title: Midtrimester N-terminal proatrial natriuretic peptide, free beta hCG, and alpha-fetoprotein in predicting preeclampsia.
abstract: OBJECTIVE
  To determine whether maternal midtrimester serum N-terminal peptide of proatrial natriuretic peptide, free beta subunit of human chorionic gonadotropin (hCGbeta), or alpha-fetoprotein (AFP) levels can predict preeclampsia.
  
  
  METHODS
  A population-based cohort included 1037 nulliparous women, of whom 637 (61%) participated in a maternal serum Down syndrome screening program. Measurements of hCGbeta, AFP, and N-terminal peptide of proatrial natriuretic peptide were made from maternal serum collected at 15-19 weeks' gestation. Sensitivity, specificity, and predictive values were calculated for elevated AFP (at least 2.0 multiples of the median [MoM]) and hCGbeta (at least 2.0 MoM) values.
  
  
  RESULTS
  No difference was found in the concentrations of the N-terminal peptide of proatrial natriuretic peptide among the 30 women in whom preeclampsia developed later (median 270 [range 142-604] pmol/L) compared with 536 women who remained normotensive (274 [51-2626] pmol/L). The sensitivity and specificity of elevated AFP in predicting preeclampsia were 3% and 98% and those of elevated hCGbeta were 20% and 84%, respectively. When a stepwise multiple logistic regression model was used, only mean arterial pressure was an independent risk factor in predicting preeclampsia.
  
  
  CONCLUSIONS
  Determinations of the proposed new marker N-terminal peptide of proatrial natriuretic peptide, as well as serum hCGbeta or AFP, are not helpful in predicting preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, University of Oulu, Finland.
authors.forename: A M
authors.initials: AM
authors.lastname: Pouta
authors.forename: A L
authors.initials: AL
authors.lastname: Hartikainen
authors.forename: O J
authors.initials: OJ
authors.lastname: Vuolteenaho
authors.forename: A O
authors.initials: AO
authors.lastname: Ruokonen
authors.forename: T J
authors.initials: TJ
authors.lastname: Laatikainen
mesh_terms: D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011262:Pregnancy Trimester, Second; D011498:Protein Precursors / Q000097:blood*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D000509:alpha-Fetoproteins; D009320:Atrial Natriuretic Factor