Document Detail


Early-pregnancy multiple serum markers and second-trimester uterine artery Doppler in predicting preeclampsia.
MedLine Citation:
PMID:  20502295     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate the ability of maternal serum markers and uterine artery Doppler in predicting preeclampsia. METHODS: In this nested case-control study, maternal serum concentrations of cystatin C, beta2-microglobulin, serum amyloid A, C-reactive protein (CRP), and neopterin were measured, and resistance index of uterine artery blood flow was assessed in 45 women in whom preeclampsia subsequently developed and in 125 women with normal pregnancy outcome. Univariable regression analysis was performed to estimate correlations between serum markers and resistance index for the development of preeclampsia. Significant variables were identified using multiple logistic regressions. RESULTS: Maternal serum markers were measured at a median gestational age of 14.7 weeks (interquartile range 3.1) in control group members and 16.3 weeks (interquartile range 4.8) in the case group members, and uterine resistance index was measured at the second-trimester scan. Univariable logistic regression showed that women with subsequent preeclampsia had increased levels of cystatin C, beta2-microglobulin, neopterin, CRP, and resistance index. Cystatin C, CRP, and resistance index remained independently associated with preeclampsia when multiple logistic regression was applied. Receiver-operating characteristic curve analysis showed that a combination of markers had a better area under the curve (AUC; 0.825) than when used in isolation (cystatin C, AUC 0.725; CRP, AUC 0.634; resistance index, AUC 0.728). Sensitivity of uterine artery resistance index, cystatin C, and CRP combined for predicting preeclampsia was 69.2% for a screen-positive rate of 15%. CONCLUSION: Maternal serum cystatin C, CRP, and uterine artery mean resistance index are independent predictors of preeclampsia. There is improved prediction of preeclampsia when serum markers are combined with Doppler indices.
Authors:
Basky Thilaganathan; Ben Wormald; Cristina Zanardini; Joanna Sheldon; Elizabeth Ralph; Aris T Papageorghiou
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  115     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1233-8     Citation Subset:  AIM; IM    
Affiliation:
Fetal Medicine Unit, Division of Clinical Developmental Sciences and Protein Reference Unit and Division of Basic Medical Sciences, St. George's University of London, London SW17 0RE, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers / blood
C-Reactive Protein / metabolism*
Case-Control Studies
Cystatin C / blood*
Female
Humans
Neopterin / blood
Pre-Eclampsia / blood*,  ultrasonography*
Pregnancy
Pregnancy Trimester, First
Pregnancy Trimester, Second
ROC Curve
Ultrasonography, Prenatal*
Young Adult
beta 2-Microglobulin / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cystatin C; 0/beta 2-Microglobulin; 670-65-5/Neopterin; 9007-41-4/C-Reactive Protein

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