Inflammatory Mediators (CA125, CRP) and Uric Acid in Association with Severity of Preeclampsia in North Kordofan State, Western Sudan

Naglaa Abdelbasit Suliman

Department of Biochmistry, Faculty of Medicine, University of Kordofan, Sudan.

Khidir Elamin Awadalla

Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kordofan, Sudan.

Khalid Hussein Bakheit *

Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Kingdom of Saudi Arabia.

Abdelrahim Osman Mohamed

Department of Biochemistry, Faculty of Medicine, University of Khartoum, Sudan.

*Author to whom correspondence should be addressed.


Introduction: Inflammatory mediators could be laboratory markers of preeclampsia, as the induction of an inflammatory process within the placenta may trigger the expression of cancer antigen 125(CA125), C-reactive protein (CRP) and uric acid (UA). Regarding the pathophysiology of pre-eclampsia, there is defective trophoblastic invasion of uteroplacental blood vessels that leads to placental ischemia, and induction of an inflammatory process within the placenta.

Objective: To evaluate the association of serum levels of cancer antigen (CA125), C-reactive protein (CRP) and serum uric acid with the Severity of Preeclampsia.

Materials and Methods: The study recruited 200 singleton Sudanese pregnant women. These participants were divided into two groups: control (n = 100) and cases (n = 100). The cases were further subdivided into; mild preeclampsia (n =46), and severe preeclampsia (n = 54). The study groups were well-matched in maternal age, gestational age and body mass index. Blood samples were taken for measurement of serum cancer antigen-CA125, uric acid and C - reactive protein using immune- assay and enzymatic automated chemical analysis.

Results: The mean levels of cancer antigen-CA125 in mild and severe preeclampsia groups were; 21.94±5.08 (IU/ml) and 40.77±9.82 (IU/ml) respectively, which were significantly higher, (P<0.001)   in comparison with the control group (16.88±7.36 (IU/ml). The mean levels of C-reactive protein in mild and severe preeclampsia were; 15.17±5.35 (mg/L), 31.49±12.56 (mg/L) respectively. There was significant difference in their levels, compared to the control group (4.79±1.78 (mg/L), (P<0.01).  Also, the mean levels of uric acid in mild and severe cases were; 6.44±1.98 and 7.37±2.00 which was significantly higher, in comparison with the control (4.00±0.61); (P<0.001). The level of uric acid also, showed significant difference within the case (severe and mild) group (P<0.05). CA125, CRP and UA level‎s correlated positively with Mean Arterial blood pressure (MAP), (r>0.7; P < 0.001). ROC curve validate the utility of these biomarker for the detection of preeclampsia severity (AUC>0. 8; P < 0.001).

Conclusion: Serum cancer antigen 125(CA125), C- reactive protein and uric acid in studied preeclampsia groups were found to be significantly higher compared with the control group, and the rises were directly associated with the severity of preeclampsia.

Keywords: Cancer antigen, C-reactive protein, uric acid, preeclampsia (PE), Sudan

How to Cite

Suliman, Naglaa Abdelbasit, Khidir Elamin Awadalla, Khalid Hussein Bakheit, and Abdelrahim Osman Mohamed. 2022. “Inflammatory Mediators (CA125, CRP) and Uric Acid in Association With Severity of Preeclampsia in North Kordofan State, Western Sudan”. International Journal of Biochemistry Research & Review 31 (10):1-10.


Download data is not yet available.


Vatten LJ, Skjærven R. Is pre-eclampsia more than one disease? BJOG An Int J Obstet Gynaecol. 2004;111(4):298–302.

Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science (80- ). 2005;308(5728):1592–4.

Craici IM, Wagner SJ, Weissgerber TL, Grande JP, Garovic VD. Advances in the pathophysiology of pre-eclampsia and related podocyte injury. Kidney Int. 2014;86(2).

Phipps E, Prasanna D, Brima W, Jim B. Preeclampsia: Updates in pathogenesis, definitions, and guidelines. Clin J Am Soc Nephrol. 2016;11(6):1102–13.

Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet [Internet]. 2005; 365(9461):785–99.

Jim B, Karumanchi SA. Preeclampsia: Pathogenesis, prevention, and long-term complications. Semin Nephrol. 2017;37(4).

