Document Detail


First-trimester placental protein 13 and placental growth factor: markers for identification of women destined to develop early-onset pre-eclampsia.
MedLine Citation:
PMID:  20840693     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE:  To investigate the predictive value of maternal serum pregnancy-associated plasma protein A (PAPP-A), free β subunit of human chorionic gonadotrophin (fβ-hCG), placental protein 13 (PP13), placental growth factor (PlGF) and a desintegrin and metalloproteinase 12 (ADAM12), for first-trimester identification of early-onset pre-eclampsia.
DESIGN:   Nested case-control study.
SETTING:   Routine first-trimester screening for trisomy 21 in the Netherlands.
POPULATION:   Eighty-eight women who developed pre-eclampsia or haemolysis, elevated liver enzymes, low platelets (HELLP) syndrome before 34 weeks of gestation and 480 controls.
METHODS:   PP13, PlGF and ADAM12 were measured in stored first-trimester serum, previously tested for PAPP-A and fβ-hCG. All marker levels were expressed in multiples of the gestation-specific normal median (MoMs). Model predicted detection rates for fixed false-positive rates were obtained for statistically significant markers alone and in combination.
MAIN OUTCOME MEASURES:   Development of pre-eclampsia or HELLP syndrome.
RESULTS:  PP13 and PlGF were reduced in women with pre-eclampsia, with medians 0.68 MoM and 0.73 MoM respectively (P < 0.0001 for both). PAPP-A was reduced (median 0.82 MoM, P < 0.02) whereas ADAM12 and fβ-hCG did not differ between control women and those with pre-eclampsia. In pre-eclampsia complicated by a small-for-gestational-age fetus, all markers except fβ-hCG had lower values, compared with pregnancies involving fetuses of normal weight. The model-predicted pre-eclampsia detection rate for a combination of PP13 and PlGF was 44% and 54%, respectively, for a fixed 5% and 10% false-positive rate.
CONCLUSION:  This study demonstrates that PP13 and PlGF in the first-trimester might be promising markers in risk assessment for early pre-eclampsia/HELLP syndrome but for an adequate screening test additional characteristics are necessary.
Authors:
E J Wortelboer; M P H Koster; H S Cuckle; P H Stoutenbeek; P C J I Schielen; G H A Visser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  117     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-15     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  1384-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands. E.Wortelboer@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
ADAM Proteins / metabolism
Adult
Biological Markers / metabolism
Case-Control Studies
Chorionic Gonadotropin, beta Subunit, Human / metabolism
Disintegrins / metabolism
Early Diagnosis
Female
Galectins / metabolism*
HELLP Syndrome / diagnosis
Humans
Membrane Proteins / metabolism
Pre-Eclampsia / diagnosis*
Pregnancy
Pregnancy Proteins / metabolism*
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / metabolism
Prenatal Diagnosis / methods*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin, beta Subunit, Human; 0/Disintegrins; 0/Galectins; 0/LGALS13 protein, human; 0/Membrane Proteins; 0/Pregnancy Proteins; 144589-93-5/placenta growth factor; EC 3.4.24.-/ADAM 12 protein; EC 3.4.24.-/ADAM Proteins; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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