Maternal Serum Netrin-1 as a New Biomarker of Preeclampsia

Abstract

Background: The netrin-1 serum is extensively expressed in various tissues such as renal tissues and placenta. It is predominantly implicated in cell migration development, cell adhesion and cell survival. Netrin-1 serum is also important in the formation of the placenta by enhancing the growth of cytotrophoblast and placental vapour development.

Aim: To determine whether the use of serum netrin-1 levels measurement might be linked to preeclampsia or might be a biomarker of preeclampsia.

Patients and Method: The case-control study was done in Alzahraa Teaching Maternity and Pediatrics Hospital / Najaf Governorate / Iraq, in the year period starting 1 st January 2024 to 1 st January 2025. The convenience sampling technique was used to recruit a total of 90 singleton pregnant women. The sample incorporated two groups whereby the case group comprised 45 pregnant women exposed to preeclampsia and the control group comprised of 45 healthy pregnant women (normotensive and never had any medical disease in their history). The serum netrin-1 was measured with the help of an Enzyme-Linked Immunosorbent Assay kit.

Findings: The serum netrin-1 mean showed a significant difference that was found to be elevated at the case group (non-severe and severe preeclampsia) than in the control group. Besides, it was also more pronounced in patients with non-severe preeclampsia than in the control group (P-value=0.001). Moreover, it was much greater in the case of severe preeclampsia patients as compared to non-severe preeclampsia (P-value=0.019). There were also significant positive associations between serum netrin-1 and alanine transaminase, aspartate transaminase, blood urea, serum creatinine and negative significant association between serum netrin-1 and platelet count in case. The sensitivity, the specificity, and the accuracy of serum netrin-1 in the diagnosis of preeclampsia were 93.3, 80 and 86.6 respectively with a cut-off point of 698 pg/ml.

Conclusion: Netrin-1 serum can be considered as a potential biomarker in the prediction and detection of preeclampsia.