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First trimester markers for pre-eclampsia: placental vs. non-placental protein serum levels
Gynecologic and Obstetric Investigation
BACKGROUND/AIM: Parallel investigation, in a matched case-control study, of the association of different first-trimester markers with the risk of subsequent pre-eclampsia (PE). METHOD: The levels of different first trimester serum markers and fetal nuchal translucency thickness were compared between 52 cases of PE and 104 control women by non-parametric two-group comparisons and by calculating matched odds ratios. RESULTS: In univariable analysis increased concentrations of inhibin A and activin A were associated with subsequent PE (p < 0.02). Multivariable conditional logistic regression models revealed an association between increased risk of PE and increased inhibin A and translucency thickness and respectively reduced pregnancy-associated plasma protein A (PAPP-A) and placental lactogen . However, these associations varied with the gestational age at sample collection. For blood samples taken in pregnancy weeks 12 and 13 only, increased levels of activin A, inhibin A and nuchal translucency thickness, and lower levels of placenta growth factor and PAPP-A were associated with an increased risk of PE. CONCLUSIONS: Members of the inhibin family and to some extent PAPP-A and placental growth factor are superior to other serum markers, and the predictive value of these depends on the gestational age at blood sampling. The availability of a single, early pregnancy 'miracle' serum marker for PE risk assessment seems unlikely in the near future.
Adult Biological Markers/analysis C-Reactive Protein/metabolism Case-Control Studies Female Humans Inhibins/*blood/metabolism Interleukin-8/metabolism Leptin/metabolism Logistic Models Nuchal Translucency Measurement Placenta/metabolism Pre-Eclampsia/blood/*diagnosis Predictive Value of Tests Pregnancy Pregnancy Proteins/analysis Pregnancy Trimester, First Pregnancy-Associated Plasma Protein-A/analysis Retrospective Studies
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