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Digoxin-Like Immunoreactive Factor in Twin and Pregnancy-Associated Hypertensive Pregnancies

From the Departments of Gynecology and Obstetrics "B" and Medicine "A", and the Clinical Pharmacology Unit, Rambam Medical Center, Faculty of Medicine, Technion, Haifa, Israel

Abstract

The objective of this study was to measure maternal total digoxin-like immunoreactive factor levels in singleton pregnancies with or without hypertension and in twin pregnancies. Plasma digoxin-like immunoreactive factor was measured in 113 third-trimester patients: 51 normotensives, 20 preeclamptics, 19 with latent or chronic hypertension, and 23 with twin pregnancies. The concentration of total digoxin-like immunoreactive factor in the twin gestations (1143 ± 249 pg/mL) was significantly higher than that in either the normotensive pregnancies (890 ± 161 pg/mL) (P < .001) or in the hypertensive pregnancies (903 ± 256 pg/mL) (P < .01). However, there were no significant differences in digoxin-like immunoreactive factor levels between the normotensive and hypertensive groups. A trend of higher, although not statistically significant, levels of digoxin-like immunoreactive factor was noted in the chronic hypertensive group as compared with the preeclamptic patients (957 ± 212 versus 852 ± 288 pg/mL). We therefore conclude that digoxin-like immunoreactive factor does not contribute significantly to the pathogenesis or prediction of preeclampsia. The increased amount of digoxin-like immunoreactive factor in twin pregnancies may reflect a contribution from multifetal origin, or might be a physiologic adaptive mechanism allowing higher cardiac output by a possible cardiotropic effect.