De Groot CJM, O’Brien TJ, Taylor RN. Biochemical evidence of impaired trophoblastic invasion of decidual stroma in women destined to have preeclampsia. Am J Obstet Gynecol. 1996;175(1):24–9.

Phipps E, Prasanna D, Brima W, Jim B, Einstein A. Mini-review preeclampsia : Updates in pathogenesis, definitions, and guidelines. 2016;11(6).

Poston L. Endothelial dysfunction in pre-eclampsia. Pharmacol Reports. 2006;58(SUPPL.):69–74.

Palei AC, Spradley FT, Warrington JP, George EM, Granger JP. Pathophysiology of hypertension in pre-eclampsia: A lesson in integrative physiology. Acta Physiol. 2013;208(3):224–33.

Roberts JM, Hubel CA. The two stage model of preeclampsia: Variations on the theme. Placenta [Internet]. 2009; 30(SUPPL.):32–7.

Hladunewich M, Karumanchi SA, Lafayette RA. Pathophysiology of the clinical manifestations of preeclampsia. Clin J Am Soc Nephrol. 2007;2(3):543–9.

Santulli P, Streuli I, Melonio I, Marcellin L, M’Baye M, Bititi A, et al. Increased serum cancer antigen-125 is a marker for severity of deep endometriosis. J Minim Invasive Gynecol [Internet]. 2015;22(2):275–84.

Muyldermans M, Cornillie FJ, Koninckx PR. Ca125 and endometriosis. Hum Reprod Update. 1995;1(2):173–87.

No A. Human peritoneal mesothelial cells are more potent than ovarian cancer cells in producing tumor marker CA-125 1. 1996;389:384–9.

Schrocksnadel H, Daxenbichler G, Artner E, Steckel-Berger G, Dapunt O. Tumor markers in hypertensive disorders of pregnancy. Gynecol Obstet Invest. 1993;35(4):204–8.

Gadducci A, Cosio S, Carpi A, Nicolini A, Genazzani AR. Serum tumor markers in the management of ovarian, endometrial and cervical cancer. Biomed Pharmacother. 2004;58(1):24–38.

Medicine A. Determination of cancer antigen-125 level and its association with preeclampsia among Sudanese women. Ann Clin Anal Med. 2020;11(9):416–9.

Tyler C, Kapur A, Felder M, Belisle JA, Trautman C, Gubbels JAA, et al. The Mucin MUC16 (CA125) binds to NK cells and monocytes from peripheral blood of women with healthy pregnancy and preeclampsia. Am J Reprod Immunol. 2012;68(1):28–37.

Bon GG, Kenemans P, Verstraeten AA, Go S, Philipi PA, Van Kamp GJ, et al. Maternal serum CA125 and CA15-3 antigen levels in normal and pathological pregnancy. Fetal Diagn Ther. 2001; 16(3):166–72.

Osanyin GE, Okunade KS, Ayotunde Oluwole A. Association between serum CA125 levels in preeclampsia and its severity among women in Lagos, South-West Nigeria. Hypertens Pregnancy [Internet]. 2018;37(2):93–7.

Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of inflammation and infection. 2018;9(April):1–11.

Bellos I, Pergialiotis V, Loutradis D, Papapanagiotou A, Daskalakis G. Serum CA-125 levels in preeclampsia: A systematic review and meta-analysis. Int J Clin Pract. 2019;73(10):1–7.

Kamel M, Ch MBB. The association of serum cancer antigen 125 and C - reactive protein level with the severity of preeclampsia. 2012;5(1).

Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation. 2003;107(3):363–9.

Savvidou MD, Lees CC, Parra M, Hingorani AD, Nicolaides KH. Levels of C-reactive protein in pregnant women who subsequently develop pre-eclampsia. BJOG An Int J Obstet Gynaecol. 2002;109(3):297–301.

Kholeif AE, Khamis MY, Eltabakh S, Swilam RS, Elhabashy A, EISherif R. Prediction of severity of preeclampsia in Egyptian patients: Role of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and C-reactive protein. Clin Exp Obstet Gynecol. 2020;47(2):183–8.

Cebesoy FB, Balat O, Dikensoy E, Kalayci H, Ibar Y. CA-125 and CRP are elevated in preeclampsia. Hypertens Pregnancy. 2009;28(2):201–11.

