia, placental abruption, acute renal failure, and pulmonary edema exhibited highest uPRL concentrations (P 0.028) and frequency of antiangiogenic PRL fragments in urine (P 0.036). High-serum PRL levels were associated with sPE independently of gestational age, proteinuria, and prolactinuria (P = 0.032).

Conclusions: Preeclampsia is characterized by increased uPRL excretion. uPRL concentrations and their isoforms appear to be suitable markers to assess the severity of preeclampsia and occurrence of adverse outcomes. PRL and and/or its isoforms might be involved in the pathophysiology of preeclampsia.