Pre-eclampsia is a major cause of perinatal mortality. Glutamate plays a critical function in the promotion of a healthy pregnancy. Therefore, the aim of this study was to determine the extent of the correlation between pre-eclampsia and 4-hydroxyglutamate acid. This is a case-control study that was conducted on a sample of 100 pregnant women in the third trimester. The study group consisted of 26 cases of mild pre-eclampsia and 24 cases of severe pre-eclampsia, while the control group consisted of 50 normotensive pregnant women. In addition to human 4-hydroxyglutamate, which was measured by ELISA, liver function test, renal function test, uric acid, serum lactate dehydrogenase (LDH), complete blood picture, and urine albumin were performed for all patients. The mean level of 4-hydroxyglutamate was significantly higher in the case group (mean ± SD = 243 ± 59 pg/ml) than in the control group (mean ± SD = 90 ± 45 pg/ml), with a range of 29-351 pg/ml vs 4-185 pg/ml and a p-value of < 0.0001/ml. Severe pre-eclampsia patients had higher mean 4-hydroxyglutamate levels (257.88 ± 43.436 pg/ml) than mild cases (229.77 ± 68.789 pg/ml), although the difference was non-significant. A 4-hydroxyglutamate level of ≥ 142.5 was shown to be a highly sensitive (92%) and specific (85.2%) indicator of pre-eclampsia using the receiver operator characteristics curve. A 4-hydroxyglutamate level of ≥ 142.5 led to a 5.75-fold higher risk of pre-eclampsia. The level of 4-hydroxy glutamate was increased significantly in pregnant women with pre-eclampsia compared to healthy women and could be used as a predicting marker with high sensitivity.
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