Qiu C, Luthy DA, Zhang C, Walsh SW, Leisenring WM, Williams MA. A prospective study of maternal serum C-reactive protein concentrations and risk of preeclampsia. Am J Hypertens. 2004;17(2):154–60.

Üstün Y, Engin-Üstün Y, Kamaci M. Association of fibrinogen and C-reactive protein with severity of preeclampsia. Eur J Obstet Gynecol Reprod Biol. 2005;121(2):154–8.

Fay RA. Uric acid in pregnancy and preeclampsia: An alternative hypothesis. Aust New Zeal J Obstet Gynaecol. 1990;30(2):141–2.

Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB, et al. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension. 2005;46(6): 1263–9.

Jeyabalan A, Conrad KP. Renal function during normal pregnancy and preeclampsia. Front Biosci. 2007;12(7): 2425–37.

Bainbridge SA, Roberts JM. Uric acid as a pathogenic factor in preeclampsia. Placenta. 2008;29(SUPPL.):67–72.

Ugwuanyi RU, Chiege IM, Agwu FE, Eleje GU, Ifediorah NM. Association between serum uric acid levels and perinatal outcome in women with preeclampsia. 2021;2021.

Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003;41(6):1183–90.

Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, et al. Hyperuricemia induces endothelial dysfunction. Kidney Int. 2005;67(5):1739–42.

Maruhashi T, Hisatome I, Kihara Y, Higashi Y. Hyperuricemia and endothelial function : From molecular background to clinical perspectives. Atherosclerosis [Internet]. 2018; 278(October):226–31.

Ah AK, Huri A, Shuaib AA, Harazi AH Al. Serum uric acid in women with preeclampsia compared to normotensive women. 2016;52(3):114–9.

Tranquilli AL, Brown MA, Zeeman GG, Dekker G, Sibai BM. The definition of severe and early-onset preeclampsia. Statements from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Pregnancy Hypertens [Internet]. 2013;3(1):44–7.

Von Dadelszen P, Magee LA. Pre-eclampsia: An Update. Curr Hypertens Rep. 2014;16(8).

Tomimatsu T, Mimura K, Matsuzaki S, Endo M, Kumasawa K, Kimura T. Preeclampsia: Maternal systemic vascular disorder caused by generalized endothelial dysfunction due to placental antiangiogenic factors. Int J Mol Sci. 2019;20(17):1–18.

Ozat M, Kanat-Pektas M, Yenicesu O, Gungor T, Danisman N, Mollamahmutoglu L. Serum concentrations of CA-125 in normal and preeclamptic pregnancies. Arch Gynecol Obstet. 2011;284(3):607– 12.

Medicine A. Determination of cancer antigen-125 level and its association with preeclampsia among Sudanese women 2020;11(9):416-419.

Mollamahmutoglu L. S of CA-125 in normal and preeclamptic pregnancies. 2010; (November);254(3):607-612.

Han A, Yıldırım G, Karaman E, Karaman Y. Pregnancy hypertension. An International Journal of Women ’ s Cardiovascular Health Maternal serum CA-125 level is elevated in severe preeclampsia. 2014;4:29–33.

Ibrahem W, Kh. Al-Assaly R, Saeed Al-Haddad N. CA-125, plasma fibrinogen and C-reactive protein in correlation with severity of preeclampsia. J Fac Med. 2017;59(1):31–5.

Stefanović M, Vukomanović P, Milosavljević M, Kutlešić R, Popović J, Tubić-Pavlović A. Insulin resistance and c-reactive protein in pre eclampsia. Bosn J Basic Med Sci. 2009;9(3):235– 8.

Martin AC, Brown MA. Could uric acid have a pathogenic role in pre-eclampsia? Nat Rev Nephrol. 2010; 6(12):744–8.

Report B. Patients with severe preeclampsia. 2003;28(4):198–9.

Leanza A, Molino G. Hyperhomocysteinemia in preeclampsia is associated to higher risk pressure profiles. 2003;81–7.

Pipkin FB. Uric acid, endothelial dysfunction and pre-eclampsia. J Hypertens. 2004;22(2):237–9.

Kanti Mandal D, Premchandra Singh Y, Das D, Sangeeta Devi N, Singh Nn, Singh Wg. Serum uric acid and c-reactive protein in preeclampsia. IOSR J Dent Med Sci Obs Gynae, Reg Inst Med Sci [Internet]. 2015;14(2):2279–853.