Serum Level Of Lactate Dehydrogenase and Gamma Glutamyl Transferase in Hypertensive Disorders of Pregnancy and Associated Factors

Abstract

Background: Hypertensive disorders of pregnancy (HDP) are predominant causes of maternal and perinatal morbidity and mortality worldwide. Gestational hypertension, chronic hypertension, preeclampsia and eclampsia are common forms of HDP affecting approximately 10% of pregnancies as medical complications in pregnant women. Lactate dehydrogenase (LDH) and gamma glutamyl transferase (GGT) have been suggested as potential biochemical markers to predict the severity of preeclampsia and gestational hypertension and as indicators of multi-organ involvement. Objective: The aim of this study was to assess serum level of lactate dehydrogenase and gamma glutamyl transferase, correlate with severity of hypertensive disorders of pregnancy and identify associated factors among pregnant women at Jimma Medical Center. Methods: A hospital based cross-sectional study was undertaken from August 3 to September 27, 2020 in Jimma Medical Center. A total of 97 study subjects (33 preeclamptics, 32 eclamptics and 32 gestational hypertensives) were recruited based on the eligibility criteria. Data were collected using a structured questionnaire through face to face interview and by reviewing participants’ medical record. Serum levels of GGT and LDH were evaluated by a fully automated chemistry analyzer called Roche Cobas 6000. The data were statistically analyzed using SPSS version 25.0. Analysis of Variance, independent sample t-test, receiver operating characteristics curve and bivariate correlation analyses were carried out. Result: We observed highest mean serum level of LDH (580.9 ±193.8 U/L) and GGT (86.1±29.2 U/L) in eclamptics as compared to their level in gestational hypertensives (276.7± 60.7 and 38.3±16.9 U/L) and preeclamptics (353 ±132.8 and 48.8 ± 29.9 U/L) respectively. Both serum GGT and LDH levels were found to have significant correlation with severity of preeclampsia (p=0.007 and 0.002) respectively. The optimal cut-off point for GGT and LDH, to differentiate complicated HDP from uncomplicated HDP, was found to be 46.5 and 376.5 U/L respectively. Conclusion: GGT is more reliable biomarker with greater sensitivity than LDH and hence, its use as a novel biomarker for better prediction of the severity and/or complications of HDP has to be pragmatic.