Predicting pre-eclampsia in women with type 1 diabetes

This study determined whether the levels of a particular protein, FABP4 predicted pre-eclampsia in pregnant women with type 1 diabetes. The authors concluded that the addition of blood FABP4 measurements improved overall accuracy in assessing the risk of pre-eclampsia.

Pre-eclampsia is a condition that can develop during pregnancy. It is associated with high blood pressure and high levels of protein in the urine. If left undetected, pre-eclampsia can lead to complications for both mother and baby. Pre-eclampsia is two to four times more likely to develop in women with type 1 diabetes compared to women without diabetes. Methods of determining who might be at higher risk are needed.

Fatty acid binding protein 4 (FABP4) is involved in the transportation of fat in the body. High levels of this protein in the blood have been associated with obesity, high blood pressure, and diabetes. These are also risk factors for pre-eclampsia. Whether or not FABP4 levels can predict who will develop pre-eclampsia is unclear.

This study investigated whether FABP4 could be used along with other traditional assessments to detect pre-eclampsia risk during the first two trimesters in women with type 1 diabetes

This study included 710 pregnant women with type 1 diabetes. Blood samples measuring FABP4 were taken during the first trimester (average of 14 weeks) and during the second trimester (average of 26 weeks). 319 of these women had their first blood FABP4 taken between 8 and 13 weeks.

17% of the women later developed pre-eclampsia. The FABP4 levels of these pre-eclampsia patients were higher in early and / or mid-pregnancy when compared to those who did not develop pre-eclampsia. Pre-eclampsia also developed in some patients who had high FABP4 blood levels at 8-13 weeks.

Those with the highest levels (i.e. the top 25%) of FABP4 during the second semester were 2.87 times more likely to develop pre-eclampsia than those with the lowest levels (i.e. the bottom 25%). When added to the collection of other risk factors, FABP4 levels increased the overall accuracy of predicting pre-eclampsia risk (using a well-established scoring system).

This study concluded that blood FABP4 levels improved the accuracy of predicting pre-eclampsia risk in pregnant women with type 1 diabetes.

Blood samples were only taken in women who were at least 8 weeks pregnant. Further studies are needed to replicate these findings.

Ask your doctor about assessing your pre-eclampsia risk.