A Longitudinal Study of Biochemical Variables in Women at Risk of Pre-Eclampsia and Role of Serotonin

Background: A multi-system disorder that typically occurs after 20 weeks of pregnancy in a woman with normal blood pressure previously is called preeclampsia. In preeclampsia patient suffer from new-onset hypertension and proteinuria. Objective: To evaluate the variations in key biochemical variables in women at risk of preeclampsia and to investigate the specific role of serotonin in the onset and progression of this disorder. Methodology: This prospective longitudinal study was conducted at Swat Medical College and its affiliated Hospitals from January 2022 to January 2023. A total of 195 pregnant women, deemed high-risk for preeclampsia based on clinical history and initial screening, were recruited for the study. At the initial visit (first trimester), demographic data and medical histories were recorded. Blood pressure measurements were taken and blood samples were collected for baseline biochemical analyses. Participants underwent scheduled follow-up visits in the second trimester and third trimester. At each visit, blood pressure was monitored, and additional blood samples were collected to measure biochemical variables of interest. Results: There is an increase observed in soluble fms-like tyrosine kinase-1 (sFlt-1) which may indicate heightened endothelial dysfunction as there is progression in pregnancy. There s a gradual increase in levels of uric acid and creatinine which reflects renal stress commonly associated with advancing gestation. Rise in levels of serotonin in increments throughout trimesters suggests a progressive physiological adaptation or potential role in vascular regulation during pregnancy. Conclusion: Our study contributes to the understanding of biochemical dynamics specifically highlighting the role of PlGF, sFlt-1, uric acid, creatinine and serotonin in the progression of preeclampsia. Hence these biomarkers are very important in the early diagnosis and treatment of those pregnant women who are at risk of developing preeclampsia thus contributing to the understanding of pathophysiology of the condition along with helping in development of targeted therapeutic strategy.