Serum CA-125: A Potential Biomarker for Pre Eclampsia and Its Severity

Background: Pre-eclampsia is a pregnancy-specific multisystem disorder characterised by new onset of hypertension after the 20th week of gestation and atleast one of the following complications, including proteinurea, significant end organ dysfunction or uteroplacental dysfunction. It poses significant risks to maternal and fetal health, necessitating early detection and management. Given pre-eclampsia's inflammatory nature and CA-125’s role in the choriodecidual unit, it may serve as a marker for detecting pre-eclampsia and its severity. Aim: This study aimed to compare serum levels of Cancer Antigen 125 (CA-125) in preeclamptic patients and normotensive pregnant women to evaluate its potential as a biomarker for pre-eclampsia and its severity. Methods: A comparative study was conducted at SMS Medical College, Jaipur, from January 2023, including 50 preeclamptic and 50 normotensive women between 32-34 weeks of gestation. Participants were selected based on defined inclusion and exclusion criteria. Detailed clinical assessments and routine blood investigations were performed, followed by the collection of fasting venous blood samples for CA-125 analysis via ELISA. Statistical analyses included unpaired t-tests, chi-square tests, and correlation evaluations, with a significance threshold set at p < 0.05. Results: The preeclampsia group (mean age: 30.88 ± 3.86 years) exhibited significantly higher mean CA-125 levels (43.73 ± 9.05 U/mL) compared to the normotensive group (12.02 ± 4.27 U/mL; p < 0.0001). Elevated CA-125 levels correlated positively with systolic blood pressure (r = 0.91) and negatively with platelet count (r = -0.304). ROC analysis indicated an optimal cut-off for CA-125 at 30.5 U/mL, achieving a sensitivity of 96% and specificity of 98%. Conclusion: This study establishes CA-125 as a promising biomarker for pre-eclampsia, particularly in identifying disease severity. Implementing CA-125 screening in clinical practice may facilitate early detection and improve maternal and fetal outcomes.