Diagnostic Performance of Lactate Dehydrogenase as A Potential Biomarker in Predicting Preeclampsia and Associated Factors Provisionally Accepted

Awgichew Behaile^{1, 2*} Endeshaw Chekol Abebe³ Melaku Mekonnen Agidew⁴ ATALO A. AYENEW⁵ Misganaw A. Mengstie² Nega Dagnew⁶ Zelalem T. Muche⁷

• ¹Institute of Biochemistry and Clinical Biochemistry, Catholic University of the Sacred Heart, Rome, Italy
• ²Department of Medical Biochemistry, College of Health Science, Debre Tabor University, Ethiopia
• ³Department of Medical Biochemistry, Department of Biochemistry, College of Health Sciences, Debre Tabor University, Ethiopia
• ⁴Department of Medical Biochemistry, college of health sciences, Debre Tabor University, Department of Biochemistry, College of Health Sciences, Debre Tabor University, Ethiopia
• ⁵Department of Human Anatomy, College of Health Science, Debre Tabor University, Ethiopia
• ⁶College of Health Science, Debre Tabor University, Ethiopia
• ⁷Department of medical Physiology, College of Health Science, Debre Tabor University, Ethiopia

Background: Preeclampsia(PE), a pregnancy specific syndrome, is defined as new-onset hypertension (≥140/90 mmHg) and proteinuria diagnosed after gestational week 20 or new-onset pre-eclampsia associated signs in the absence of proteinuria, and it may tend to present as late as 4-6 weeks' postpartum period. It is a leading cause of maternal mortality in both developed and developing countries. In order to prevent PE, the disease must be diagnosed at its earliest stage, however, the triads of high blood pressure, edema and albuminuria is neither specific nor sensitive enough for diagnosing the disease. Lactate dehydrogenase (LDH) is useful biochemical marker reflecting the occurrence of complications associated with preeclampsia. Besides, it has been suggested as potential biomarker to predict the severity of preeclampsia and as indicator of multiorgan involvement. The aim of this study was to investigate the diagnostic accuracy of LDH, which is affordable and easy to test, as a potential clinical biomarker to predict onset of preeclampsia.A hospital based cross-sectional study was conducted as of September 9 to December 24, 2022 at Debre Birhan Comprehensive Specialized Hospital (DBCSH). A total of 132 study subjects (66 preeclamptic and 66 normotensive controls) were enrolled in the study. A receiver operating characteristics (ROC) curve was used to calculate the area under the curve (AUC) and determine diagnostic accuracy of LDH. Youden's index was used to identify an optimal cut-off point for LDH in detecting preeclampsia associated complications.Result: AUC for LDH was found to be 0.963 (95% CI: 0.91,1.0; p = 0.000) from ROC curve analysis. An optimal cut-off point for LDH was 376.5 U/L having a sensitivity and specificity of 87.5 % and 90.8 % respectively.Serum LDH had an AUC of greater than 0.8 and showed good diagnostic accuracy in predicting development of preeclampsia. Disease duration, gestational age, systolic and diastolic blood pressure among enormous number of predictor variables had association with serum level of LDH.